International Archives of Allergy and Immunology最新文献

Introduction: Postoperative recurrence remains a significant challenge in the management of chronic rhinosinusitis with nasal polyps (CRSwNP), imposing a heavy burden on patients and healthcare systems. Existing prediction models often rely on invasive tissue sampling or limited clinical phenotype. This study aimed to construct a broad-spectrum, noninvasive nomogram by integrating clinical characteristics with a panel of serum inflammatory biomarkers to predict the risk of recurrence after endoscopic sinus surgery (ESS).

Methods: A total of 312 patients with CRSwNP who underwent ESS at our center between January 2019 and October 2023 were retrospectively recruited. Patients were randomly divided into a training cohort (n = 218) and a validation cohort (n = 94) at a 7:3 ratio. Clinical data and preoperative serum levels of inflammatory markers (eotaxin-1, periostin, IL-5, total IgE) were collected. Least Absolute Shrinkage and Selection Operator (LASSO) regression was used to screen optimal predictors. A nomogram was established based on multivariate logistic regression analysis. The model's performance was assessed using the concordance index (C-index), calibration curves, and decision curve analysis (DCA).

Results: During a minimum of 2-year follow-up, recurrence occurred in 38.5% of the total cohort. LASSO and multivariate analyses identified five independent predictors: history of asthma (odds ratio [OR] = 3.45), revision surgery (OR = 2.12), Lund-Mackay score (OR = 1.15), serum eotaxin-1 level (OR = 1.02 per pg/mL), and serum periostin level (OR = 1.04 per ng/mL). The developed nomogram demonstrated robust discrimination, with a C-index of 0.892 (95% confidence interval [CI]: 0.851-0.933) in the training cohort and 0.865 (95% CI: 0.812-0.918) in the validation cohort. Internal validation showed an optimism-corrected C-index of 0.879. Calibration plots revealed excellent agreement between predicted and observed probabilities. DCA indicated that the nomogram provided substantial net clinical benefit across a wide range of threshold probabilities.

Conclusion: We successfully developed a novel, high-discrimination nomogram incorporating clinical factors and serum biomarkers (eotaxin-1 and periostin). This tool offers a practical, noninvasive approach for clinicians to identify high-risk CRSwNP patients early, facilitating personalized postoperative management and potentially guiding the use of biological therapies.

Background: Recent studies have shown that food allergen-specific IgE is associated with cardiovascular mortality. We aimed to investigate the associations of common food-specific IgE sensitization with all-cause, cancer, and non-cancer mortality.

Methods: This study was a cohort analysis using data from the 2005-2006 US National Health and Nutrition Examination Survey (NHANES). Participants examined for allergen-specific IgE were included, and mortality outcomes up to 2019 were ascertained through linkage with the National Death Index. Cox proportional hazards models adjusted for demographic, lifestyle, and clinical factors assessed associations between food-specific IgE sensitization and mortality, with subgroup analyses among participants consuming the corresponding foods.

Results: 4,424 adults were included. During a median follow-up of 13.8 years, there were 879 (19.9%) all-cause mortality, including 705 non-cancer mortality and 174 cancer-related mortality. Sensitization to at least 1 animal-derived food (HR 1.32, 95% CI 1.02-1.70, p=0.035) was associated with higher all-cause mortality, particularly for sensitization to milk (HR 1.44, 95% CI 1.08-1.94, p=0.015), shrimp (HR 1.46, 95% CI 1.06-2.01, p=0.022), and egg (HR 1.30, 95% CI 1.04-1.63, p=0.023), but not peanut. For non-cancer mortality, consistent and stronger associations were observed. In food consumers, associations were further strengthened for sensitization to milk (HR 1.63, 95% CI 1.27-2.09, p<0.001), egg (HR 1.58, 95% CI 1.25-2.01, p<0.001), and shrimp (HR 1.89, 95% CI 1.02-3.50, p=0.043) as risk factors for non-cancer mortality.

Conclusions: Food-specific IgE sensitization was associated with increased risks of all-cause and non-cancer mortality, suggesting that IgE sensitization may carry systemic implications extending beyond allergy.

