Annals of Allergy Asthma & Immunology最新文献

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2025 American College of Allergy, Asthma and Immunology Annals fellow-in-training award winners: The future of allergy and immunology. 2025年美国过敏、哮喘和免疫学学会年鉴在职研究员获奖者：过敏和免疫学的未来。

IF 4.7 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2025-11-15 DOI: 10.1016/j.anai.2025.09.016

Mitchell H Grayson

引用次数: 0

2025 American College of Allergy, Asthma and Immunology Annals fellow-in-training award winners 2025年ACAAI年鉴培训奖获得者：过敏和免疫学的未来。

IF 4.7 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2025-11-15 DOI: 10.1016/j.anai.2025.09.016

Mitchell H. Grayson MD

引用次数: 0

Characterization of food protein-induced enterocolitis syndrome among Asian American children. 亚裔美国儿童食物蛋白诱导的小肠结肠炎综合征的特征。

IF 4.7 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2025-11-11 DOI: 10.1016/j.anai.2025.11.002

Charles Feng, Priscilla Wong, Satish Mudiganti, Xiaowei Yan, Diamonne Mitchell, Ngoc Tran, Latha Palaniappan, Anna Chen Arroyo

Background: Limited data currently exist regarding the clinical characteristics of food protein-induced enterocolitis syndrome (FPIES) among Asian American (AsA) children.

Objective: To evaluate a cohort of AsA children with FPIES in a Northern California health care system.

Methods: We performed a retrospective analysis of children below 18 years of age with more than or equal to 1 outpatient clinical encounter with FPIES (International Classification of Diseases, 10th Revision, Clinical Modification, K52.21) diagnosed between October 1, 2015, and December 31, 2022. Patient/parent self-reported race/ethnicity was used. Two board-certified allergists reviewed the charts of all AsA children diagnosed with having FPIES. Market basket analysis was performed to identify correlations among FPIES food categories.

Results: Of 129,989 AsA children, 146 (0.11%) had acute FPIES, most of which were male (52%) and had atopic dermatitis (55.5%). Median age at diagnosis was 7 months. Among 21 children (14%) who underwent oral food challenges, 66.6% (14/21) passed the challenge. Multi-food FPIES was observed in 23.9% (35/146) and atypical FPIES was observed in 14.4% (21/146) of the cohort. Approximately 28% of Asian Indian and 10% of Filipino children had more than 1 trigger food. The most common culprit foods included egg (36.3%), oats (24%), milk (16.4%), avocado (9.6%), rice (6.8%), and peanut (5.5%). Market basket analysis revealed that having an egg-related trigger was associated with not having an avocado-related trigger, with a confidence level of 88% and a lift value of 1.33.

Conclusion: This large pediatric AsA FPIES cohort demonstrates distinguishing features, including a high proportion of egg FPIES and lack of common food co-associations. Understanding these clinical differences may significantly enhance clinicians' ability to diagnosis and manage FPIES among the rapidly growing heterogeneous AsA population.

背景：目前关于亚裔美国人（AsA）儿童食物蛋白性小肠结肠炎综合征（FPIES）临床特征的数据有限。目的：我们评估北加州医疗保健系统中AsA儿童的FPIES队列。结果：129989例AsA患儿中，146例（0.11%）有急性FPIES，其中多数为男性（52%），并有特应性皮炎（55.5%）。诊断时的中位年龄为7个月。在21名（14%）接受口腔食物挑战的儿童中，66.6%（14/21）通过了挑战。23.9%（35/146）的患者出现多种食物FPIES， 14.4%（21/146）的患者出现非典型FPIES。大约28%的亚洲印度儿童和10%的菲律宾儿童食用了bbb1触发食物。最常见的罪魁祸首食物包括鸡蛋（36.3%）、燕麦（24%）、牛奶（16.4%）、鳄梨（9.6%）、大米（6.8%）和花生（5.5%）。MBA表明，有鸡蛋相关的触发因素与没有鳄梨相关的触发因素相关，置信水平为88%，提升值为1.33。结论：这个大型儿童AsA FPIES队列显示出明显的特征，包括鸡蛋FPIES比例高和缺乏常见的食物联合关联。了解这些临床差异可以显著提高临床医生在快速增长的异质AsA人群中诊断和管理FPIES的能力。

