Pub Date : 2026-02-01DOI: 10.1016/j.jaip.2025.08.037
Priya Chopra MD , David Mark Fleischer MD , Carina Venter PhD, RD
{"title":"Beyond Desensitization: Oral Immunotherapy and Growth in Children With Food Allergies—Promise or Pitfall?","authors":"Priya Chopra MD , David Mark Fleischer MD , Carina Venter PhD, RD","doi":"10.1016/j.jaip.2025.08.037","DOIUrl":"10.1016/j.jaip.2025.08.037","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 2","pages":"Pages 402-403"},"PeriodicalIF":6.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146116356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.jaip.2025.12.030
David M. Lang MD , Allen P. Kaplan MD
{"title":"Chronic Urticaria: The Long and Winding Road","authors":"David M. Lang MD , Allen P. Kaplan MD","doi":"10.1016/j.jaip.2025.12.030","DOIUrl":"10.1016/j.jaip.2025.12.030","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 2","pages":"Pages 503-504"},"PeriodicalIF":6.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146116416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.jaip.2025.12.010
Nada Ayoub MD , Joe Zein MD, PhD
{"title":"Reply to “Menopause and Asthma Unlinked? It’s More Complicated”","authors":"Nada Ayoub MD , Joe Zein MD, PhD","doi":"10.1016/j.jaip.2025.12.010","DOIUrl":"10.1016/j.jaip.2025.12.010","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 2","pages":"Pages 536-537"},"PeriodicalIF":6.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146116418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/S2213-2198(26)00009-7
{"title":"Original Article Highlights From This Issue","authors":"","doi":"10.1016/S2213-2198(26)00009-7","DOIUrl":"10.1016/S2213-2198(26)00009-7","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 2","pages":"Pages A9-A11"},"PeriodicalIF":6.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146116778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.jaip.2025.11.039
Paula J. Busse MD , Jie Shen Fok MD , Sohini Shah Kamdar MD , Hilary J. Longhurst FRACP, PhD , Marc A. Riedl MD, MS
Hereditary angioedema (HAE) with C1-inhibitor deficiency is a rare condition presenting with episodes of swelling without urticaria. Historically, acute and prophylactic HAE treatment options were limited and associated with considerable side effects, high burden of treatment, and unreliable symptom relief. Over the past decade, newer targeted therapies have been investigated and approved for both acute therapy and long-term prophylaxis. These therapies have dramatically reduced morbidity and mortality of HAE and consequently improved the quality of life of patients. This review article will outline the current and potential future treatments for HAE.
{"title":"Updates on the Current and Evolving Treatment for Hereditary Angioedema","authors":"Paula J. Busse MD , Jie Shen Fok MD , Sohini Shah Kamdar MD , Hilary J. Longhurst FRACP, PhD , Marc A. Riedl MD, MS","doi":"10.1016/j.jaip.2025.11.039","DOIUrl":"10.1016/j.jaip.2025.11.039","url":null,"abstract":"<div><div>Hereditary angioedema (HAE) with C1-inhibitor deficiency is a rare condition presenting with episodes of swelling without urticaria. Historically, acute and prophylactic HAE treatment options were limited and associated with considerable side effects, high burden of treatment, and unreliable symptom relief. Over the past decade, newer targeted therapies have been investigated and approved for both acute therapy and long-term prophylaxis. These therapies have dramatically reduced morbidity and mortality of HAE and consequently improved the quality of life of patients. This review article will outline the current and potential future treatments for HAE.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 2","pages":"Pages 375-383"},"PeriodicalIF":6.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146116787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.jaip.2025.12.004
Philip H. Li MBBS, MD , Feng Xu MS , Weihong Shi MMed , Thomas S.H. Chik MBChB , Man Yee Chu MBBS , Timothy C.M. Li MBChB , Jin-Xian Huang MD, PhD , Andy K.C. Kan MBBS , Ning Liu MD , Xiangling Zhang MD , Juan Meng MD, PhD
Background
Penicillin allergy is frequently mislabeled, leading to the unnecessary use of second-line antibiotics and contributing to antimicrobial resistance. Preemptive penicillin skin tests (PST) remain mandatory in mainland China and is associated with high false-positive rates. In contrast, Hong Kong follows evidence-based, standardized allergy assessment protocols under the Hong Kong Drug Allergy Delabelling Initiative (HK-DADI).
Objective
To evaluate longitudinal outcomes of protocol-based penicillin delabeling in real-world clinical practice across mainland China and Hong Kong.
Methods
This prospective, multiregional study included 514 patients (206 from mainland China and 308 from Hong Kong) who underwent allergy evaluation between September 2023 and January 2025. All centers followed the HK-DADI protocol, including structured history-taking, skin testing, and drug provocation testing. Longitudinal outcomes included delabeling rates, penicillin reuse, and health-related quality of life.
