World Allergy Organization Journal最新文献

{"title":"Cardiovascular and metabolic outcomes associated with moderate-to-severe atopic dermatitis: A systematic review and meta-analysis","authors":"Suvijak Untaaveesup MD ,&nbsp;Thipsukon Amnartpanich MD ,&nbsp;Noraworn Jirattikanwong MD ,&nbsp;Anchaya Boonsom MD ,&nbsp;Treedanuch Treemethawee MD ,&nbsp;Pornteera Srichana MD ,&nbsp;Chettha Yimkijboriharn MD ,&nbsp;Phichayut Phinyo MD, PhD ,&nbsp;Wannada Laisuan MD ,&nbsp;Torpong Thongngarm MD","doi":"10.1016/j.waojou.2025.101035","DOIUrl":"10.1016/j.waojou.2025.101035","url":null,"abstract":"<div><h3>Background</h3><div>Chronic systemic inflammation in individuals with moderate-to-severe atopic dermatitis (AD) potentially predisposes them to metabolic and cardiovascular diseases. Nevertheless, evidence with regard to such association is limited.</div></div><div><h3>Objective</h3><div>To assess the association between metabolic and cardiovascular outcomes and moderate-to-severe AD.</div></div><div><h3>Methods</h3><div>A systematic search was performed through PubMed, Scopus, EMBASE, and Cochrane for population-based studies that addressed the effects of moderate-to-severe AD on metabolic and cardiovascular outcomes compared with the general population from inception to August 31, 2023. Meta-analysis was performed using the random effects model. The pooled odds ratio (OR) and certainty of evidence for each outcome were reported.</div></div><div><h3>Results</h3><div>We included 11 studies, 4 retrospective cohorts, 1 prospective cohort, 4 cross-sectional, and 2 case-control studies involving 405,170 moderate-to-severe AD patients compared to 4,591,478 unaffected controls. Moderate-to-severe AD was associated with a higher risk of myocardial infarction with an OR (95% CI) of 1.33 (1.07, 1.65), angina 1.33 (1.06, 1.66), heart failure 1.56 (1.28, 1.90), stroke 1.45 (1.21, 1.74), hypertension 1.38 (1.18, 1.63), dyslipidemia 1.27 (1.15, 1.41), and metabolic syndrome 1.24 (1.05, 1.42) with very low certainty of evidence. No significantly increased risk of cardiovascular death with an odds ratio (95% CI) of 1.81 (0.96, 3.44) and diabetes of 1.24 (0.91, 1.68) was observed. High heterogeneity was observed in most studies for all of the outcomes.</div></div><div><h3>Conclusion</h3><div>Our meta-analysis demonstrated a modest but significant association between moderate-to-severe AD and increased susceptibility to metabolic and cardiovascular diseases. Initial assessment of cardiovascular and metabolic risk for patients with moderate-to-severe AD should be considered to enable early management strategies.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 3","pages":"Article 101035"},"PeriodicalIF":3.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sensitization profiles to olive pollen allergens and allergic respiratory disease severity in patients from Jaén, Spain: A cross-sectional study","authors":"Manuel Alcántara Villar MD/PhD ,&nbsp;Sara Anaya Anaya MD ,&nbsp;Alicia López Guerrero MD ,&nbsp;Alba Martínez Chamorro Gda ,&nbsp;Carmen Rosa Garrido Gda","doi":"10.1016/j.waojou.2025.101030","DOIUrl":"10.1016/j.waojou.2025.101030","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the molecular sensitization profile of patients allergic to olive pollen and evaluate its correlation with the type and severity of the allergic respiratory disease (ARD).</div></div><div><h3>Patients and methods</h3><div>Observational, cross-sectional study including patients aged 5–55 years with seasonal ARD (rhinitis and/or asthma) due to olive pollen sensitization from the Jaén University Hospital (Jaén, Spain), an area with prolonged high olive pollen exposure. Specific IgE (sIgE) levels to Ole e 1, Ole e 7, and Ole e 9 and clinical variables were considered. ARD severity was categorized according to the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines (rhinitis) and the Guía Española para el Manejo del Asma (GEMAv4.2).