Pub Date : 2025-12-22DOI: 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.
{"title":"Tolerance of the venom immunotherapy switch from a highly purified aluminium hydroxide adsorbed hymenoptera venom extract to a nonpurified aqueous venom extract","authors":"Anna Gschwend MD, PhD, Lukas Joerg MD","doi":"10.1016/j.waojou.2025.101160","DOIUrl":"10.1016/j.waojou.2025.101160","url":null,"abstract":"<div><h3>Background</h3><div>European guidelines caution against switching from purified aluminium-hydroxide–adsorbed (AHA) venom extracts to non-purified aqueous extracts, and supporting data are lacking.</div></div><div><h3>Objective</h3><div>To assess feasibility and short-term safety of switching from Alutard® (AHA) to Venomil® (non-purified aqueous) in routine care.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"19 1","pages":"Article 101160"},"PeriodicalIF":4.3,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841281","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 : 2025-12-18DOI: 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.
{"title":"An international scoping review of epidemiologic studies on severe cutaneous adverse reactions","authors":"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","doi":"10.1016/j.waojou.2025.101145","DOIUrl":"10.1016/j.waojou.2025.101145","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"19 1","pages":"Article 101145"},"PeriodicalIF":4.3,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145792112","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 : 2025-12-15DOI: 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.
{"title":"The exploration of immunological landscape and drug targets in chronic rhinosinusitis with nasal polyps","authors":"Ruxiang Zhang PhD, Peipei Fu PhD, Hao Tian PhD","doi":"10.1016/j.waojou.2025.101140","DOIUrl":"10.1016/j.waojou.2025.101140","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"19 1","pages":"Article 101140"},"PeriodicalIF":4.3,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145750227","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 : 2025-12-01DOI: 10.1016/j.waojou.2025.101148
Rajesh Melaram , James Adefisoye , Donald E. Warden , Stephen Potter , Hasan Arshad , Hongmei Zhang
{"title":"Corrigendum to “Pollen exposures in pregnancy and early life are associated with childhood asthma incidence” [World Allergy Organ J 17 (2024) 1–6]","authors":"Rajesh Melaram , James Adefisoye , Donald E. Warden , Stephen Potter , Hasan Arshad , Hongmei Zhang","doi":"10.1016/j.waojou.2025.101148","DOIUrl":"10.1016/j.waojou.2025.101148","url":null,"abstract":"","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 12","pages":"Article 101148"},"PeriodicalIF":4.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736984","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 : 2025-12-01DOI: 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.
{"title":"Off-label applications of omalizumab: Current insights and perspectives","authors":"Aleksandra Jaromin MD, Aleksandra Wardzyńska MD, PhD","doi":"10.1016/j.waojou.2025.101156","DOIUrl":"10.1016/j.waojou.2025.101156","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 12","pages":"Article 101156"},"PeriodicalIF":4.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736988","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 : 2025-12-01DOI: 10.1016/j.waojou.2025.101146
Laura Huey Mien Lim MSc , Yah Ru Juang BSc , Sanjay H. Chotirmall MB BCh BAO FRCPI FCCP FRCP PhD , Kelvin Bryan Tan PhD , Mariko Siyue Koh MBBS MRCP , John A. Abisheganaden MBBS MRCP MMed FAMS FRCP , David B. Price FRCGP , Ming-Ju Tsai MD PhD , Mei Fong Liew MBBS MRCP MMed , Pei Yee Tiew MD PhD , Anthony Chau Ang Yii MB BChir MA MRCP , Wenjia Chen PhD
Background
In some countries including Singapore, biologic therapies are not routinely available. Instead, oral corticosteroid (OCS) is commonly used for severe asthma management, which could lead to substantial adverse health events.
Objective
To estimate the multimorbidity costs in asthma patients from a multi-ethnic Asian population.
Methods
We examined national health administrative data (2012–2019) from Singapore. Direct medical costs were summed from costs of hospitalisation, emergency department (ED), specialist care, and public primary care. Prescription data were not available but formed part of public primary care costs. We measured cost per patient-year (PY) in 2023 Singaporean dollars (SGD$1 = US$0.76 = ₤0.60 = €0.69). We performed propensity-score matching on asthma and non-asthma patients, and applied generalised linear models to estimate total and excess costs due to asthma, OCS-related comorbidities, and other comorbidity groups.