Results
The overall delabeling rate was 90.3%, with significantly higher rates among patients previously labeled owing to preemptive PSTs. Among this subgroup, 98.2% had negative skin tests and 99.4% had subsequent negative drug provocation testing. One-quarter of delabeled patients reused penicillin within 6 months (without allergic reactions), with fourfold higher rates in mainland China (45.5% vs 12.0%; P < .001). Sustained health-related quality of life improvements were observed at 12 months, particularly among those previously mislabeled by PSTs.
Conclusions
This study demonstrates the effectiveness of HK-DADI in correcting widespread mislabeling in China and highlights the potential for implementing protocol-based delabeling initiatives across diverse regions. The high rate of mislabeling underscores the urgent need for reform of PST practices and supports global efforts to combat antimicrobial resistance with protocol-based delabeling initiatives.
{"title":"Prospective Multiregional Evaluation of Protocol-Based Penicillin Allergy Delabeling in China: Real-World Outcomes Challenge Mandatory Preemptive Skin Testing Policies","authors":"Philip H. Li MBBS, MD , Feng Xu MS , Weihong Shi MMed , Thomas S.H. Chik MBChB , Man Yee Chu MBBS , Timothy C.M. Li MBChB , Jin-Xian Huang MD, PhD , Andy K.C. Kan MBBS , Ning Liu MD , Xiangling Zhang MD , Juan Meng MD, PhD","doi":"10.1016/j.jaip.2025.12.004","DOIUrl":"10.1016/j.jaip.2025.12.004","url":null,"abstract":"<div><h3>Background</h3><div>Penicillin allergy is frequently mislabeled, leading to the unnecessary use of second-line antibiotics and contributing to antimicrobial resistance. Preemptive penicillin skin tests (PST) remain mandatory in mainland China and is associated with high false-positive rates. In contrast, Hong Kong follows evidence-based, standardized allergy assessment protocols under the Hong Kong Drug Allergy Delabelling Initiative (HK-DADI).</div></div><div><h3>Objective</h3><div>To evaluate longitudinal outcomes of protocol-based penicillin delabeling in real-world clinical practice across mainland China and Hong Kong.</div></div><div><h3>Methods</h3><div>This prospective, multiregional study included 514 patients (206 from mainland China and 308 from Hong Kong) who underwent allergy evaluation between September 2023 and January 2025. All centers followed the HK-DADI protocol, including structured history-taking, skin testing, and drug provocation testing. Longitudinal outcomes included delabeling rates, penicillin reuse, and health-related quality of life.</div></div><div><h3>Results</h3><div>The overall delabeling rate was 90.3%, with significantly higher rates among patients previously labeled owing to preemptive PSTs. Among this subgroup, 98.2% had negative skin tests and 99.4% had subsequent negative drug provocation testing. One-quarter of delabeled patients reused penicillin within 6 months (without allergic reactions), with fourfold higher rates in mainland China (45.5% vs 12.0%; <em>P</em> < .001). Sustained health-related quality of life improvements were observed at 12 months, particularly among those previously mislabeled by PSTs.</div></div><div><h3>Conclusions</h3><div>This study demonstrates the effectiveness of HK-DADI in correcting widespread mislabeling in China and highlights the potential for implementing protocol-based delabeling initiatives across diverse regions. The high rate of mislabeling underscores the urgent need for reform of PST practices and supports global efforts to combat antimicrobial resistance with protocol-based delabeling initiatives.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 2","pages":"Pages 445-452.e3"},"PeriodicalIF":6.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145758511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/S2213-2198(26)00012-7
{"title":"Information for Readers","authors":"","doi":"10.1016/S2213-2198(26)00012-7","DOIUrl":"10.1016/S2213-2198(26)00012-7","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 2","pages":"Page A14"},"PeriodicalIF":6.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146116359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/S2213-2198(26)00014-0
{"title":"Continuing Medical Education Calendar","authors":"","doi":"10.1016/S2213-2198(26)00014-0","DOIUrl":"10.1016/S2213-2198(26)00014-0","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 2","pages":"Pages A19-A20"},"PeriodicalIF":6.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146116780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.jaip.2025.11.038
Florence Ida Hsu MD , Jonathan A. Bernstein MD , Krishan D. Chhiba MD, PhD , Sarbjit S. Saini MD