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引用次数: 0

Clinical and genetic study in factor XII hereditary angioedema in a population from Southern Spain. 西班牙南部人群中因子XII遗传性血管性水肿的临床和遗传学研究。

IF 4.7 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2025-11-10 DOI: 10.1016/j.anai.2025.11.003

Teresa de Aramburu Mera, Krasimira Baynova, José Manuel Lucena Soto, José Raúl García Lozano, Stefan Cimbollek

引用次数: 0

Identifying gaps: A survey of food allergy knowledge and management in US adults. 识别差距：美国成年人食物过敏知识和管理调查。

IF 4.7 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2025-11-07 DOI: 10.1016/j.anai.2025.10.033

Sofia Halperin-Goldstein, Joey Tan, Erin Malawer, Sarah McCollum, Anita Roach, Stephanie Leeds

Background: Food allergy (FA) disproportionately affects communities of color in the United States. However, few studies have evaluated adult-specific disparities in FA.

Objective: To explore differences in FA prevalence, knowledge, and care among US adults.

Methods: A survey of adults with FA which collected data on self-reported allergens, anaphylaxis knowledge, epinephrine autoinjector (EAI) prescriptions, and health care utilization. Outcomes were compared by race/ethnicity, insurance type, and geographic region.

Results: Among the 1006 survey respondents, FA rates to common allergens differed by race/ethnicity. Higher rates of peanut (50.61%) and tree nut (45.73%) allergies were reported by Black vs White participants (35.50% and 34.81%, respectively) and Other (38.89% and 33.33%, respectively) (P < .001 and P = .03). Race and insurance status emerged as predictors of anaphylaxis knowledge, with Black and Hispanic/Latino participants recognizing 8% fewer anaphylaxis symptoms than White respondents (P < .0001 and P = .006, respectively) and uninsured participants identifying 8% fewer symptoms than privately insured subjects (P = .02). Uninsured and publicly insured subjects had lower odds of EAI prescriptions compared with the privately insured (odds ratio [OR] 0.24, P < .0001 and .63, P = .0009, respectively). Black (OR 0.69, P = .06) and uninsured and publicly insured respondents (OR 0.41, P = .0003 and OR 0.69, P = .01, respectively) had lower odds of allergist-diagnosed FA than their White and privately insured counterparts.

Conclusion: This study demonstrates differences in self-reported food allergens by race/ethnicity and anaphylaxis symptom recognition, EAI access, and FA-related health care utilization by race/ethnicity and insurance status. These findings provide insight into potential drivers of disparities in adult FA and may inform efforts to improve care for vulnerable populations.

背景：食物过敏（FA）不成比例地影响着美国的有色人种社区。然而，很少有研究调查成人特异性FA差异。目的：探讨美国成年人中FA患病率、知识和护理的差异。方法：对食物过敏的成年人进行调查，收集其自我报告的过敏原、过敏反应知识、肾上腺素自动注射器（EAI）处方和医疗保健利用情况。结果按种族/民族、保险类型和地理区域进行比较。结果：在1006名调查对象中，常见过敏原的FA率因种族/民族而异。黑人受试者对花生（50.61%）和树坚果（45.73%）过敏的报告率高于白人（分别为35.50%和34.81%）和其他（分别为38.89%和33.33%）。结论：本研究表明，种族/民族、过敏反应症状识别、EAI获取和饮食相关医疗保健利用在种族/民族和保险状况方面存在差异。这些发现为成人FA差异的潜在驱动因素提供了见解，并可能为改善弱势群体的护理提供信息。

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引用次数: 0

Severe food protein-induced enterocolitis syndrome with seizures and concern for developmental delay: A case report. 严重食物蛋白诱导的肠结肠炎综合征伴癫痫发作并关注发育迟缓：1例报告。

IF 4.7 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2025-11-04 DOI: 10.1016/j.anai.2025.10.028

