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Phenotyping Asthma Exacerbations: One Step Further in the Management of Severe Asthma. 哮喘恶化的表型分析:重症哮喘管理更进一步。
IF 6.1 3区 医学 Q1 ALLERGY Pub Date : 2025-02-18 Epub Date: 2024-11-28 DOI: 10.18176/jiaci.1043
I Ojanguren, S Quirce, I Bobolea, L Pérez de Llano, V Del Pozo

Asthma, a prevalent chronic respiratory disease, manifests in heterogeneous phenotypes and endotypes, necessitating bespoke therapeutic approaches. Asthma exacerbations are characterized by worsening of symptoms and decline in lung function and present substantial challenges despite advances in understanding and treatment. Viral respiratory infections, notably those caused by rhinovirus, serve as primary triggers, with allergic sensitization and environmental exposures increasing susceptibility. Deficient antiviral responses in asthmatic airway epithelial cells, particularly impaired interferon production, perpetuate inflammation and hyperresponsiveness, contributing to exacerbations. Additionally, genetic polymorphisms influence host responses and susceptibility. Recent studies underscore the association between specific inflammatory profiles, particularly eosinophil-mediated inflammation, and the frequency of exacerbations. Biologic therapies targeting inflammatory pathways show promise in reducing the frequency of exacerbations, thus underscoring the importance of understanding inflammatory phenotypes when selecting treatment. Notably, T2 inhibitors may modulate immune responses, potentially mitigating viral exacerbations. Characterizing exacerbations is crucial for optimizing therapeutic strategies. Evidence suggests a dissociation between baseline inflammatory profiles and exacerbation phenotypes, highlighting the need for individualized management. Phenotyping exacerbations using sputum analysis helps to identify predominant inflammatory patterns and thus inform treatment decisions. The varied responses to biologic therapies further emphasize the importance of phenotyping exacerbations in refining treatment algorithms. In conclusion, phenotyping asthma exacerbations provides valuable insights into underlying inflammatory mechanisms and enables personalized therapy. Understanding the complex interplay between viral triggers, inflammatory pathways, and responses to treatment is essential if we are to effectively manage severe asthma and reduce the burden of exacerbations. Further research into the mechanistic actions of biologic therapies in mitigating viral exacerbations is warranted to optimize asthma management strategies.

哮喘是一种常见的慢性呼吸道疾病,表现为不同的表型和内型,因此需要采用不同的治疗方法。哮喘加重的特点是症状恶化和肺功能下降,尽管人们对哮喘的认识和治疗取得了进步,但哮喘加重仍然是一个巨大的挑战。病毒性呼吸道感染,尤其是由鼻病毒引起的感染,是主要的诱发因素,而过敏致敏和环境暴露则增加了易感性。哮喘患者气道上皮细胞的抗病毒反应不足,尤其是干扰素分泌受损,会导致炎症和高反应性长期存在,从而导致病情恶化。此外,基因多态性也会影响宿主的反应和易感性。最近的研究强调了特定炎症特征(尤其是嗜酸性粒细胞介导的炎症)与病情恶化频率之间的联系。针对炎症通路的生物疗法有望降低病情恶化的频率,因此强调了在选择治疗方法时了解炎症表型的重要性。值得注意的是,T2 抑制剂可调节免疫反应,从而有可能减轻病毒性病情加重。确定病情恶化的特征对于优化治疗策略至关重要。有证据表明,基线炎症特征与加重表型之间存在差异,这凸显了个体化管理的必要性。利用痰液分析对加重表型进行分析有助于确定主要的炎症模式,从而为治疗决策提供依据。对生物疗法的不同反应进一步强调了表型分析在完善治疗算法方面的重要性。总之,哮喘加重的表型分析为了解潜在的炎症机制提供了宝贵的信息,并能实现个性化治疗。要想有效控制重症哮喘并减轻病情加重的负担,了解病毒诱因、炎症途径和治疗反应之间复杂的相互作用至关重要。为了优化哮喘管理策略,我们有必要进一步研究生物疗法在减轻病毒性加重方面的机理作用。
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引用次数: 0
Factors Affecting the Safety and Effectiveness of Venom Immunotherapy. 毒液免疫疗法安全性和有效性的影响因素。
IF 6.1 3区 医学 Q1 ALLERGY Pub Date : 2025-02-18 Epub Date: 2023-11-08 DOI: 10.18176/jiaci.0967
L Arzt-Gradwohl, S A Herzog, W Aberer, T Alfaya Arias, D Antolín-Amérigo, P Bonadonna, E Boni, A Bożek, M Chełmińska, B Ebner, N Frelih, R Gawlik, A Gelincik, T Hawranek, W Hoetzenecker, A Jiménez Blanco, K Kita, R Kendirlinan, M Košnik, K Laipold, R Lang, F Marchi, M Mauro, M Nittner-Marszalska, I Poziomkowska-Gęsicka, V Pravettoni, D Preziosi, O Quercia, N Reider, M Rosiek-Biegus, B Ruiz-Leon, C Schrautzer, P Serrano, A Sin, B A Sin, J Stoevesandt, A Trautmann, M Vachová, G J Sturm

