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

{"title":"Seed allergy evaluation and outcomes in a pediatric food challenge center","authors":"Timothy M. Buckey MD, MBE , Alexandra Navard-Keck MD , Jasmyn Atalla MD , Layla Samandi MD , Gita Ram MD , Jonathan M. Spergel MD, PhD , Katie L. Kennedy MD","doi":"10.1016/j.jaip.2025.10.009","DOIUrl":"10.1016/j.jaip.2025.10.009","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 1","pages":"Pages 297-299"},"PeriodicalIF":6.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145369199","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}

{"title":"Treatable Traits of Hymenoptera Venom–Induced Anaphylaxis: A Real-Life–Based Study","authors":"Audrey Kamga MD ,&nbsp;Jean Luc Bourrain MD ,&nbsp;Pascal Demoly MD, PhD ,&nbsp;Luciana Kase Tanno MD, PhD","doi":"10.1016/j.jaip.2025.10.045","DOIUrl":"10.1016/j.jaip.2025.10.045","url":null,"abstract":"<div><h3>Background</h3><div>“Treatable traits” (TT) have been proposed as a new paradigm for asthma but never applied to anaphylaxis. Hymenoptera venom–induced anaphylaxis (HVA) is one of the leading causes of anaphylaxis worldwide.</div></div><div><h3>Objective</h3><div>Our aim was to propose TT for HVA based on evidence-based data.</div></div><div><h3>Methods</h3><div>This is a historic-prospective study based on the Hymenoptera venom–induced allergy and hypersensitivity database fed regularly by allergists at the Montpellier University hospital. Patients were classified as having “mild anaphylaxis” (MA), “moderate-severe anaphylaxis” (MSA), or “nonanaphylaxis” (NA), following Ring and Messmer Severity Score, and characteristics have been evaluated for each group. The potential risk factors have been classified as modifiable/controllable (MCRF) and nonmodifiable (NRF), and TT have been proposed from a preventive perspective.</div></div><div><h3>Results</h3><div>Of overall 602 patients, 54.2% were men, with a mean age of 42.3 years. A total of 218 patients (36.2%) developed MA, 159 (26.4%) MSA, and 213 (35.4%) NA. Age and atopic and cardiovascular diseases were identified as significant NRF. Symptoms appeared within 5 minutes (<em>P</em> &lt; .01) and less than 1 hour in MSA. Skin tests and <em>in vitro</em> ves v5 (<em>P</em> &lt; .0355) were significant and sensitive tools for the diagnosis. Occupational exposure (30%), along with the use of adrenaline, and venom immunotherapy were considered MCRF.</div></div><div><h3>Conclusions</h3><div>Our results brought the evidence to TT through HVA data and tailored adapted preventive strategies to all severity degrees of HVA. This article based on real-life data is a wake-up call for actions. Step forward implementation of actions among specialists and the general population should be put in place to reduce the morbimortality induced by HVA.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 1","pages":"Pages 260-273"},"PeriodicalIF":6.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524799","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}

{"title":"Information for Readers","authors":"","doi":"10.1016/S2213-2198(25)01167-5","DOIUrl":"10.1016/S2213-2198(25)01167-5","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 1","pages":"Page A18"},"PeriodicalIF":6.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145903904","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}

{"title":"Diagnosis and Management of Patients With Mast Cell Activation Syndromes: Status 2026","authors":"","doi":"10.1016/j.jaip.2025.12.017","DOIUrl":"10.1016/j.jaip.2025.12.017","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 1","pages":"Page 29"},"PeriodicalIF":6.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145903908","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}