Chronic urticaria, which is divided into chronic spontaneous urticaria (CSU) and chronic inducible urticaria (CIndU), affects a significant percentage of the global population and carries a high burden of unmet medical need. Current standard of care includes nonsedating H1-antihistamines and omalizumab, which targets peripheral blood IgE and downregulates mast cell and basophil IgE receptors. However, omalizumab provides complete hive resolution in approximately 45% of patients and does not produce lasting remission. This review examines the clinical data for newly approved and emerging systemic therapies spanning IgE-based and non–IgE-based targeting strategies. The therapeutic landscape has expanded rapidly, and multiple mechanisms are under investigation. IgE-targeted approaches include omalizumab biosimilars, with CT-P39 having received Food and Drug Administration (FDA) approval. Dupilumab received FDA approval for H1-antihistamine-refractory CSU, supporting targeting type 2 cytokines, IL-4 and IL-13. Most recently, a Bruton’s tyrosine kinase inhibitor (BTKi), remibrutinib, demonstrated significant reductions in Urticaria Activity Score over 7 days in phase 3 trials, leading to FDA approval. Newer c-Kit (cKit or KIT) inhibitors have also shown efficacy in CSU and CIndU, with barzolvolimab showing sustained efficacy post-treatment. Finally, other BTKi, Janus kinase (JAK) inhibitors, tyrosine kinase 2/JAK inhibitors, MRGPRX2 antagonists, and other novel mechanisms are advancing through clinical trials. Some drugs have been halted in development because of safety concerns, such as fenebrutinib (BTKi), THB001 (Larvol; c-Kit inhibitor), and EP262 (MRGPRX2 antagonist), whereas others, targeting the alarmin thymic stromal lymphopoietin (tezepelumab), the Th2 cytokine IL-5 (mepolizumab) and its receptor IL-5R (benralizumab), as well as lirentelimab (sialic acid–binding immunoglobulin-like lectin 8 [Siglec-8]) and AK006 (Siglec-6), were halted because of lack of efficacy. However, these failed trials have provided informed insights into the relevant pathways for CSU pathogenesis and treatment. In summary, systemic therapies for CSU are maturing with multiple phase 3 programs targeting the IgE pathway and Th2 cytokines leading to recent approvals. This review will provide an overview of these recently completed and ongoing clinical studies investigating emerging IgE and non-IgE therapeutic options for CSU.
{"title":"Systemic Treatments for Chronic Spontaneous Urticaria: Anti-IgE and Beyond","authors":"Florence Ida Hsu MD , Jonathan A. Bernstein MD , Krishan D. Chhiba MD, PhD , Sarbjit S. Saini MD","doi":"10.1016/j.jaip.2025.11.038","DOIUrl":"10.1016/j.jaip.2025.11.038","url":null,"abstract":"<div><div>Chronic urticaria, which is divided into chronic spontaneous urticaria (CSU) and chronic inducible urticaria (CIndU), affects a significant percentage of the global population and carries a high burden of unmet medical need. Current standard of care includes nonsedating H1-antihistamines and omalizumab, which targets peripheral blood IgE and downregulates mast cell and basophil IgE receptors. However, omalizumab provides complete hive resolution in approximately 45% of patients and does not produce lasting remission. This review examines the clinical data for newly approved and emerging systemic therapies spanning IgE-based and non–IgE-based targeting strategies. The therapeutic landscape has expanded rapidly, and multiple mechanisms are under investigation. IgE-targeted approaches include omalizumab biosimilars, with CT-P39 having received Food and Drug Administration (FDA) approval. Dupilumab received FDA approval for H1-antihistamine-refractory CSU, supporting targeting type 2 cytokines, IL-4 and IL-13. Most recently, a Bruton’s tyrosine kinase inhibitor (BTKi), remibrutinib, demonstrated significant reductions in Urticaria Activity Score over 7 days in phase 3 trials, leading to FDA approval. Newer c-Kit (cKit or KIT) inhibitors have also shown efficacy in CSU and CIndU, with barzolvolimab showing sustained efficacy post-treatment. Finally, other BTKi, Janus kinase (JAK) inhibitors, tyrosine kinase 2/JAK inhibitors, MRGPRX2 antagonists, and other novel mechanisms are advancing through clinical trials. Some drugs have been halted in development because of safety concerns, such as fenebrutinib (BTKi), THB001 (Larvol; c-Kit inhibitor), and EP262 (MRGPRX2 antagonist), whereas others, targeting the alarmin thymic stromal lymphopoietin (tezepelumab), the Th2 cytokine IL-5 (mepolizumab) and its receptor IL-5R (benralizumab), as well as lirentelimab (sialic acid–binding immunoglobulin-like lectin 8 [Siglec-8]) and AK006 (Siglec-6), were halted because of lack of efficacy. However, these failed trials have provided informed insights into the relevant pathways for CSU pathogenesis and treatment. In summary, systemic therapies for CSU are maturing with multiple phase 3 programs targeting the IgE pathway and Th2 cytokines leading to recent approvals. This review will provide an overview of these recently completed and ongoing clinical studies investigating emerging IgE and non-IgE therapeutic options for CSU.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 2","pages":"Pages 361-372"},"PeriodicalIF":6.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146116337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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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