Introduction: Studies specifically focusing on drug-induced anaphylaxis (DIA) in children are few. There is no study comparing inpatient (IP) and outpatient (OP) settings in DIA, either in children or in adults. We aimed to compare the characteristics of pediatric DIAs observed in IP and OP settings.

Methods: Patients aged ≤18 years who were diagnosed with DIA at our institution over the past 15 years were included in the study. The diagnosis of DIA was made clinically, and diagnostic testing were performed in eligible patients. Patients were categorized as IP and OP groups based on the settings in which DIA occurred.

Results: A total of 162 pediatric DIAs (55% IP vs. 45% OP) were reviewed. The most frequent triggering drugs were chemotherapeutics, enzyme replacement therapies for metabolic disorders, and antibiotics in IP group, and NSAIDs, antibiotics, and local anesthetics in OP group. Parenteral drug use was more frequent in IP group (p<0.001). Age at DIA, time to DIA, and severity of DIA were similar between the two groups. However, after excluding parenteral drugs from OP group, significant differences in all three parameters were seen in IP group (p<0.05 for each). Patients in IP group had more non-allergic chronic comorbidities and gastrointestinal symptoms, while OP group showed higher rates of asthma, allergic rhinitis, and acute infections as co-factors (p≤0.001 for each). Antihistamine and systemic corticosteroid use was higher in OP group (p<0.05 for each), but the use of IM adrenaline was similar in both groups.

Conclusion: Triggering drugs, clinical presentations, management, chronic allergic and non-allergic comorbidities, and co-factors in pediatric DIA differ between the two groups. Contrary to expectations, the setting did not affect the onset or severity of DIA, likely due to the higher frequency of parenteral drug administration in OP settings.

Objective: This study aimed to analyze allergen profiles associated with respiratory allergic diseases in pediatric populations in Guangzhou, China, and provide a theoretical basis for prevention and management strategies.

Methods: A cross-sectional study was conducted among 1,230 children between 0 and 14 years of age who underwent allergen-specific immunoglobulin E antibody testing via immunoblotting at a hospital in Guangzhou, Guangdong Province, China, between January 2020 and January 2024. Positivity rates for allergens were analyzed and compared across categories (type and grade), age groups, seasons, and sex.

Results: Sensitization to at least one allergen was detected in 43.9% (n = 540) of the children. The overall sensitization rate did not differ significantly by sex or among age groups (p > 0.05). The predominant inhalant allergen was Dermatophagoides farinae / Dermatophagoides pteronyssinus (22.93%, n = 282), while the most common food allergen was egg white / egg yolk (10.73%, n = 132) (p < 0.05). Allergen positivity ranged from one to five allergen types, with frequency decreasing as the number of allergens increased (p < 0.05). A shift in the dominant allergen type was observed with increasing age: food allergens were common among infants and toddlers (p < 0.05), whereas inhalant allergens were dominant among preschool and school-age children (p < 0.05).

Conclusion: The allergen sensitization spectrum among children with respiratory allergies in Guangzhou exhibits a distinct pattern that evolves with age. The predominant allergens among infants and toddlers were food-based, specifically milk, beef / lamb, and egg white / egg yolk, whereas among preschool and school-age children, inhalant allergies, particularly Dermatophagoides farinae / Dermatophagoides pteronyssinus and house dust, were most prevalent. These region-specific findings highlight the importance of implementing age-appropriate strategies for the diagnosis, prevention, and management of pediatric respiratory allergic diseases.

In the article "Efficacy and Safety of Tumor Necrosis Factor Inhibitors, Interleukin-17 Inhibitors, and Janus Kinase Inhibitors in Patients with Non-Radiographic Axial Spondyloarthritis: A Systematic Review and Network Meta-Analysis" [Int Arch Allergy Immunol. 2025;186:784-801; https://doi.org/10.1159/000542744] by Li et al., the funding information was incorrectly given. The correct funding information should read as follows:Funding SourcesMedical Science Research Project of Hebei, grant No. 20230609.

Introduction: Sjogren's syndrome (SS) is a systemic autoimmune disease characterized by exocrine gland dysfunction and a T1/T3-skewed inflammation. Chronic rhinosinusitis (CRS) is more prevalent in SS, most likely due to the specific cytokine milieu, and the loss of secretory glands and secretion associated antimicrobials. However, the impact of SS on CRS immunopathology and symptomatology is unclear. This study evaluated whether CRS in SS patients exhibits a distinct clinical profile compared to CRS alone.

