World Allergy Organization Journal最新文献_第2页

Distinct treatment response trajectories to allergen immunotherapy in allergic asthma and rhinitis: Insights from a multicenter study in routine clinical practice 过敏性哮喘和鼻炎的不同治疗反应轨迹：来自常规临床实践的多中心研究的见解

IF 4.3 2区医学 Q2 ALLERGY

World Allergy Organization Journal

Pub Date : 2026-01-01 DOI: 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.

虽然过敏原特异性免疫疗法（AIT）被认为是一种有效的治疗方法，但其疗效差异很大。然而，对AIT的临床反应轨迹是否在个体之间存在差异以及是否影响其有效性尚未进行研究。目的本研究旨在描述三年AIT （3y-AIT）的真实临床反应轨迹。方法我们在53个中心进行了一项回顾性多中心研究，以确定屋尘螨过敏性哮喘和鼻炎患者接受三年AIT的临床反应轨迹。采用视觉模拟量表（VAS）在4个时间点评估AIT的疗效：基线（AIT前）、治疗1年、2年和3年。基于这些时间点VAS变化的聚类分析用于定义反应轨迹。使用来自52个中心（联盟队列）的数据进行初步分析，并使用来自另一个中心（广州队列）的数据进行验证。结果在联盟队列中，确定了4种不同的临床反应轨迹。第一类患者第一年症状加重，第3年无好转。第二组患者在第2年出现症状恶化，第3年出现明显恢复和积极反应。第3类和第4类，分别以较高和较低的基线症状严重程度为特征，在AIT治疗3年后表现出明显的改善。在广州队列中，观察到类似的4种反应轨迹模式：较高的基线症状严重程度和家庭烟草暴露是集群1的关键特征（p < 0.001），而集群2的呼吸道感染率最高（>；1/年，p < 0.001）。尽管有这些不同的轨迹，第一年的有效性仍然是3年AIT反应的理想预测指标，AUC为0.75。结论：本研究确定了日常临床实践中3年AIT的4种主要治疗反应轨迹，突出了个体间AIT反应的异质性。值得注意的是，第一年的有效性似乎是3年AIT结果的理想预测因子。

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引用次数: 0

The definition of asthma remission in children: A scoping review by the WAO Paediatric Asthma Committee 儿童哮喘缓解的定义：WAO儿科哮喘委员会的范围审查

IF 4.3 2区医学 Q2 ALLERGY

World Allergy Organization Journal

Pub Date : 2026-01-01 DOI: 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.

背景：哮喘缓解已成为潜在的治疗目标。然而，缓解的定义主要集中在成人人群中，对于如何定义儿童缓解的共识有限。目的全面回顾儿童哮喘缓解的定义，并评价这些定义的一致性和适用性。方法本综述按照PRISMA-ScR指南进行。PubMed MEDLINE检索了2010年1月至2024年2月间发表的研究。符合条件的研究包括患有哮喘的儿童和已报告的缓解定义。提取关键缓解标准并进行分类，并使用分层聚类分析来确定关键模式。结果29项研究符合纳入标准。大多数（79.3%）以无临床症状为基础定义儿童哮喘缓解。最常见的缓解期为1 - 2年。68.9%的研究采用了无药物标准。少数研究报告了治疗缓解，但它越来越被认为是一个有效的结果。客观评估，如肺功能正常（21%）和没有支气管高反应性（10.3%），很少被纳入。聚类分析显示缓解定义的3种主要模式：基于症状，基于事件，1种包括客观标准。结论：目前儿科人群哮喘缓解的定义主要是基于症状的，客观生理指标的纳入有限。建立针对儿科人群的基于共识的缓解定义对于确保临床相关性和与现实世界疾病模式的一致性至关重要。

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引用次数: 0

Predictive value of computed tomography for eosinophilic chronic rhinosinusitis with nasal polyps in different histopathologic criteria 不同组织病理标准下嗜酸性慢性鼻窦炎伴鼻息肉的计算机断层扫描预测价值

IF 4.3 2区医学 Q2 ALLERGY

World Allergy Organization Journal

Pub Date : 2026-01-01 DOI: 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.