</div></div><div><h3>Results</h3><div>We included 1111 patients (mean [SD] age: 23.4 [12.7] years, 47.7% female) with asthma (87.8%) and rhinitis (96.9%). Ole e 1 sensitization was the most prevalent (79.6%), followed by Ole e 7 (62.0%) and Ole e 9 (50.8%); 60.3% of patients were sensitized to more than 1 olive pollen allergen and 19.2% had negative sIgE results. Ole e 1, Ole e 7, and Ole e 9 sensitizations were associated with asthma diagnosis and severity (<em>p</em> &lt; 0.001 for all), Ole e 7 sensitization with rhinitis diagnosis (<em>p</em> = 0.006), and Ole e 1 and Ole e 9 with rhinitis severity (<em>p</em> = 0.007 and <em>p</em> = 0.006, respectively). The Ole e 1, Ole e 7, and Ole e 9 triple sensitization profile was associated with asthma diagnosis (<em>p</em> &lt; 0.001) and severity (<em>p</em> = 0.029), and with rhinitis severity (<em>p</em> = 0.009).</div></div><div><h3>Conclusion</h3><div>Sensitizations to the olive pollen allergens Ole e 7 and Ole e 9 are prevalent in areas with prolonged high pollen exposure and become major allergens together with Ole e 1. In these areas, a considerable proportion of patients allergic to olive pollen have negative sIgE results. Triple sensitization to Ole e 1, Ole e 7, and Ole e 9 is associated with ARD severity and asthma diagnosis. The sensitization profiles based on molecular diagnosis (MD) may affect decisions regarding allergen immunotherapy treatment.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 3","pages":"Article 101030"},"PeriodicalIF":3.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143474134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"WAO - ARIA consensus on chronic cough: Executive summary","authors":"Philip W. Rouadi MD ,&nbsp;Samar A. Idriss MD ,&nbsp;Jean Bousquet MD, PhD ,&nbsp;Mario Morais-Almeida MD ,&nbsp;Cecilio R. Azar MD ,&nbsp;Mona Sulaiman Al-Ahmad MD ,&nbsp;Anahí Yáñez MD ,&nbsp;Maryam Ali Y Al-Nesf MD, MSc ,&nbsp;Talal M. Nsouli MD ,&nbsp;Sami L. Bahna MD, DrPH ,&nbsp;Eliane Abou-Jaoude MD ,&nbsp;Fares H. Zaitoun MD ,&nbsp;Usamah M. Hadi MD ,&nbsp;Glenis K. Scadding MD ,&nbsp;Peter K. Smith MBBS, PhD ,&nbsp;René Maximiliano Gómez MD, PhD ,&nbsp;Sandra N. González-Díaz MD, PhD ,&nbsp;Ludger Klimek MD, PhD ,&nbsp;Georges S. Juvelekian MD ,&nbsp;Moussa A. Riachy MD ,&nbsp;Ignacio J. Ansotegui MD, PhD","doi":"10.1016/j.waojou.2025.101034","DOIUrl":"10.1016/j.waojou.2025.101034","url":null,"abstract":"<div><div>Acute cough is a highly prevalent symptom in clinical practice. Chronic cough is a complex disease with significant impact on quality of life. The mechanistic pathways of chronic cough in cough-comorbid clinical phenotypes are elusive. Mounting evidence suggests presence of a hypersensitive cough reflex and implication of transient receptor potential channels and P2X receptors in cough neuronal pathways. Previously, the World Allergy Organization (WAO)/Allergic Rhinitis and its Impact on Asthma (ARIA) Joint Committee on Chronic Cough published updated experimental and clinical data on chronic cough, in addition to a multidisciplinary care pathway approach to its management. The goal of this manuscript is to provide clinicians with a succinct summary of chronic cough pathophysiology, clinical phenotypes, and management strategies in both primary and cough specialty care. This executive summary is a primer for clinicians on chronic cough. Increasing awareness on the topic among primary care physicians will improve the outcome of management of patients with chronic cough.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 3","pages":"Article 101034"},"PeriodicalIF":3.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143474135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and clinical assessment of a novel probiotic candy in the prevention of respiratory infections in asthmatic children","authors":"Rana Tafrishi ,&nbsp;Hamid Ahanchian ,&nbsp;Seyed ali Jafari ,&nbsp;Abolfazl Pahlevanloo ,&nbsp;Hamidreza Kianifar ,&nbsp;Mohammadali Kiani ,&nbsp;Nasrin Moazzen ,&nbsp;Tahereh sadeghi ,&nbsp;Peter D. Sly","doi":"10.1016/j.waojou.2024.101023","DOIUrl":"10.1016/j.waojou.2024.101023","url":null,"abstract":"<div><h3>Objective</h3><div>Asthma is the most common chronic disease among children. Upper respiratory infections are often the cause of asthma exacerbation. Studies suggested that spore-forming probiotics can reduce viral infections. This study aimed to determine the effect of spore-forming probiotic <em>Bacillus</em> candy on respiratory illnesses in asthmatic children.