{"title":"Longitudinal Associations Between Household Use of “Green” Cleaning Products and Asthma Symptoms","authors":"Emilie Pacheco Da Silva PhD ,&nbsp;Raphaëlle Varraso PhD ,&nbsp;Léopold K. Fezeu MD, PhD ,&nbsp;Pilar Galan MD, PhD ,&nbsp;Serge Hercberg MD, PhD ,&nbsp;Mathilde Touvier PhD ,&nbsp;Christophe Paris MD, PhD ,&nbsp;Nicole Le Moual PhD ,&nbsp;Orianne Dumas PhD","doi":"10.1016/j.jaip.2025.09.027","DOIUrl":"10.1016/j.jaip.2025.09.027","url":null,"abstract":"<div><h3>Background</h3><div>The household use of irritant and sprayed cleaning products is an established asthma risk factor, which could motivate consumers to turn to “green” products. However, only 2 cross-sectional studies, with inconsistent results, evaluated the potential respiratory health impacts of “green” products.</div></div><div><h3>Objective</h3><div>To investigate 2-years effects on asthma of household use of “green” products and irritants/sprays, using longitudinal data from the French NutriNet-Santé cohort.</div></div><div><h3>Methods</h3><div>The asthma symptom score and household use of “green” products and irritants/sprays were evaluated using standardized questionnaires in 2018 and 2020. The evolution of weekly use (persistent, increased <em>vs</em> no weekly use) was studied in association with (1) the asthma symptom score in 2020; (2) the incidence of asthma symptoms between 2018 and 2020 (incidence <em>vs</em> asymptomatic); and (3) the evolution of asthma symptoms between 2018 and 2020 (improvement, deterioration <em>vs</em> symptomatic stable) by logistic regressions. Models were adjusted for sex, age, smoking status, body mass index, educational level, and use of irritants/sprays (for “green” products).</div></div><div><h3>Results</h3><div>Our study was based on 30,012 adults (mean age: 49 ± 14 years; 74% women). For irritants/sprays, persistent (40%) and increased (26%) use was associated with asthma symptoms (mean score ratio MSR [95% CI values]: 1.26 [1.18-1.34], and MSR: 1.14 [1.06-1.22], respectively), incidence (odds ratio OR [95% CI values]: 1.30 [1.16-1.45], and OR: 1.07 [0.95-1.20], respectively), and deterioration (OR: 1.48 [1.19-1.85], and OR: 1.28 [1.01-1.64], respectively). For green products, persistent (20%) and increased (12%) use was associated with symptoms in 2020 (MSR: 1.08 [1.01-1.16], and MSR: 1.07 [0.99-1.16], respectively), and associations were suggested with incidence (OR: 1.09 [0.97-1.22], and OR: 1.11 [0.97-1.27], respectively).</div></div><div><h3>Conclusions</h3><div>Persistent and increased use of irritants/sprays but also of “green” products was associated with deleterious effects on asthma over time.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 1","pages":"Pages 176-184.e3"},"PeriodicalIF":6.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214432","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}

{"title":"Transient hepatitis as a novel withdrawal phenomenon after danazol discontinuation in hereditary angioedema","authors":"Mats de Lange MD ,&nbsp;R. Bart Takkenberg MD, PhD ,&nbsp;Joanne Verheij MD, PhD ,&nbsp;Danny M. Cohn MD, PhD","doi":"10.1016/j.jaip.2025.10.027","DOIUrl":"10.1016/j.jaip.2025.10.027","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 1","pages":"Pages 300-302.e1"},"PeriodicalIF":6.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423342","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}