背景计算机断层扫描（CT）是嗜酸性慢性鼻窦炎伴鼻息肉（eCRSwNP）的一种良好的无创预测工具，如何选择合适的CT参数至关重要，特别是因为目前尚无一致的组织病理学标准来诊断eCRSwNP。目的选择合适的CT参数预测不同标准下的eCRSwNP。方法对147例CRSwNP患者行鼻窦CT扫描和组织病理学检查。采用9个常见CT参数和5个eCRSwNP代表性标准（>5/HPF、>10/HPF、>70/HPF、>；10%/HPF和>；20%/HPF）。采用Logistic回归分析和ROC分析评价CT参数的预测价值。结果9个CT参数中，嗅裂（OC）评分、筛窦与上颌窦比值（E/M）、后筛窦（PE）评分与eCRSwNP显著相关。在eCRSwNP的5个代表性标准中，结果均表明OC评分不仅在单因素分析中是显著的预测因子，在多因素分析中也是最显著的预测因子。同时，将OC得分和E/M比纳入多变量logistic回归模型。模型的临床方便分界点为OC评分>；2和E/M比值>；2.5。结论OC评分、E/M比值、PE评分与鼻息肉组织嗜酸性粒细胞增多有显著相关性。其中，在5个代表性标准中，OC评分是预测eCRSwNP的最佳指标。OC评分与E/M比值结合可获得较好的eCRSwNP预测价值。

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引用次数: 0

Early control or gradual relief? Gender-specific real-world insights into omalizumab response in chronic spontaneous urticaria patients 早期控制还是逐渐缓解？慢性自发性荨麻疹患者对omalizumab反应的性别特异性现实世界见解

IF 4.3 2区医学 Q2 ALLERGY

World Allergy Organization Journal

Pub Date : 2026-01-01 DOI: 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}

引用次数: 0

Retrospective analysis of the efficacy and safety of 100 mg abrocitinib in patients with moderate to severe atopic dermatitis: Real-world study 100mg阿布替尼治疗中重度特应性皮炎的疗效和安全性回顾性分析：现实世界研究

IF 4.3 2区医学 Q2 ALLERGY

World Allergy Organization Journal

Pub Date : 2026-01-01 DOI: 10.1016/j.waojou.2025.101167

Maoying Li MMed , Cuihong Lian MD , Xi Wang MMed

Objective

This study aimed to evaluate the real-world efficacy and safety of abrocitinib in Chinese patients with moderate to severe atopic dermatitis, while exploring the influence of prior dupilumab treatment on therapeutic outcomes. A single-center retrospective cohort study was conducted at the Department of Dermatology, Shenzhen Second People's Hospital, from July 2022 to December 2024.

Materials

A total of 264 patients diagnosed with moderate to severe atopic dermatitis based on the Hanifin-Rajka criteria were enrolled. Participants were categorized into 2 groups: the initial abrocitinib group (n = 168) and the dupilumab-to-abrocitinib switch group (n = 96), depending on their previous exposure to dupilumab therapy.

Treatment

The initial dose of abrocitinib was administered at 100 mg once daily for the first 12 weeks, followed by a gradual tapering schedule: 100 mg every other day from week 12 to week 36, and 100 mg every third day from week 36 to week 48. For 29 patients showing suboptimal response, the dosage was escalated to 200 mg once daily.

Methods

The primary endpoints included the response rates for EASI-75/90, IGA 0/1 (defined as a reduction of ≥2 points from baseline), and PP-NRS4 at 48 weeks. Safety assessments involved monitoring adverse events (AEs). Statistical analyses were performed using SPSS software, including t-tests, analysis of variance, and chi-square tests.

Results

At 48 weeks, the overall response rate for EASI-90 was 42.75%, and the PP-NRS4 response rate was 69.08%. The initial treatment group demonstrated significantly better outcomes compared to the switch group (EASI-90: 47.6% vs. 33.3%, p < 0.05). Regarding safety, 39.02% of patients experienced adverse events, primarily nausea (14.0%) and acne-like rash (11.0%), with no reports of serious adverse events or treatment discontinuation.