Methods: In this retrospective study, 14 patients with co-morbid SS and CRS were compared to 90 CRS patients without rheumatologic or other comorbid systemic disease. CRS severity was assessed using the Sino-Nasal Outcome Test (SNOT-22), Lund-Mackay Score (LMS), Lund-Kennedy Score (LKS), and T2 inflammatory markers (IgE, absolute eosinophil count, and nasal polyp presence).

Results: Demographics were similar between groups. Objective disease burden was greatest in CRS with nasal polyps, with higher LMS (p < 0.001) and LKS (p < 0.001) than the other groups. Despite this, SS patients reported the highest SNOT-22 total scores (p = 0.027). SS showed significantly higher scores in several domains, including nasal obstruction (p < 0.001), ear fullness (p < 0.001), reduced concentration (p < 0.001), frustration or irritability (p = 0.022), and fatigue (p = 0.044), with trends for need to blow the nose (p = 0.051), thick nasal discharge (p = 0.073), facial pain or pressure (p = 0.063), waking up tired (p = 0.096), and reduced productivity (p = 0.052).

Conclusions: SS appears to confer a distinct CRS phenotype marked by heightened symptom burden not reflected by conventional disease metrics. This discrepancy may reflect neuroinflammatory amplification driven by SS's T1/T3 cytokine profile. These findings highlight the need for symptom-focused, multidisciplinary care in this population.

Introduction Venom immunotherapy (VIT) is the most effective treatment approach for preventing severe systemic reactions caused by Hymenoptera stings. In some cases, the detection of specific IgE positivity for both honeybee and wasp venoms can create diagnostic and therapeutic challenges. In this study, we aimed to evaluate the effectiveness of the Immulite 2000 3g component-based diagnostic test (CBDT) in determining true sensitization in patients with dual venom positivity who were scheduled for VIT. Methods In this prospective study, 66 patients who presented to the Immunology and Allergy Diseases outpatient clinic between January 2019 and December 2024 with a history of systemic reaction following a bee sting and who were indicated for VIT were evaluated. Results The mean age of the patients was 46.3 ± 12.9 years, with a male predominance. Honeybee stings were the most common (50%). Forty-two patients had single-venom sensitization, while 22 had specific IgE positivity for both Apis mellifera and Vespula vulgaris. According to the CBDT results, 6 of the 22 patients had dual sensitization, while 7 patients had sensitization only to Vespula. Patients with indeterminate venom sensitization had higher Api m 1/Ves v 5 specific IgE ratios. Conclusion In our study, using the Immulite2000 3gAllergy CBDT results, venom sensitization could not be clearly determined in 41% of patients with dual sensitization to venom allergens, and true double sensitization was identified in only 27% of these patients. Therefore, we suggest that including additional species-specific antigens (especially Ves v 1) alongside in the Immulite2000 3gAllergy CBDT panel could improve the detection of true sensitization. Furthermore, when supported by accurate and reliable clinical history, a specific IgE Api m 1/Ves v 5 ratio greater than 5 can represent a significant and useful hypothesis. However, further studies are needed to confirm this hypothesis.

Introduction: Chronic rhinosinusitis (CRS) is a common chronic inflammatory disease in children, often comorbid with allergic rhinitis (AR). The role of miR-132-3p with AR and CRS in children remains unclear. To evaluate the diagnostic value and regulatory mechanism of miR-132-3p for pediatric AR-complicated CRS with nasal polyposis (CRSwNP).

Methods: A total of 265 children were enrolled, including 90 AR cases and 175 AR-complicated CRSwNP cases. Serum miR-132-3p and JAK1 expression were detected by RT-qPCR. ROC curve, correlation, and multivariate logistic regression analyses were used to assess diagnostic value and clinical associations. House dust mite extract (HDM)-induced human nasal epithelial cells (HNEpCs) were used as the inflammation model. Cell transfection, ELISA, and dual-luciferase reporter assay were performed to verify the regulatory mechanism.

