Annals of Allergy Asthma & Immunology最新文献

英文中文

The use of grocery-sourced real food solutions in sublingual immunotherapy for food allergies.

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2025-03-08 DOI: 10.1016/j.anai.2025.03.001

Brock A Williams, Ally Baaske, Lianne Soller, Stephanie C Erdle, Tiffany Wong, Raymond Mak, Nikhila D Schroeder, Edmond S Chan

Background: Sublingual immunotherapy (SLIT) is a safe, effective therapy for the treatment of food allergy. Studies demonstrating SLIT efficacy have primarily used pharmaceutical glycerinated food extracts for the administration of food allergens, which may limit accessibility due to extract cost and availability.

Objective: To develop novel sample protocols and resources for the preparation of grocery-sourced real food SLIT solutions, which could help more clinicians incorporate food SLIT into their practice and increase accessibility to this treatment. Secondly, to describe our site's experience with real food SLIT implementation.

Methods: Three- and five-dose build-up protocols were developed using powdered or liquid-based forms of food allergens, with a maintenance dose of 2-4 mg protein/day. Patient adherence and satisfaction data were collected via online surveys. After 1-2 years of daily real food SLIT maintenance dosing, patients were offered a low-dose oral food challenge (OFC) (cumulative dose, 330-340 mg protein).

Results: Sample protocols for real food SLIT were developed for 31 foods, including peanut, cow's milk, cashew, egg, and sesame. At our site, 305 patients have undergone or are currently undergoing real food SLIT. Of 162 satisfaction survey respondents, 99% (n=160) were satisfied or very satisfied with their care. Adherence surveys showed that 82% of respondents (n=105/128) reported consistently taking their SLIT dose. Among a subset of 33 patients, 57 low-dose OFCs were performed, of which 70.1% (n=40) were successful.

Conclusion: Grocery-sourced real food SLIT solutions present another food SLIT option that may expand the feasibility and accessibility of this safe and effective food allergy immunotherapy.

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引用次数: 0

Gene therapy for inborn errors of immunity: current clinical progress.

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2025-03-07 DOI: 10.1016/j.anai.2025.02.026

Sathi Wijeyesinghe, Javier Chinen

Hematopoietic stem cell transplant has been the single curative treatment for inborn errors of immunity (IEI) and is recommended for the most severe IEI conditions, such as severe combined immunodeficiency (SCID). However, adverse outcomes primarily due to histocompatibility differences between the donor and the patient are still of concern. Progress in genetic and molecular mechanisms, as well as new technology to insert DNA sequences in cell genomes has allowed the development of strategies to treat genetic diseases by correcting the gene defect in patients' cells. This technology is named gene therapy. Gene therapy approaches being developed for IEI are mediated by gene insertion, using a retroviral vector, or by gene editing, using a combination of a nuclease and a DNA template. After the unexpected occurrence of oncogenesis associated with the initial retroviral vector designs, significant advances have led to successful gene therapy clinical trials for three forms of SCID, which demonstrated the safety and efficacy of this approach. Active preclinical and clinical studies are ongoing for diverse IEI, including chronic granulomatous disease, leukocyte adhesion deficiency, severe congenital neutropenia, Wiskott-Aldrich syndrome, X-linked agammaglobulinemia and familial forms of hemophagocytic lymphohistiocytosis.

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引用次数: 0

Dupilumab efficacy in relation to changes in club cell secretory protein 16.

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2025-03-03 DOI: 10.1016/j.anai.2025.02.019

Yui Murai, Toshiyuki Koya, Hiroki Koda, Wakana Uji, Moe Tanaka, Masahiro Endo, Kyoichiro Oshima, Takahiro Matsuda, Hiroshi Ueno, Ami Aoki, Kenjiro Shima, Yosuke Kimura, Toshiaki Kikuchi

Background: Although the performance of dupilumab in severe asthma has been evaluated, the detailed mechanism underlying its effect remains unclear.

Objective: To analyze the effect of dupilumab on serum club cell secretory protein 16 (CC16).

Methods: A total of 25 patients who were administered dupilumab and underwent computed tomography before and approximately 4 months after the introduction of dupilumab were included. Clinical and computed tomography parameters before and after dupilumab administration, such as mucus plug score and wall area measurement, were compared along with serum CC16 levels. The correlation between the clinical background and treatment effects was also evaluated.