Background: The safety profile of venom immunotherapy (VIT) is a relevant issue, and considerable differences have been reported in the safety and efficacy of this treatment modality. The primary aim of this study was to evaluate the safety of angiotensin-converting enzyme inhibitors and ß-blockers during VIT. In a second analysis, we evaluated data on premedication and venom preparations and their association with systemic adverse events (AEs) during the up-dosing phase and the first year of the maintenance phase, as well as the outcome of field stings and sting challenges.

Methods: Ours was an open, prospective, observational, multicenter study that recruited 1425 patients, of whom 1342 underwent VIT.

Results: Premedication with oral antihistamines was taken by 52.1% of patients during up-dosing and 19.7% of patients during the maintenance phase. Antihistamines had no effect on the frequency of systemic AEs (P=.11), although large local reactions (LLRs) were less frequent (OR, 0.74; 95%CI, 0.58-0.96; P=.02). Aqueous preparations were preferred for up-dosing (73.0%), and depot preparations were used for the maintenance phase (64.5%). The type of venom preparation had no influence on the frequency of systemic AEs or on the effectiveness of VIT (P=.26 and P=.80, respectively), while LLRs were less frequent with depot preparations (P<.001).

Conclusions: Pretreatment with oral antihistamines during VIT significantly reduces the frequency of LLRs but not systemic AEs. All venom preparations were equally effective and did not differ in terms of the frequency of systemic AEs.

背景和目的:毒液免疫疗法(VIT)的安全性是一个相关问题,据报道,VIT的安全性和有效性存在相当大的差异。本研究的主要目的是评估ACE抑制剂和β受体阻滞剂在VIT期间的安全性,该研究已经发表。在第二项分析中,评估了在给药增加阶段和维持阶段第一年期间与全身不良事件(AE)相关的用药前和毒液制剂的数据,以及现场蜇伤和蜇伤挑战的结果。方法:本研究是一项开放性、前瞻性、观察性、多中心的研究。总共有1425名患者入选,1342名患者进行了VIT。结果:52.1%的患者在用药前服用口服抗组胺药,19.7%的患者在维持期服用。服用抗组胺药对全身AE的发生率没有影响(p=0.11),但局部大反应(LLR)的发生率较低(OR:0.74;95%CI:0.58-0.96;p=0.02)。水性制剂优先用于给药(73.0%),储备制剂优先用于维持期(64.5%)。毒液制剂的类型对全身AE发生率和VIT的有效性(分别为p=0.26和p=0.80),而当使用储备制剂时,LLR的出现频率较低(p结论:在VIT期间口服抗组胺药预处理可显著降低LLR的频率,但不会降低全身AE的频率。所有使用的毒液制剂都同样有效,全身AE的发生频率没有差异。
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引用次数: 0
Exercise-Dependent Codfish Allergy due to Tropomyosin. 托品肌肽导致的运动依赖性鳕鱼过敏症
IF 6.1 3区 医学 Q1 ALLERGY Pub Date : 2025-02-18 Epub Date: 2024-11-12 DOI: 10.18176/jiaci.1022
V Faihs, C Kugler, B Eberlein, R Bent, U Darsow, T M Boehm, C Hilger, T Biedermann, A Kuehn, K Brockow
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引用次数: 0
LAD2 Mast Cell Activation Test Associates With the Reaction Severity and Diagnoses BAT Nonresponders in Hymenoptera Venom Allergy. LAD2肥大细胞活化试验和反应的严重程度相关,并诊断膜翅目毒液过敏中BAT无反应。
IF 6.1 3区 医学 Q1 ALLERGY Pub Date : 2025-02-18 Epub Date: 2023-11-08 DOI: 10.18176/jiaci.0969
A Koren, L Dejanovic, P Kopac, R Erzen, N Bajrovic, M Zidarn, P Korosec

