Pub Date : 2024-11-01Epub Date: 2024-08-08DOI: 10.1016/j.jaip.2024.08.010
Jorge F Maspero, Alessandro G Fiocchi, Antoine Deschildre, Leonard B Bacharier, Arman Altincatal, Elizabeth Laws, David J Lederer, Bolanle Akinlade, Megan Hardin
{"title":"Dupilumab improves pediatric type 2 asthma outcomes independent of patient baseline characteristics.","authors":"Jorge F Maspero, Alessandro G Fiocchi, Antoine Deschildre, Leonard B Bacharier, Arman Altincatal, Elizabeth Laws, David J Lederer, Bolanle Akinlade, Megan Hardin","doi":"10.1016/j.jaip.2024.08.010","DOIUrl":"10.1016/j.jaip.2024.08.010","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":null,"pages":null},"PeriodicalIF":8.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914564","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 : 2024-11-01Epub Date: 2024-08-20DOI: 10.1016/j.jaip.2024.08.023
Michaela Lucas, Britta S von Ungern-Sternberg, Annabelle Arnold, Michelle Trevenen, Susan Herrmann, Laure Braconnier, Syed Ali, Catherine Jepp, David Sommerfield, Kevin Murray, Kristina Rueter
Background: There is a scarcity of prospective studies investigating the relative roles of skin prick and intradermal testing, serum specific IgE, and extended oral challenges in diagnosing children with reported β-lactam allergies.
Objective: To determine the sensitivity and specificity of skin testing and serum specific IgE in children with β-lactam allergies, with immediate and nonimmediate historic reactions.
Methods: Four hundred children with parent-reported β-lactam allergies were recruited into an open-label prospective study. Detailed allergy histories were collected. Those with medically observed and documented histories of anaphylaxis, requiring epinephrine, or severe cutaneous adverse reactions were excluded. In total, 380 children underwent all testing modalities and a direct provocation test. Each child was followed up for a minimum of 3 years.
Results: True allergy in children was uncommon; 8.3% reacted to the direct provocation challenge or the 5-day extended oral provocation challenge. Children reporting cephalosporin allergy or a reaction within 1 year were more likely to react to direct provocation testing. The sensitivity, specificity, and positive predictive value of skin testing were 12.5%, 98.8%, and 20.0% for direct challenge outcomes, 4.76%, 99.0%, and 25.0% for extended challenge outcomes, and 6.9%, 99.0%, and 40.0% for both challenges combined, respectively. Follow-up investigations revealed that 5.7% of children had a mild repeat reaction and 2.7% continued to avoid the culprit despite successful delabeling. The relabeling rate for children readmitted to hospital was 15%, with the relabeing being unfounded.
Conclusions: Genuine β-lactam allergies were rare, with over 90% of children effectively delabeled. Skin and serum specific IgE testing did not aid the diagnosis of β-lactam antibiotic allergy in children, regardless of medical history. Extended oral challenges proved valuable in confirming allergies and boosted parental confidence.
背景:很少有前瞻性研究调查皮肤点刺和皮内试验、血清特异性免疫球蛋白 E 和扩展口服挑战在诊断报告的β-内酰胺过敏儿童中的相对作用:目的:确定皮肤测试和血清特异性免疫球蛋白 E 在β-内酰胺过敏儿童中的敏感性和特异性:一项开放标签的前瞻性研究招募了四百名由家长报告的β-内酰胺过敏儿童。研究人员收集了详细的过敏史资料。经医学观察并记录有过敏性休克病史、需要肾上腺素或 SCAR 的儿童被排除在外。共有 380 名儿童接受了所有测试方式和直接激发试验。每个儿童都接受了至少三年的随访:结果:儿童真正的过敏并不常见,8%-3% 的儿童对直接激发试验或 5 天延长口服激发试验有反应。对头孢菌素过敏或一年内出现过过敏反应的儿童更有可能对直接激发试验产生反应。皮试的敏感性、特异性和阳性预测值分别为:直接激发试验结果的 12-5%、98-8% 和 20-0%;延长激发试验结果的 4-76%、99-0% 和 25-0%;两种激发试验结果的 6-9%、99-0% 和 40-0%。后续调查显示,5%-7% 的儿童有轻微的重复反应,2%-7% 的儿童在成功脱标后仍继续回避罪魁祸首。再次入院治疗的儿童中,再次标签率为 15%,且再次标签没有依据:结论:真正的β-内酰胺过敏很少见,90% 以上的儿童能有效解除标签。无论病史如何,皮肤和血清特异性免疫球蛋白 E 测试都不能帮助诊断儿童对β-内酰胺类抗生素过敏。事实证明,扩展口服挑战对确认过敏和增强家长的信心很有价值。
