World Allergy Organization Journal最新文献

{"title":"Predicting the effectiveness of omalizumab in patients with refractory chronic rhinosinusitis with nasal polyps comorbid with asthma based on inflammatory biomarkers","authors":"Yutong Sima MD ,&nbsp;Ming Zheng MD ,&nbsp;Yan Zhao PhD ,&nbsp;Siqi Ge PhD ,&nbsp;Chengyao Liu MD ,&nbsp;Ping Wang BS ,&nbsp;Xiangdong Wang MD, PhD ,&nbsp;Luo Zhang MD, PhD","doi":"10.1016/j.waojou.2024.101009","DOIUrl":"10.1016/j.waojou.2024.101009","url":null,"abstract":"<div><h3>Background</h3><div>The treatment of refractory chronic rhinosinusitis with nasal polyps (CRSwNP) with omalizumab has been well studied based on clinical evaluation. Nevertheless, ideal quantitative or qualitative biomarkers for predicting a different response to biologics urgently need to be explored. We aim to identify potential biomarkers for predicting a good or poor response in patients with refractory CRSwNP.</div></div><div><h3>Methodology</h3><div>Patients received an endoscopic and radiological evaluation, a visual analogue scale (VAS) assessment, and a 22-item sinonasal outcome test (SNOT-22). Forty-eight biomarkers involving type 1 (T1), type 2 (T2), and type 3 (T3) inflammatory factors, chemokines, and remodeling factors were detected in nasal secretion and serum samples at baseline and after 24 weeks of omalizumab treatment.</div></div><div><h3>Results</h3><div>Eighteen patients with CRSwNP and 16 patients as control were enrolled. Patients with CRSwNP who received oamlizumab treatment with the SNOT-22 and VAS scores improved by 8.9 and 2 points in 72.22% and 50%, respectively. The nasal polyp score (NPS) and Lund-Mackay score were significantly improved in 55.56% of patients. The concentrations of T2 inflammatory biomarker, granulocyte-macrophage colony-stimulating factor (GM-CSF), T3 inflammatory biomarkers, granulocyte colony-stimulating factor (G-CSF), chemokine (C-X-C motif) ligand (CXCL)-1, and chemokine (C–C motif) ligand-20 (CCL-20), T1 inflammatory biomarker, IP-10 (CXCL-10), and granzyme B in nasal secretion and serum periostin were significantly decreased. Serum CCL-3 (AUC = 0.836) and CCL-4 (AUC = 0.909) levels predicted the improvement of SNOT-22 score, respectively. Serum IL-8 (AUC = 0.883) predicted poor improvement in nasal congestion score. Nasal secretion CXCL-1 (AUC = 0.812), GM-CSF (AUC = 0.813), IgE (AUC = 0.900) and IP-10 (AUC = 0.800) effectively predicted none or less improvement in nasal polyp score.</div></div><div><h3>Conclusions</h3><div>Omalizumab remarkably affects inflammatory mediators in different pathways. CCL-3 and CCL-4 in serum and IgE, CXCL-1, GM-CSF, and IP-10 in nasal secretion may be considered as preferable biomarkers for predicting favorable or ineffective response to omalizumab therapy in patients with refractory CRSwNP comorbid with asthma, based on various clinical indicators.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 1","pages":"Article 101009"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11700293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933555","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":"COVID-19 related epigenetic changes and atopic dermatitis: An exploratory analysis","authors":"Zhenwei Tang MD ,&nbsp;Yu Chen MBBS ,&nbsp;Yuzhen Ouyang MBBS ,&nbsp;Yu Peng MD, PhD ,&nbsp;Xiaoyong Man MD, PhD","doi":"10.1016/j.waojou.2024.101022","DOIUrl":"10.1016/j.waojou.2024.101022","url":null,"abstract":"<div><h3>Background</h3><div>While epidemiological data suggest a connection between atopic dermatitis (AD) and COVID-19, the molecular mechanisms underlying this relationship remain unclear.</div></div><div><h3>Objective</h3><div>To investigate whether COVID-19-related CpGs may contribute to AD development and whether this association is mediated through the regulation of specific genes’ expression.</div></div><div><h3>Methods</h3><div>We combined Mendelian randomization and transcriptome analysis for data-driven explorations.</div></div><div><h3>Results</h3><div>Among the 172 CpGs -associated with COVID-19 infection, merely 3 of them exhibited significant impacts on the risk of AD, including cg04543273, cg11916609, and cg10636246. In the following analysis of the causal effects of CpGs and their related gene expression, cg04543273 inhibited LMAN2 expression. However, there was not a significant impact of cg11916609 and cg10636246 on the expression of their corresponding genes. Besides, transcriptome analysis suggested that LMAN2 expression was significantly upregulated among the COVID-19-infected population, and LMAN2 expression was obviously correlated with Type 2 helper cells across different post-infection time points.