Background: The usefulness of the mast cell activation test (MAT) in diagnosing patients with uninterpretable basophil activation test (BAT) results caused by nonresponding basophils has not been addressed. Our study evaluated whether the results of the MAT were associated with the severity of the allergic reaction.

Methods: We recruited 39 patients with Hymenoptera venom allergy (HVA), 22 nonsensitized controls, and 37 BAT nonresponding HVA patients. Specific IgE levels for honeybee venom (HBV) and yellow jacket venom (YJV) and total IgE were quantified using the IMMULITE® system. We performed a BAT and a MAT, which was based on the response of LAD2 cells to HBV and YJV.

Results: We first optimized the susceptibility of LAD2 cells to IgE-mediated degranulation in HVA and showed that prestimulation with IL-33 and IL-6 significantly increased the responsiveness of LAD2 cells to allergen stimulation (P<.01). The LAD2 MAT results correlated with the BAT results, and patients with severe sting reactions (Mueller grades III and IV) had a median 2-fold higher LAD2 MAT score than patients with nonsevere sting reactions (large local reaction or Mueller grades I and II) (P<.05). Furthermore, LAD2 MAT provided conclusive results in 20 of the 37 HVA patients (54.1%) with nonresponding basophils in the BAT.

Conclusions: The LAD2 MAT is a new diagnostic tool for HVA patients with nonresponding basophils. LAD2 MAT can identify patients at risk of severe sting reactions and can thus help guide recommendations for venom immunotherapy and improve the management of patients with HVA.

背景和目的:肥大细胞活化试验(MAT)在诊断由无反应性嗜碱性粒细胞引起的无法解释的嗜碱性粒激活试验(BAT)患者中的有用性尚未得到解决。如果MAT的结果与过敏反应的严重程度有关,则应进一步评估。方法:我们招募了39名膜翅目毒液过敏(HVA)患者、22名非致敏对照和37名BAT无反应的HVA患者。使用Immulite系统对蜜蜂毒液(HBV)、黄夹克毒液(YJV)和总IgE的特异性IgE水平进行定量。用LAD2细胞对HBV和YJV进行BAT和MAT应答。结果:我们首先优化了LAD2细胞对HVA中IgE介导的脱颗粒的易感性,并表明IL-33和IL-6的预刺激显著增加了LAD2细胞对过敏原刺激的反应性(结论:LAD2-MAT是一种新的诊断工具,适用于无反应性嗜碱性粒细胞的HVA患者。此外,LAD2-MAT可以识别有严重刺痛反应风险的患者,从而有助于指导毒液免疫疗法的建议,并改善HVA患者的管理。
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引用次数: 0
Stability of Asthma Phenotypes in the Spanish Cohort of the MEGA Project. MEGA 项目西班牙队列中哮喘表型的稳定性。
IF 6.1 3区 医学 Q1 ALLERGY Pub Date : 2025-02-18 Epub Date: 2024-11-26 DOI: 10.18176/jiaci.1026
M J Rial, D Betancor, J A Cañas, J M Olaguibel, J M Rodrigo-Muñoz, M J Alvarez-Puebla, E Arismendi, B Barroso, I Bobolea, B Cárdaba, M J Cruz, E Curto, V Del Pozo, J Domínguez-Ortega, A Garcia de la Fuente, F J González-Barcala, J A Luna-Porta, C Martínez-Rivera, J Mullol, X Muñoz, C Picado, V Plaza, S Quirce, L Soto-Retes, M Valverde-Monge, J Sastre
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引用次数: 0
Sunflower (Helianthus annuus) Seed Allergy. 向日葵(Helianthus annuus)种子过敏。
IF 6.1 3区 医学 Q1 ALLERGY Pub Date : 2025-02-18 Epub Date: 2023-12-12 DOI: 10.18176/jiaci.0965
C Galleani, M C Diéguez, B Cabanillas, C Martín-Arriscado Arroba, A Enríquez-Matas, J F Crespo

Background and objectives: Sunflower seed is one of the most common edible seeds. Its consumption is growing. Cases of sunflower seed allergy have been reported since the 1970s. However, there are few data on the prevalence and clinical manifestations of sunflower seed allergy. To improve our understanding of sunflower seed allergy.

