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Corrigendum to “Black-box optimization in immunology and beyond: A practical guide to algorithms and future directions” [Allergol Int 74 (2025) 549–62] “免疫学及其他领域的黑箱优化：算法和未来方向的实用指南”[Allergol Int 74(2025) 549-62]的勘误表。

IF 6.7 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2026-01-01 DOI: 10.1016/j.alit.2025.11.001

Takanori Kawabata , Taku Tsuzuki , Tsuyoshi Tatsukawa , Kota Matsui , Eiryo Kawakami

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IF 6.7 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2026-01-01

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IF 6.7 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2026-01-01

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IF 6.7 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2026-01-01

引用次数: 0

Clinical remission in severe asthma treated with biologics and macrolides: Definition, prevalence, associated factors, and future perspectives 用生物制剂和大环内酯类药物治疗严重哮喘的临床缓解：定义、患病率、相关因素和未来展望

IF 6.7 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2026-01-01 DOI: 10.1016/j.alit.2025.10.001

Yuto Hamada , Dennis Thomas , Vanessa M. McDonald , Michael Fricker , Liam G. Heaney , Peter G. Gibson

Severe asthma is associated with persistent symptoms, frequent exacerbations, oral corticosteroid dependence, and reduced lung function. The emergence of biologic therapies targeting type 2 (T2) cytokines, including IL-5, IL-4, IL-13, thymic stromal lymphopoietin, and circulating IgE, has changed disease management and led to substantial improvement. This approach has also introduced the concept of clinical remission (defined as controlled symptoms, no maintenance corticosteroid use, no exacerbations, and optimized/stabilized lung function) as a potential treatment target.

Although some guidelines propose remission criteria, no universally accepted definition exists, and reported prevalence varies depending on definitions, and therapies, and patient groups. Clinical remission has been achieved in approximately one-third of patients receiving T2-targeted biologics. Factors associated with achieving clinical remission include less severe disease (less symptoms, fewer exacerbations, and better lung function), fewer comorbidities (e.g. obesity, anxiety/depression), greater T2-disease activity (the presence of nasal polyps and higher T2 biomarkers), and early treatment response. Azithromycin therapy can also contribute to achieving remission in both T2-high and T2-low moderate to severe asthma phenotypes.

Future perspectives on asthma remission include integrating a treatable traits approach, establishing and validating the definition of complete remission, and assessing the long-term benefits of achieving remission. Complete remission may encompass clinical remission, inflammatory remission (normalization of T2 biomarkers), and structural/functional remission (resolution of bronchial hyperresponsiveness, mucus plugging, and airway remodeling). Standardizing remission criteria will enable the identification of predictive factors and facilitate personalized, treat-to-target strategies. Early induction of clinical remission may be a promising strategy for optimizing outcomes in severe asthma.

严重哮喘与持续症状、频繁恶化、口服皮质类固醇依赖和肺功能降低相关。针对2型（T2）细胞因子的生物疗法的出现，包括IL-5、IL-4、IL-13、胸腺基质淋巴生成素和循环IgE，已经改变了疾病的管理并导致了实质性的改善。该方法还引入了临床缓解的概念（定义为症状控制，不使用维持性皮质类固醇，无恶化，优化/稳定肺功能）作为潜在的治疗目标。尽管一些指南提出了缓解标准，但没有普遍接受的定义，报告的患病率因定义、治疗和患者群体而异。大约三分之一接受t2靶向生物制剂治疗的患者达到了临床缓解。与实现临床缓解相关的因素包括疾病较轻（症状较少，恶化较少，肺功能较好），合共病较少（例如肥胖，焦虑/抑郁），T2疾病活动性较大（鼻息肉和较高T2生物标志物的存在），以及早期治疗反应。阿奇霉素治疗也有助于实现t2高和t2低的中度至重度哮喘表型的缓解。哮喘缓解的未来前景包括整合可治疗的特征方法，建立和验证完全缓解的定义，以及评估实现缓解的长期益处。完全缓解可能包括临床缓解、炎症缓解（T2生物标志物的正常化）和结构/功能缓解（支气管高反应性、粘液堵塞和气道重塑的消退）。标准化缓解标准将使预测因素的识别和促进个性化，治疗到目标的策略。早期诱导临床缓解可能是优化重症哮喘预后的一种有希望的策略。

