Pub Date : 2026-01-14DOI: 10.1016/j.waojou.2025.101159
Giorgio Walter Canonica MD , Gianenrico Senna MD , Luisa Brussino MD , Maria Aliani MD , Elena Altieri MD , Pietro Bracciale MD , Maria Filomena Caiaffa MD , Paolo Cameli MD , Marco Caminati MD , Cristiano Caruso MD , Stefano Centanni MD , Fausto De Michele MD , Stefano Del Giacco MD , Fabiano Di Marco MD , Laura Malerba MD , Francesco Menzella MD , Paola Rogliani MD , Micaela Romagnoli MD , Pietro Schino MD , Jan Walter Schroeder MD , Girolamo Pelaia MD
Background
Clinical remission is an emerging treatment goal in severe eosinophilic asthma (SEA). While benralizumab, an anti-IL-5Rα monoclonal antibody, has demonstrated efficacy in SEA, its ability to induce clinical remission in real-life settings over extended follow-up remains underexplored.
Methods
This post hoc analysis of the multicenter, retrospective ANANKE study evaluated clinical remission over 24 months in 167 Italian patients with SEA treated with benralizumab. Remission was defined according to the Severe Asthma Network Italy (SANI) criteria. Complete clinical remission (cCR) required the absence of oral corticosteroid (OCS) use and the presence of 3 criteria: no symptoms, no exacerbations, and stable lung function. Partial clinical remission (pCR) required the absence of OCS use and 2 of the 3 criteria. Outcomes were assessed at 3, 12, and 24 months.
Results
The proportion of patients achieving clinical remission increased over time: 87.2% at 3 months (40.4% pCR, 46.8% cCR), 95.0% at 12 months (17.5% pCR, 77.5% cCR), and 96.1% at 24 months (23.5% pCR, 72.6% cCR). No baseline demographic or clinical characteristics were found to significantly predict remission status. Blood eosinophil counts declined from a mean of 476.7 to 5.2 cells/μL at 24 months.
Conclusion
In this real-world Italian cohort, benralizumab was associated with rapid and sustained clinical remission in patients with SEA over 24 months. The high remission rates observed early and maintained throughout treatment support the role of benralizumab as a disease-modifying therapy and reinforce clinical remission as a meaningful therapeutic goal in SEA.
{"title":"Clinical remission in patients with severe eosinophilic asthma treated with benralizumab over 24 months: Post hoc analysis of the ANANKE study","authors":"Giorgio Walter Canonica MD , Gianenrico Senna MD , Luisa Brussino MD , Maria Aliani MD , Elena Altieri MD , Pietro Bracciale MD , Maria Filomena Caiaffa MD , Paolo Cameli MD , Marco Caminati MD , Cristiano Caruso MD , Stefano Centanni MD , Fausto De Michele MD , Stefano Del Giacco MD , Fabiano Di Marco MD , Laura Malerba MD , Francesco Menzella MD , Paola Rogliani MD , Micaela Romagnoli MD , Pietro Schino MD , Jan Walter Schroeder MD , Girolamo Pelaia MD","doi":"10.1016/j.waojou.2025.101159","DOIUrl":"10.1016/j.waojou.2025.101159","url":null,"abstract":"<div><h3>Background</h3><div>Clinical remission is an emerging treatment goal in severe eosinophilic asthma (SEA). While benralizumab, an anti-IL-5Rα monoclonal antibody, has demonstrated efficacy in SEA, its ability to induce clinical remission in real-life settings over extended follow-up remains underexplored.</div></div><div><h3>Methods</h3><div>This post hoc analysis of the multicenter, retrospective ANANKE study evaluated clinical remission over 24 months in 167 Italian patients with SEA treated with benralizumab. Remission was defined according to the Severe Asthma Network Italy (SANI) criteria. Complete clinical remission (cCR) required the absence of oral corticosteroid (OCS) use and the presence of 3 criteria: no symptoms, no exacerbations, and stable lung function. Partial clinical remission (pCR) required the absence of OCS use and 2 of the 3 criteria. Outcomes were assessed at 3, 12, and 24 months.</div></div><div><h3>Results</h3><div>The proportion of patients achieving clinical remission increased over time: 87.2% at 3 months (40.4% pCR, 46.8% cCR), 95.0% at 12 months (17.5% pCR, 77.5% cCR), and 96.1% at 24 months (23.5% pCR, 72.6% cCR). No baseline demographic or clinical characteristics were found to significantly predict remission status. Blood eosinophil counts declined from a mean of 476.7 to 5.2 cells/μL at 24 months.</div></div><div><h3>Conclusion</h3><div>In this real-world Italian cohort, benralizumab was associated with rapid and sustained clinical remission in patients with SEA over 24 months. The high remission rates observed early and maintained throughout treatment support the role of benralizumab as a disease-modifying therapy and reinforce clinical remission as a meaningful therapeutic goal in SEA.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"19 2","pages":"Article 101159"},"PeriodicalIF":4.3,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145957886","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}
Pub Date : 2026-01-13DOI: 10.1016/j.waojou.2025.101151
Josefina Zakzuk MD, PhD , Juliana Quintero MD, PhD , Devian Parra Eco , Victoria Marrugo MSc , Maria A. Forero Molina MD , Carlos Quiroz MD , Margarita Ochoa-Díaz MD, Esp., MSc, PhD , Doris Gómez MSc, PhD , Elizabeth García MD
Introduction
Papular urticaria (PU) is a chronic allergic reaction to arthropod bites and is a common cause of pediatric dermatologic consultations in tropical regions. This study aimed to assess the prevalence and associated factors of PU among children in Cartagena, Colombia, and to explore the relationship between insect presence and disease presentation.
Methods
Surveys were used to assess living conditions, and the diagnosis was confirmed by medical history and physical examination.