{"title":"Comparing Skin and Serum Testing to Direct Challenge Outcomes in Children With β-Lactam Allergies.","authors":"Michaela Lucas, Britta S von Ungern-Sternberg, Annabelle Arnold, Michelle Trevenen, Susan Herrmann, Laure Braconnier, Syed Ali, Catherine Jepp, David Sommerfield, Kevin Murray, Kristina Rueter","doi":"10.1016/j.jaip.2024.08.023","DOIUrl":"10.1016/j.jaip.2024.08.023","url":null,"abstract":"<p><strong>Background: </strong>There is a scarcity of prospective studies investigating the relative roles of skin prick and intradermal testing, serum specific IgE, and extended oral challenges in diagnosing children with reported β-lactam allergies.</p><p><strong>Objective: </strong>To determine the sensitivity and specificity of skin testing and serum specific IgE in children with β-lactam allergies, with immediate and nonimmediate historic reactions.</p><p><strong>Methods: </strong>Four hundred children with parent-reported β-lactam allergies were recruited into an open-label prospective study. Detailed allergy histories were collected. Those with medically observed and documented histories of anaphylaxis, requiring epinephrine, or severe cutaneous adverse reactions were excluded. In total, 380 children underwent all testing modalities and a direct provocation test. Each child was followed up for a minimum of 3 years.</p><p><strong>Results: </strong>True allergy in children was uncommon; 8.3% reacted to the direct provocation challenge or the 5-day extended oral provocation challenge. Children reporting cephalosporin allergy or a reaction within 1 year were more likely to react to direct provocation testing. The sensitivity, specificity, and positive predictive value of skin testing were 12.5%, 98.8%, and 20.0% for direct challenge outcomes, 4.76%, 99.0%, and 25.0% for extended challenge outcomes, and 6.9%, 99.0%, and 40.0% for both challenges combined, respectively. Follow-up investigations revealed that 5.7% of children had a mild repeat reaction and 2.7% continued to avoid the culprit despite successful delabeling. The relabeling rate for children readmitted to hospital was 15%, with the relabeing being unfounded.</p><p><strong>Conclusions: </strong>Genuine β-lactam allergies were rare, with over 90% of children effectively delabeled. Skin and serum specific IgE testing did not aid the diagnosis of β-lactam antibiotic allergy in children, regardless of medical history. Extended oral challenges proved valuable in confirming allergies and boosted parental confidence.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":null,"pages":null},"PeriodicalIF":8.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037657","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 : 2024-11-01Epub Date: 2024-08-20DOI: 10.1016/j.jaip.2024.08.027
Donald Day Stevenson, Ronald Alan Simon
{"title":"History of Aspirin-Exacerbated Respiratory Disease: Discovery, Clinical Features, and Treatment.","authors":"Donald Day Stevenson, Ronald Alan Simon","doi":"10.1016/j.jaip.2024.08.027","DOIUrl":"10.1016/j.jaip.2024.08.027","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":null,"pages":null},"PeriodicalIF":8.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037658","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 : 2024-11-01Epub Date: 2024-08-05DOI: 10.1016/j.jaip.2024.07.027
So Lim Kim, Brian S Schwartz, Thanh-Huyen Vu, David B Conley, Leslie C Grammer, Amina Guo, Atsushi Kato, Robert C Kern, Michelle H Prickett, Robert P Schleimer, Stephanie Smith, Whitney W Stevens, Lydia Suh, Bruce K Tan, Kevin C Welch, Anju T Peters
Background: Studies have shown an association between chronic rhinosinusitis (CRS) and non-cystic fibrosis (CF) bronchiectasis.
Objective: We aimed to determine whether CRS increases the risk of developing non-CF bronchiectasis.