</div></div><div><h3>Conclusion</h3><div>Overall, this study provides new insights of the COVID-19-related onset and exacerbation of AD-COVID-19-related epigenetic changes and their regulatory impact on transcription. A novel role of LMAN2 was proposed in the relationship between viral infection and AD. More studies are warranted to further explore the mechanism of LMAN2-related immunopathology.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 1","pages":"Article 101022"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048570","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":"Multi-biofluid metabolomics analysis of allergic respiratory rhinitis and asthma in early childhood","authors":"Chih-Yung Chiu MD, PhD ,&nbsp;Meng-Han Chiang MS ,&nbsp;Chieh-Ni Kuo BS ,&nbsp;Mei-Ling Cheng PhD ,&nbsp;Gigin Lin MD, PhD","doi":"10.1016/j.waojou.2024.101013","DOIUrl":"10.1016/j.waojou.2024.101013","url":null,"abstract":"<div><h3>Background</h3><div>Childhood rhinitis and asthma are allergic respiratory diseases triggered by common allergens, but they affect different parts of the respiratory system, leading to distinct symptoms. However, a comprehensive multi-biofluid metabolomics-based approach to uncover valuable insights into childhood allergies and allergen sensitization remains unaddressed.</div></div><div><h3>Methods</h3><div>Seventy-six children, comprising 26 with rhinitis, 26 with asthma, and 24 healthy controls, were enrolled. Fecal, blood, and urine metabolomic analyses using ¹H nuclear magnetic resonance (NMR) spectroscopy were conducted. An integrative analysis of their associations with allergen-specific IgE levels in the context of allergic rhinitis and asthma were also assessed.</div></div><div><h3>Results</h3><div>The analysis of 228 various biofluid samples revealed strong positive correlations between stool and blood metabolites, while blood metabolites exhibited negative correlations with most urine metabolites. Five and 19 metabolites were significantly different in children with rhinitis and asthma, respectively (<em>P</em> &lt; 0.05). Among them, blood isovaleric acid correlated positively with stool IgE levels in rhinitis, while stool butyric acid and acetic acid in asthma exhibited strong negative correlations with total serum and mite allergen-specific IgE levels (<em>P</em> &lt; 0.01). Blood metabolic profiles appeared to have the highest area under the curve (AUC) of 0.732 for rhinitis, whereas stool metabolic profiles had the highest AUC of 0.799 for asthma.</div></div><div><h3>Conclusions</h3><div>Multiple biofluid metabolomics provides comprehensive insights into childhood allergies, with blood profiles associated with allergic rhinitis and fecal profiles linked to asthma. Their short-chain fatty acid metabolites related to IgE levels emphasize the significant role of the gut microbiota in childhood rhinitis and asthma.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 1","pages":"Article 101013"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985334","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":"Gut microbiota and plasma metabolites in pregnant mothers and infant atopic dermatitis: A multi-omics study","authors":"Bingqian Du MA.Sc ,&nbsp;Aga Shama BA.Sc ,&nbsp;Yi Zhang BA.Sc ,&nbsp;Baolan Chen MA.Sc ,&nbsp;Yongqi Bu BA.Sc ,&nbsp;Pei-an Chen MA.Sc ,&nbsp;Chuzhi Lin BA.Sc ,&nbsp;Jie Liu MA.Sc ,&nbsp;Juan Zheng MA.Sc ,&nbsp;Zhenjun Li MD, PhD ,&nbsp;Qingsong Chen PhD ,&nbsp;Yu Sun PhD ,&nbsp;Xi Fu PhD","doi":"10.1016/j.waojou.2024.101017","DOIUrl":"10.1016/j.waojou.2024.101017","url":null,"abstract":"<div><h3>Background</h3><div>Many studies reported the influence of infants' gut microbiota on atopic dermatitis (AD) postnatally, yet the role of maternal gut microbiota and plasma metabolites in infants’ AD remains largely unexplored.</div></div><div><h3>Methods</h3><div>Sixty-three pregnant mother-infants were enrolled and followed after childbirth in Guangzhou, China. Demographic information, maternal stool and plasma samples, and records for infants’ AD were collected. Maternal gut microbiota/metabolome and plasma metabolome were profiled using shotgun metagenomics and non-targeted metabolomics. Logistic regression and multi-omics analysis were used to explore characteristic maternal gut microbiota in the AD and health groups.