{"title":"Impact of Fungal Sensitization on Long-Term Outcomes in Severe Asthma","authors":"Robin Réau MD ,&nbsp;Pascale Nicaise PharmD ,&nbsp;Axelle Dupont MD, PhD ,&nbsp;Catherine Neukirch MD ,&nbsp;Pierre Le Guen MD ,&nbsp;Maud Garinat MD ,&nbsp;Mathilde Le Brun MD ,&nbsp;Camille Taillé MD, PhD","doi":"10.1016/j.jaip.2025.10.025","DOIUrl":"10.1016/j.jaip.2025.10.025","url":null,"abstract":"<div><h3>Background</h3><div>Fungal sensitization has been associated with some features of severe asthma, but whether severe asthma with fungal sensitization (SAFS) requires specific management remains unclear. The long-term outcomes of SAFS remain poorly studied.</div></div><div><h3>Objective</h3><div>To assess the impact of fungal sensitization on disease severity using the Asthma Severity Scoring System (ASSESS) score and its evolution over time in a severe asthma cohort.</div></div><div><h3>Methods</h3><div>This retrospective analysis included adult patients with severe asthma evaluated at Bichat Hospital (Paris, France) between 2017 and 2022. All patients underwent specific IgE testing for <em>Aspergillus</em>, <em>Botrytis</em>, <em>Alternaria</em>, <em>Penicillium</em>, <em>Cladosporium</em>, and <em>Candida</em>. SAFS was defined as the presence of at least 1 positive specific IgE result.</div></div><div><h3>Results</h3><div>Among the 245 patients included, 69 (28.2%) had SAFS. At baseline, the ASSESS score was significantly higher in the SAFS group than in the severe asthma without fungal sensitization (SAwoFS) group (13.7 ± 2.8 vs 12.0 ± 3.0; <em>P</em> &lt; .0001). This greater severity was supported by a lower FEV₁ (65.5% vs 76.5% predicted; <em>P</em> = .0007), higher daily oral corticosteroid use (36.2% vs 18.2%; <em>P</em> = .0026), and higher hospitalization rates over the last 6 months (36.2% vs 19.9%; <em>P</em> = .007). At 12 months, the mean ASSESS score significantly decreased in both groups (SAFS: 12.4 ± 3.4; SAwoFS: 10.2 ± 3.6; <em>P</em> = .00015), but remained significantly higher in the SAFS group, driven by persistently lower FEV₁ (65% vs 80% predicted; <em>P</em> = .0006), higher exacerbation rate (74.6% vs 55.3%; <em>P</em> = .008), and higher daily oral corticosteroid use (30% vs 14.7%; <em>P</em> = .009). Biologics were initiated in 51% of patients with SAFS and 56% of patients with SAwoFS. Among patients treated with biologics, ASSESS scores remained significantly higher in the SAFS group (12.8 vs 10.0; <em>P</em> = .0015).</div></div><div><h3>Conclusions</h3><div>Patients with SAFS represent a particularly severe asthma phenotype, even after treatment with biologics. Nonetheless, they show a significant response to standardized care for severe asthma.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 1","pages":"Pages 196-204"},"PeriodicalIF":6.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423316","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}

{"title":"Effect of Weight Loss on Asthma in Obese Adult Patients With Asthma: A Systematic Review and Meta-Analysis","authors":"Aleksandra Rybka-Fraczek MD, PhD,&nbsp;Izabela Orzolek MD,&nbsp;Marta Dabrowska MD, PhD","doi":"10.1016/j.jaip.2025.10.014","DOIUrl":"10.1016/j.jaip.2025.10.014","url":null,"abstract":"<div><h3>Background</h3><div>Given its substantial impact on asthma, obesity is regarded as a treatable trait in asthma management.</div></div><div><h3>Objective</h3><div>This systematic review and meta-analyses aim to assess weight loss intervention effects on asthma control in obese adults with asthma.</div></div><div><h3>Methods</h3><div>We searched databases until February 2025 for English-language randomized controlled trials assessing weight loss influence on asthma control, quality of life, or lung function in obese adults. Six studies with 522 participants were included. Effect sizes were pooled as mean or standardized mean difference.</div></div><div><h3>Results</h3><div>Weight reduction over 12 to 24 weeks significantly improved Asthma Control Questionnaire score (–0.75; 95% confidence interval [95% CI] –0.91 to –0.59; I² = 0.0%) and quality of life (1.05; 95% CI 0.17–1.93; I² = 86.4%). Lung function also improved, with a mean forced expiratory volume in 1 second increase of 4.65% (95% CI 2.96–6.33; I² = 0.0%). However, benefits were not sustained at the 52-week follow-up, showing no significant changes in asthma control (–0.67, 95% CI –1.48 to 0.14; I² = 5.2%) or quality of life (0.05; 95% CI – 0.15 to 0.26; I² = 0.8%). Subgroup analysis revealed that participants achieving 10% or greater reduction experienced marked asthma control improvements (–1.37; 95% CI –1.55 to –1.20; I² = 0.0%).</div></div><div><h3>Conclusions</h3><div>Weight reduction over 12 to 24 weeks significantly improves asthma control, quality of life, and lung function, with pronounced benefits in individuals losing 10% or greater baseline weight. Effects were not maintained at 52 weeks, indicating sustained weight management necessity for preserve long-term benefits. Nevertheless, available data remain limited because findings primarily address short-term outcomes and were based on limited number of patients.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 1","pages":"Pages 153-163.e4"},"PeriodicalIF":6.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534782","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}