</div></div><div><h3>Methods &amp; materials</h3><div>In this randomized trial, 69 children aged 7–11 years with mild intermittent asthma were randomized to receive probiotic candy (containing 10¹⁰ CFU probiotic <em>Bacillus</em> coagulans) or placebo candy, daily for 2 months. The primary outcome was the number of viral respiratory infections. Secondary outcomes included salbutamol metered-dose inhaler (MDI) use, oral corticosteroids, school absenteeism, emergency department visits and hospitalizations, and Pediatric Asthma Control Questionnaire (c-ACT).</div></div><div><h3>Results</h3><div>The frequency of symptomatic respiratory illnesses was significantly lower in the probiotic candy group compared to placebo in the first month (0.28 ± 0.45 vs. 0.51 ± 0.50, p = 0.054), the second month (0.08 ± 0.28 vs. 0.41 ± 0.49, p = 0.001) and the total study (0.37 ± 0.54 vs. 0.90 ± 0.73, 0.001). The percent of patients with prednisolone consumption in the probiotic group was lower than the control group (2.9% vs. 14.7%) but did not show a significant difference (p = 0.081) and no difference was seen in the rate of emergency department visits and hospitalization between the 2 groups (both p = 0.254). The use of salbutamol and school absenteeism in the probiotic group was significantly lower than in the control group (p = 0.040 and p = 0.046, respectively. There was no significant difference in the evaluated scores for asthma control (c-ACT) in both probiotic and placebo groups. After the intervention, the difference between the 2 groups has become significant (p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Adding spore-forming probiotic candy containing <em>Bacillus</em> coagulans to standard asthma treatments reduced symptomatic respiratory illnesses over two months. Further studies including longer treatment periods are needed before making recommendations for routine use.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 2","pages":"Article 101023"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143180786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The experiences of ferric carboxymaltose desensitization and provocation","authors":"Fatma Dindar Çelik MD ,&nbsp;Kurtuluş Aksu MD ,&nbsp;Özgür Akkale MD ,&nbsp;Hatice Çelik Tuğlu MD ,&nbsp;Melis Yağdıran MD ,&nbsp;Onur Telli MD ,&nbsp;Gürgün Tuğçe Vural Solak MD ,&nbsp;Enes Çelik MD","doi":"10.1016/j.waojou.2024.101025","DOIUrl":"10.1016/j.waojou.2024.101025","url":null,"abstract":"<div><h3>Background</h3><div>To present the characteristics of drug hypersensitivity reactions (DHR) among iron preparations and to describe the outcomes of rapid drug desensitization (RDD) and drug provocation tests (DPT) of ferric carboxymaltose (FCM).</div></div><div><h3>Methods</h3><div>The retrospective descriptive study comprised patients with hypersensitivy to iron supplements. Low-risk according to the index reaction with iron, 10 patients underwent a 4-step DPT with FCM; an 11-step RDD protocol was administered to 21 patients not classified as low-risk. RDD success was evaluated for each cycle separately, defining successful completion as the implementation of all steps in both RDD and DPT protocols without subsequent early and/or late reactions.</div></div><div><h3>Results</h3><div>Among the 21 patients (mean age: 41.73 ± 10.98 years, all female) hypersensitive to iron underwent FCM RDD, 20 patients (95.2%) successfully completed FCM treatment with RDD. RDD failed in only 1 patient (4.8%). The total number of desensitization cycles was 29, of which 28 (96.5%) were successful. Urticaria was the most common breakthrough hypersensitivity reaction and observed in 7 (33.3%) patients. Ten patients received FCM with DPT. The iron replacement therapy for these 10 patients was successfully completed. Urticaria developed in 2 patients after the completion of DPT.</div></div><div><h3>Conclusions</h3><div>RDD is a dependable procedure facilitating the efficient delivery and completion of FCM treatments in patients with iron hypersensitivity. Additionally, FCM can be applied with DPT in low-risk patients.