Journal of Allergy and Clinical Immunology-In Practice最新文献

英文中文

The Effect of Climate Change on Allergen and Irritant Exposure

IF 8.2 1区医学 Q1 ALLERGY

Journal of Allergy and Clinical Immunology-In Practice

Pub Date : 2025-02-01 DOI: 10.1016/j.jaip.2025.01.002

引用次数: 0

Empiric elimination diets for eosinophilic esophagitis: Barriers, facilitators, and impact on quality of life 嗜酸性粒细胞食管炎的经验性消除饮食：障碍、促进因素以及对生活质量的影响。

IF 8.2 1区医学 Q1 ALLERGY

Journal of Allergy and Clinical Immunology-In Practice

Pub Date : 2025-02-01 DOI: 10.1016/j.jaip.2024.10.030

Pooja Mehta MD, MSCS , Zhaoxing Pan PhD , Glenn T. Furuta MD , Kara Kliewer RD, PhD

引用次数: 0

Early Treatment Response to Mepolizumab Predicts Clinical Remission in Severe Eosinophilic Asthma 对美泊利单抗的早期治疗反应可预测严重嗜酸性粒细胞性哮喘的临床缓解。

IF 8.2 1区医学 Q1 ALLERGY

Journal of Allergy and Clinical Immunology-In Practice

Pub Date : 2025-02-01 DOI: 10.1016/j.jaip.2024.10.041

Yuto Hamada MD, PhD , Peter G. Gibson FRACP, DMed , Erin S. Harvey PhD , Sean Stevens MBiostat , Hayley Lewthwaite PhD , Michael Fricker PhD , Vanessa M. McDonald PhD , Andrew Gillman FRACP , Mark Hew FRACP, PhD , Vicky Kritikos PhD , John W. Upham MBBS, FRACP, PhD , Dennis Thomas PhD

Background

Mepolizumab can induce an early response and clinical remission in people with severe eosinophilic asthma (SEA).

Objective

To find whether early response to mepolizumab (100 mg) could predict future asthma remission and to identify the best predictor of treatment response to mepolizumab for achieving remission.

Methods

The Australian Mepolizumab Registry was used to investigate the early response to mepolizumab at 3 and 6 months and relate this to clinical remission at 12 months. Treatment response was assessed using the 5-item Asthma Control Questionnaire (ACQ-5), oral corticosteroid (OCS) dose, exacerbation frequency, and postbronchodilator FEV₁. Clinical remission, assessed at 12 months, was defined as an ACQ-5 score less than or equal to 1.0 at 12 months, no exacerbations in the previous 6 months, and no OCS use for asthma in the previous 6 months. We estimated the optimism-corrected area under the curve for internal validation.

Results

We analyzed 255 participants with SEA. Seventy-eight (30.6%) participants achieved clinical remission at 12 months. A prediction model including ACQ-5 score, exacerbation frequency, OCS dose, and postbronchodilator FEV₁ at 6 months was more predictive of achieving remission than measures at 3 months. The ACQ-5 score at 6 months had the highest optimism-corrected area under the curve of 0.778 (95% CI, 0.719-0.833). An ACQ-5 score less than 1.5 at 6 months had a sensitivity of 85.9% for achieving clinical remission, whereas an ACQ-5 score less than 0.75 had a specificity of 84.7%.

Conclusions

The ACQ-5 score at 6 months was the best predictor of achieving clinical remission at 12 months in people with SEA treated with mepolizumab. These results can be used to design a treat-to-target paradigm for asthma, in which treatment response is assessed at 6 months to predict clinical remission.