Methods: We evaluated the clinical and immunological features of patients with sunflower seed allergy diagnosed in the allergy department of a tertiary hospital in Madrid over a 5-year period.

Results: Forty-seven patients reported adverse reactions after ingestion of sunflower seed and were sensitized specifically to sunflower seed, as determined by skin prick test (median, 8 mm) or specific IgE (median, 1.10 kUA/L). Most reactions were adult-onset and were preceded by a history of atopy and other food allergies, predominantly to peach, peanut, and nuts. The clinical presentation of sunflower seed allergy ranged from mild to severe, with many patients experiencing severe reactions, in which epinephrine was underused. Repeated exposures to sunflower seed in the same patient showed severity of symptoms to vary. Levels of sunflower seed IgE were strongly correlated with levels of IgE to nonspecific lipid transfer proteins, while the severity of the reactions did not differ significantly according to sensitization to the proteins.

Conclusion: Our findings reveal variability in the clinical presentations of sunflower seed allergy on repeated exposures and underuse of epinephrine in anaphylaxis. We highlight the importance of strict avoidance of sunflower seed and accurate prescription and administration of epinephrine in allergic patients.

背景和目的:葵花籽是最常见的食用种子之一,其消费量正在不断增长。自 20 世纪 70 年代以来,就有关于葵花籽过敏的病例报告。然而,有关葵花籽过敏的发病率和临床表现的数据却很少。为了加深对葵花籽过敏的了解:方法:我们评估了马德里一家三甲医院过敏科在 5 年内确诊的葵花籽过敏患者的临床和免疫学特征:结果:47 名患者在摄入葵花籽后出现不良反应,并通过皮肤点刺试验(中位数为 8 mm)或特异性 IgE(中位数为 1.10 kUA/L)确定对葵花籽有特异性过敏反应。他们中的大多数人在成年后对葵花籽产生过敏反应,之前曾有过过敏史和其他食物过敏史,主要是对桃、花生和坚果过敏。葵花籽过敏的临床表现从轻微到严重不等,严重反应的患者比例很高,而且往往治疗不足。同一患者在反复接触葵花籽后,症状的严重程度也不尽相同。葵花籽 IgE 的水平与非特异性脂质转移蛋白的 IgE 水平密切相关,但根据对这些蛋白的致敏程度,反应的严重程度并无明显差异:我们的研究结果表明,反复接触葵花籽过敏的临床表现存在差异,过敏性休克时肾上腺素的使用不足。我们强调,过敏患者必须严格避免食用葵花籽,并准确开具处方和使用肾上腺素。
{"title":"Sunflower (Helianthus annuus) Seed Allergy.","authors":"C Galleani, M C Diéguez, B Cabanillas, C Martín-Arriscado Arroba, A Enríquez-Matas, J F Crespo","doi":"10.18176/jiaci.0965","DOIUrl":"10.18176/jiaci.0965","url":null,"abstract":"<p><strong>Background and objectives: </strong>Sunflower seed is one of the most common edible seeds. Its consumption is growing. Cases of sunflower seed allergy have been reported since the 1970s. However, there are few data on the prevalence and clinical manifestations of sunflower seed allergy. To improve our understanding of sunflower seed allergy.</p><p><strong>Methods: </strong>We evaluated the clinical and immunological features of patients with sunflower seed allergy diagnosed in the allergy department of a tertiary hospital in Madrid over a 5-year period.</p><p><strong>Results: </strong>Forty-seven patients reported adverse reactions after ingestion of sunflower seed and were sensitized specifically to sunflower seed, as determined by skin prick test (median, 8 mm) or specific IgE (median, 1.10 kUA/L). Most reactions were adult-onset and were preceded by a history of atopy and other food allergies, predominantly to peach, peanut, and nuts. The clinical presentation of sunflower seed allergy ranged from mild to severe, with many patients experiencing severe reactions, in which epinephrine was underused. Repeated exposures to sunflower seed in the same patient showed severity of symptoms to vary. Levels of sunflower seed IgE were strongly correlated with levels of IgE to nonspecific lipid transfer proteins, while the severity of the reactions did not differ significantly according to sensitization to the proteins.