Methods: A retrospective analysis was conducted utilizing electronic medical records from an academic center. Patients with CRS without bronchiectasis, with at least 1 chest computed tomography (CT) scan performed after the diagnosis of CRS, were identified between January 2006 and December 2015. Charts were reviewed until May 2022. The control group was age-, sex-, and race-matched, and included patients without CRS, asthma, or chronic obstructive pulmonary disease (COPD) who had at least 1 chest CT scan. Bronchiectasis was identified by chest CT radiology reports. The odds of developing bronchiectasis were analyzed in patients with CRS without asthma or COPD (cohort 1) and patients with CRS with asthma or COPD (cohort 2).
Results: The odds of developing bronchiectasis were significantly higher in patients with CRS (139 of 1,594; 8.7%) than in patients in the control group (443 of 7,992; 5.5%; odds ratio OR 1.63; 95% confidence interval [95% CI] 1.34-1.99). Furthermore, the odds of developing bronchiectasis were higher in cohort 1 (63 of 863; 7.3%; OR 1.34; 05% CI 1.02-1.76) and cohort 2 (76/ of 731; 10.4%; OR 1.98; 95% CI 1.53-2.55) versus the control group. After adjusting for confounding diseases, the association was attenuated in cohort 1 (OR 1.22; 95% CI 0.92-1.61) but remained significant in cohort 2 (OR 1.78; 95% CI 1.37-2.31).
Conclusions: The CRS is associated with the future development of non-CF bronchiectasis. Patients with CRS, especially those with asthma or COPD, have a higher likelihood of developing bronchiectasis than patients without CRS.
{"title":"Associations Between Chronic Rhinosinusitis and the Development of Non-Cystic Fibrosis Bronchiectasis.","authors":"So Lim Kim, Brian S Schwartz, Thanh-Huyen Vu, David B Conley, Leslie C Grammer, Amina Guo, Atsushi Kato, Robert C Kern, Michelle H Prickett, Robert P Schleimer, Stephanie Smith, Whitney W Stevens, Lydia Suh, Bruce K Tan, Kevin C Welch, Anju T Peters","doi":"10.1016/j.jaip.2024.07.027","DOIUrl":"10.1016/j.jaip.2024.07.027","url":null,"abstract":"<p><strong>Background: </strong>Studies have shown an association between chronic rhinosinusitis (CRS) and non-cystic fibrosis (CF) bronchiectasis.</p><p><strong>Objective: </strong>We aimed to determine whether CRS increases the risk of developing non-CF bronchiectasis.</p><p><strong>Methods: </strong>A retrospective analysis was conducted utilizing electronic medical records from an academic center. Patients with CRS without bronchiectasis, with at least 1 chest computed tomography (CT) scan performed after the diagnosis of CRS, were identified between January 2006 and December 2015. Charts were reviewed until May 2022. The control group was age-, sex-, and race-matched, and included patients without CRS, asthma, or chronic obstructive pulmonary disease (COPD) who had at least 1 chest CT scan. Bronchiectasis was identified by chest CT radiology reports. The odds of developing bronchiectasis were analyzed in patients with CRS without asthma or COPD (cohort 1) and patients with CRS with asthma or COPD (cohort 2).</p><p><strong>Results: </strong>The odds of developing bronchiectasis were significantly higher in patients with CRS (139 of 1,594; 8.7%) than in patients in the control group (443 of 7,992; 5.5%; odds ratio OR 1.63; 95% confidence interval [95% CI] 1.34-1.99). Furthermore, the odds of developing bronchiectasis were higher in cohort 1 (63 of 863; 7.3%; OR 1.34; 05% CI 1.02-1.76) and cohort 2 (76/ of 731; 10.4%; OR 1.98; 95% CI 1.53-2.55) versus the control group. After adjusting for confounding diseases, the association was attenuated in cohort 1 (OR 1.22; 95% CI 0.92-1.61) but remained significant in cohort 2 (OR 1.78; 95% CI 1.37-2.31).</p><p><strong>Conclusions: </strong>The CRS is associated with the future development of non-CF bronchiectasis. Patients with CRS, especially those with asthma or COPD, have a higher likelihood of developing bronchiectasis than patients without CRS.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":null,"pages":null},"PeriodicalIF":8.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903523","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 : 2024-11-01Epub Date: 2024-08-08DOI: 10.1016/j.jaip.2024.08.009
Battoul Fakhry, Amy Attaway, Hyun Jo Kim, Zaid Yaqoob, Sadeer G Al-Kindi, Celine Chedraoui, Joelle Sleiman, Joe G Zein