Results: The number of mucus plugs and airway wall area decreased significantly after dupilumab introduction. The number of mucus plugs was positively correlated with both age and serum IgE levels. The number of mucus plugs and airway wall area was inversely correlated with percent of predicted forced expiratory volume in 1 second (FEV₁) and maximal mid-expiratory flow. Dupilumab treatment resulted in a significant increase in serum CC16 levels and led to a significant improvement in asthma symptoms, quality-of-life scores, FEV₁, and exacerbation frequency. In addition, changes in CC16 were significantly correlated with changes in the fraction of exhaled nitric oxide, IgE, quality-of-life score, FEV₁, maximal mid-expiratory flow, and mucus plug score.

Conclusion: These data suggest that dupilumab improves symptoms and respiratory functions by altering the airway epithelial environment.

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引用次数: 0

Clinical burden, treatment, and disease control in patients with chronic spontaneous urticaria 慢性自发性荨麻疹患者的临床负担、治疗和疾病控制：真实世界证据。

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2025-03-01 DOI: 10.1016/j.anai.2024.12.008

Marc A. Riedl MD, MS , Dhaval Patil MS , Jonathan Rodrigues MD , Merin Kuruvilla MD , Tara Raftery PhD , Irina Pivneva PhD , Jason Doran MBA , Arthur Voegel MA , James Signorovitch PhD , Gil Yosipovitch MD

Background

Chronic spontaneous urticaria (CSU) is an unpredictable inflammatory skin condition with substantial clinical burden that affects 0.23% to 0.78% of the US population.

Objective

To describe the incidence and prevalence of patients with a record of CSU diagnosis, treatment patterns, disease control, and clinical and economic burden in a US cohort of patients with CSU.

Methods

Adults with a record of CSU diagnosis within the US HealthVerity claims database were eligible. Age- and gender-adjusted prevalence/incidence rates were calculated for January 2017 to December 2022. Clinical characteristics were described during the 1 year before CSU diagnosis (baseline) and the time after (follow-up). Proxy events representing uncontrolled CSU (any record of prescriptions for corticosteroids, biologics, or immunosuppressants [excluding all antihistamines and over-the-counter medication] or any CSU-related inpatient admissions or emergency department or urgent care visits) were used to identify patients with uncontrolled CSU. Health care resource utilization (HCRU) and health care costs were described.

Results

Overall, 200,298 patients were followed-up for a median of 2.3 years after diagnosis. Estimated cumulative prevalence of diagnosed CSU was 0.57% (women: 0.80%; men: 0.32%). The average annual incidence rate was 0.08%. Corticosteroids were the most prescribed treatment during follow-up among the 166,195 patients prescribed at least 1 treatment (94.3%). Proxy events were observed in 59.1% of the patients. HCRU and health care costs increased from baseline in patients with uncontrolled CSU during follow-up.

Conclusion

Of patients with CSU who were prescribed treatment, more than 50% experienced uncontrolled CSU, which was associated with increased HCRU and health care costs.

背景：慢性自发性荨麻疹（CSU）是一种不可预测的炎症性皮肤病，具有巨大的临床负担，影响了0.23-0.78%的美国人口。目的：描述美国CSU患者队列中有CSU诊断、治疗模式、疾病控制、临床和经济负担记录的患者的发病率和患病率。方法：在美国HealthVerity索赔数据库中有CSU诊断记录的成年人符合条件。计算了2017年1月至2022年12月经年龄和性别调整的患病率/发病率。描述CSU诊断前1年（基线）和诊断后1年（随访）的临床特征。代表不受控制的CSU的代理事件（任何皮质类固醇、生物制剂或免疫抑制剂的处方记录[不包括所有抗组胺药和非处方药]或任何与CSU相关的住院或急诊室或紧急护理就诊记录）被用于识别不受控制的CSU患者。描述了卫生保健资源利用（HCRU）和卫生保健费用。结果：总体而言，200,298例患者在诊断后随访，中位随访时间为2.3年。诊断为CSU的累积患病率估计为0.57%(女性：0.80%；男人:0.32%)。年平均发病率为0.08%。在接受≥1种治疗的166195例患者中，糖皮质激素是随访期间最常用的治疗方法（94.3%）。59.1%的患者出现代理事件。随访期间，不受控制的CSU患者的HCRU和医疗费用较基线增加。结论：在接受处方治疗的CSU患者中，约50%的患者出现了不受控制的CSU，这与HCRU和医疗费用的增加有关。

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引用次数: 0

Further evidence for the roles of computed tomography in managing severe asthma 进一步证明计算机断层扫描在治疗严重哮喘中的作用

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2025-03-01 DOI: 10.1016/j.anai.2024.12.014

Naoya Tanabe MD, PhD

引用次数: 0

Mild asthma—What matters to patients and parents 轻度哮喘-对患者和家长有什么影响？

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2025-03-01 DOI: 10.1016/j.anai.2024.11.017

Emma Greimann MD , George E. Freigeh MD, MA , Rachel P. Wettenstein BS , Belinda Nelson MSW, PhD , Laurie M. Carpenter MSW , Arjun Mohan MBBS , Alan Baptist MD, MPH

Background

Mild asthma has received less attention despite accounting for most of patient with asthma. However, asthma complications including hospitalizations and progressive loss of lung function frequently occur in such patients. The priorities of patients with mild asthma are unknown, hindering the ability to advance care.