Benjamin Martinez, Shatha Alhamdi, Julia E M Upton

引用次数: 0

CAREGIVER PERCEPTIONS OF PRIMARY CARE DRIVEN DIRECT ORAL CHALLENGES EVALUATING PEDIATRIC PENICILLIN ALLERGIES 护理人员对初级保健的认知驱动了评估儿科青霉素过敏的直接口腔挑战

IF 4.7 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2025-11-01 DOI: 10.1016/j.anai.2025.08.050

M. Kellam, C. Mercadel, J. Smartt, K. Alvarez, C. Termulo, T. Chow

Introduction

Penicillin allergy is cited as the most common drug allergy in pediatrics. Having a penicillin allergy label has negative health implications. Penicillin allergy evaluation through direct oral challenges is an under-utilized resource. The goal of this study was to better understand caregivers’ experiences of their child with a documented penicillin allergy undergoing direct amoxicillin challenges at their primary care office.

Methods

Telephone interviews were conducted with caregivers of pediatric patients who had undergone direct oral amoxicillin challenges at community oriented primary care clinics through Parkland Health in Dallas, Texas between June 2022 and November 2024. The interview consisted of both open-ended and close-ended questions that were created based on previously reported surveys and edited by a panel of allergists to ensure content validity.

Results

Of the 56 children who completed the challenge testing, 30 interviews were completed. Most caregivers had never heard of penicillin allergy testing prior to it being recommended to their child. Approximately half of caregivers cited concern of their child having a bad reaction during the test that was alleviated by further education. Most of the caregivers were extremely satisfied with the process and all caregivers were likely to recommend it to others.

Conclusion

There is a need for continued education surrounding the risks of penicillin allergy labels and the availability of penicillin allergy testing. Penicillin allergy testing through primary care offices was a positive experience for most families and could improve access for pediatric patients with a penicillin allergy label.

青霉素过敏是儿科最常见的药物过敏。青霉素过敏标签对健康有负面影响。通过直接口服刺激进行青霉素过敏评价是一种未充分利用的资源。本研究的目的是为了更好地了解护理人员在其初级保健办公室接受直接阿莫西林挑战的有青霉素过敏记录的孩子的经历。方法对2022年6月至2024年11月期间在德克萨斯州达拉斯市帕克兰健康中心的社区初级保健诊所接受直接口服阿莫西林挑战的儿科患者的护理人员进行电话访谈。访谈包括开放式和封闭式问题，这些问题是根据先前报告的调查创建的，并由过敏症专家小组编辑，以确保内容的有效性。结果在56名完成挑战测试的儿童中，完成了30个访谈。大多数护理人员在向孩子推荐青霉素过敏试验之前从未听说过。大约一半的看护人表示，他们担心孩子在测试期间会有不良反应，而进一步的教育减轻了这种担忧。大多数护理人员对这个过程非常满意，所有护理人员都可能向其他人推荐它。结论有必要就青霉素过敏标签的危险性和青霉素过敏试验的可获得性进行继续教育。通过初级保健办公室进行青霉素过敏试验对大多数家庭来说是一种积极的体验，可以改善有青霉素过敏标签的儿科患者的就诊机会。

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引用次数: 0

A DELPHI CONSENSUS STUDY ON THE BARRIERS TO ON-DEMAND TREATMENT FOR HEREDITARY ANGIOEDEMA ATTACKS 遗传性血管性水肿发作按需治疗障碍的德尔菲共识研究

IF 4.7 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2025-11-01 DOI: 10.1016/j.anai.2025.08.113

A. Banerji , J. Bernstein , P. Busse , M. Cancian , D. Cohn , T. Craig , M. Hide , M. Riedl , W. Lumry , A. Zanichelli

Introduction

Hereditary angioedema (HAE) is a rare inherited disorder characterized by attacks of swelling. Guidelines for management of HAE attacks emphasize early use of on-demand treatment. This international Delphi panel aimed to characterize challenges associated with on-demand treatment of HAE attacks.

Methods

A modified Delphi method was used, involving 3 rounds of surveys. A third-party administrator and two non-voting co-chairs designed and managed the surveys, data collection, and analysis. The global panel consisted of 19 expert HAE clinicians. Consensus was defined as ≥75% agreement with ≥75% of panelists voting.