Conclusion

Abrocitinib demonstrates rapid and sustained efficacy, particularly in alleviating pruritus, among Chinese patients with moderate to severe atopic dermatitis. The stepwise dose reduction regimen is both safe and feasible. Patients without prior dupilumab exposure exhibited superior therapeutic responses.

目的本研究旨在评价阿布替尼治疗中国中重度特应性皮炎患者的实际疗效和安全性，同时探讨既往杜匹单抗治疗对治疗结果的影响。本研究于2022年7月至2024年12月在深圳市第二人民医院皮肤内科进行单中心回顾性队列研究。根据Hanifin-Rajka标准，共纳入264例诊断为中度至重度特应性皮炎的患者。参与者被分为两组：最初的阿布替尼组（n = 168）和杜匹单抗-阿布替尼转换组（n = 96），这取决于他们以前接受过杜匹单抗治疗。治疗前12周，abrocitinib的初始剂量为100mg，每天一次，随后逐渐减量：从第12周到第36周，每隔一天100mg，从第36周到第48周，每三天100mg。对于29名反应不理想的患者，剂量增加到200mg，每日一次。方法主要终点包括48周时EASI-75/90、IGA 0/1（定义为较基线降低≥2点）和PP-NRS4的缓解率。安全性评估包括监测不良事件（ae）。采用SPSS软件进行统计分析，包括t检验、方差分析和卡方检验。结果治疗48周时，EASI-90总有效率为42.75%，PP-NRS4总有效率为69.08%。与切换组相比，初始治疗组表现出明显更好的结果（EASI-90: 47.6%对33.3%,p < 0.05）。在安全性方面，39.02%的患者出现不良事件，主要是恶心（14.0%）和痤疮样皮疹（11.0%），没有严重不良事件或停止治疗的报告。结论阿布替尼在中国中重度特应性皮炎患者中表现出快速、持续的疗效，特别是在缓解瘙痒方面。逐步减量方案既安全又可行。先前未暴露于dupilumab的患者表现出更好的治疗反应。

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引用次数: 0

Tolerance of the venom immunotherapy switch from a highly purified aluminium hydroxide adsorbed hymenoptera venom extract to a nonpurified aqueous venom extract 毒液免疫疗法的耐受性从高度纯化的氢氧化铝吸附膜翅目毒液提取物切换到非纯化的水毒液提取物

IF 4.3 2区医学 Q2 ALLERGY

World Allergy Organization Journal

Pub Date : 2025-12-22 DOI: 10.1016/j.waojou.2025.101160

Anna Gschwend MD, PhD, Lukas Joerg MD

Background

European guidelines caution against switching from purified aluminium-hydroxide–adsorbed (AHA) venom extracts to non-purified aqueous extracts, and supporting data are lacking.

Objective

To assess feasibility and short-term safety of switching from Alutard® (AHA) to Venomil® (non-purified aqueous) in routine care.

Methods

Retrospective single-centre case series (March 2021–August 2024). Fifteen patients with hymenoptera venom allergy (13 bee, 2 wasp) on maintenance Alutard® were switched to Venomil®. Starting doses and escalation were individualised. Primary outcome was tolerability during switch; secondary outcomes were visits required to re-establish maintenance dosing.

Results

Before switching, 10/15 were on 100 μg and 5/15 on 200 μg. Starting Venomil® doses were 20 μg (7/15), 30 μg (1/15), or 50 μg (6/15); 1 patient underwent ultra-rush re-induction after a systemic field sting on 100,000 SQU Alutard®. Fourteen of 15 patients tolerated the switch without systemic events; 1 bee-venom patient developed a Mueller grade II reaction during escalation toward 100 μg but subsequently reached 200 μg with gradual outpatient increments. Among those without events, 9/13 reached 100 μg on day 1 and 4/13 by day 7; achieving 200 μg typically required 3–4 visits.

Conclusions

In a real-world setting with product constraints, switching from purified AHA to a non-purified aqueous extract was feasible and generally well tolerated when dosing was individualised and monitored. Prospective, standardised studies with sting-challenge endpoints are warranted.