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 2","pages":"Article 101025"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11787419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repeated and alternate stimulations with dsRNA and SEB alter responses in macrophages and epithelial cells","authors":"Jun-Pyo Choi, PhD ,&nbsp;Yae-Eun Kim, BS ,&nbsp;Min-Kyung Kim, MS ,&nbsp;Mi-Hyun Kang, MS ,&nbsp;Yu-Kyoung Hwang, MD ,&nbsp;Jeong-Eun Yoon, MD ,&nbsp;Yoon-Seok Chang, MD, PhD ,&nbsp;Sae-Hoon Kim, MD, PhD","doi":"10.1016/j.waojou.2025.101026","DOIUrl":"10.1016/j.waojou.2025.101026","url":null,"abstract":"<div><h3>Introduction</h3><div>The innate immune system is activated by foreign molecules via pattern recognition receptors and other surveillance systems, producing diverse cytokines that recruit and activate other immune cells. Recent studies have shown that once activated by foreign molecules, the innate immune system exhibits altered responses upon subsequent exposure to the same or different infectious agents, such as lipopolysaccharides (LPS) or bacteria. However, as these alterations in response to viral infection and staphylococcal enterotoxin B (SEB) in the airways have not been fully elucidated, we focused on the changes in immune responses induced by repeated stimulation of macrophages and epithelial cells with foreign molecules.</div></div><div><h3>Methods</h3><div>THP-1-derived macrophages and BEAS-2B epithelial cells were stimulated with dsRNA (double-stranded RNA) or SEB and cultured in fresh complete medium for 4 days. Subsequently, the cells were re-stimulated with different doses of dsRNA or SEB, and the cytokine and signal phosphorylation levels were evaluated.</div></div><div><h3>Results</h3><div>Repeated stimulation with high dose of dsRNA or SEB, induced an increase in IL-10, CCL2, CCL22, CCL24, CXCL10, and CXCL11 in macrophages, while only repeated stimulation with dsRNA stimulation resulted in an increase in IL-6, CCL2, CCL5, CCL24, CXCL11, and TGF-β in epithelial cells. Cross-stimulation with SEB-dsRNA induced an increase in CCL5, CCL20, CCL22, CCL24, CXCL10, and CXCL11 levels in macrophages. However, in epithelial cells, SEB-dsRNA stimulation increased the levels of CCL5, CXCL11, and TGF-β, while dsRNA-SEB stimulation elevated CCL1, CCL20, CXCL10, and CXCL11. These cytokine changes were driven by distinct phosphorylation patterns in macrophages and epithelial cells, depending on the type and intensity of stimuli.</div></div><div><h3>Conclusion</h3><div>Repeated stimulation with the same or cross-over stimuli induced alterations in the immune response of macrophages and epithelial cells. These observations indicated that persistent airway stimulation can lead to changes in airway inflammation, potentially leading to asthma.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 2","pages":"Article 101026"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143179815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term effects of dupilumab on chronic rhinosinusitis with nasal polyps: A step towards clinical remission","authors":"Mona Al-Ahmad MD, FRCPC ,&nbsp;Asmaa Ali MD, PhD ,&nbsp;Wafaa Talat MD, PhD ,&nbsp;Haitham A. Dawood MD, PhD ,&nbsp;Osama Imam MD, PhD","doi":"10.1016/j.waojou.2024.101024","DOIUrl":"10.1016/j.waojou.2024.101024","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Clinical remission, defined as the absence of disease activity and symptoms, is an emerging goal in the management of chronic rhinosinusitis with nasal polyps (CRSwNP). This study aimed to evaluate the long-term effects of dupilumab on patients with CRSwNP, with or without asthma, and explore the potential for achieving clinical remission.</div></div><div><h3>Methods</h3><div>A two-year prospective study was conducted on 109 patients with CRSwNP, with or without asthma, who were eligible for dupilumab as an add-on therapy. Comprehensive assessments, including clinical, laboratory, and radiological evaluations, were performed before and after treatment. Clinical remission of CRSwNP was defined as 12 months of dupilumab treatment, no exacerbations requiring oral corticosteroids (OCS), no need for nasal sinus operation, no anosmia or hyposmia, a Sino-Nasal Outcome Test (SNOT-22) score under 20, and a Lund-Mackay score (LMS) below 10. For those with comorbid asthma, clinical remission was defined as an asthma control test (ACT) score of 19 or higher, no asthma exacerbations, and no need for OCS.