Results

Following 3 rounds of voting, 24 statements were confirmed across 4 key areas related to on-demand treatment: early administration, burden of treatment, tolerability and convenience, and patient-clinician interactions. Panelists defined “early treatment” as ≤60 minutes after onset of an HAE attack; obstacles to early treatment include recognition of an attack and embarrassment/anxiety about administering parenteral treatment. Access to on-demand treatment (ie, carrying medication, cost, insurance coverage, regulatory approval) can be a burden for patients and reducing cost and increasing access may increase adherence to guidelines. Improving available options for on-demand treatment would reduce some of the associated burdens. Logistical obstacles (eg, parenteral administration) impact convenience, which along with tolerability concerns (eg, side effects), can limit early use of on-demand treatment. Panelists agreed that patient–physician shared decision-making should be utilized.

Conclusion

These Delphi consensus statements demonstrate the unmet need for safe, effective, and convenient on-demand treatments for HAE attacks that will enable patients to improve adherence with HAE guidelines.

遗传性血管性水肿（HAE）是一种罕见的以肿胀发作为特征的遗传性疾病。HAE发作管理指南强调早期使用按需治疗。这个国际德尔菲小组旨在描述HAE发作按需治疗的相关挑战。方法采用改进的德尔菲法，共进行3轮调查。一名第三方管理员和两名无投票权的联合主席设计和管理调查、数据收集和分析。全球小组由19名HAE临床专家组成。共识定义为≥75%的专家组成员投票同意≥75%。结果经过3轮投票，24项声明得到确认，涉及与按需治疗相关的4个关键领域：早期给药、治疗负担、耐受性和便利性以及患者与临床医生的互动。小组成员将“早期治疗”定义为HAE发作后≤60分钟；早期治疗的障碍包括对疾病发作的识别以及对进行静脉注射治疗的尴尬/焦虑。获得按需治疗（即携带药物、费用、保险范围、监管部门批准）可能成为患者的负担，降低费用和增加获得可能会增加对指南的遵守。改善按需治疗的现有选择将减轻一些相关负担。后勤障碍（如肠外给药）影响便利性，再加上耐受性问题（如副作用），可限制按需治疗的早期使用。小组成员一致认为，应该利用医患共同决策。这些德尔菲共识声明表明，对HAE发作的安全、有效和方便的按需治疗的需求尚未得到满足，这将使患者提高对HAE指南的依从性。

{"title":"A DELPHI CONSENSUS STUDY ON THE BARRIERS TO ON-DEMAND TREATMENT FOR HEREDITARY ANGIOEDEMA ATTACKS","authors":"A. Banerji , J. Bernstein , P. Busse , M. Cancian , D. Cohn , T. Craig , M. Hide , M. Riedl , W. Lumry , A. Zanichelli","doi":"10.1016/j.anai.2025.08.113","DOIUrl":"10.1016/j.anai.2025.08.113","url":null,"abstract":"<div><h3>Introduction</h3><div>Hereditary angioedema (HAE) is a rare inherited disorder characterized by attacks of swelling. Guidelines for management of HAE attacks emphasize early use of on-demand treatment. This international Delphi panel aimed to characterize challenges associated with on-demand treatment of HAE attacks.</div></div><div><h3>Methods</h3><div>A modified Delphi method was used, involving 3 rounds of surveys. A third-party administrator and two non-voting co-chairs designed and managed the surveys, data collection, and analysis. The global panel consisted of 19 expert HAE clinicians. Consensus was defined as ≥75% agreement with ≥75% of panelists voting.</div></div><div><h3>Results</h3><div>Following 3 rounds of voting, 24 statements were confirmed across 4 key areas related to on-demand treatment: early administration, burden of treatment, tolerability and convenience, and patient-clinician interactions. Panelists defined “early treatment” as ≤60 minutes after onset of an HAE attack; obstacles to early treatment include recognition of an attack and embarrassment/anxiety about administering parenteral treatment. Access to on-demand treatment (ie, carrying medication, cost, insurance coverage, regulatory approval) can be a burden for patients and reducing cost and increasing access may increase adherence to guidelines. Improving available options for on-demand treatment would reduce some of the associated burdens. Logistical obstacles (eg, parenteral administration) impact convenience, which along with tolerability concerns (eg, side effects), can limit early use of on-demand treatment. Panelists agreed that patient–physician shared decision-making should be utilized.</div></div><div><h3>Conclusion</h3><div>These Delphi consensus statements demonstrate the unmet need for safe, effective, and convenient on-demand treatments for HAE attacks that will enable patients to improve adherence with HAE guidelines.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"135 5","pages":"Page S34"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145442306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