</p><p><strong>Conclusion: </strong>Our findings reveal variability in the clinical presentations of sunflower seed allergy on repeated exposures and underuse of epinephrine in anaphylaxis. We highlight the importance of strict avoidance of sunflower seed and accurate prescription and administration of epinephrine in allergic patients.</p>","PeriodicalId":50173,"journal":{"name":"Journal of Investigational Allergology and Clinical Immunology","volume":" ","pages":"32-39"},"PeriodicalIF":6.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138811936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Armelline Almond Allergy: The First Reported Case. Armelline杏仁过敏:第一例报道。
IF 6.1 3区 医学 Q1 ALLERGY Pub Date : 2025-02-18 Epub Date: 2024-12-05 DOI: 10.18176/jiaci.1033
L Alessi, S Cirrincione, B Aiuto, E Gosso, L Cavallarin, M G Giuffrida, G Monti, C Lamberti
{"title":"Armelline Almond Allergy: The First Reported Case.","authors":"L Alessi, S Cirrincione, B Aiuto, E Gosso, L Cavallarin, M G Giuffrida, G Monti, C Lamberti","doi":"10.18176/jiaci.1033","DOIUrl":"10.18176/jiaci.1033","url":null,"abstract":"","PeriodicalId":50173,"journal":{"name":"Journal of Investigational Allergology and Clinical Immunology","volume":" ","pages":"73-75"},"PeriodicalIF":6.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Two Nonimmediate Reactions to Oxaliplatin and Docetaxel Confirmed by Lymphocyte Transformation Test and Treated With Successful Rapid Desensitization Procedures. 淋巴细胞转化试验证实奥沙利铂和多西紫杉醇两种非立即反应,并成功进行快速脱敏治疗。
IF 6.1 3区 医学 Q1 ALLERGY Pub Date : 2025-02-18 Epub Date: 2024-12-19 DOI: 10.18176/jiaci.1030
M P Berges-Gimeno, A Barra-Castro, C Fernandez-Lozano, E Solano-Solares, N Martinez-Jañez, C Pueyo-Lopez, J Martínez-Botas
{"title":"Two Nonimmediate Reactions to Oxaliplatin and Docetaxel Confirmed by Lymphocyte Transformation Test and Treated With Successful Rapid Desensitization Procedures.","authors":"M P Berges-Gimeno, A Barra-Castro, C Fernandez-Lozano, E Solano-Solares, N Martinez-Jañez, C Pueyo-Lopez, J Martínez-Botas","doi":"10.18176/jiaci.1030","DOIUrl":"10.18176/jiaci.1030","url":null,"abstract":"","PeriodicalId":50173,"journal":{"name":"Journal of Investigational Allergology and Clinical Immunology","volume":" ","pages":"70-72"},"PeriodicalIF":6.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ozenoxacin-Induced Contact Dermatitis With Tolerance to Ciprofloxacin. 氧氟沙星诱发的接触性皮炎对环丙沙星耐受。
IF 6.1 3区 医学 Q1 ALLERGY Pub Date : 2025-02-18 Epub Date: 2024-11-13 DOI: 10.18176/jiaci.1031
M N Otero-Fernández, E Laffond-Yges, R M Castillo-Loja, A Cabrera-Núñez, M E Mazoteras-Martínez, F J Muñoz-Bellido, I Dávila
{"title":"Ozenoxacin-Induced Contact Dermatitis With Tolerance to Ciprofloxacin.","authors":"M N Otero-Fernández, E Laffond-Yges, R M Castillo-Loja, A Cabrera-Núñez, M E Mazoteras-Martínez, F J Muñoz-Bellido, I Dávila","doi":"10.18176/jiaci.1031","DOIUrl":"10.18176/jiaci.1031","url":null,"abstract":"","PeriodicalId":50173,"journal":{"name":"Journal of Investigational Allergology and Clinical Immunology","volume":" ","pages":"72-73"},"PeriodicalIF":6.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
How Far Are We From Achieving Delabeling of False Penicillin/ß-Lactam Allergy Alerts? A Population Problem. 我们离消除青霉素/ß-内酰胺过敏警报误报还有多远?人口问题。
IF 6.1 3区 医学 Q1 ALLERGY Pub Date : 2025-02-18 Epub Date: 2024-05-09 DOI: 10.18176/jiaci.1004
M A Tejedor-Alonso, M Perez-Encinas, S Sanz Márquez, J J Martinez Simon, L Moreno-Nuñez, A Gonzalez-Moreno, J Macias-Iglesias, A Rosado-Ingelmo