{"title":"Polycystic ovary syndrome and the risk of asthma in reproductive-age women: Insights from 2 real-world large cohorts.","authors":"Battoul Fakhry, Amy Attaway, Hyun Jo Kim, Zaid Yaqoob, Sadeer G Al-Kindi, Celine Chedraoui, Joelle Sleiman, Joe G Zein","doi":"10.1016/j.jaip.2024.08.009","DOIUrl":"10.1016/j.jaip.2024.08.009","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":null,"pages":null},"PeriodicalIF":8.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914566","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 : 2024-11-01Epub Date: 2024-09-07DOI: 10.1016/j.jaip.2024.08.052
Anna De Benedetto, Mark Boguniewicz, Peck Y Ong, Derek K Chu, Lynda C Schneider
Atopic dermatitis is a common chronic inflammatory skin disorder, with a complex pathogenesis. It is characterized by eczematous skin lesions, pruritus, and recurrent skin infections and has a negative impact on patients' and caregivers' quality of life. The American Academy of Allergy, Asthma & Immunology/American College of Allergy, Asthma and Immunology Joint Task Force Atopic Dermatitis Guideline Panel recently released updated AD guidelines. This guideline focuses on addressing clinical questions using trustworthy guideline development standards, including mitigating the potential influence of financial and nonfinancial conflicts of interest, and Grading of Recommendations Assessment, Development, and Evaluation methodology. A multidisciplinary panel used systematic reviews and meta-analyses to inform specific recommendations addressing optimal use of topical treatments, dilute bleach bath, dietary avoidance/elimination, allergen immunotherapy, and systemic treatments. The comprehensive recommendations, emphasizing the third principle of evidence-based medicine-that evidence alone is never enough, and that patient values and preferences must be carefully considered when determining optimal treatments for patients and populations-provide a framework to support clinicians in selecting an optimal treatment plan for each patient. This review provides an overview of the guideline and discusses how those recommendations relate to current practice.
{"title":"Atopic Dermatitis (Eczema) Guidelines 2023: Highlights.","authors":"Anna De Benedetto, Mark Boguniewicz, Peck Y Ong, Derek K Chu, Lynda C Schneider","doi":"10.1016/j.jaip.2024.08.052","DOIUrl":"10.1016/j.jaip.2024.08.052","url":null,"abstract":"<p><p>Atopic dermatitis is a common chronic inflammatory skin disorder, with a complex pathogenesis. It is characterized by eczematous skin lesions, pruritus, and recurrent skin infections and has a negative impact on patients' and caregivers' quality of life. The American Academy of Allergy, Asthma & Immunology/American College of Allergy, Asthma and Immunology Joint Task Force Atopic Dermatitis Guideline Panel recently released updated AD guidelines. This guideline focuses on addressing clinical questions using trustworthy guideline development standards, including mitigating the potential influence of financial and nonfinancial conflicts of interest, and Grading of Recommendations Assessment, Development, and Evaluation methodology. A multidisciplinary panel used systematic reviews and meta-analyses to inform specific recommendations addressing optimal use of topical treatments, dilute bleach bath, dietary avoidance/elimination, allergen immunotherapy, and systemic treatments. The comprehensive recommendations, emphasizing the third principle of evidence-based medicine-that evidence alone is never enough, and that patient values and preferences must be carefully considered when determining optimal treatments for patients and populations-provide a framework to support clinicians in selecting an optimal treatment plan for each patient. This review provides an overview of the guideline and discusses how those recommendations relate to current practice.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":null,"pages":null},"PeriodicalIF":8.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300427","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 : 2024-11-01Epub Date: 2024-08-06DOI: 10.1016/j.jaip.2024.07.029
Elsa R Treffeisen, Claire Mepyans, Ellen R Conroy, Heather J Baer, David N Williams, Kathryn A Williams, Lynda C Schneider
Background: Sunflower seeds are a popular allergen-free peanut alternative.
Objective: To describe sunflower seed allergy incidence and characteristics.
Methods: We conducted a retrospective cohort study of patients with sunflower seed allergy from 1995 to 2021 in a pediatric allergy clinic. We described demographic characteristics, testing results, atopic comorbidities, and reaction histories of patients with sunflower seed allergy and calculated the annual cumulative incidence of the allergy. Logistic regression was used to estimate the increase in odds of sunflower seed allergy diagnosis for each year from 1995 to 2021.