Results
A total of 725 children aged 1–6 years from 30 schools and 13 childcare centers were included, PU was diagnosed in 260 children, resulting in an age- and gender-adjusted prevalence rate of 35.9% (95% CI: 30.3–43.4). Lesions were primarily found on exposed areas, such as the lower limbs (97%) and arms (54%). Children aged 1–2 years (aOR = 3.01, 95% CI: 1.54–5.93, p < 0.001) and 3–4 years (aOR = 1.84, 95% CI: 1.11–3.08, p = 0.02) had a higher risk of PU than those aged 5–6 years. The antecedent of mosquito bites was reported in most PU cases (96.0%) and controls (93.0%), without significant differences between groups. The frequency of mosquito presence at home was similar between case and controls. Mosquito density was higher in the lower socioeconomic strata (p < 0.001). The most commonly identified species were Aedes aegypti (57.7%) and Culex quinquefasciatus (38.2%). Fleas were found in only 3% of the homes.
Conclusion
We identified a high prevalence of PU in the city. Despite the widespread presence of mosquitoes, no association between mosquito bites and PU was observed. Younger age emerged as a risk factor for PU, and socioeconomic disparities influenced higher mosquito density.
{"title":"Prevalence and risk factors of papular urticaria among school children in Cartagena, Colombia","authors":"Josefina Zakzuk MD, PhD , Juliana Quintero MD, PhD , Devian Parra Eco , Victoria Marrugo MSc , Maria A. Forero Molina MD , Carlos Quiroz MD , Margarita Ochoa-Díaz MD, Esp., MSc, PhD , Doris Gómez MSc, PhD , Elizabeth García MD","doi":"10.1016/j.waojou.2025.101151","DOIUrl":"10.1016/j.waojou.2025.101151","url":null,"abstract":"<div><h3>Introduction</h3><div>Papular urticaria (PU) is a chronic allergic reaction to arthropod bites and is a common cause of pediatric dermatologic consultations in tropical regions. This study aimed to assess the prevalence and associated factors of PU among children in Cartagena, Colombia, and to explore the relationship between insect presence and disease presentation.</div></div><div><h3>Methods</h3><div>Surveys were used to assess living conditions, and the diagnosis was confirmed by medical history and physical examination.</div></div><div><h3>Results</h3><div>A total of 725 children aged 1–6 years from 30 schools and 13 childcare centers were included, PU was diagnosed in 260 children, resulting in an age- and gender-adjusted prevalence rate of 35.9% (95% CI: 30.3–43.4). Lesions were primarily found on exposed areas, such as the lower limbs (97%) and arms (54%). Children aged 1–2 years (aOR = 3.01, 95% CI: 1.54–5.93, p < 0.001) and 3–4 years (aOR = 1.84, 95% CI: 1.11–3.08, p = 0.02) had a higher risk of PU than those aged 5–6 years. The antecedent of mosquito bites was reported in most PU cases (96.0%) and controls (93.0%), without significant differences between groups. The frequency of mosquito presence at home was similar between case and controls. Mosquito density was higher in the lower socioeconomic strata (p < 0.001). The most commonly identified species were <em>Aedes aegypti</em> (57.7%) and <em>Culex quinquefasciatus</em> (38.2%). Fleas were found in only 3% of the homes.</div></div><div><h3>Conclusion</h3><div>We identified a high prevalence of PU in the city. Despite the widespread presence of mosquitoes, no association between mosquito bites and PU was observed. Younger age emerged as a risk factor for PU, and socioeconomic disparities influenced higher mosquito density.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"19 2","pages":"Article 101151"},"PeriodicalIF":4.3,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145957885","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}
Pub Date : 2026-01-01DOI: 10.1016/j.waojou.2025.101164
Kyoung Yong Jeong PhD , Yoon Ji Shin BSc , Haeun Kim BSc , Yong Seok Lee PhD , Minkyu Sang PhD , Hyun Kyung Oh MD , Kyung Hee Park MD, PhD , Jae-Hyun Lee MD, PhD , Jung-Won Park MD, PhD
Background
Ginseng is a widely consumed herbal supplement. However, ginseng, especially raw ginseng, can cause allergic reactions, including pollen-food allergy syndrome (PFAS). This study aimed to identify the PFAS-causative allergen in Korean ginseng and to establish methods for its quantification.
Methods
Candidate allergens were screened using genomic and transcriptomic analyses. Proteomic profiling with patient sera was performed to identify the clinically relevant allergen. A recombinant protein was generated, and its allergenicity compared with the primary sensitizer, Que ac 1, by ELISA. A two-site ELISA was developed for the quantification of the ginseng allergen using monoclonal antibodies against recombinant protein. Multiple reaction monitoring (MRM) mass spectrometry was applied for validation.
Results
Genome and transcriptome analysis identified 4 candidate allergens: pathogenesis-related 10 (PR-10) protein, profilin, non-specific lipid transfer protein (nsLTP), and thaumatin-like protein. Among these, PR-10 (designated Pana g 1) was the sole allergen detected by proteomic analysis. Recombinant Pana g 1 was recognized by 4 of 5 patients. Inhibition ELISA showed stronger IgE reactivity to Que ac 1 than to Pana g 1, with marked cross-reactivity between the 2. Pana g 1 levels in ginseng extract were quantified as 4.26 μg/mg of protein by ELISA and 4.54 μg/mg by MRM in the ginseng extract.
Conclusion
Pana g 1 is the major PFAS-causative allergen in Korean ginseng. Recombinant Pana g 1 shows promise as a diagnostic tool for ginseng-induced PFAS. The quantification systems established here may also support standardization of ginseng extracts and allergen monitoring.