Interest in finding efficient ways to remove penicillin allergy alerts has grown as a result of awareness of the considerable excess of falsenegative diagnoses in patients with penicillin allergy labels (90%-95%), the poorer course with non-ß-lactam antibiotics, the increase in bacterial resistance, and the fact that these problems can affect up to 20% of the population in some countries. The strategies proposed have generated many publications in countries where the number of allergists to conduct such studies is low. In many cases where delabeling is performed, the risk of ß-lactam allergy is low, and a single penicillin challenge is sufficient to delabel the alert. However, other less "ultrarapid" strategies can be used to administer a ß-lactam during an admission for infection and thus postpone delabeling until traditional drug allergy consultations. However, the definitive withdrawal of ß-lactam alerts is threatened by nonremoval of alerts in electronic health records and by the reactivation or nonsynchronization of alerts between electronic systems at different levels of care. Allergy departments need to reflect on how to implement practices that enable rapid and efficient delabeling of drug allergy alerts, especially in patients with major comorbidities.

背景:由于人们意识到青霉素过敏标签患者的假阴性诊断率相当高(90%-95%)、使用非ß-内酰胺类抗生素的疗效较差、细菌耐药性增加,以及在某些国家这些问题可能会影响多达 20% 的人口,因此人们对寻找消除青霉素过敏警报的有效方法越来越感兴趣。在开展此类研究的过敏学家人数较少的国家,所提出的策略已发表了许多论文。在很多情况下,ß-内酰胺类药物过敏的风险很低,一次青霉素挑战就足以解除警报。然而,也可以采用其他不那么 "超快速 "的策略,在入院治疗感染期间使用ß-内酰胺类药物,从而将解除标签的时间推迟到传统的药物过敏会诊之后。然而,ß-内酰胺类药物警报的最终撤消受到电子健康记录中警报未撤消以及不同级别医疗机构电子系统之间警报重新激活或不同步的威胁。过敏科需要反思如何快速有效地解除药物过敏警报,尤其是对有重大并发症的患者。
{"title":"How Far Are We From Achieving Delabeling of False Penicillin/ß-Lactam Allergy Alerts? A Population Problem.","authors":"M A Tejedor-Alonso, M Perez-Encinas, S Sanz Márquez, J J Martinez Simon, L Moreno-Nuñez, A Gonzalez-Moreno, J Macias-Iglesias, A Rosado-Ingelmo","doi":"10.18176/jiaci.1004","DOIUrl":"10.18176/jiaci.1004","url":null,"abstract":"<p><p>Interest in finding efficient ways to remove penicillin allergy alerts has grown as a result of awareness of the considerable excess of falsenegative diagnoses in patients with penicillin allergy labels (90%-95%), the poorer course with non-ß-lactam antibiotics, the increase in bacterial resistance, and the fact that these problems can affect up to 20% of the population in some countries. The strategies proposed have generated many publications in countries where the number of allergists to conduct such studies is low. In many cases where delabeling is performed, the risk of ß-lactam allergy is low, and a single penicillin challenge is sufficient to delabel the alert. However, other less \"ultrarapid\" strategies can be used to administer a ß-lactam during an admission for infection and thus postpone delabeling until traditional drug allergy consultations. However, the definitive withdrawal of ß-lactam alerts is threatened by nonremoval of alerts in electronic health records and by the reactivation or nonsynchronization of alerts between electronic systems at different levels of care. Allergy departments need to reflect on how to implement practices that enable rapid and efficient delabeling of drug allergy alerts, especially in patients with major comorbidities.</p>","PeriodicalId":50173,"journal":{"name":"Journal of Investigational Allergology and Clinical Immunology","volume":" ","pages":"12-23"},"PeriodicalIF":6.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140900153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Journal of Investigational Allergology and Clinical Immunology
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