RE-ANALYSIS OF RECOMBINANT C1 INHIBITOR (RHC1-INH) CLINICAL DATA WITH CONTEMPORARY TIME-TO-EVENT ENDPOINT DEFINITIONS 重组c1抑制剂（rhc1-inh）临床数据与当代事件终点定义的重新分析

IF 4.7 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2025-11-01 DOI: 10.1016/j.anai.2025.08.116

M. Riedl , N. Narsipur , D. Jones , R. Tachdjian , A. Relan , E. Aiello , A. Gough , J. Harper , H. Li , A. Harrington

Introduction

Recent hereditary angioedema (HAE) trials have defined efficacy endpoints using patient-reported outcome (PRO) measures that differ from those used in earlier rhC1-INH studies, which relied on visual analog scale (VAS). This reanalysis applied the output of mapping algorithms to align historical and recent PRO measures with contemporary endpoint definitions.

Methods

Using pooled data from 3 phase 3 randomized, placebo-controlled clinical trials (NCT00225147, NCT01188564, NCT00262301) of rhC1-INH, this analysis applied results from a PRO mapping study to convert VAS scores to Patient Global Impression of Severity (PGI-S) categories. A Cox proportional hazards model estimated time to complete resolution (TTCR), defined as time to first report of a PGI-S score of “none,” between rhC1-INH and placebo groups.

Results

Across trials, 48 and 60 patients received rhC1-INH and placebo (saline), respectively. Most patients were White (95.0%-95.8%) and female (66.7%-68.8%) across both arms, with a median (IQR) age of 39 (31-47) years for rhC1-INH and 39 (29-53) years for placebo. The most common attack locations were above the neck (44.4%) and abdominal (35.2%) across both arms. Baseline attack severity, based on the PGI-S scale, was either severe (16.7%) or very severe (83.3%) across both arms. The median (IQR) TTCR was 4.48 (2.50, 7.02) hours for rhC1-INH and 24 (5.97, >24) hours for placebo (P<0.001).

Conclusion

Treatment with rhC1-INH significantly reduced the TTCR compared with placebo. Building on the primary endpoint data from phase 3 trials, these results confirm that rhC1-INH delivers both rapid onset of symptom relief and resolution of HAE attacks.

最近的遗传性血管性水肿（HAE）试验使用患者报告的结果（PRO）来确定疗效终点，这与早期rhC1-INH研究中使用的方法不同，后者依赖于视觉模拟量表（VAS）。该再分析应用映射算法的输出来将历史和最近的PRO测量与当代端点定义对齐。方法采用来自rhC1-INH的3个3期随机、安慰剂对照临床试验（NCT00225147、NCT01188564、NCT00262301）的汇总数据，应用PRO制图研究的结果将VAS评分转换为患者整体严重程度印象（PGI-S）分类。Cox比例风险模型估计了rhC1-INH组和安慰剂组之间的完全缓解时间（TTCR），定义为首次报告PGI-S评分为“无”的时间。结果在所有试验中，分别有48例和60例患者接受了rhC1-INH和安慰剂（生理盐水）。两组的大多数患者为白人（95.0%-95.8%）和女性（66.7%-68.8%），rhC1-INH组的中位（IQR）年龄为39（31-47）岁，安慰剂组为39（29-53）岁。最常见的发作部位为颈部以上（44.4%）和腹部（35.2%）。根据PGI-S量表，两组患者的基线发作严重程度为严重（16.7%）或非常严重（83.3%）。rhC1-INH组的中位（IQR） TTCR为4.48（2.50,7.02）小时，安慰剂组为24 （5.97,>24）小时（P<0.001）。结论与安慰剂相比，rhC1-INH治疗可显著降低TTCR。基于3期试验的主要终点数据，这些结果证实rhC1-INH既能快速缓解症状，又能缓解HAE发作。