Results
We identified 19,979 paediatric and 48,237 adult asthma patients (48.2% males, 50.4% Chinese, 13.9% Indian, 26.8% Malay), and matched equal number of non-asthma patients. Paediatric and adult asthma patients respectively incurred $816.3/PY (95% CI: $803.0/PY-$829.5/PY) and $1855.9/PY (95% CI: $1845.0/PY-$1871.0/PY) in total costs. The average ($1610.9/PY [95% CI: $1599.5/PY-$1621.3/PY]) was thrice of non-asthma patients’ ($530.4/PY). Excess costs (mean = $927.2/PY) were driven by asthma ($403.0/PY), OCS-related comorbidities ($104.0/PY), other metabolic disease ($116.4/PY), circulatory diseases ($112.9/PY) and non-asthma respiratory conditions ($107.4/PY). All excess cost components increased steadily over the 8-year study period.
Conclusion
The burden of asthma multimorbidity in Singapore is severe, with a considerable fraction attributable to OCS-related comorbidities. Policies should aim to reduce excess OCS use and enhance integrated multimorbidity management.
{"title":"Economic burden of asthma multimorbidity in Singapore: Shadow costs of steroid use","authors":"Laura Huey Mien Lim MSc , Yah Ru Juang BSc , Sanjay H. Chotirmall MB BCh BAO FRCPI FCCP FRCP PhD , Kelvin Bryan Tan PhD , Mariko Siyue Koh MBBS MRCP , John A. Abisheganaden MBBS MRCP MMed FAMS FRCP , David B. Price FRCGP , Ming-Ju Tsai MD PhD , Mei Fong Liew MBBS MRCP MMed , Pei Yee Tiew MD PhD , Anthony Chau Ang Yii MB BChir MA MRCP , Wenjia Chen PhD","doi":"10.1016/j.waojou.2025.101146","DOIUrl":"10.1016/j.waojou.2025.101146","url":null,"abstract":"<div><h3>Background</h3><div>In some countries including Singapore, biologic therapies are not routinely available. Instead, oral corticosteroid (OCS) is commonly used for severe asthma management, which could lead to substantial adverse health events.</div></div><div><h3>Objective</h3><div>To estimate the multimorbidity costs in asthma patients from a multi-ethnic Asian population.</div></div><div><h3>Methods</h3><div>We examined national health administrative data (2012–2019) from Singapore. Direct medical costs were summed from costs of hospitalisation, emergency department (ED), specialist care, and public primary care. Prescription data were not available but formed part of public primary care costs. We measured cost per patient-year (PY) in 2023 Singaporean dollars (SGD$1 = US$0.76 = ₤0.60 = €0.69). We performed propensity-score matching on asthma and non-asthma patients, and applied generalised linear models to estimate total and excess costs due to asthma, OCS-related comorbidities, and other comorbidity groups.</div></div><div><h3>Results</h3><div>We identified 19,979 paediatric and 48,237 adult asthma patients (48.2% males, 50.4% Chinese, 13.9% Indian, 26.8% Malay), and matched equal number of non-asthma patients. Paediatric and adult asthma patients respectively incurred $816.3/PY (95% CI: $803.0/PY-$829.5/PY) and $1855.9/PY (95% CI: $1845.0/PY-$1871.0/PY) in total costs. The average ($1610.9/PY [95% CI: $1599.5/PY-$1621.3/PY]) was thrice of non-asthma patients’ ($530.4/PY). Excess costs (mean = $927.2/PY) were driven by asthma ($403.0/PY), OCS-related comorbidities ($104.0/PY), other metabolic disease ($116.4/PY), circulatory diseases ($112.9/PY) and non-asthma respiratory conditions ($107.4/PY). All excess cost components increased steadily over the 8-year study period.</div></div><div><h3>Conclusion</h3><div>The burden of asthma multimorbidity in Singapore is severe, with a considerable fraction attributable to OCS-related comorbidities. Policies should aim to reduce excess OCS use and enhance integrated multimorbidity management.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 12","pages":"Article 101146"},"PeriodicalIF":4.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624794","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 : 2025-12-01DOI: 10.1016/j.waojou.2025.101153
Stephanie Korn MD, PhD , Eugene R. Bleecker MD , Arnaud Bourdin MD, PhD , Christopher McCrae PhD , Maria L. Jison MD , Andrew Menzies-Gow PhD, FRCP
The majority of patients with severe asthma have an eosinophilic phenotype. Interleukin-5 (IL-5) plays a key role in the pathophysiology of severe eosinophilic asthma (SEA) through its effects on eosinophil maturation, survival, and recruitment to the airways. Benralizumab is an anti-IL-5 receptor α (IL-5Rα) monoclonal antibody that binds to IL-5R on eosinophils. Binding of benralizumab to IL-5R blocks IL-5 binding and leads to eosinophil cell death via natural killer cell-mediated antibody-dependent cellular cytotoxicity, macrophage-mediated antibody-dependent cellular phagocytosis/efferocytosis, and tumour necrosis factor receptor 1-mediated apoptosis; the result is the removal of eosinophils from blood and tissue. Benralizumab was approved for the treatment of SEA in 2017 based on the WINDWARD clinical trial programme, which included the pivotal phase 3 trials SIROCCO and CALIMA. Subsequent clinical studies, as well as real-world evidence studies, have reinforced the efficacy of benralizumab for the treatment of SEA and provided evidence about its safety and tolerability profile, including in children. Clinical data have also demonstrated that reduction of background medications, such as oral and inhaled corticosteroids, is possible in patients with SEA controlled with benralizumab. Benralizumab has been investigated for the treatment of other eosinophil-associated diseases, including a phase 3 study for eosinophilic granulomatosis with polyangiitis (EGPA) in which benralizumab was non-inferior to the anti-IL-5 monoclonal antibody mepolizumab: as a result, benralizumab was recently approved for the treatment of EGPA. Phase 3 studies are ongoing with benralizumab for the treatment of hypereosinophilic syndrome and chronic obstructive pulmonary disease.