</div></div><div><h3>Results</h3><div>Dupilumab significantly improved CRSwNP outcomes in both groups, including SNOT-22 scores, nasal polyp size (LMS), and anosmia/hyposmia. Comorbid asthma was highly prevalent (79.8%), and patients with asthma had significantly larger nasal polyps, both before and after dupilumab therapy, despite similar symptom improvement. Higher fractional exhaled nitric oxide (FeNO) and blood eosinophil count (BEC) levels, along with anosmia/hyposmia, predicted larger polyp size. Dupilumab also significantly improved asthma outcomes, increasing forced expiratory volume in 1 s (FEV1) and decreasing FeNO. Clinical remission was achieved in 11% of patients, with a slightly lower rate in those with asthma (7.3%).</div></div><div><h3>Conclusion</h3><div>Dupilumab treatment can achieve clinical remission in CRSwNP. However, comorbid asthma appears to reduce the likelihood of remission and is associated with larger nasal polyps, even with similar symptom improvement. Asthma may independently influence polyp development, potentially impacting long-term outcomes in CRSwNP.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 2","pages":"Article 101024"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11787525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High protein diet increases the risk of allergic sensitization but not asthma in mice through modulation of the cytokine milieu toward Th2 bias","authors":"Waleed Al-Herz MD ,&nbsp;Fawaz Azizieh PhD ,&nbsp;Raj Raghupathy PhD","doi":"10.1016/j.waojou.2025.101031","DOIUrl":"10.1016/j.waojou.2025.101031","url":null,"abstract":"<div><h3>Introduction</h3><div>The role of different nutrients in allergic sensitization is not clear. In this study we aimed to determine the effect of high protein (HP) diet on allergic sensitization, cytokine profile, and asthma in mice.</div></div><div><h3>Methods</h3><div>Seven- to eight-week old female BALB/c mice were fed either normal (ND) or HP diet and were sensitized with ovalbumin intraperitoneally followed by intranasal challenge. Allergic sensitization was tested by measuring anti-ovalbumin (OVA) IgE, IgG1, and IgG2a antibodies. Cytokine levels were tested by multiplex ELISA in splenocyte supernatants after stimulation. Airway inflammation was tested by measuring total and differential cell counts in bronchoalveolar lavage fluid and by measuring bronchial mucus production, goblet cell hyperplasia and perivascular and peribronchial inflammation severity scores by histologic examination.</div></div><div><h3>Results</h3><div>Mice fed HP diet had a significant increase in weight and higher levels of OVA-specific IgE and IgG1 antibodies compared to the ND group (P-values 0.002, 0.007 and &lt;0.001, respectively). In addition, they showed a selective Th2 bias in cultured splenocyte supernatants compared to the ND group as demonstrated by higher IL-4 and IL-6 levels (P-values &lt;0.001 and 0.011, respectively) and higher ratios of Th2 to Th1 cytokines. However, the level of airway inflammation was comparable between both groups.</div></div><div><h3>Conclusions</h3><div>HP diet increases the risk of allergic sensitization though increase in Th2 cytokines. Efforts should be made to define the upper limit of protein in the diet that does not predispose to allergic sensitization. The effect of diet on health should remain a focus of research for the establishment of optimal health and resilience.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 2","pages":"Article 101031"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143283670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid food desensitization associated with omalizumab before oral immunotherapy","authors":"Bruna Giavina-Bianchi MD,&nbsp;Pedro Giavina-Bianchi MD, PhD","doi":"10.1016/j.waojou.2025.101032","DOIUrl":"10.1016/j.waojou.2025.101032","url":null,"abstract":"<div><div>In this report, we propose an innovative approach to managing patients with food-induced anaphylaxis by performing rapid food desensitization alongside the use of omalizumab as an introductory step to oral immunotherapy. This combined strategy aims to enhance both the safety and effectiveness of the process, which seeks to induce immunological tolerance to food allergens, while reducing the risk of severe allergic reactions during treatment. The use of omalizumab helps prevent anaphylaxis and improves the patient's ability to tolerate the allergen. Rapid desensitization offers significant time and cost savings. As more scientific evidence supports rapid food desensitization, it could become a valuable tool for clinicians managing food-induced anaphylaxis, offering a promising avenue for the treatment of food allergies, especially in complex cases.