{"title":"Targeted Treatment in Asthma—Opportunities and Challenges","authors":"Ioana Agache MD, PhD ,&nbsp;Magdalena Zemelka-Wiacek PhD ,&nbsp;Radosław Gawlik MD, PhD ,&nbsp;Steve N. Georas MD, PhD ,&nbsp;Karina Jahnz-Różyk MD, PhD ,&nbsp;Maciej Kupczyk MD, PhD ,&nbsp;Marcin Moniuszko MD, PhD ,&nbsp;Ralph Mӧsges MD, PhD ,&nbsp;Manali Mukherjee PhD ,&nbsp;Parameswaran Nair MD, PhD ,&nbsp;Alberto Papi MD, PhD ,&nbsp;Marek Sanak MD, PhD ,&nbsp;Ali Ӧnder Yildirim PhD ,&nbsp;Marek Jutel MD, PhD","doi":"10.1016/j.jaip.2025.11.023","DOIUrl":"10.1016/j.jaip.2025.11.023","url":null,"abstract":"<div><div>This review summarizes the key insights and future directions on targeted asthma treatment discussed during the 2025 Expert Meeting supported by the Central and Southern European Allergy and Asthma Alliance (CSEA3). Targeted treatment in asthma is becoming an attainable goal for selected patients but is not yet established as a standard asthma care pathway. The expert panel identified 4 key priorities to advance targeted asthma management: (1) Defining remission—a universally accepted, evidence-based definition is needed to guide clinical practice and guideline development. (2) The management of mild asthma guided by patient stratification according to asthma pathogenetic pathways (endotype) and risk profile may enable more tailored therapy and better outcomes. (3) Biomarker discovery and validation—research must prioritize predictive biomarkers that are easy to measure at the point of care, supported by innovative trials that combine precision immunology and machine learning. (4) Optimizing implementation and addressing the barriers to adopting stratified care, including limited resources and cost-effectiveness concerns, must be addressed. Digital tools offer promise but require further validation. Coordinated efforts are essential to translate advances in personalized asthma treatment into better outcomes and more sustainable care, particularly in resource-limited settings.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 1","pages":"Pages 76-93"},"PeriodicalIF":6.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145642211","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}

{"title":"Revisiting Type 2 Inflammation and Airway Hyper-responsiveness in COPD","authors":"Philipp Suter MD,&nbsp;Robert Greig MD,&nbsp;Rory Chan PhD,&nbsp;Brian J. Lipworth MD","doi":"10.1016/j.jaip.2025.10.033","DOIUrl":"10.1016/j.jaip.2025.10.033","url":null,"abstract":"<div><div>Airway hyper-responsiveness (AHR) is well established in asthma but remains under-recognized in chronic obstructive pulmonary disease (COPD). The recognition of COPD heterogeneity, particularly eosinophilic COPD and asthma COPD overlap, has increased interest in AHR as a clinical marker of type 2 (T2) inflammation. This phenotype is present in 20% to 40% of patients with COPD and has become a focus of clinical trials exploring biologics targeting IL-4, IL-5, IL-13, and thymic stromal lymphopoietin. We aim to review current evidence on AHR in COPD, its relationship with inflammatory phenotypes, diagnostic modalities, and therapeutic implications. AHR in COPD reflects both structural and inflammatory mechanisms. Direct challenges such as methacholine predominantly assess airway geometry, whereas indirect challenges such as mannitol reflect more activity of T2 inflammation and correlates consequently with eosinophils and fractional exhaled nitric oxide. Patients with AHR may derive greater benefit from inhaled corticosteroids than AHR-negative patients. Although AHR reduction has been demonstrated with biologics in asthma, no study has evaluated their effects on AHR in COPD. AHR represents a clinically relevant and promising treatable trait in COPD, particularly in T2-high phenotypes. Standardized challenges combined with the integration of inflammatory markers and targeted trials of biologics are needed to clarify its role in personalized COPD management and therapeutic decision-making.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 1","pages":"Pages 67-75"},"PeriodicalIF":6.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904251","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}