{"title":"Benralizumab: Bringing winds of change to eosinophil-associated diseases","authors":"Stephanie Korn MD, PhD , Eugene R. Bleecker MD , Arnaud Bourdin MD, PhD , Christopher McCrae PhD , Maria L. Jison MD , Andrew Menzies-Gow PhD, FRCP","doi":"10.1016/j.waojou.2025.101153","DOIUrl":"10.1016/j.waojou.2025.101153","url":null,"abstract":"<div><div>The majority of patients with severe asthma have an eosinophilic phenotype. Interleukin-5 (IL-5) plays a key role in the pathophysiology of severe eosinophilic asthma (SEA) through its effects on eosinophil maturation, survival, and recruitment to the airways. Benralizumab is an anti-IL-5 receptor α (IL-5Rα) monoclonal antibody that binds to IL-5R on eosinophils. Binding of benralizumab to IL-5R blocks IL-5 binding and leads to eosinophil cell death via natural killer cell-mediated antibody-dependent cellular cytotoxicity, macrophage-mediated antibody-dependent cellular phagocytosis/efferocytosis, and tumour necrosis factor receptor 1-mediated apoptosis; the result is the removal of eosinophils from blood and tissue. Benralizumab was approved for the treatment of SEA in 2017 based on the WINDWARD clinical trial programme, which included the pivotal phase 3 trials SIROCCO and CALIMA. Subsequent clinical studies, as well as real-world evidence studies, have reinforced the efficacy of benralizumab for the treatment of SEA and provided evidence about its safety and tolerability profile, including in children. Clinical data have also demonstrated that reduction of background medications, such as oral and inhaled corticosteroids, is possible in patients with SEA controlled with benralizumab. Benralizumab has been investigated for the treatment of other eosinophil-associated diseases, including a phase 3 study for eosinophilic granulomatosis with polyangiitis (EGPA) in which benralizumab was non-inferior to the anti-IL-5 monoclonal antibody mepolizumab: as a result, benralizumab was recently approved for the treatment of EGPA. Phase 3 studies are ongoing with benralizumab for the treatment of hypereosinophilic syndrome and chronic obstructive pulmonary disease.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 12","pages":"Article 101153"},"PeriodicalIF":4.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736987","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 : 2025-12-01DOI: 10.1016/j.waojou.2025.101147
Heng Wang MSc , Ruoyan Wang MS , Jie Lan PhD , Wanfeng Zhang PhD , Guang Li MD , Hui Nie MD , Longke Ran PhD
Background
Allergic asthma is a heterogeneous inflammatory airway disease with limited biomarkers and unclear immune mechanisms, complicating diagnosis and treatment.
Objectives
This study aimed to identify key genes in allergic asthma patients, assess their role in immune regulation, and screen for potential therapeutic agents.
Methods
RNA was extracted from blood samples of 36 allergic asthma patients and 19 healthy controls for high-throughput sequencing. Differentially Expressed Genes (DEGs) were identified and subjected to Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses. Four key genes were identified by intersecting DEGs with key modular genes from Weighted Gene Co-expression Network Analysis (WGCNA), top-ranked genes from Random Forest (RF), and significant genes from Extreme Gradient Boosting (XGBoost). Core genes were determined via Protein-protein Interaction (PPI) network analysis and further evaluated using immune infiltration and molecular docking.
Results
A total of 333 DEGs were identified, mainly involved in oxygen transport and pathology. TMIGD2, OBSCN, FCGBP, and FBLN2 were screened as key genes, with OBSCN and FBLN2 designated as core genes. Immune infiltration analysis revealed associations between core genes and various immune cells, and molecular docking showed strong binding affinities of midecamycin and paricalcitol to core genes.