背景：欧洲指南警告不要从纯化的氢氧化铝吸附（AHA）毒液提取物转向非纯化的水提取物，并且缺乏支持数据。目的评价在常规护理中从Alutard®（AHA）改用Venomil®（非纯化水）的可行性和短期安全性。方法回顾性单中心病例系列（2021年3月- 2024年8月）。将15例膜翅目毒液过敏患者（13例蜜蜂，2例黄蜂）从维持Alutard®改为Venomil®。起始剂量和剂量递增是个体化的。主要结局是转换期间的耐受性；次要结果是重新建立维持剂量所需的就诊。结果切换前，10/15的人使用100 μg， 5/15的人使用200 μg。Venomil®起始剂量分别为20 μg（7/15）、30 μg（1/15）、50 μg (6/15)；1例患者在100,000 SQU Alutard®系统野刺后进行了超快速再诱导。15例患者中有14例耐受转换，无系统性事件；1例蜂毒患者在向100 μg升高时出现Mueller II级反应，但随后随着门诊逐渐增加达到200 μg。无事件组中，9/13在第1天达到100 μg， 4/13在第7天达到100 μg；达到200 μg通常需要3-4次访问。结论：在具有产品限制的现实环境中，从纯化AHA转换为非纯化的水提取物是可行的，并且在个体化和监测剂量时通常耐受良好。有必要进行具有刺穿挑战终点的前瞻性、标准化研究。

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引用次数: 0

An international scoping review of epidemiologic studies on severe cutaneous adverse reactions 严重皮肤不良反应流行病学研究的国际范围综述

IF 4.3 2区医学 Q2 ALLERGY

World Allergy Organization Journal

Pub Date : 2025-12-18 DOI: 10.1016/j.waojou.2025.101145

Jeayoon Lee PharmD , Hee jung Ha PharmD , Minoh Ko PharmD, PhD , In-Wha Kim PhD , Hayeon Kim PharmD , Kyungim Kim PhD , Hye-Ryun Kang MD, PhD , Jung Mi Oh PharmD

Background

Severe cutaneous adverse reactions (SCARs) are rare but potentially life-threatening drug hypersensitivity reactions. Understanding their epidemiology is critical for improving patient management and informing preventive strategies.

Objective

This scoping analysis aims to systematically examine international epidemiologic studies on SCARs, identify geographic patterns and research gaps, and propose directions for future SCAR epidemiology research.

Methods

A scoping review of observational studies on SCAR epidemiology published between January 2018 and July 2025 was conducted using PubMed and Embase. Studies were selected based on predefined criteria, with additional hand-searching. Data were extracted on study design, geographic region, data sources, and culprit drug classes.

Results

A total of 143 studies were included. The Asia-Pacific region accounted for the largest share (55.9%), followed by Europe (20.9%) and North America (16.8%), with limited representation from Africa and South America. Hospital medical records were the most common data source (54.5%), followed by pharmacovigilance databases (23.1%) and registries (13.3%). Most studies focused on general SCAR epidemiology (58.4%), with others addressing drug-specific (28.7%) and pediatric SCAR (13.3%). Traditional high-risk drugs including anticonvulsants, antigout agents, antibiotics, and antipyretics were reported across all regions, while antituberculosis drugs and traditional medicines were more frequent in the Asia-Pacific. Emerging trends include immune checkpoint inhibitor (ICI)-related SCARs, reflecting the expanding use of novel cancer therapies.

Conclusion

Substantial regional disparities were identified in SCAR epidemiology research. These findings highlight the need for standardized data collection, expanded surveillance infrastructure, and region-specific strategies to improve international drug safety as well as SCAR prevention and management.