人参是一种被广泛食用的草药补充剂。然而，人参，尤其是生人参，会引起过敏反应，包括花粉食物过敏综合征（PFAS）。本研究旨在鉴定红参中诱发pfas的过敏原，并建立其定量方法。方法采用基因组学和转录组学分析筛选候选过敏原。对患者血清进行蛋白质组学分析，以确定临床相关的过敏原。制备了重组蛋白，并通过ELISA对其与原致敏剂Que ac 1的致敏性进行了比较。利用重组蛋白单克隆抗体，建立了人参过敏原的双位点ELISA定量方法。采用多反应监测（MRM）质谱法进行验证。结果基因组和转录组分析鉴定出4种候选过敏原：发病相关10蛋白（PR-10）、profilin、非特异性脂质转移蛋白（nsLTP）和thaumatin样蛋白。其中PR-10（命名为Pana g1）是唯一通过蛋白质组学分析检测到的过敏原。重组Pana g1在5例患者中被4例识别。抑制酶联免疫吸附试验显示，IgE对Que ac 1的反应性强于对Pana g1的反应性，且两者之间存在明显的交叉反应。ELISA法测定人参提取物中Pana g 1蛋白含量为4.26 μg/mg， MRM法测定人参提取物中Pana g 1蛋白含量为4.54 μg/mg。结论panag1是红参中主要的致pfas变应原。重组panag1有望作为人参诱导的PFAS的诊断工具。这里建立的定量系统也可以支持人参提取物和过敏原监测的标准化。
{"title":"Characterization of Pana g 1, an important cause of pollen-food allergy syndrome from Korean ginseng, Panax ginseng","authors":"Kyoung Yong Jeong PhD , Yoon Ji Shin BSc , Haeun Kim BSc , Yong Seok Lee PhD , Minkyu Sang PhD , Hyun Kyung Oh MD , Kyung Hee Park MD, PhD , Jae-Hyun Lee MD, PhD , Jung-Won Park MD, PhD","doi":"10.1016/j.waojou.2025.101164","DOIUrl":"10.1016/j.waojou.2025.101164","url":null,"abstract":"<div><h3>Background</h3><div>Ginseng is a widely consumed herbal supplement. However, ginseng, especially raw ginseng, can cause allergic reactions, including pollen-food allergy syndrome (PFAS). This study aimed to identify the PFAS-causative allergen in Korean ginseng and to establish methods for its quantification.</div></div><div><h3>Methods</h3><div>Candidate allergens were screened using genomic and transcriptomic analyses. Proteomic profiling with patient sera was performed to identify the clinically relevant allergen. A recombinant protein was generated, and its allergenicity compared with the primary sensitizer, Que ac 1, by ELISA. A two-site ELISA was developed for the quantification of the ginseng allergen using monoclonal antibodies against recombinant protein. Multiple reaction monitoring (MRM) mass spectrometry was applied for validation.</div></div><div><h3>Results</h3><div>Genome and transcriptome analysis identified 4 candidate allergens: pathogenesis-related 10 (PR-10) protein, profilin, non-specific lipid transfer protein (nsLTP), and thaumatin-like protein. Among these, PR-10 (designated Pana g 1) was the sole allergen detected by proteomic analysis. Recombinant Pana g 1 was recognized by 4 of 5 patients. Inhibition ELISA showed stronger IgE reactivity to Que ac 1 than to Pana g 1, with marked cross-reactivity between the 2. Pana g 1 levels in ginseng extract were quantified as 4.26 μg/mg of protein by ELISA and 4.54 μg/mg by MRM in the ginseng extract.</div></div><div><h3>Conclusion</h3><div>Pana g 1 is the major PFAS-causative allergen in Korean ginseng. Recombinant Pana g 1 shows promise as a diagnostic tool for ginseng-induced PFAS. The quantification systems established here may also support standardization of ginseng extracts and allergen monitoring.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"19 1","pages":"Article 101164"},"PeriodicalIF":4.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884921","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}
Epithelial barrier impairment is a characteristic pathological hallmark of allergic rhinitis (AR), yet the mechanisms contributing to this dysfunction remain incompletely understood. Our aim is to assess the impact of glucose transporter 1 (GLUT1) on epithelial barrier function in AR.
Methods
We performed proteomics analysis on nasal mucosa from AR patients and healthy controls (HCs) to identify differential proteins, which were validated using immunofluorescence, western blotting, and RT-qPCR. Nasal epithelial cells from HCs were isolated to evaluate house dust mite (HDM)-induced changes in GLUT1 expression and regulatory mechanisms. An AR mouse model was constructed to examine the effects of GLUT1 inhibition on nasal inflammation and barrier function.
Results
Tissue proteomics analysis revealed a distinct protein expression profile in AR patients compared with HCs, with GLUT1 identified as the most upregulated protein. Cohort validation demonstrated significantly elevated GLUT1 expression in the AR group, predominantly localized in epithelial cells. Moreover, GLUT1 mRNA levels showed a positive correlation with visual analogue scales and total nasal symptom scores, and a negative correlation with tissue ZO-1 and occludin expressions. In vitro studies indicated that HDM stimulation enhanced GLUT1 expression and reduced ZO-1 and occludin levels in nasal epithelial cells in a dose-dependent manner. Treatment with a GLUT1 inhibitor effectively restored ZO-1 and occludin expressions. Animal model experiments further confirmed that GLUT1 inhibition alleviated nasal inflammation and improved mucosal barrier function.
Conclusion
AR displays a distinct tissue-specific protein expression profile, with enhanced GLUT1 levels associated with disease severity and epithelial barrier dysfunction. Inhibition of GLUT1 has been shown to reduce nasal inflammation and improve epithelial barrier function in AR.