{"title":"RE-ANALYSIS OF RECOMBINANT C1 INHIBITOR (RHC1-INH) CLINICAL DATA WITH CONTEMPORARY TIME-TO-EVENT ENDPOINT DEFINITIONS","authors":"M. Riedl , N. Narsipur , D. Jones , R. Tachdjian , A. Relan , E. Aiello , A. Gough , J. Harper , H. Li , A. Harrington","doi":"10.1016/j.anai.2025.08.116","DOIUrl":"10.1016/j.anai.2025.08.116","url":null,"abstract":"<div><h3>Introduction</h3><div>Recent hereditary angioedema (HAE) trials have defined efficacy endpoints using patient-reported outcome (PRO) measures that differ from those used in earlier rhC1-INH studies, which relied on visual analog scale (VAS). This reanalysis applied the output of mapping algorithms to align historical and recent PRO measures with contemporary endpoint definitions.</div></div><div><h3>Methods</h3><div>Using pooled data from 3 phase 3 randomized, placebo-controlled clinical trials (NCT00225147, NCT01188564, NCT00262301) of rhC1-INH, this analysis applied results from a PRO mapping study to convert VAS scores to Patient Global Impression of Severity (PGI-S) categories. A Cox proportional hazards model estimated time to complete resolution (TTCR), defined as time to first report of a PGI-S score of “none,” between rhC1-INH and placebo groups.</div></div><div><h3>Results</h3><div>Across trials, 48 and 60 patients received rhC1-INH and placebo (saline), respectively. Most patients were White (95.0%-95.8%) and female (66.7%-68.8%) across both arms, with a median (IQR) age of 39 (31-47) years for rhC1-INH and 39 (29-53) years for placebo. The most common attack locations were above the neck (44.4%) and abdominal (35.2%) across both arms. Baseline attack severity, based on the PGI-S scale, was either severe (16.7%) or very severe (83.3%) across both arms. The median (IQR) TTCR was 4.48 (2.50, 7.02) hours for rhC1-INH and 24 (5.97, >24) hours for placebo (<em>P</em><0.001).</div></div><div><h3>Conclusion</h3><div>Treatment with rhC1-INH significantly reduced the TTCR compared with placebo. Building on the primary endpoint data from phase 3 trials, these results confirm that rhC1-INH delivers both rapid onset of symptom relief and resolution of HAE attacks.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"135 5","pages":"Page S35"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145442367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

DIAGNOSTIC VALUE OF TEAR TRYPTASE (T-TRYPTASE) IN OCULAR SURFACE DISORDERS (OSD): ALLERGIC CONJUNCTIVITIS PATIENTS 泪液胰蛋白酶（t-tryptase）在眼表疾病（osd）中的诊断价值：过敏性结膜炎患者

IF 4.7 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2025-11-01 DOI: 10.1016/j.anai.2025.08.092

B. Hsieh , S. Alnsour , L. Bielory

Introduction

Climate change is associated with increased OSD, including ocular allergies. Ocular surface immunological diagnostics have become increasingly relevant in understanding and managing OSD. The diagnostic value of t-tryptase in seasonal (SAC)/perennial (PAC) and vernal (VKC) allergic conjunctivitis are not well understood.

Methods

Procedures followed were in accordance with the Helsinki Declaration as revised in 2013 and is a non-human research project. PubMed search for t-IgE studies using "tear tryptase" yielded 5 studies(N) with 108 subjects(n) containing measurements of t-tryptase, stratified by VKC (n = 75) and SAC/PAC (n = 33). A total of 50 non-atopic control subjects were also included. Ocular allergies were confirmed through a combination of symptom history (N=5), physical exam (N=3), positive skin prick testing and/or serum IgE (N=3). Pooled means and variance were calculated according to sample size weighting with the formulas Σn_i x mean_i /Σn_i and Σ(n_i - 1) x variance_i /(Σn_i - N).