背景：严重皮肤不良反应（scar）是罕见的，但可能危及生命的药物过敏反应。了解其流行病学对于改善患者管理和告知预防策略至关重要。目的系统分析SCAR的国际流行病学研究，确定SCAR的地理分布和研究差距，为今后SCAR流行病学研究提出方向。方法利用PubMed和Embase对2018年1月至2025年7月发表的SCAR流行病学观察性研究进行范围综述。研究是根据预定义的标准选择的，并进行额外的人工搜索。从研究设计、地理区域、数据来源和罪魁祸首药物类别中提取数据。结果共纳入143项研究。亚太地区所占份额最大（55.9%），其次是欧洲（20.9%）和北美（16.8%），非洲和南美的代表数量有限。医院病历是最常见的数据来源（54.5%），其次是药物警戒数据库（23.1%）和登记处（13.3%）。大多数研究关注一般SCAR流行病学（58.4%），其他研究关注药物特异性（28.7%）和儿科SCAR（13.3%）。包括抗惊厥药、抗痛风药、抗生素和退烧药在内的传统高危药物在所有地区都有报告，而抗结核药物和传统药物在亚太地区更为常见。新兴趋势包括免疫检查点抑制剂（ICI）相关的疤痕，反映了新的癌症治疗方法的扩大使用。结论SCAR流行病学研究存在明显的地区差异。这些发现强调需要标准化的数据收集、扩大监测基础设施和针对特定区域的战略，以改善国际药物安全以及SCAR的预防和管理。

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引用次数: 0

The exploration of immunological landscape and drug targets in chronic rhinosinusitis with nasal polyps 慢性鼻窦炎伴鼻息肉的免疫景观及药物靶点探讨

IF 4.3 2区医学 Q2 ALLERGY

World Allergy Organization Journal

Pub Date : 2025-12-15 DOI: 10.1016/j.waojou.2025.101140

Ruxiang Zhang PhD, Peipei Fu PhD, Hao Tian PhD

Background

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a prevalent inflammatory disorder characterized by nasal obstruction and polyp formation. Despite its prevalence, the complex pathogenesis of CRSwNP remains not fully understood, hindering the development of effective treatments. This study aims to delineate the immunological landscape of CRSwNP by integrating single-cell RNA sequencing (scRNA-seq) and Mendelian randomization (MR) approaches.

Methods

We conducted a systematic MR analysis using summary statistics from genome-wide association studies (GWAS) and expression quantitative trait loci (eQTL) data. The identified genes were further scrutinized through scRNA-seq analysis of CRSwNP tissues to assess cell-specific expression patterns. Pathway enrichment and protein-protein interaction (PPI) network analyses were performed to explore the biological mechanisms underlying CRSwNP.

Results

The MR analysis identified several genes, including HLA-DRB1, HLA-DQA1, and HLA-DQB1, as significantly associated with CRSwNP. The scRNA-seq analysis validated these findings, revealing cell-specific enrichment in basal cells. Notably, these genes were found to be involved in immune cell recruitment and the reshaping of the immune microenvironment. Furthermore, the study highlighted the role of genes like TCF7L1, KANSL1-AS1, and POLR2J3, which showed contrasting expression patterns and potential regulatory roles in CRSwNP.

Conclusion

This integrative study provides novel insights into the molecular and cellular underpinnings of CRSwNP. The identified genes and their role in immunopathogenesis offer potential therapeutic targets and highlight the importance of cell-specific gene expression in disease mechanisms. The combination of MR with scRNA-seq represents a powerful approach to elucidate complex traits and may pave the way for precision medicine in CRSwNP management.