</div></div><div><h3>Results</h3><div>The α-diversity of maternal gut microbiota in health group was significantly higher than AD group (Shannon diversity <em>P</em> = 0.02, Simpson diversity <em>P</em> = 0.04). Short-chain fatty acids (SCFAs) producing microorganisms, including <em>Faecalibacterium</em>, <em>Roseburia</em>, <em>Butyricicoccus</em>, and <em>Ruminococcus</em>, as well as the abundance of phenylalanine, tyrosine, and tryptophan biosynthesis pathway, were enriched in health group (LDA&gt;2 and <em>P</em> &lt; 0.05). Virulent factors (VFs) involved in immune modulation were enriched in the health group, while VFs involving in adhesin were enriched in the AD group (<em>P</em> &lt; 0.05). Metabolomic analysis showed that a polyunsaturated fatty acid/linoleic acid, 13S-hydroxyoctadecadienoic, were negatively associated with AD in both the gut and plasma samples (FDR&lt;0.05). Several other linoleic acids and flavonoids were negatively associated with AD (FDR&lt;0.05). Neural network analysis revealed that microorganisms enriched in health group may produce these protective fatty acids.</div></div><div><h3>Conclusions</h3><div>Our findings show that maternal gut microorganisms/metabolites and plasma metabolites during pregnancy impact subsequent pathogenesis of infants AD. This illuminates new strategies against early AD in offspring.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 1","pages":"Article 101017"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030328","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":"Serum and urine eosinophil-derived neurotoxin (EDN) levels predict biologic response in severe asthma","authors":"Yu Ri Kang MD ,&nbsp;Hyunkyoung Kim MS, MPH ,&nbsp;Chae Eun Lee BS ,&nbsp;Jae-Woo Jung MD, PhD ,&nbsp;Ji-Yong Moon MD, PhD ,&nbsp;So Young Park MD, MS ,&nbsp;Sae-Hoon Kim MD, PhD ,&nbsp;Min-Suk Yang MD, PhD ,&nbsp;Byung Keun Kim MD, PhD ,&nbsp;Jae-Woo Kwon MD, PhD ,&nbsp;Hye-Kyung Park MD, PhD ,&nbsp;Young-Hee Nam MD, PhD ,&nbsp;Young-Joo Cho MD, PhD ,&nbsp;Taehoon Lee MD, PhD ,&nbsp;Ian M. Adcock MD, PhD ,&nbsp;Pank Bhavsar MD, PhD ,&nbsp;Kian Fan Chung MD, PhD ,&nbsp;Tae-Bum Kim MD, PhD","doi":"10.1016/j.waojou.2024.100990","DOIUrl":"10.1016/j.waojou.2024.100990","url":null,"abstract":"<div><h3>Background</h3><div>Eosinophils are crucial in allergic inflammation, and their correlation with asthma severity has made them a focal point in predicting treatment outcomes. Blood eosinophil count is a commonly utilized marker. However, its limitations have prompted alternative biomarker exploration, such as eosinophil-derived neurotoxin (EDN).</div></div><div><h3>Objective</h3><div>This research was conducted over 24 weeks on 56 patients with severe asthma treated with mepolizumab, reslizumab, and dupilumab. We aimed to evaluate the clinical significance of blood eosinophil count and their potential, including those of blood EDN levels and urine EDN values as biomarkers for predicting treatment response.</div></div><div><h3>Methods</h3><div>The analysis encompassed examining correlations between biomarkers and clinical features, including exacerbation rates and lung function, through ELISA assays and subsequent statistical analyses. The study protocol is registered at <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> (<span><span>NCT05164939</span><svg><path></path></svg></span>).</div></div><div><h3>Results</h3><div>The findings underscore strong correlations between serum EDN levels, blood eosinophil counts, and treatment responses, with EDN demonstrating comparable predictive capabilities to blood eosinophil counts to determine treatment responses. Different biologics exhibited varying efficacy regarding baseline eosinophil counts and EDN levels.</div></div><div><h3>Conclusions</h3><div>Blood eosinophil counts and EDN levels show potential as predictive markers for treatment responses in patients with severe asthma undergoing biologic therapies. However, further comprehensive studies are warranted to enhance the reliability and applicability of EDN as an effective asthma treatment biomarker.