{"title":"Increased glucose transporter 1 contributes to epithelial barrier dysfunction in allergic rhinitis","authors":"Cui Xia PhD , Kang Zhu MD , Chao Yu MD , Jingguo Chen MD , Tianxi Gao MD , Yanni Zhang MD","doi":"10.1016/j.waojou.2025.101158","DOIUrl":"10.1016/j.waojou.2025.101158","url":null,"abstract":"<div><h3>Background</h3><div>Epithelial barrier impairment is a characteristic pathological hallmark of allergic rhinitis (AR), yet the mechanisms contributing to this dysfunction remain incompletely understood. Our aim is to assess the impact of glucose transporter 1 (GLUT1) on epithelial barrier function in AR.</div></div><div><h3>Methods</h3><div>We performed proteomics analysis on nasal mucosa from AR patients and healthy controls (HCs) to identify differential proteins, which were validated using immunofluorescence, western blotting, and RT-qPCR. Nasal epithelial cells from HCs were isolated to evaluate house dust mite (HDM)-induced changes in GLUT1 expression and regulatory mechanisms. An AR mouse model was constructed to examine the effects of GLUT1 inhibition on nasal inflammation and barrier function.</div></div><div><h3>Results</h3><div>Tissue proteomics analysis revealed a distinct protein expression profile in AR patients compared with HCs, with GLUT1 identified as the most upregulated protein. Cohort validation demonstrated significantly elevated GLUT1 expression in the AR group, predominantly localized in epithelial cells. Moreover, GLUT1 mRNA levels showed a positive correlation with visual analogue scales and total nasal symptom scores, and a negative correlation with tissue ZO-1 and occludin expressions. In vitro studies indicated that HDM stimulation enhanced GLUT1 expression and reduced ZO-1 and occludin levels in nasal epithelial cells in a dose-dependent manner. Treatment with a GLUT1 inhibitor effectively restored ZO-1 and occludin expressions. Animal model experiments further confirmed that GLUT1 inhibition alleviated nasal inflammation and improved mucosal barrier function.</div></div><div><h3>Conclusion</h3><div>AR displays a distinct tissue-specific protein expression profile, with enhanced GLUT1 levels associated with disease severity and epithelial barrier dysfunction. Inhibition of GLUT1 has been shown to reduce nasal inflammation and improve epithelial barrier function in AR.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"19 1","pages":"Article 101158"},"PeriodicalIF":4.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926903","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}
Pub Date : 2026-01-01DOI: 10.1016/j.waojou.2025.101162
Michele Piazza PhD , Alessandra Gori MD , Carlo Capristo MD , Attilio L. Boner MD
Bronchiolitis, primarily caused by respiratory syncytial virus (RSV), is a common respiratory infection in infants and a known precursor to recurrent wheezing and asthma. This review explores the role of oxidative stress and trace element deficiencies in the pathogenesis of bronchiolitis and its long-term sequelae.
Infants with reduced lung function due to prematurity or congenital airway anomalies exhibit heightened susceptibility to RSV infection. Growing evidence implicates oxidative stress and deficiencies in zinc, selenium, and magnesium as significant contributors to disease progression. Impaired antioxidant defenses exacerbate viral inflammatory responses, leading to prolonged symptoms and recurrent wheezing with potential developmental delays.
Studies consistently demonstrate that children with bronchiolitis exhibit elevated oxidative stress markers and reduced antioxidant capacity, with trace element deficiencies correlating with disease severity. Reduced defenses against oxidative stress may be associated with recurrent wheezing episodes, which are more frequent after rhinovirus bronchiolitis than after RSV bronchiolitis. Thus, RSV and rhinovirus (RV) bronchiolitis may unmask pre-existing vulnerabilities rather than directly causing long-term damage associated with later asthma.
Micronutrient supplementation, particularly zinc and selenium, has shown potential in reducing respiratory infection duration and severity. COVID-19 pandemic evidence further supports nutritional status as a key modulator of respiratory disease outcomes, with nutraceuticals like curcumin and flavonoids demonstrating anti-inflammatory benefits.
Given the safety and accessibility of micronutrient supplementation, early nutritional assessment and intervention in high-risk infants may offer a cost-effective strategy to improve long-term respiratory outcomes. Bronchiolitis should be viewed as a clinical signal warranting proactive, holistic pediatric care rather than merely an acute illness.
{"title":"Bronchiolitis and recurrent respiratory infections: The role of oxidative stress from early life inflammation to long-term outcomes – A narrative review","authors":"Michele Piazza PhD , Alessandra Gori MD , Carlo Capristo MD , Attilio L. Boner MD","doi":"10.1016/j.waojou.2025.101162","DOIUrl":"10.1016/j.waojou.2025.101162","url":null,"abstract":"<div><div>Bronchiolitis, primarily caused by respiratory syncytial virus (RSV), is a common respiratory infection in infants and a known precursor to recurrent wheezing and asthma. This review explores the role of oxidative stress and trace element deficiencies in the pathogenesis of bronchiolitis and its long-term sequelae.</div><div>Infants with reduced lung function due to prematurity or congenital airway anomalies exhibit heightened susceptibility to RSV infection. Growing evidence implicates oxidative stress and deficiencies in zinc, selenium, and magnesium as significant contributors to disease progression. Impaired antioxidant defenses exacerbate viral inflammatory responses, leading to prolonged symptoms and recurrent wheezing with potential developmental delays.</div><div>Studies consistently demonstrate that children with bronchiolitis exhibit elevated oxidative stress markers and reduced antioxidant capacity, with trace element deficiencies correlating with disease severity. Reduced defenses against oxidative stress may be associated with recurrent wheezing episodes, which are more frequent after rhinovirus bronchiolitis than after RSV bronchiolitis. Thus, RSV and rhinovirus (RV) bronchiolitis may unmask pre-existing vulnerabilities rather than directly causing long-term damage associated with later asthma.</div><div>Micronutrient supplementation, particularly zinc and selenium, has shown potential in reducing respiratory infection duration and severity. COVID-19 pandemic evidence further supports nutritional status as a key modulator of respiratory disease outcomes, with nutraceuticals like curcumin and flavonoids demonstrating anti-inflammatory benefits.</div><div>Given the safety and accessibility of micronutrient supplementation, early nutritional assessment and intervention in high-risk infants may offer a cost-effective strategy to improve long-term respiratory outcomes. Bronchiolitis should be viewed as a clinical signal warranting proactive, holistic pediatric care rather than merely an acute illness.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"19 1","pages":"Article 101162"},"PeriodicalIF":4.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884919","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}
Pub Date : 2026-01-01DOI: 10.1016/j.waojou.2025.101165
Yijing Xu MD , Ruoyu Ji MD , Juan Liu MD , Xiangyi Cui MSc , Heng Zhang MD , Naiqing Cao MD , Yongmei Yu MD , Yingnan Li MD , He Lai MD , Yuxiang Zhi MD
Background
Hereditary angioedema (HAE) is a rare and potentially life-threatening genetic disorder. Lanadelumab, a monoclonal antibody inhibiting plasma kallikrein, has been approved for long-term prophylaxis (LTP) in HAE patients aged ≥12 years since 2020 in China, but real-world evidence in Chinese populations is insufficient. Here, we assessed the real-world effectiveness, safety, and treatment acceptability of lanadelumab for LTP in Chinese HAE patients.