慢性鼻窦炎伴鼻息肉（CRSwNP）是一种以鼻塞和息肉形成为特征的常见炎症性疾病。尽管CRSwNP普遍存在，但其复杂的发病机制仍未完全了解，这阻碍了有效治疗方法的发展。本研究旨在通过整合单细胞RNA测序（scRNA-seq）和孟德尔随机化（MR）方法来描绘CRSwNP的免疫学景观。方法利用全基因组关联研究（GWAS）和表达数量性状位点（eQTL）数据的汇总统计数据进行系统的MR分析。通过CRSwNP组织的scRNA-seq分析进一步仔细检查鉴定的基因，以评估细胞特异性表达模式。通过通路富集和蛋白-蛋白相互作用（PPI）网络分析来探索CRSwNP的生物学机制。结果MR分析确定了几个基因，包括HLA-DRB1、HLA-DQA1和HLA-DQB1，与CRSwNP显著相关。scRNA-seq分析证实了这些发现，揭示了基底细胞中的细胞特异性富集。值得注意的是，这些基因被发现参与免疫细胞募集和免疫微环境的重塑。此外，该研究强调了TCF7L1、KANSL1-AS1和POLR2J3等基因在CRSwNP中的作用，这些基因在CRSwNP中表现出不同的表达模式和潜在的调节作用。这项综合研究为CRSwNP的分子和细胞基础提供了新的见解。已鉴定的基因及其在免疫发病机制中的作用提供了潜在的治疗靶点，并突出了细胞特异性基因表达在疾病机制中的重要性。MR与scRNA-seq的结合代表了一种阐明复杂性状的有力方法，并可能为CRSwNP管理的精准医学铺平道路。

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引用次数: 0

Corrigendum to “Pollen exposures in pregnancy and early life are associated with childhood asthma incidence” [World Allergy Organ J 17 (2024) 1–6] “孕期和早期接触花粉与儿童哮喘发病率相关”[世界过敏器官J 17(2024) 1-6]的勘误表

IF 4.3 2区医学 Q2 ALLERGY

World Allergy Organization Journal

Pub Date : 2025-12-01 DOI: 10.1016/j.waojou.2025.101148

Rajesh Melaram , James Adefisoye , Donald E. Warden , Stephen Potter , Hasan Arshad , Hongmei Zhang

引用次数: 0

Off-label applications of omalizumab: Current insights and perspectives omalizumab的适应症外应用：当前的见解和观点

IF 4.3 2区医学 Q2 ALLERGY

World Allergy Organization Journal

Pub Date : 2025-12-01 DOI: 10.1016/j.waojou.2025.101156

Aleksandra Jaromin MD, Aleksandra Wardzyńska MD, PhD

Omalizumab is a humanized monoclonal antibody that binds free IgE. Consequently, it exhibits inhibitory properties against allergic cascades. Over the past 20 years, omalizumab has been in the market, and studies have shown its strong tolerability and safety profile. Since 2003 in the United States of America and 2005 in Europe, omalizumab has been available to patients as a therapeutic option. In Europe, it is registered for the treatment of allergic asthma, chronic spontaneous urticaria, and chronic sinusitis with polyps. In the United States, it has been registered for the treatment of allergic asthma, chronic spontaneous urticaria, and chronic food allergies in children over 1 year of age. With a universal target point for most allergic conditions, omalizumab has the potential to become the most versatile biological drug for allergologists. The literature describes numerous uses of omalizumab as an adjuvant or monotherapy for allergic conjunctivitis, systemic mastocytosis, food allergies, drug hypersensitivity, allergic bronchopulmonary aspergillosis, and allergen immunotherapy, among others. In the following publication, we will provide you with the current knowledge regarding the use of omalizumab in conditions other than those covered by the current product registration.

Omalizumab是一种结合游离IgE的人源化单克隆抗体。因此，它表现出对过敏级联反应的抑制特性。在过去的20年里，omalizumab已经进入市场，研究表明其具有很强的耐受性和安全性。自2003年在美国和2005年在欧洲，omalizumab已作为一种治疗选择提供给患者。在欧洲，它被注册用于治疗过敏性哮喘，慢性自发性荨麻疹和慢性鼻窦炎伴息肉。在美国，它已被注册用于治疗1岁以上儿童的过敏性哮喘、慢性自发性荨麻疹和慢性食物过敏。对于大多数过敏情况，omalizumab具有普遍的靶点，有可能成为过敏症学家最通用的生物药物。文献描述了omalizumab作为过敏性结膜炎、全身性肥大细胞增多症、食物过敏、药物过敏、过敏性支气管肺曲霉病和过敏原免疫治疗等的辅助或单一治疗的许多用途。在接下来的出版物中，我们将为您提供有关在当前产品注册所涵盖的条件之外使用omalizumab的当前知识。

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引用次数: 0