Objective

To identify patient and parent perspectives on the definition of mild asthma, treatment preferences, concerns and goals of care.

Methods

Participants with self-defined mild/intermittent asthma were recruited using emails distributed through the Allergy & Asthma Network and Allergy Foundation of America. A demographic survey and measures of asthma control/quality of life were completed. Focus groups consisting of approximately 5 participants and a focus group leader were conducted.

Results

A total of 20 patients and 20 parents of children with mild asthma participated. Focus groups revealed significant variability in the definition and treatment preferences. Frequency of symptoms appears to be a key driver in treatment decisions for mild asthma, and those with infrequent symptoms were opposed to the addition of an inhaled corticosteroid to albuterol. Use of recommended asthma monitoring strategies such as asthma action plans or peak flow meters was low among adults. Participants desired more education from their providers regarding asthma remission and long-term complications associated with mild asthma.

Conclusion

There is significant heterogeneity in the definition and treatment preferences among patients and parents of those with mild asthma. Shared decision making between patients and providers is necessary to personalize medical decisions in those with mild asthma.

背景：轻度哮喘在哮喘患者中占多数，但受到的关注较少。然而，哮喘并发症包括住院和肺功能进行性丧失经常发生在这类患者中。轻度哮喘患者的优先级未知，阻碍了推进护理的能力。目的：了解患者和家长对轻度哮喘的定义、治疗偏好、关注问题和护理目标的看法。方法：通过过敏与哮喘网络（AAN）和美国过敏基金会（AAFA）发送的电子邮件招募自定义轻度/间歇性哮喘的参与者。完成了人口统计调查和哮喘控制/生活质量测量。由大约5名参与者和一名焦点小组组长组成的焦点小组进行了研究。结果：共有20名患者和20名轻度哮喘患儿家长参与。焦点小组揭示了定义和治疗偏好的显著差异。症状的频率似乎是轻度哮喘治疗决策的关键驱动因素，那些症状不频繁的人反对在沙丁胺醇中加入吸入皮质类固醇。成人中推荐的哮喘监测策略（如哮喘行动计划或峰值流量计）的使用率较低。参与者希望从他们的提供者那里得到更多关于哮喘缓解和与轻度哮喘相关的长期并发症的教育。结论：轻度哮喘的定义和治疗偏好在患者和家长之间存在显著的异质性。患者和医疗服务提供者之间的共同决策对于轻度哮喘患者的个性化医疗决策是必要的。

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引用次数: 0

Do no harm: An ethical approach to refractory anaphylaxis to chemotherapy 不伤害：化疗难治性过敏反应的伦理方法。

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2025-03-01 DOI: 10.1016/j.anai.2024.11.024

Timothy M. Buckey MD, MBE

引用次数: 0

High prevalence of eosinophilic gastrointestinal disorders in patients with atopic disease 嗜酸性粒细胞性胃肠道疾病在特应性疾病患者中的高发率。

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2025-03-01 DOI: 10.1016/j.anai.2024.12.001

Alexandra A. Weir MS , Onyinye I. Iweala MD, PhD , Evan S. Dellon MD, MPH

引用次数: 0

Utility of using thoracic computed tomography to measure lung function decline and detect unsuspected emphysema in severe asthma

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2025-03-01 DOI: 10.1016/j.anai.2024.11.007

Arthur F. Gelb MD, Donald P. Tashkin MD

引用次数: 0

Performance of 5-domain rhinology-focused symptom score with dupilumab in chronic rhinosinusitis with nasal polyps 在慢性鼻窦炎伴鼻息肉患者中使用杜普鲁单抗进行五域鼻科症状评分。

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2025-03-01 DOI: 10.1016/j.anai.2024.11.001

Kirsten Stewart MBChB , Chris RuiWen Kuo MD , Rory Chan PhD , Brian Lipworth MD

引用次数: 0

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Annals of Allergy Asthma & Immunology

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