Methods
This multicenter observational study enrolled type I/II HAE patients ≥12 years who initiated lanadelumab for LTP between June 2022 and December 2024 across 5 tertiary medical centers in China, with a minimum follow-up time of 6 months. Attack frequency, emergency interventions, patient-reported outcome measures (PROMs), dosing interval extension and acceptability were described and if feasible, compared pair-wise before and after lanadelumab treatment.
Results
Fifty HAE patients (36 prospectively enrolled and 14 retrospectively included) were included with a median follow-up of 17.5 months. Dosing intervals were successfully extended in 80% of patients. Attack-free rate (AFR) remarkably elevated from 0.0% to 65.6% (cumulative 1-year AFR) and 66.7% (observed 1-year AFR). The proportion of patients experiencing severe attacks significantly declined. Results of PROMs also substantially improved. Treatment-emergent adverse events were mostly mild. 78% of patients reported significant economic burden associated with lanadelumab use.
Conclusion
Lanadelumab demonstrates high efficacy in reducing HAE attacks and improving quality of life in Chinese patients in a safe manner. Successful symptom-guided dosing interval extension was achievable in most patients. Despite clinical benefits, its high cost imposes financial burdens on our patients, but this should be weighed against the cost savings achieved through improved disease control.
{"title":"Efficacy and acceptability of lanadelumab for long-term prophylaxis in hereditary angioedema: A Chinese multicenter real-world analysis","authors":"Yijing Xu MD , Ruoyu Ji MD , Juan Liu MD , Xiangyi Cui MSc , Heng Zhang MD , Naiqing Cao MD , Yongmei Yu MD , Yingnan Li MD , He Lai MD , Yuxiang Zhi MD","doi":"10.1016/j.waojou.2025.101165","DOIUrl":"10.1016/j.waojou.2025.101165","url":null,"abstract":"<div><h3>Background</h3><div>Hereditary angioedema (HAE) is a rare and potentially life-threatening genetic disorder. Lanadelumab, a monoclonal antibody inhibiting plasma kallikrein, has been approved for long-term prophylaxis (LTP) in HAE patients aged ≥12 years since 2020 in China, but real-world evidence in Chinese populations is insufficient. Here, we assessed the real-world effectiveness, safety, and treatment acceptability of lanadelumab for LTP in Chinese HAE patients.</div></div><div><h3>Methods</h3><div>This multicenter observational study enrolled type I/II HAE patients ≥12 years who initiated lanadelumab for LTP between June 2022 and December 2024 across 5 tertiary medical centers in China, with a minimum follow-up time of 6 months. Attack frequency, emergency interventions, patient-reported outcome measures (PROMs), dosing interval extension and acceptability were described and if feasible, compared pair-wise before and after lanadelumab treatment.</div></div><div><h3>Results</h3><div>Fifty HAE patients (36 prospectively enrolled and 14 retrospectively included) were included with a median follow-up of 17.5 months. Dosing intervals were successfully extended in 80% of patients. Attack-free rate (AFR) remarkably elevated from 0.0% to 65.6% (cumulative 1-year AFR) and 66.7% (observed 1-year AFR). The proportion of patients experiencing severe attacks significantly declined. Results of PROMs also substantially improved. Treatment-emergent adverse events were mostly mild. 78% of patients reported significant economic burden associated with lanadelumab use.</div></div><div><h3>Conclusion</h3><div>Lanadelumab demonstrates high efficacy in reducing HAE attacks and improving quality of life in Chinese patients in a safe manner. Successful symptom-guided dosing interval extension was achievable in most patients. Despite clinical benefits, its high cost imposes financial burdens on our patients, but this should be weighed against the cost savings achieved through improved disease control.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"19 1","pages":"Article 101165"},"PeriodicalIF":4.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884922","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}
Pub Date : 2026-01-01DOI: 10.1016/j.waojou.2025.101168
Pingan Zhang MD , Rundong Qin PhD , Weixi Zhang PhD , Yungang Yang PhD , Huabin Li PhD , Xiaoyan Dong PhD , Yong He PhD , Huiying Wang PhD , Zhimin Chen PhD , Liang Chen PhD , Jinzhun Wu PhD , Yanmin Bao PhD , Man Tian PhD , Guolin Tan PhD , Jing Ye PhD , Meiling Jin PhD , Yi Liang PhD , Kang Xu PhD , Lijuan Mao PhD , Qingqing Lv PhD , Jing Li MD
Background
While allergen-specific immunotherapy (AIT) is recognized as an effective treatment, its efficacy varies widely. However, whether clinical response trajectories to AIT differ among individuals and influence its effectiveness has not been investigated.
Objective
This study aimed to characterize real-world clinical response trajectories to three-year AIT (3y-AIT).
Methods
We conducted a retrospective multicenter study across 53 centers to identify clinical response trajectories in patients with house dust mite allergic asthma and rhinitis undergoing three-year AIT. The efficacy of AIT was primarily assessed using the Visual Analog Scale (VAS) for allergic symptoms at 4 time points: baseline (before AIT), and at 1, 2, and 3 years of treatment. Clustering analysis based on VAS changes at these time points was used to define response trajectories. Initial analysis was performed using data from 52 centers (Alliance cohort), and validation was conducted using data from a separate center (Guangzhou cohort).
Results
In the Alliance cohort, 4 distinct clinical response trajectories were identified. Cluster 1 showed symptom worsening in the first year, with no improvement by year 3. Cluster 2 exhibited symptom deterioration in the second year, followed by significant recovery and a positive response by year 3. Clusters 3 and 4, characterized by higher and lower baseline symptom severity, respectively, demonstrated marked improvement after 3 years of AIT. In the Guangzhou cohort, a similar pattern of 4 response trajectories was observed: higher baseline symptom severity and family tobacco exposure were key features of Cluster 1 (p < 0.001), while Cluster 2 had the highest rate of respiratory infections (>1/year, p < 0.001). Despite these distinct trajectories, first-year effectiveness emerged as an ideal predictor of the 3-year AIT response, with an AUC of 0.75.