背景：美博利珠单抗可诱导严重嗜酸性粒细胞性哮喘（SEA）患者出现早期反应和临床缓解：美泊利珠单抗可诱导严重嗜酸性粒细胞性哮喘（SEA）患者产生早期反应并获得临床缓解：我们质疑对美泊珠单抗的早期反应能否预测未来的哮喘缓解，并试图确定美泊珠单抗治疗反应的最佳预测指标，以实现缓解：方法：利用澳大利亚美泊利珠单抗登记处调查3个月和6个月时对美泊利珠单抗的早期反应，并将其与12个月时的临床缓解联系起来。治疗反应通过哮喘控制问卷（ACQ）-5、口服皮质类固醇（OCS）剂量、恶化频率和支气管扩张剂后 FEV1 进行评估。临床缓解在 12 个月时进行评估，其定义为 12 个月时 ACQ-5 ≤1.0、前 6 个月无加重、前 6 个月未因哮喘使用过 OCS。我们估算了用于内部验证的乐观校正曲线下面积（AUC）：我们对 255 名 SEA 患者进行了分析。78名患者（30.6%）在12个月后获得了临床缓解。一个包括 ACQ-5 评分、加重频率、OCS 剂量和 6 个月时支气管扩张剂后 FEV1 的预测模型比 3 个月时的指标更能预测病情是否得到缓解。6 个月时的 ACQ-5 评分具有最高的乐观校正 AUC，为 0.778 [95% CI：0.719-0.833]。ACQ-5 评分结论：6个月时的ACQ-5评分是预测使用美泊利珠单抗治疗的SEA患者在12个月时达到临床缓解的最佳指标。这些结果可用于设计哮喘的 "靶向治疗 "范例，即在6个月时评估治疗反应以预测临床缓解。

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引用次数: 0

Sirolimus as a possible treatment in cleavage-resistant RIPK1-induced autoinflammatory syndrome 西罗莫司可用于治疗抗裂解 RIPK1 诱导的自身炎症（CRIA）综合征。

IF 8.2 1区医学 Q1 ALLERGY

Journal of Allergy and Clinical Immunology-In Practice

Pub Date : 2025-02-01 DOI: 10.1016/j.jaip.2024.11.003

Marco Cattalini MD , Manuela Cortesi MD , Manuela Baronio PhD , Antonella Insalaco MD , Fabrizio de Benedetti MD , Vassilios Lougaris Prof , Raffaele Badolato Prof

引用次数: 0

Real-World Effectiveness of Lanadelumab in Hereditary Angioedema: Multicountry INTEGRATED Observational Study 拉那珠单抗对遗传性血管性水肿的实际疗效：多国 INTEGRATED 观察性研究。

IF 8.2 1区医学 Q1 ALLERGY

Journal of Allergy and Clinical Immunology-In Practice

Pub Date : 2025-02-01 DOI: 10.1016/j.jaip.2024.12.008

Markus Magerl MD , Laurence Bouillet MD, PhD , Inmaculada Martinez-Saguer PhD, MD , Francois Gavini MSc , Nawal Bent-Ennakhil MSc , Laura Sayegh MSc , Irmgard Andresen MD

Background

Hereditary angioedema (HAE) is a rare genetic disease characterized by recurrent episodes of cutaneous or subcutaneous edema. There is clinical need for treatments that reduce the rate of HAE attacks in patients.

Objectives

Primary objectives were to evaluate the effectiveness of lanadelumab on attack-free rate (AFR; proportion of patients who had zero HAE attacks), and of every 2-week and every 4-week adjustments on AFR.

Methods

A retrospective medical chart review study was conducted in 19 HAE centers and included data from patients with type I or II HAE treated with lanadelumab (index treatment) in Germany, France, Greece, and Austria who were aged 12 years or older (ClinicalTrials.gov identifier: NCT04861090). Data abstraction occurred September 15, 2021, to June 29, 2022. Analyses were primarily descriptive.

Results

Data from 198 patients were collected (61.6% female, 91.9% with type I HAE). Lanadelumab treatment patterns varied between countries. Cumulative AFR improved from 0% (preindex) to 54.4% (12 months postindex) and 39.4% (postindex; median duration, 28.8 months). Monthly AFRs varied from 16.2% to 28.3% preindex (17.7% AFR in the month before index date), and from 82.7% (month 1) to more than 95% at multiple time points between 26 and 43 months postindex. Patients with interval increases (n = 144 [72.7%]) showed improved cumulative AFR (0% preindex to 50.0% postindex).

Conclusions

This real-world study demonstrates that lanadelumab long-term prophylaxis is effective in improving AFR in patients with type I/II HAE on every 2-week dosing and dose interval increases. Effectiveness with lanadelumab is rapid and was observed starting from the first month of starting therapy.