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 1","pages":"Article 100990"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081236","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":"Allergen immunotherapy in Italy: How, when, and why—A real-world study conducted through a patient association","authors":"Giovanni Paoletti MD ,&nbsp;Emanuele Nappi MD ,&nbsp;Maria Chiara Bragato MD ,&nbsp;Paola Valli MD ,&nbsp;Mattia Giovannini MD ,&nbsp;Domenico Gargano MD ,&nbsp;Luca Pecoraro MD ,&nbsp;Deborah Diso MSc ,&nbsp;Simona Barbaglia MSc ,&nbsp;Giorgio Walter Canonica MD ,&nbsp;Enrico Heffler MD, PhD","doi":"10.1016/j.waojou.2024.101015","DOIUrl":"10.1016/j.waojou.2024.101015","url":null,"abstract":"<div><h3>Background</h3><div>Allergen immunotherapy (AIT) is the only treatment that modifies the natural course of allergies. However, AIT is only used in some eligible patients, is frequently underused, and only a few studies investigated this aspects. Understanding AIT utilization patterns might disclose information about why it is underused, thus providing valuable insights on how to broaden the positive impact it can have on the population.</div></div><div><h3>Methods</h3><div>A questionnaire aiming to assess the trends of the use of AIT in Italy, patient health literacy on AIT, and the impact of respiratory allergies and AIT on patients' lives was submitted to patients affiliated with Respiriamo Insieme APS patient's association during the period between May and October 2023.</div></div><div><h3>Results</h3><div>Nine hundred forty-four patients completed the questionnaire. Most patients reported to be affected by allergic rhinitis (81.1%), allergic asthma (45.4%), and/or allergic conjunctivitis (41.2%), and many of them presenting a combination of these diseases. Only 53.8% knew about AIT's existence, and AIT was proposed to only 33.1% of the 858 patients affected by allergic rhinitis and/or allergic asthma, of which 29.2% decided not to initiate the therapy. Common reasons for AIT refusal were related to indecisiveness (26.5%), costs (22.9%), and skepticism (19.3%). Among the remaining 70.8% who accepted to start AIT, 21.4% discontinued the treatment beforehand, on average 18.26 months from initiation. There was a high heterogeneity in the suggested duration of AIT, with 20.4% of patients receiving indications to continue AIT for less than 3 years. AIT positively impacted patients' lives as most patients who completed AIT found it effective and safe, and experienced a significant reduction in the workdays/schooldays lost due to disease exacerbations.</div></div><div><h3>Conclusions</h3><div>The outcomes of this research pointed out a lot of misinformation surrounding AIT, calling for improvements in awareness and information on its efficacy and safety. Also, we noted a significant reduction in work/school days lost in patients who completed AIT and a good patient-reported safety and efficacy profile. We advocate for better economic accessibility through national-level standardization in treatment refundability. Notably, the collaboration with the patient association was crucial, and it would have been challenging to conduct this research otherwise.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 1","pages":"Article 101015"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985326","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":"Changes in anaphylaxis trends and characteristics in emergency department admissions in Türkiye: From 2015 to 2021 based on the Ministry of Health database","authors":"Elif Soyak Aytekin MD ,&nbsp;Seda Şirin MD ,&nbsp;Esra Kıratlı Nalbant MD ,&nbsp;Naim Ata MD ,&nbsp;Ahmet Sertçelik MD ,&nbsp;Mustafa Mahir Ülgü MD ,&nbsp;Şuayip Birinci MD ,&nbsp;Koray Harmancı MD ,&nbsp;Zülfikar Akelma MD","doi":"10.1016/j.waojou.2024.101019","DOIUrl":"10.1016/j.waojou.2024.101019","url":null,"abstract":"<div><h3>Background</h3><div>The incidence of anaphylaxis is increasing worldwide. However, there is a lack of data on anaphylaxis trends in Türkiye. This study aims to analyse trends in anaphylaxis-related emergency department (ED) visits and examines factors associated with fatal anaphylaxis in Türkiye.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed data from Türkiye's Ministry of Health database from 2015 to 2022. Codes from the International Classification of Diseases, 10th revision (ICD-10), were used to identify anaphylaxis.