Conclusion
This study identified 4 primary treatment response trajectories to 3-year AIT in daily clinical practice, highlighting the heterogeneous nature of AIT responses among individuals. Notably, first-year effectiveness appears to be an ideal predictor of the 3-year AIT outcome.
{"title":"Distinct treatment response trajectories to allergen immunotherapy in allergic asthma and rhinitis: Insights from a multicenter study in routine clinical practice","authors":"Pingan Zhang MD , Rundong Qin PhD , Weixi Zhang PhD , Yungang Yang PhD , Huabin Li PhD , Xiaoyan Dong PhD , Yong He PhD , Huiying Wang PhD , Zhimin Chen PhD , Liang Chen PhD , Jinzhun Wu PhD , Yanmin Bao PhD , Man Tian PhD , Guolin Tan PhD , Jing Ye PhD , Meiling Jin PhD , Yi Liang PhD , Kang Xu PhD , Lijuan Mao PhD , Qingqing Lv PhD , Jing Li MD","doi":"10.1016/j.waojou.2025.101168","DOIUrl":"10.1016/j.waojou.2025.101168","url":null,"abstract":"<div><h3>Background</h3><div>While allergen-specific immunotherapy (AIT) is recognized as an effective treatment, its efficacy varies widely. However, whether clinical response trajectories to AIT differ among individuals and influence its effectiveness has not been investigated.</div></div><div><h3>Objective</h3><div>This study aimed to characterize real-world clinical response trajectories to three-year AIT (3y-AIT).</div></div><div><h3>Methods</h3><div>We conducted a retrospective multicenter study across 53 centers to identify clinical response trajectories in patients with house dust mite allergic asthma and rhinitis undergoing three-year AIT. The efficacy of AIT was primarily assessed using the Visual Analog Scale (VAS) for allergic symptoms at 4 time points: baseline (before AIT), and at 1, 2, and 3 years of treatment. Clustering analysis based on VAS changes at these time points was used to define response trajectories. Initial analysis was performed using data from 52 centers (Alliance cohort), and validation was conducted using data from a separate center (Guangzhou cohort).</div></div><div><h3>Results</h3><div>In the Alliance cohort, 4 distinct clinical response trajectories were identified. Cluster 1 showed symptom worsening in the first year, with no improvement by year 3. Cluster 2 exhibited symptom deterioration in the second year, followed by significant recovery and a positive response by year 3. Clusters 3 and 4, characterized by higher and lower baseline symptom severity, respectively, demonstrated marked improvement after 3 years of AIT. In the Guangzhou cohort, a similar pattern of 4 response trajectories was observed: higher baseline symptom severity and family tobacco exposure were key features of Cluster 1 (p < 0.001), while Cluster 2 had the highest rate of respiratory infections (>1/year, p < 0.001). Despite these distinct trajectories, first-year effectiveness emerged as an ideal predictor of the 3-year AIT response, with an AUC of 0.75.</div></div><div><h3>Conclusion</h3><div>This study identified 4 primary treatment response trajectories to 3-year AIT in daily clinical practice, highlighting the heterogeneous nature of AIT responses among individuals. Notably, first-year effectiveness appears to be an ideal predictor of the 3-year AIT outcome.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"19 1","pages":"Article 101168"},"PeriodicalIF":4.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926905","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}
Pub Date : 2026-01-01DOI: 10.1016/j.waojou.2025.101166
Eleni Anastasiou MD , Michael Miligkos MD , Yuichi Adachi MD, PhD , Ignacio J. Ansotegui MD, PhD , Héctor A. Badellino MD, PhD , Spiros Bekiaris , Zeinab A. El-Sayed MD, PhD , Adnan Custovic PhD , Ivana Filipovic MD , James E. Gern MD, PhD , Rene Maximiliano Gómez PhD , Cesar Pozo Beltrán MD , Rasha El-Owaidy MD , Elham Hossny MD, PhD , Ömer Kalayci MD , Peter N. Le Souëf MD , Mário Morais-Almeida MD, PhD , Antonio Nieto-Garcia MD, PhD , Paulo M. Pitrez MD , Cristina Rivas-Juesas MD , Nikolaos G. Papadopoulos MD, PhD
Background
Asthma remission has emerged as a potential therapeutic goal. However, definitions of remission have primarily focused on adult populations, with limited consensus on how remission should be defined in children.
Objective
To comprehensively review how asthma remission has been defined in children and to evaluate consistency and applicability of these definitions.
Methods
This scoping review was conducted following PRISMA-ScR guidelines. PubMed MEDLINE was searched for studies published between January 2010 and February 2024. Eligible studies included children with asthma and reported definitions of remission. Key remission criteria were extracted and categorized, and hierarchical cluster analysis was used to identify key patterns.
Results
Twenty-nine studies met the inclusion criteria. Most (79.3%) defined paediatric asthma remission based on the absence of clinical symptoms. The most common remission timeframe ranged from 1 to 2 years. A medication-free criterion was used in 68.9% of studies. On-treatment remission was reported in the minority of studies, but it is increasingly acknowledged as a valid outcome. Objective assessments, such as normal lung function (21%) and absence of bronchial hyperresponsiveness (10.3%), were infrequently included. Cluster analysis revealed 3 main patterns for remission definition: symptom-based, event-based, and 1 including objective criteria.
Conclusion
Current definitions of asthma remission in paediatric populations are predominantly symptom-based, with limited inclusion of objective physiological measures. Establishing consensus-based definitions for remission tailored to paediatric populations is essential to ensure clinical relevance and alignment with real-world disease patterns.