背景：遗传性血管性水肿（HAE）是一种罕见的遗传性疾病，以反复发作的皮肤或皮下水肿为特征。临床需要降低患者HAE发作率的治疗方法。目的：主要目的是评估lanadelumab对无发作率（AFR）的有效性；无HAE发作的患者比例)，每两周（Q2W）和每四周（Q4W）调整AFR。方法：在19个HAE中心进行了一项回顾性医学图表回顾研究，纳入了来自德国、法国、希腊和奥地利年龄≥12岁的接受lanadelumab（指数治疗）治疗的I型或II型HAE患者的数据。数据抽取发生在2021年9月15日至2022年6月29日。分析主要是描述性的。结果：收集了198例患者的数据（61.6%为女性，91.9%为I型HAE）。Lanadelumab的治疗模式因国家而异。累计AFR从0%（指数前）提高到54.4%（指数后12个月）和39.4%（指数后）；中位持续时间28.8个月)。月度AFR从指数前的16.2%到28.3%（指数前一个月为17.7%），在指数后26至43个月的多个时间点上，AFR从82.7%（第一个月）到bb0.95%不等。时间间隔增加的患者（n=144, 72.7%）的累积AFR改善（指数前为0%，指数后为50.0%）。结论：这项现实世界的研究表明，lanadelumab LTP在Q2W和剂量间隔增加时可有效改善HAE I/II型患者的AFR。lanadelumab的疗效迅速，从开始治疗的第一个月开始观察。

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引用次数: 0

Mold Remediation in Homes After Flooding 洪水后房屋的霉菌修复。

IF 8.2 1区医学 Q1 ALLERGY

Journal of Allergy and Clinical Immunology-In Practice

Pub Date : 2025-02-01 DOI: 10.1016/j.jaip.2024.12.018

Amber Hardeman MD, MPH, MBA , Erin C. Lindgren , John C. Carlson MD, PhD

引用次数: 0

Emergency visits for childhood asthma exacerbations are linked to socioeconomic factors 儿童哮喘加重的急诊就诊与社会经济因素有关。

IF 8.2 1区医学 Q1 ALLERGY

Journal of Allergy and Clinical Immunology-In Practice

Pub Date : 2025-02-01 DOI: 10.1016/j.jaip.2024.10.028

Bruno Mahut MD , Jeanne Pergeline MD , Plamen Bokov MD, PhD , Nicole Beydon MD , Aurélie Bourmaud MD, PhD , Christophe Delclaux MD, PhD

引用次数: 0

Demographics, Types of Patient-Reported Allergic Diseases, and Anaphylaxis in Mastocytosis: A Single-Center US Experience 肥大细胞增多症患者的人口统计学特征、患者报告的过敏性疾病类型和过敏性休克：美国单中心经验。

IF 8.2 1区医学 Q1 ALLERGY

Journal of Allergy and Clinical Immunology-In Practice

Pub Date : 2025-02-01 DOI: 10.1016/j.jaip.2024.10.039

Rayan N. Kaakati MD , Dilawar Khokhar MD , Cem Akin MD, PhD

Background

Patients with mastocytosis are at increased risk of anaphylaxis. Idiopathic anaphylaxis and venom-induced allergy are commonly reported in mastocytosis; however, the incidence of other allergies has been less well studied.

Objective

To characterize the true prevalence of allergic disease including food, venom, contrast, and drug allergy compared with the number of patients who simply avoid potential triggers. We also gathered demographic information.

Methods

We performed a retrospective study of 259 consecutive pediatric and adult patients with a confirmed diagnosis of either cutaneous or systemic mastocytosis who received care through the University of Michigan Health system from January 1, 2018, to March 17, 2021.

Results

Mastocytosis was more prevalent in non-Hispanic white population. As compared with the general population, patients had similar rates of atopy and allergies with a slight increase in reported asthma prevalence. The overall prevalence of anaphylaxis was 28%, and the great majority occurred in systemic mastocytosis, with the most common trigger being hymenoptera venoms. Most patients reported drug allergies preemptively to avoid exposure, particularly to nonsteroidal anti-inflammatory drugs. We also saw an increase in contrast-induced anaphylaxis compared with previous literature, and a lower prevalence of venom allergy as compared with European cohorts.

Conclusions

Our study characterizes the rate of common atopic conditions as well as allergies in a large cohort of patients with mastocytosis in the United States. Anaphylaxis in cutaneous mastocytosis is rare. Hymenoptera venoms were the most common trigger for anaphylaxis, whereas drug allergies were overreported preemptively to avoid potential exposures due to concern for having a reaction.