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 2","pages":"Article 101032"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143179816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Desensitization to colecalciferol in 18 patients with immediate hypersensitivity reactions","authors":"Özge Atik MD ,&nbsp;Fatma Merve Tepetam MD ,&nbsp;Şeyma Özden MD ,&nbsp;Ali Can MD ,&nbsp;Bengü Şaylan MD","doi":"10.1016/j.waojou.2025.101029","DOIUrl":"10.1016/j.waojou.2025.101029","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Hypersensitivity reactions (HSRs) to colecalciferol (vitamin D) have been rarely reported and the mechanism is unknown. As an alternative treatment was not recommended for vitamin D deficiency, a desensitization protocol with colecalciferol can be performed. We found that there is no standard desensitization protocol for vitamin D. In this study, we aimed to investigate clinical features and skin test results of patients with HSRs to the vitamin D and effectiveness of the 6-step desensitization protocol in which we applied oral drops of colecalciferol.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;This retrospective cross-sectional study included 18 patients with a history of HSRs to oral vitamin D supplements and patients who were planned to receive oral vitamin D replacement. Before desensitization, some of the patients underwent skin tests (skin prick test and intradermal test) with colecalciferol, and the results were recorded. Skin tests were not performed in patients with a history of drug use (antihistamine, systemic steroid, omalizumab, etc.) that affected the results of skin tests. All patients were applied an one bag 6-step desensitization protocol with colecalciferol. Vitamin D3 solution was administered totally 30 drop (4000 IU)/day (1 drop:133.33 IU of 3333 IU/mL) dose of colecalciferol (Devit-3®, DEVA-Türkiye, 15 mL/50,000 IU, 1 mL = 25 drop) at 15-minutes intervals without premedication.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The patient group consisted of 16 female subjects (89%); the mean age was 46 ± 12 years. When the patients were evaluated in terms of the risk of hypersensitivity reactions according to their clinical history, 5 patients had a history of anaphylaxis with vitamin D preparations (colecalciferol oral drop, n = 3; colecalciferol capsule, n = 2), and 13 patients had a history of HSRs other than anaphylaxis with isolated cutaneous reactions (pruritus, flushing, urticaria and angioedema) (n = 11, colecalciferol oral drop; n = 2, colecalciferol capsule). Skin prick test (SPT) and intradermal test (IDT) were performed on 9 patients. SPTs and IDTs were negative in all patients. Urticaria occur during desensitization in only one patient but vitamin D replacement was performed within the following 48–72 h after HSRs. All other patients tolerated 30 drop (4000 IU) and have continued to take same dose every day for the last 6 weeks with no adverse reactions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Desensitization with oral vitamin D preparations has a crucial role for patients who can not receive vitamin D supplements by other ways. Vitamin D drop forms, which are better absorbed than capsule forms which contains the lowest units per/mL without the need to dilute the preparation, not contain any additives with HSRs potential such as gelatin and peanut oil are good option. Our 6-step desensitization protocol with oral drop of colecalciferol is a reliable protocol in patients with a history of vitamin D HSR","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 2","pages":"Article 101029"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143179817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}