Results: From 1995 to 2021, we identified 235 patients with sunflower seed allergy. Among patients with sunflower seed allergy, the median age at diagnosis was 3.9 years. More than three-quarters of patients had another atopic condition. Half of the reactions consisted of mild urticaria or rash, and a quarter met criteria for anaphylaxis. The cumulative incidence ranged from 0% (1995-1999, 2001-2004, and 2006) to 0.38% (2021). From 1995 to 2021, the odds of sunflower seed allergy diagnosis increased annually by 21% (odds ratio, 1.21; 95% CI, 1.17-1.25).
Conclusions: In our single-center cohort of children with sunflower seed allergy, most children were diagnosed in early childhood, had high rates of comorbid atopic conditions, and had high rates of cutaneous reactions to sunflower seed products. Moreover, in our cohort, incidence of sunflower seed allergy increased.
{"title":"Characterization and Incidence of Sunflower Seed Allergy in a Pediatric Allergy Clinic.","authors":"Elsa R Treffeisen, Claire Mepyans, Ellen R Conroy, Heather J Baer, David N Williams, Kathryn A Williams, Lynda C Schneider","doi":"10.1016/j.jaip.2024.07.029","DOIUrl":"10.1016/j.jaip.2024.07.029","url":null,"abstract":"<p><strong>Background: </strong>Sunflower seeds are a popular allergen-free peanut alternative.</p><p><strong>Objective: </strong>To describe sunflower seed allergy incidence and characteristics.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of patients with sunflower seed allergy from 1995 to 2021 in a pediatric allergy clinic. We described demographic characteristics, testing results, atopic comorbidities, and reaction histories of patients with sunflower seed allergy and calculated the annual cumulative incidence of the allergy. Logistic regression was used to estimate the increase in odds of sunflower seed allergy diagnosis for each year from 1995 to 2021.</p><p><strong>Results: </strong>From 1995 to 2021, we identified 235 patients with sunflower seed allergy. Among patients with sunflower seed allergy, the median age at diagnosis was 3.9 years. More than three-quarters of patients had another atopic condition. Half of the reactions consisted of mild urticaria or rash, and a quarter met criteria for anaphylaxis. The cumulative incidence ranged from 0% (1995-1999, 2001-2004, and 2006) to 0.38% (2021). From 1995 to 2021, the odds of sunflower seed allergy diagnosis increased annually by 21% (odds ratio, 1.21; 95% CI, 1.17-1.25).</p><p><strong>Conclusions: </strong>In our single-center cohort of children with sunflower seed allergy, most children were diagnosed in early childhood, had high rates of comorbid atopic conditions, and had high rates of cutaneous reactions to sunflower seed products. Moreover, in our cohort, incidence of sunflower seed allergy increased.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":null,"pages":null},"PeriodicalIF":8.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908262","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 : 2024-11-01Epub Date: 2024-08-14DOI: 10.1016/j.jaip.2024.08.016
Florence Schleich, Eléonore Maury, Claus Bachert, Mieke Jansen, Sandra Gurdain, Jan Van Schoor
{"title":"The Belgian IgE study: Staphylococcus aureus toxins in adult severe asthma.","authors":"Florence Schleich, Eléonore Maury, Claus Bachert, Mieke Jansen, Sandra Gurdain, Jan Van Schoor","doi":"10.1016/j.jaip.2024.08.016","DOIUrl":"10.1016/j.jaip.2024.08.016","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":null,"pages":null},"PeriodicalIF":8.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996923","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 : 2024-11-01Epub Date: 2024-08-24DOI: 10.1016/j.jaip.2024.08.031
Malina C Patel, Dan Costin, Beth McLellan, Sara DiFalco, Jessica Oh
{"title":"Transient Serpentine Supravenous Erythema During Rapid Drug Desensitization.","authors":"Malina C Patel, Dan Costin, Beth McLellan, Sara DiFalco, Jessica Oh","doi":"10.1016/j.jaip.2024.08.031","DOIUrl":"10.1016/j.jaip.2024.08.031","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":null,"pages":null},"PeriodicalIF":8.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074528","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 : 2024-11-01Epub Date: 2024-07-09DOI: 10.1016/j.jaip.2024.07.001
Victoria X Soriano, Katrina J Allen, Shyamali C Dharmage, Desalegn Markos Shifti, Kirsten P Perrett, Rushani Wijesuriya, Jennifer J Koplin, Rachel L Peters
Background: Infant feeding guidelines in Australia changed in 2016 to recommend introducing common allergy-causing foods by age 1 year to prevent food allergy. Although most Australian infants now eat peanut and egg by age 6 months, some still develop food allergy despite the early introduction of allergens.