Results: Serum miR-132-3p was significantly downregulated in the CRS versus AR group, and miR-132-3p was lower in eosinophil CRSwNP (ECRSwNP) than non-eosinophilic CRS (NECRSwNP). In HNEpCs, HDM reduced miR-132-3p and elevated JAK1, IL-25, IL-33, and TSLP. miR-132-3p mimics inhibited the upregulation of these factors and directly targeted JAK1. JAK1 overexpression reversed the inhibitory effect of miR-132-3p.

Conclusions: miR-132-3p is significantly downregulated in the serum of children with AR-complicated CRSwNP, which can serve as a non-invasive diagnostic marker for differentiating NECRSwNP from ECRSwNP, and is associated with disease severity. It regulates HDM-mediated type 2 inflammation by targeting JAK1, participating in CRSwNP pathogenesis.

Background and aim: Despite the increasing prevalence of food allergies worldwide, Algeria remains severely underrepresented in WHO/FAO epidemiological databases, hampering evidence-based policymaking and harmonization of labeling protocols. This study addresses this gap and presents the first analysis of IgE-mediated food sensitization in Algiers (Algeria).

Materials and methods: Sensitization to 29 food allergens was assessed in a cohort of 637 patients (2016-2019) using the Allergy-Screen® immunoassay (Mediwiss Analytic GmbH). Clinical and epidemiological datasets were statistically analyzed with two-way ANOVA and Tukey's HSD test to determine significant sensitization patterns.

Results: Among the participants, 37.67% (n = 240) experienced sensitization to ≥ 1 allergen, with cow's milk F2 (12.56%), egg white F1 (5.5%), peanut F13 (4.7%), and shrimp F24 (4.55%) being the dominant triggers. Age-stratified analysis revealed significant disparities (p < 0.001): cow's milk allergy predominated in children (≤ 16 years), while shrimp sensitization peaked in adults (> 16 years). Sex-specific trends highlighted elevated sensitization in women ≤ 16 years versus > 16 years (p < 0.001) and men ≤ 16 years versus ≥ 40 years (p < 0.01), highlighting that age is a determining factor in allergic risk. Polysensitization was common, complicating the clinical management of atopic individuals.

Conclusion: As Algeria's first epidemiological mapping, this study delivers foundational data imperative for evidence-based allergy management, diagnostic refinement, and national food safety policy in alignment with global priorities.

Background: Hypersensitivity reactions (HSRs) to taxane- and platinum-based chemotherapeutic agents are common and may interrupt essential cancer therapy. Rapid drug desensitization (RDD) enables patients to continue treatment safely; however, detailed analyses directly comparing desensitization outcomes between taxanes and platinums remain relatively uncommon.

Objective: To describe the clinical characteristics of taxane- and platinum-induced HSRs and to compare desensitization outcomes, breakthrough reactions (BTRs), and graded-challenge success between these drug groups.

Methods: This retrospective study included 27 patients who underwent 30 desensitization procedures, comprising 94 RDD cycles. Standardized 8-, 12-, or 16-step RDD protocols were applied based on the severity of the index reaction and the clinical risk assessment. Demographic and clinical data, characteristics of index HSRs, BTRs during RDD, and outcomes of graded challenges were recorded and analyzed.

Results: Index HSRs most frequently occurred during the first or second infusion (66.6%) and were predominantly moderate in severity (53.3%). Cutaneous symptoms were present in 96.7% of reactions, and anaphylaxis occurred in 30%. Taxane HSRs developed significantly earlier than platinum reactions (69% vs. 24% during the first cycle, p=0.003). The overall RDD success rate was 97.9%. Seventeen BTRs (18.1%) occurred, most of which were mild (82.4%) and limited to cutaneous involvement (100%). BTRs were significantly more common with platinums than with taxanes (34.8% vs. 2.1%, p<0.001). Graded challenge was successful more often with taxanes than with platinums (53.8% vs. 17.6%, p=0.045). No severe or life-threatening BTRs were observed.

Conclusion: RDD enabled the safe continuation of chemotherapy with both taxanes and platinums, with high success rates and infrequent, mostly mild BTRs. Platinum desensitizations carried a higher BTR risk, whereas selected taxane-allergic patients successfully transitioned to graded challenge. These findings support RDD as an effective strategy for managing chemotherapy-induced HSRs and highlight the need for individualized, risk-based protocol selection in clinical practice.