背景：肥大细胞增多症患者发生过敏性休克的风险增加。特发性过敏性休克和毒液引起的过敏是肥大细胞增多症的常见病，但对其他过敏的发病率研究较少：我们试图确定过敏性疾病（包括食物、毒液、对比剂和药物过敏）的真实发病率，并与单纯避免潜在诱发因素的患者人数进行比较。我们还收集了人口统计学信息：我们对 2018 年 1 月 1 日至 2021 年 3 月 17 日期间在密歇根大学医疗系统接受治疗的 259 名确诊为皮肤或全身性肥大细胞增多症的连续儿童和成人患者进行了回顾性研究：肥大细胞增多症在非西班牙裔白人中更为常见。与普通人群相比，患者的特应性和过敏症发病率相似，但报告的哮喘发病率略有增加。过敏性休克的总发病率为 28%，绝大多数发生在 SM 患者身上，最常见的诱发因素是膜翅目昆虫毒液。大多数患者为了避免接触药物，特别是非甾体抗炎药，会先期报告药物过敏。与之前的文献相比，我们还发现造影剂诱发的过敏性休克有所增加，而与欧洲队列相比，毒物过敏的发生率较低：我们的研究描述了美国一大批肥大细胞增多症患者中常见特应性疾病和过敏症的发病率。过敏性休克在乳腺增生症患者中很少见。膜翅目昆虫毒液是最常见的过敏性休克诱因，而药物过敏则是由于担心发生反应而先期报告过多，以避免潜在的接触。

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引用次数: 0

The Effect of Wildfires on Asthma and Allergies 野火对哮喘和过敏的影响。

IF 8.2 1区医学 Q1 ALLERGY

Journal of Allergy and Clinical Immunology-In Practice

Pub Date : 2025-02-01 DOI: 10.1016/j.jaip.2024.12.004

John R. Balmes MD , Anne Hicks MD, MSc, PhD , Mary M. Johnson MD, PhD , Kari C. Nadeau MD

Climate change is a major driver of the frequency and severity of wildfires caused by extended periods of drought and hotter, drier weather superimposed on the legacy of fire suppression in the Mountain West of the United States. In recent years, increased wildfire smoke has negated the improvements in air quality made by clean energy transitions. Wildfire smoke is a complex mixture of gases and solids, a chief constituent of which is fine particulate matter (PM_2.5). Exposure to PM_2.5 is associated with adverse respiratory outcomes, including exacerbations of asthma and chronic obstructive pulmonary disease. In the face of increasing wildfire smoke exposures, it is critical that adaptation and mitigation strategies be put in place to minimize health effects. Individual strategies include modifying behavior and creating clean air spaces in homes to avoid wildfire smoke exposure. Community strategies include regulations promoting fire-resistant buildings and landscaping; establishing wildfire monitoring and alert systems; providing safe clean spaces where individuals can minimize wildfire smoke exposure and find evacuation routes; and creating health care response teams. Mitigation to prevent wildfires includes forest management and establishing monitoring systems and protocols to control forest fires in the wildland urban interface before they increase in size and intensity. Research into understanding the mechanism by which wildfire smoke mediates adverse health effects can inform guidelines to mitigate its health effects further.

气候变化是野火发生频率和严重程度的主要驱动因素，因为长期干旱和炎热干燥的天气叠加了美国西部山区的灭火遗产。近年来，增加的野火烟雾正在抵消清洁能源转型所带来的空气质量改善。野火烟雾是气体和固体的复杂混合物，其主要成分是细颗粒物（PM2.5）。PM2.5暴露与不良呼吸结果相关，包括哮喘和慢性阻塞性肺疾病（COPD）的恶化。面对越来越多的野火烟雾，至关重要的是，必须制定适应和缓解战略，以尽量减少对健康的影响。个人策略包括改变行为和在家中创造清洁的空气空间，以避免野火烟雾。社区战略包括促进防火建筑和景观美化的法规，建立野火监测和警报系统，个人可以最大限度地减少野火烟雾暴露的安全清洁空间，疏散路线和卫生保健响应团队。预防野火的缓解措施包括森林管理和建立监测系统和协议，以便在森林火灾规模和强度增加之前控制荒地城市界面（WUI）的森林火灾。通过研究了解野火烟雾介导不良健康影响的机制，可以为进一步减轻其健康影响的指导方针提供信息。

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引用次数: 0

Climate Change and the Practice of Allergy and Immunology

IF 8.2 1区医学 Q1 ALLERGY

Journal of Allergy and Clinical Immunology-In Practice

Pub Date : 2025-02-01 DOI: 10.1016/j.jaip.2024.11.024

Jill A. Poole MD , Kari C. Nadeau MD, PhD

引用次数: 0

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