Results

Baseline t-tryptase for VKC patients was significantly higher at 67.8 ± 22.9 ng/ml, compared to 26.0 ± 0.1 ng/ml for SAC/PAC patients, and 12.3 ± 3.2 ng/ml for controls. Higher t-tryptase levels were associated with more severe VKC disease graded by clinical symptoms.

Conclusion

Tear tryptase can be leveraged for diagnostic purposes with high levels found in patients with VKC, compared to SAC/PAC patients and controls. Higher levels of t-tryptase may correspond to greater VKC disease severity.

气候变化与OSD增加有关，包括眼部过敏。眼表免疫诊断在理解和治疗OSD方面越来越重要。t-tryptase在季节性(SAC)/多年性（PAC）和春性（VKC）变应性结膜炎中的诊断价值尚不清楚。方法遵循2013年修订的《赫尔辛基宣言》程序，为非人类研究项目。PubMed检索使用“泪液胰蛋白酶”的t-IgE研究得到5项研究(N)， 108名受试者(N)包含t-胰蛋白酶的测量，通过VKC （N = 75）和SAC/PAC （N = 33）分层。共纳入50名非特应性对照受试者。结合症状史（N=5）、体格检查（N=3）、皮肤点刺试验阳性和/或血清IgE （N=3）确认眼部过敏。根据样本量加权计算合并均值和方差，公式为Σni x meani /Σni和Σ（ni - 1） x variancei /（Σni - N）。结果VKC患者的t-tryptase基线值为67.8±22.9 ng/ml， SAC/PAC患者为26.0±0.1 ng/ml，对照组为12.3±3.2 ng/ml。较高的t-胰蛋白酶水平与临床症状分级的更严重的VKC疾病相关。结论与SAC/PAC患者和对照组相比，VKC患者泪液胰蛋白酶水平较高，可用于诊断目的。t-胰蛋白酶水平越高，VKC疾病的严重程度越高。

{"title":"DIAGNOSTIC VALUE OF TEAR TRYPTASE (T-TRYPTASE) IN OCULAR SURFACE DISORDERS (OSD): ALLERGIC CONJUNCTIVITIS PATIENTS","authors":"B. Hsieh , S. Alnsour , L. Bielory","doi":"10.1016/j.anai.2025.08.092","DOIUrl":"10.1016/j.anai.2025.08.092","url":null,"abstract":"<div><h3>Introduction</h3><div>Climate change is associated with increased OSD, including ocular allergies. Ocular surface immunological diagnostics have become increasingly relevant in understanding and managing OSD. The diagnostic value of t-tryptase in seasonal (SAC)/perennial (PAC) and vernal (VKC) allergic conjunctivitis are not well understood.</div></div><div><h3>Methods</h3><div>Procedures followed were in accordance with the Helsinki Declaration as revised in 2013 and is a non-human research project. PubMed search for t-IgE studies using \"tear tryptase\" yielded 5 studies(N) with 108 subjects(n) containing measurements of t-tryptase, stratified by VKC (n = 75) and SAC/PAC (n = 33). A total of 50 non-atopic control subjects were also included. Ocular allergies were confirmed through a combination of symptom history (N=5), physical exam (N=3), positive skin prick testing and/or serum IgE (N=3). Pooled means and variance were calculated according to sample size weighting with the formulas Σn<sub>i</sub> x mean<sub>i</sub> /Σn<sub>i</sub> and Σ(n<sub>i</sub> - 1) x variance<sub>i</sub> /(Σn<sub>i</sub> - N).</div></div><div><h3>Results</h3><div>Baseline t-tryptase for VKC patients was significantly higher at 67.8 ± 22.9 ng/ml, compared to 26.0 ± 0.1 ng/ml for SAC/PAC patients, and 12.3 ± 3.2 ng/ml for controls. Higher t-tryptase levels were associated with more severe VKC disease graded by clinical symptoms.</div></div><div><h3>Conclusion</h3><div>Tear tryptase can be leveraged for diagnostic purposes with high levels found in patients with VKC, compared to SAC/PAC patients and controls. Higher levels of t-tryptase may correspond to greater VKC disease severity.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"135 5","pages":"Pages S26-S27"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145442410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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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