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引用次数: 0

Consensus definition of clinical remission in asthma for the Japanese asthma prevention and management guidelines (JGL 2024): A modified delphi survey and comprehensive review 日本哮喘预防和管理指南（JGL 2024）中哮喘临床缓解的共识定义：一项修改的德尔菲调查和综合评价

IF 6.7 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2026-01-01 DOI: 10.1016/j.alit.2025.11.004

Hiroyuki Nagase , Norihiro Harada , Junichiro Tezuka , Masaki Futamura , Mizuho Nagao , Takumi Takizawa , Shigemi Yoshihara , Makoto Nagata , Akio Niimi , Masao Yamaguchi

Clinical remission in asthma has gained prominence as both a therapeutic goal and a research endpoint, although its operational definitions have varied. To harmonize Japanese practice with emerging global frameworks, the Japanese Society of Allergology (JSA) conducted a two-round modified Delphi survey to establish a consensus definition for inclusion in the 2024 Asthma Prevention and Management Guidelines (JGL 2024).

In Round 1 (January 2024), 81 JGL 2024 guideline committee members representing adult and pediatric specialties were invited. Seventy-four percent agreed that clinical remission should be defined, and 50 % supported including both on- and off-treatment remission. Four core components emerged: absence of exacerbations, well-controlled symptoms, no continuous oral corticosteroid use, and optimization of pulmonary function.

Round 2 refined operational thresholds for symptom control, adopting ACT ≥23 (C-ACT ≥23 for children) and ACQ ≤0.75, consistent with JGL's long-standing goal of achieving a truly symptom-free state without reliever use. Pulmonary function was defined as “optimization,” encompassing normalization where achievable and stabilization when normalization is unlikely (e.g., airway remodeling), which received strong agreement.

Collaboration between adult and pediatric experts affirmed clinical remission as a milestone toward off-treatment remission and potential cure, broadening its applicability across severities and age groups. This review further summarizes evidence supporting remission as an outcome of biologic therapy, its key predictors (e.g., smoking, obesity, disease duration), pediatric perspectives, and future directions. JGL 2024 formally adopts these criteria, providing a rigorous and pragmatic framework to advance patient-centered asthma care and reframe management toward disease modification and eventual cure.

临床缓解在哮喘已经获得突出作为治疗目标和研究终点，尽管其操作定义有所不同。为了使日本的实践与新兴的全球框架保持一致，日本过敏症学会（JSA）进行了两轮修正德尔菲调查，以建立共识定义，纳入2024年哮喘预防和管理指南（JGL 2024）。第1轮（2024年1月）邀请了81名代表成人和儿科专业的JGL 2024指南委员会成员。74%的人同意应该定义临床缓解，50%的人支持包括治疗期间和非治疗期间的缓解。出现了四个核心组成部分：没有恶化，症状控制良好，不持续口服皮质类固醇，肺功能优化。第2轮细化了症状控制的操作阈值，采用ACT≥23（儿童C-ACT≥23）和ACQ≤0.75，符合JGL长期以来的目标，即在不使用缓解剂的情况下实现真正的无症状状态。肺功能被定义为“优化”，包括可实现的正常化和不可能正常化时的稳定（例如气道重塑），这得到了强烈的认同。成人和儿科专家之间的合作肯定了临床缓解是治疗缓解和潜在治愈的里程碑，扩大了其在严重程度和年龄组中的适用性。这篇综述进一步总结了支持缓解作为生物治疗结果的证据、其关键预测因素（如吸烟、肥胖、疾病持续时间）、儿科观点和未来方向。JGL 2024正式采用这些标准，提供严格和务实的框架，以推进以患者为中心的哮喘护理，并重新构建疾病改变和最终治愈的管理。