Objectives: To describe the prevalence of food allergy in a cohort recruited after introducing the nationwide allergy prevention recommendations; identify characteristics of infants who developed allergy despite early introduction of allergens; and estimate the causal effect of modifiable exposures on food allergy prevalence and whether this differed between infants who were introduced to allergens before or after age 6 months.
Methods: We recruited a population-based sample of 12-month-old infants in Melbourne, Australia. Infants had skin prick tests to four foods and parents completed questionnaires. Infants with evidence of sensitization were offered oral food challenges. Prevalence estimates were adjusted using inverse probability weighting.
Results: In a cohort of infants (n = 1,420) in which nearly all infants had been introduced to common allergens such as egg, milk, and peanut by age 1 year, the prevalence of food allergy remained high at 11.3% (95% CI, 9.6-13.4). Infants who developed food allergy despite introduction of the allergen by age 6 months were more likely to have Asian-born parents. Early-onset moderate or severe eczema was associated with an increased odds of food allergy irrespective of whether allergens were introduced before or after age 6 months. Among infants who were introduced to peanut at age 6 months or earlier, antibiotic use by age 6 months was associated with an increased odds of peanut allergy (adjusted odds ratio = 6.03; 95% CI, 1.15-31.60).
Conclusions: In a cohort in which early allergen introduction was common, the prevalence of food allergy remained high. Infants who developed food allergy despite introduction of the respective allergen by age 6 months were more likely to have had Asian parents and early-onset eczema. New interventions are needed for infants with a phenotype of food allergy that is not amenable to early allergen introduction.
{"title":"Prevalence and Determinants of Food Allergy in the Era of Early Allergen Introduction: The EarlyNuts Population-Based Study.","authors":"Victoria X Soriano, Katrina J Allen, Shyamali C Dharmage, Desalegn Markos Shifti, Kirsten P Perrett, Rushani Wijesuriya, Jennifer J Koplin, Rachel L Peters","doi":"10.1016/j.jaip.2024.07.001","DOIUrl":"10.1016/j.jaip.2024.07.001","url":null,"abstract":"<p><strong>Background: </strong>Infant feeding guidelines in Australia changed in 2016 to recommend introducing common allergy-causing foods by age 1 year to prevent food allergy. Although most Australian infants now eat peanut and egg by age 6 months, some still develop food allergy despite the early introduction of allergens.</p><p><strong>Objectives: </strong>To describe the prevalence of food allergy in a cohort recruited after introducing the nationwide allergy prevention recommendations; identify characteristics of infants who developed allergy despite early introduction of allergens; and estimate the causal effect of modifiable exposures on food allergy prevalence and whether this differed between infants who were introduced to allergens before or after age 6 months.</p><p><strong>Methods: </strong>We recruited a population-based sample of 12-month-old infants in Melbourne, Australia. Infants had skin prick tests to four foods and parents completed questionnaires. Infants with evidence of sensitization were offered oral food challenges. Prevalence estimates were adjusted using inverse probability weighting.</p><p><strong>Results: </strong>In a cohort of infants (n = 1,420) in which nearly all infants had been introduced to common allergens such as egg, milk, and peanut by age 1 year, the prevalence of food allergy remained high at 11.3% (95% CI, 9.6-13.4). Infants who developed food allergy despite introduction of the allergen by age 6 months were more likely to have Asian-born parents. Early-onset moderate or severe eczema was associated with an increased odds of food allergy irrespective of whether allergens were introduced before or after age 6 months. Among infants who were introduced to peanut at age 6 months or earlier, antibiotic use by age 6 months was associated with an increased odds of peanut allergy (adjusted odds ratio = 6.03; 95% CI, 1.15-31.60).</p><p><strong>Conclusions: </strong>In a cohort in which early allergen introduction was common, the prevalence of food allergy remained high. Infants who developed food allergy despite introduction of the respective allergen by age 6 months were more likely to have had Asian parents and early-onset eczema. New interventions are needed for infants with a phenotype of food allergy that is not amenable to early allergen introduction.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":null,"pages":null},"PeriodicalIF":8.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592091","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}