</div></div><div><h3>Results</h3><div>During the study period, a total 21,370 ED admissions for anaphylaxis were identified, and anaphylaxis admissions increased 1.23-fold from 3.90 to 4.79 per 10⁵ population per year. The anaphylaxis trigger was unknown in 79.9% of cases, followed by drugs (11.7%), food (5.7%) and venom (2.7%). Epinephrine was administered in 49.6% of cases, and a total of 424 patients (2.1% of total cases) died. The frequency of intensive care unit (ICU) hospitalization increased 6.0-fold from 2015 to 2021, and age-adjusted average-weighted mortality rate for anaphylaxis was 0.66 per million. Older age, presence of asthma, and ICU hospitalization were found to be significantly associated with fatal anaphylaxis (p &lt; 0.001 for all). Frequencies of death were 9.1% for venom anaphylaxis, 1.2% in drug anaphylaxis, and 0.2% for food anaphylaxis. Epinephrine autoinjector (EAI) was prescribed for 6.9% of all patients.</div></div><div><h3>Conclusions</h3><div>This is the first study of ED admissions for anaphylaxis using a large, nationwide data from Türkiye. Increasing numbers of ED admissions, ICU hospitalizations and mortality show that anaphylaxis is an important public health issue in Türkiye.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 1","pages":"Article 101019"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985331","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":"Biologics as well as inhaled anti-asthmatic therapy achieve clinical remission: Evidence from the Severe Asthma Network in Italy (SANI)","authors":"Giorgio Walter Canonica MD ,&nbsp;Francesco Blasi PhD ,&nbsp;Pierluigi Paggiaro MD ,&nbsp;Enrico Heffler PhD ,&nbsp;Fulvio Braido MD ,&nbsp;Luisa Brussino PhD ,&nbsp;Giulia Scioscia PhD ,&nbsp;Cristina Cardini MsC ,&nbsp;Chiara Oriecuia MsC ,&nbsp;Isabella Sala MsC ,&nbsp;Vincenzo Bagnardi PhD","doi":"10.1016/j.waojou.2024.101016","DOIUrl":"10.1016/j.waojou.2024.101016","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to evaluate the impact of severe asthma (SA) treatments after 12 months in achieving clinical remission (CR) within the context of the Severe Asthma Network in Italy (SANI) using the recent SANI definition of CR on treatment.</div></div><div><h3>Methods</h3><div>CR has been defined by SANI as complete, partial, and no CR. Complete CR is defined by the absence of oral corticosteroids (OCS), no symptoms, no exacerbations, and stable lung function, and partial CR requires the absence of OCS and the fulfillment of 2 out of the other 3 criteria. Patients who do not meet the previous criteria do not reach CR.</div></div><div><h3>Results</h3><div>After 12 months of treatment, 283 patients were selected to evaluate the effectiveness of biologics (225 patients) and inhaled therapy (58 patients) in achieving CR. Among patients treated with biologic agents, 45.8% reached complete CR, 23.1% partial CR, and 31.1% no CR. Differences in CR achievement according to type of biologic agent administered were observed. Interesting results were found when assessing the inhaled therapy (ICS/LABA/LAMA and no biologics) effectiveness: 34.5% patients reached complete CR, 34.5% partial CR, and 31.0% did not reach CR. This finding is noteworthy since it further supports the efficacy of inhaled treatment in certain SA patients and highlights the relevance of using CR as a modern outcome of SA treatments. Chronic rhinosinusitis with nasal polyps (CRSwNP) comorbidity was associated, though not significantly, with CR achievement in patients treated with biologics. Asthma Control Test (ACT) and Asthma Control Questionnaire (ACQ) scores significantly impacted CR (p = 0.003 and p = 0.027, respectively), while biomarkers, namely IgE, blood eosinophils, or fractional exhaled nitric oxide (FeNO), were not associated with CR achievement.</div></div><div><h3>Conclusions</h3><div>This study confirmed the effectiveness of biologics in reaching CR and demonstrated also inhaled therapies able to achieve CR. These innovative findings should encourage post hoc analysis of randomized clinical trials or even retrospective analysis of SA patient cohorts to evaluate CR with different inhaled treatments and further define the populations eligible for each treatment.</div></div><div><h3>Trial registration</h3><div>ClinicalTrials.gov ID: <span><span>NCT06625216</span><svg><path></path></svg></span>; Central Ethics Committee: Comitato Etico Area Vasta Nord-Ovest Toscana (study number 1245/2016, protocol number:73714).