Conclusions
This study highlights the roles of OBSCN and FBLN2 in immune regulation in allergic asthma, suggesting midecamycin and paricalcitol as potential therapeutic agents.
{"title":"Identification of diagnostic genes and drug prediction of allergic asthma by integrated bioinformatics analysis, machine learning, and molecular docking","authors":"Heng Wang MSc , Ruoyan Wang MS , Jie Lan PhD , Wanfeng Zhang PhD , Guang Li MD , Hui Nie MD , Longke Ran PhD","doi":"10.1016/j.waojou.2025.101147","DOIUrl":"10.1016/j.waojou.2025.101147","url":null,"abstract":"<div><h3>Background</h3><div>Allergic asthma is a heterogeneous inflammatory airway disease with limited biomarkers and unclear immune mechanisms, complicating diagnosis and treatment.</div></div><div><h3>Objectives</h3><div>This study aimed to identify key genes in allergic asthma patients, assess their role in immune regulation, and screen for potential therapeutic agents.</div></div><div><h3>Methods</h3><div>RNA was extracted from blood samples of 36 allergic asthma patients and 19 healthy controls for high-throughput sequencing. Differentially Expressed Genes (DEGs) were identified and subjected to Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses. Four key genes were identified by intersecting DEGs with key modular genes from Weighted Gene Co-expression Network Analysis (WGCNA), top-ranked genes from Random Forest (RF), and significant genes from Extreme Gradient Boosting (XGBoost). Core genes were determined via Protein-protein Interaction (PPI) network analysis and further evaluated using immune infiltration and molecular docking.</div></div><div><h3>Results</h3><div>A total of 333 DEGs were identified, mainly involved in oxygen transport and pathology. TMIGD2, OBSCN, FCGBP, and FBLN2 were screened as key genes, with OBSCN and FBLN2 designated as core genes. Immune infiltration analysis revealed associations between core genes and various immune cells, and molecular docking showed strong binding affinities of midecamycin and paricalcitol to core genes.</div></div><div><h3>Conclusions</h3><div>This study highlights the roles of OBSCN and FBLN2 in immune regulation in allergic asthma, suggesting midecamycin and paricalcitol as potential therapeutic agents.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 12","pages":"Article 101147"},"PeriodicalIF":4.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736989","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 : 2025-12-01DOI: 10.1016/j.waojou.2025.101150
Song Li MD , Yiwu Zheng PhD , Lei Cheng MD, PhD
Messenger RNA (mRNA) vaccines are composed of mRNA sequences encoding pathogens. The first coronavirus mRNA vaccine (BNT162B2, Pfizer/BioNTech), approved in the United Kingdom in 2020, had prevented approximately 20 million deaths globally within the first year of use. mRNA vaccines were initially used against tumors and infectious diseases, but recent research has also turned its attention to the prevention of allergic diseases. Here, we summarized the characteristics and outcomes of mRNA vaccines in preventing allergic diseases and analyzed their advantages over traditional inactivated vaccines and DNA vaccines. This review focused on the feasibility, potential mechanisms, and preclinical research results of prophylactic allergen mRNA vaccines in the prevention of type I hypersensitivity reactions, and preliminarily addressed the key issues in clinical trials of allergen mRNA vaccines. Allergen mRNA vaccines hold promise for preventing IgE-mediated allergic diseases, yet their potential uses warrant further clinical investigations.
{"title":"Messenger RNA vaccines in the prevention of allergic diseases","authors":"Song Li MD , Yiwu Zheng PhD , Lei Cheng MD, PhD","doi":"10.1016/j.waojou.2025.101150","DOIUrl":"10.1016/j.waojou.2025.101150","url":null,"abstract":"<div><div>Messenger RNA (mRNA) vaccines are composed of mRNA sequences encoding pathogens. The first coronavirus mRNA vaccine (BNT162B2, Pfizer/BioNTech), approved in the United Kingdom in 2020, had prevented approximately 20 million deaths globally within the first year of use. mRNA vaccines were initially used against tumors and infectious diseases, but recent research has also turned its attention to the prevention of allergic diseases. Here, we summarized the characteristics and outcomes of mRNA vaccines in preventing allergic diseases and analyzed their advantages over traditional inactivated vaccines and DNA vaccines. This review focused on the feasibility, potential mechanisms, and preclinical research results of prophylactic allergen mRNA vaccines in the prevention of type I hypersensitivity reactions, and preliminarily addressed the key issues in clinical trials of allergen mRNA vaccines. Allergen mRNA vaccines hold promise for preventing IgE-mediated allergic diseases, yet their potential uses warrant further clinical investigations.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 12","pages":"Article 101150"},"PeriodicalIF":4.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145694546","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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