{"title":"The definition of asthma remission in children: A scoping review by the WAO Paediatric Asthma Committee","authors":"Eleni Anastasiou MD , Michael Miligkos MD , Yuichi Adachi MD, PhD , Ignacio J. Ansotegui MD, PhD , Héctor A. Badellino MD, PhD , Spiros Bekiaris , Zeinab A. El-Sayed MD, PhD , Adnan Custovic PhD , Ivana Filipovic MD , James E. Gern MD, PhD , Rene Maximiliano Gómez PhD , Cesar Pozo Beltrán MD , Rasha El-Owaidy MD , Elham Hossny MD, PhD , Ömer Kalayci MD , Peter N. Le Souëf MD , Mário Morais-Almeida MD, PhD , Antonio Nieto-Garcia MD, PhD , Paulo M. Pitrez MD , Cristina Rivas-Juesas MD , Nikolaos G. Papadopoulos MD, PhD","doi":"10.1016/j.waojou.2025.101166","DOIUrl":"10.1016/j.waojou.2025.101166","url":null,"abstract":"<div><h3>Background</h3><div>Asthma remission has emerged as a potential therapeutic goal. However, definitions of remission have primarily focused on adult populations, with limited consensus on how remission should be defined in children.</div></div><div><h3>Objective</h3><div>To comprehensively review how asthma remission has been defined in children and to evaluate consistency and applicability of these definitions.</div></div><div><h3>Methods</h3><div>This scoping review was conducted following PRISMA-ScR guidelines. PubMed MEDLINE was searched for studies published between January 2010 and February 2024. Eligible studies included children with asthma and reported definitions of remission. Key remission criteria were extracted and categorized, and hierarchical cluster analysis was used to identify key patterns.</div></div><div><h3>Results</h3><div>Twenty-nine studies met the inclusion criteria. Most (79.3%) defined paediatric asthma remission based on the absence of clinical symptoms. The most common remission timeframe ranged from 1 to 2 years. A medication-free criterion was used in 68.9% of studies. On-treatment remission was reported in the minority of studies, but it is increasingly acknowledged as a valid outcome. Objective assessments, such as normal lung function (21%) and absence of bronchial hyperresponsiveness (10.3%), were infrequently included. Cluster analysis revealed 3 main patterns for remission definition: symptom-based, event-based, and 1 including objective criteria.</div></div><div><h3>Conclusion</h3><div>Current definitions of asthma remission in paediatric populations are predominantly symptom-based, with limited inclusion of objective physiological measures. Establishing consensus-based definitions for remission tailored to paediatric populations is essential to ensure clinical relevance and alignment with real-world disease patterns.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"19 1","pages":"Article 101166"},"PeriodicalIF":4.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926918","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}
Pub Date : 2026-01-01DOI: 10.1016/j.waojou.2025.101161
Zhiying Nie MD, PhD , Yuanyuan Guo MD , Mingmin Bi MD, PhD , Chuxin Chen MD , Yunfei Gao PhD , Mengshi Chi MD , Yunping Fan MD, PhD , Jianbo Shi MD, PhD , Fenghong Chen MD, PhD
Background
Computed tomography (CT) scan is a good and noninvasive prediction tool for eosinophilic chronic rhinosinusitis with nasal polyps (eCRSwNP), and how to choose the appropriate CT parameter is crucial—especially because there have not been unanimous histopathologic criteria to diagnose eCRSwNP.
Objective
This study sought to select the suitable CT parameter to predict eCRSwNP in different criteria.
Method
This retrospective study included 147 CRSwNP patients who underwent a sinus CT scan and histopathological examination. Nine common CT parameters and 5 representative criteria of eCRSwNP (>5/HPF, >10/HPF, >70/HPF, >10%/HPF and >20%/HPF) were adopted. Logistic regression analysis and ROC analysis were performed to evaluate the predictive value of CT parameters.
Result
Among the 9 CT parameters, olfactory cleft (OC) score, ethmoid sinus and maxillary sinus ratio (E/M ratio), and posterior ethmoid (PE) score were significantly associated with eCRSwNP. In the 5 representative criteria of eCRSwNP, all the results showed that the OC score was not only the significant predictor in the univariate analysis, but also the most significant one in the multivariate analysis. Meanwhile, both OC score and E/M ratio were included in the multivariable logistic regression model. The clinically convenient cut-off points of model were OC score >2 and E/M ratio >2.5.
Conclusion
The OC score, E/M ratio, and PE score were significantly associated with eosinophilia of nasal polyp tissue. Therein, OC score was the best marker to predict eCRSwNP among the 5 representative criteria. The combination of OC score and E/M ratio can obtain a better predictive value of eCRSwNP.
{"title":"Predictive value of computed tomography for eosinophilic chronic rhinosinusitis with nasal polyps in different histopathologic criteria","authors":"Zhiying Nie MD, PhD , Yuanyuan Guo MD , Mingmin Bi MD, PhD , Chuxin Chen MD , Yunfei Gao PhD , Mengshi Chi MD , Yunping Fan MD, PhD , Jianbo Shi MD, PhD , Fenghong Chen MD, PhD","doi":"10.1016/j.waojou.2025.101161","DOIUrl":"10.1016/j.waojou.2025.101161","url":null,"abstract":"<div><h3>Background</h3><div>Computed tomography (CT) scan is a good and noninvasive prediction tool for eosinophilic chronic rhinosinusitis with nasal polyps (eCRSwNP), and how to choose the appropriate CT parameter is crucial—especially because there have not been unanimous histopathologic criteria to diagnose eCRSwNP.</div></div><div><h3>Objective</h3><div>This study sought to select the suitable CT parameter to predict eCRSwNP in different criteria.</div></div><div><h3>Method</h3><div>This retrospective study included 147 CRSwNP patients who underwent a sinus CT scan and histopathological examination. Nine common CT parameters and 5 representative criteria of eCRSwNP (>5/HPF, >10/HPF, >70/HPF, >10%/HPF and >20%/HPF) were adopted. Logistic regression analysis and ROC analysis were performed to evaluate the predictive value of CT parameters.</div></div><div><h3>Result</h3><div>Among the 9 CT parameters, olfactory cleft (OC) score, ethmoid sinus and maxillary sinus ratio (E/M ratio), and posterior ethmoid (PE) score were significantly associated with eCRSwNP. In the 5 representative criteria of eCRSwNP, all the results showed that the OC score was not only the significant predictor in the univariate analysis, but also the most significant one in the multivariate analysis. Meanwhile, both OC score and E/M ratio were included in the multivariable logistic regression model. The clinically convenient cut-off points of model were OC score >2 and E/M ratio >2.5.</div></div><div><h3>Conclusion</h3><div>The OC score, E/M ratio, and PE score were significantly associated with eosinophilia of nasal polyp tissue. Therein, OC score was the best marker to predict eCRSwNP among the 5 representative criteria. The combination of OC score and E/M ratio can obtain a better predictive value of eCRSwNP.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"19 1","pages":"Article 101161"},"PeriodicalIF":4.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926904","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}
Pub Date : 2026-01-01DOI: 10.1016/j.waojou.2025.101163
Sarah Preis MD , Milena Lisiecki , Tilo Biedermann MD , Sophia Horster MD , Alexander Zink MD, PhD
Background
Chronic spontaneous urticaria (CSU) disproportionately affects women, yet gender-specific analyses in treatment response remain scarce. Real-world data on the impact of gender on omalizumab efficacy are limited.