</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 1","pages":"Article 101016"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11741032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016365","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":"Tumors in the setting of dupilumab use: A review of the literature","authors":"Shumeng Guo ,&nbsp;Liangchun Wang MD, PhD ,&nbsp;Dingfang Bu MD, PhD ,&nbsp;Fengjie Liu MD, PhD","doi":"10.1016/j.waojou.2024.101006","DOIUrl":"10.1016/j.waojou.2024.101006","url":null,"abstract":"<div><div>Dupilumab is the first monoclonal antibody approved for treating moderate-to-severe atopic dermatitis (AD) and has significantly improved the quality of life of AD patients. However, the safety of dupilumab is yet unclear in the context of cancer. Therefore, we aimed to investigate the safety of dupilumab and its relationship with the progression and occurrence of tumors. By reviewing relevant medical records of 90 patients who had pre-existing tumors before dupilumab treatment or presented new tumors after dupilumab treatment, we found that dupilumab probably had no significant negative effects on most tumors, but several patients with Cutaneous T-cell lymphomas (CTCLs) had relatively unfavorable outcomes during dupilumab treatment. Besides, CTCLs and lymphomas accounted for the majority of patients who presented new tumors after dupilumab treatment. Several patients were first diagnosed with presumed AD and probably were the presentations of CTCL at an early stage, and they developed typical CTCL symptoms after dupilumab treatment. Finally we came to the conclusion that dupilumab is safe for most patients with cancer. However, the effect of dupilumab on CTCLs is disputable. The use of dupilumab requires individual evaluation and closely monitored. When the efficacy is poor, re-evaluation of the diagnosis, especially of CTCLs and related diseases, is necessary.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 1","pages":"Article 101006"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933480","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 baked side: Cow's milk and egg protein threshold dose distributions in children reacting to baked milk and baked egg","authors":"Rocco Luigi Valluzzi MD ,&nbsp;Carla Riccardi MD ,&nbsp;Sara Urbani MD ,&nbsp;Davide Ursi MD ,&nbsp;Deborah Zavettieri MD ,&nbsp;Francesco Di Girolamo PhD ,&nbsp;Lamia Dahdah MD ,&nbsp;Veronica Calandrelli PharmD ,&nbsp;Vincenzo Fierro MD ,&nbsp;Alessandro Fiocchi MD","doi":"10.1016/j.waojou.2024.101012","DOIUrl":"10.1016/j.waojou.2024.101012","url":null,"abstract":"<div><h3>Background</h3><div>Children allergic to milk and egg, but tolerant to baked products, display higher reactivity thresholds than the general population of children allergic to milk and egg. We sought to verify the reactivity thresholds of milk- and egg-allergic children who also react to baked milk and baked egg, respectively.</div></div><div><h3>Methods</h3><div>We retrospectively assessed consecutive oral food challenge (OFC) for baked milk and egg between January 2018 and March 2022 in a population of baked milk- and baked-egg allergic children.</div></div><div><h3>Results</h3><div>Among 407 children included (median age 56 - IQR 31.1–103.7 months, 67.1% male), 93 (23.6%) returned positive OFC results, 41 with baked milk, and 52 with baked egg. The most conservative ED01 was 0.4 mg total protein (IQR 0.1–2.7) for milk and 2.2 mg total protein (IQR 0.6–7.3) for egg. The respective ED05 was 3.9 (IQR 1.1–14) mg for milk and 11.7 (IQR 5–27.2) mg for egg. Such thresholds are consistent to those found for fresh milk (0.8 times for ED01, 1.1 times for ED05). For egg, they are 6.5 (egg ED01), and 7.5 (egg ED05) times lower than for native form.Compared to the currently used thresholds, they are 1.3 (milk ED01), 1.3 (milk ED05), 11 (egg ED01), and 4.9 (egg ED05) times higher.</div></div><div><h3>Conclusions</h3><div>Milk thresholds are similar to those already observed in baked allergic versus baked tolerant children, while EDs for egg are at least 1.6 times higher than those currently indicated.Egg-allergic patients could be exempt from the recommendations of absolute avoidance of foods when present in infinitesimal quantities, represented by precautionary allergen labelling based on current EDs.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 1","pages":"Article 101012"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11714411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958869","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}