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IF 6.7 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2026-01-01

引用次数: 0

Clinical efficacy of mepolizumab and dupilumab for eosinophilic otitis media: Analysis of patient clinical characteristic 美泊珠单抗和杜匹单抗治疗嗜酸性中耳炎的临床疗效：患者临床特征分析。

IF 6.7 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2026-01-01 DOI: 10.1016/j.alit.2025.07.002

Saori Kikuchi , Tomonori Sugiyama , Saemi Suzuki , Yukiko Iino

Background

Eosinophilic otitis media (EOM) is characterized by eosinophilic infiltration of the middle ear; it is frequently associated with bronchial asthma and chronic rhinosinusitis with nasal polyposis. Although biologics have been used to treat EOM, their efficacy based on clinical characteristics remains unclear. In this study, we evaluated the effectiveness of biologics and analyzed the clinical factors that influenced outcomes.

Methods

We retrospectively studied 29 patients with EOM treated with either mepolizumab or dupilumab as an adjunct to standard therapy, which included intratympanic instillation of triamcinolone. Clinical efficacy was assessed by severity scores, temporal bone computed tomography scores, and pure-tone audiometry. The control group comprised 15 patients with EOM who did not receive biologics. We also analyzed the correlations between changes in severity score from baseline and clinical factors for each patient.

Results

Both biologics groups had significantly lower severity scores at 6 months, with sustained effects until 12 months. The patients with severe middle ear mucosal changes and high baseline severity scores experienced significant improvement with the use of dupilumab; mepolizumab was more effective in elderly patients. Temporal bone computed tomography scores improved in both biologics groups, indicating inflammation resolution in the whole temporal bone. No deterioration of bone-conduction hearing levels was observed in any group.

Conclusions

Mepolizumab and dupilumab showed efficacy for EOM, with therapeutic effects evident within 6 months. Dupilumab is preferable for patients with severe mucosal changes, whereas mepolizumab may benefit elderly patients. Further studies are needed to refine treatment strategies.

背景：嗜酸性中耳炎（EOM）以中耳嗜酸性浸润为特征；它常与支气管哮喘和慢性鼻窦炎合并鼻息肉病有关。虽然生物制剂已被用于治疗EOM，但其基于临床特征的疗效尚不清楚。在这项研究中，我们评估了生物制剂的有效性，并分析了影响结果的临床因素。方法：我们回顾性研究了29例EOM患者，使用美波珠单抗或杜匹单抗作为标准治疗的辅助治疗，其中包括鼓室内滴注曲安奈德。临床疗效通过严重程度评分、颞骨计算机断层扫描评分和纯音听力学来评估。对照组为15例EOM患者，未接受生物制剂治疗。我们还分析了每位患者从基线开始的严重程度评分变化与临床因素之间的相关性。结果：两个生物制剂组在6个月时的严重程度评分均显著降低，并持续到12个月。使用杜匹单抗后，中耳黏膜严重改变和基线严重程度评分较高的患者有显著改善；Mepolizumab对老年患者更有效。两个生物制剂组的颞骨计算机断层扫描评分均有所改善，表明整个颞骨的炎症消退。在任何组中均未观察到骨传导听力水平的恶化。结论：美泊珠单抗和杜匹单抗对EOM均有疗效，且6个月内疗效明显。Dupilumab适用于严重粘膜改变的患者，而mepolizumab可能有利于老年患者。需要进一步的研究来完善治疗策略。

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IF 6.7 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2026-01-01

引用次数: 0

IF 6.7 2区医学 Q1 ALLERGY

Allergology International

Pub Date : 2026-01-01

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