Objective
To investigate gender-specific differences in clinical characteristics, comorbidities, and response dynamics to omalizumab in a real-life CSU cohort.
Methods
We conducted a retrospective, monocentric cohort study including 250 CSU patients (60% female) treated with omalizumab between 2013 and 2023. Clinical characteristics, comorbidities, laboratory parameters, and treatment timelines were analyzed. Disease control was assessed using the Urticaria Control Test (UCT) at 4 timepoints over 12 months. Statistical comparisons were performed using appropriate univariate tests and linear mixed-effects modeling.
Results
Female patients had significantly higher rates of autoimmune thyroiditis, asthma, atopic eczema, allergies, and more frequently received long-term thyroid hormone therapy. While both sexes showed substantial improvement in UCT scores over time, male patients achieved faster and more stable disease control, with significantly higher UCT scores at early timepoints (p = 0.027 at timepoint 2, p = 0.004 at timepoint 3). However, overall treatment outcomes after 12 months did not differ significantly between female and male patients. Variability in response was higher among women, possibly reflecting biological heterogeneity, including hormonal status.
Conclusion
Although long-term response to omalizumab is comparable between sexes, male CSU patients demonstrate faster and more consistent clinical improvement. The greater variability in female patients may be linked to immunological or hormonal cofactors. Future studies should consider menopausal status and immune profiles to identify response-modifying subgroups and support personalized treatment strategies in CSU.
背景：慢性自发性荨麻疹（CSU）对女性的影响不成比例，但针对治疗反应的性别分析仍然很少。关于性别对omalizumab疗效影响的真实数据有限。目的：在现实生活中的CSU队列中，研究临床特征、合并症和对omalizumab的反应动态的性别差异。方法：我们进行了一项回顾性、单中心队列研究，包括2013年至2023年间接受omalizumab治疗的250例CSU患者（60%为女性）。分析临床特征、合并症、实验室参数和治疗时间表。使用荨麻疹控制试验（UCT）在12个月内的4个时间点评估疾病控制情况。采用适当的单变量检验和线性混合效应模型进行统计比较。结果女性患者自身免疫性甲状腺炎、哮喘、特应性湿疹、过敏发生率明显高于女性患者，且长期接受甲状腺激素治疗的患者较多。随着时间的推移，两性的UCT评分均有显著改善，男性患者的疾病控制更快、更稳定，早期时间点的UCT评分明显更高（时间点2 p = 0.027，时间点3 p = 0.004）。然而，12个月后的总体治疗结果在女性和男性患者之间没有显著差异。女性的反应差异更大，可能反映了生物异质性，包括激素状况。结论：尽管两性对omalizumab的长期反应具有可比性，但男性CSU患者的临床改善更快、更一致。女性患者的较大差异可能与免疫或激素辅助因素有关。未来的研究应考虑绝经状态和免疫状况，以确定反应修饰亚组，并支持CSU的个性化治疗策略。
{"title":"Early control or gradual relief? Gender-specific real-world insights into omalizumab response in chronic spontaneous urticaria patients","authors":"Sarah Preis MD , Milena Lisiecki , Tilo Biedermann MD , Sophia Horster MD , Alexander Zink MD, PhD","doi":"10.1016/j.waojou.2025.101163","DOIUrl":"10.1016/j.waojou.2025.101163","url":null,"abstract":"<div><h3>Background</h3><div>Chronic spontaneous urticaria (CSU) disproportionately affects women, yet gender-specific analyses in treatment response remain scarce. Real-world data on the impact of gender on omalizumab efficacy are limited.</div></div><div><h3>Objective</h3><div>To investigate gender-specific differences in clinical characteristics, comorbidities, and response dynamics to omalizumab in a real-life CSU cohort.</div></div><div><h3>Methods</h3><div>We conducted a retrospective, monocentric cohort study including 250 CSU patients (60% female) treated with omalizumab between 2013 and 2023. Clinical characteristics, comorbidities, laboratory parameters, and treatment timelines were analyzed. Disease control was assessed using the Urticaria Control Test (UCT) at 4 timepoints over 12 months. Statistical comparisons were performed using appropriate univariate tests and linear mixed-effects modeling.</div></div><div><h3>Results</h3><div>Female patients had significantly higher rates of autoimmune thyroiditis, asthma, atopic eczema, allergies, and more frequently received long-term thyroid hormone therapy. While both sexes showed substantial improvement in UCT scores over time, male patients achieved faster and more stable disease control, with significantly higher UCT scores at early timepoints (p = 0.027 at timepoint 2, p = 0.004 at timepoint 3). However, overall treatment outcomes after 12 months did not differ significantly between female and male patients. Variability in response was higher among women, possibly reflecting biological heterogeneity, including hormonal status.</div></div><div><h3>Conclusion</h3><div>Although long-term response to omalizumab is comparable between sexes, male CSU patients demonstrate faster and more consistent clinical improvement. The greater variability in female patients may be linked to immunological or hormonal cofactors. Future studies should consider menopausal status and immune profiles to identify response-modifying subgroups and support personalized treatment strategies in CSU.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"19 1","pages":"Article 101163"},"PeriodicalIF":4.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926917","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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