Current Allergy and Asthma Reports最新文献

Purpose of review: Dendritic cells are specialized antigen presenting cells that bridge innate and adaptive immune responses. Here, we focus on the role of dendritic cells in food tolerance and food allergy pathogenesis and treatment.

Recent findings: In addition to dendritic cells, the recently identified subset of RORγt⁺ antigen presenting cells appears to contribute to oral tolerance to foods. Dendritic cells play a central role in establishing oral food tolerance, but also in aberrantly promoting allergic sensitization when activated by certain inflammatory environmental stimuli. We review what is known about the environmental signals, dendritic cell subsets, and dendritic cell responses that promote both oral food tolerance and allergic sensitization. We also discuss the role of dendritic cells in emerging food allergy treatments such as oral immunotherapy and sublingual immunotherapy. Dendritic cells thus play important and multifaceted roles in tolerance and allergy to foods, and better mechanistic understanding of what distinguishes these processes could lead to improved food allergy prevention and treatment strategies.

Purpose of review: There is a growing number of allergy delabeling programs across diverse clinical specialties and care settings. The electronic health record (EHR) can be leveraged to facilitate allergy delabeling. The purpose of this review is to describe EHR tools that have been used in allergy delabeling programs. We also provide recommendations for organizations considering EHR-based allergy delabeling workflows that incorporate clinical informatics best practices.

Recent findings: Recent literature describes several EHR tools used in delabeling. These tools can be organized around the steps of the allergy delabeling workflow: 1. Identify eligible patients, 2. Risk stratify, 3. Evaluation and testing, 4. Documentation of outcome, 5. Delabeling, and 6. Allergy label reconciliation. Standardized EHR tools across the allergy delabeling workflow can lead to successful delabeling and support of diverse stakeholders. Partnering with EHR vendors presents an opportunity to make these tools readily available and improve allergy documentation.

Purpose of review: This paper aims to evaluate the burden of contact allergy caused by cosmetic products, identifying the key allergens involved and examining recent regulatory and diagnostic developments. The review addresses which substances commonly induce allergic contact dermatitis and how current trends and emerging allergens impact clinical practice.

Recent findings: Fragrances remain the most prevalent cosmetic allergens, with numerous compounds capable of triggering sensitization. Recent regulatory improvements in fragrance labeling are helping to reduce exposure to major allergens. Preservatives such as formaldehyde and isothiazolinones have historically caused widespread allergic reactions, but restrictions have lowered their incidence. Hair cosmetic allergens, especially para-phenylenediamine (PPD) and related chemicals, continue to cause significant allergic responses in consumers and professionals. Newly recognized allergens appear in sunscreens, skin lightening agents, and natural ingredients like propolis and carvone. The primary diagnostic methods include patch testing with baseline and specialized cosmetic allergen panels, photopatch testing for photoallergens, and repeated open application tests to support clinical evaluation. Contact allergy due to cosmetics is a growing dermatological issue, primarily driven by fragrances and hair dye allergens, with emerging allergens contributing to the evolving landscape. Continued vigilance in diagnosis, improved regulatory measures, and increased reporting are essential to reduce allergy rates and enhance patient care. This review underlines the need for ongoing research and prevention strategies targeting novel cosmetic allergens.

Purpose of the review: The respiratory system is essential for gas exchange and immune defense but is highly susceptible to pathogens and harmful agents. Chronic rhinosinusitis, asthma, COPD, and emerging viral infections represent a global health burden. As the first line of defense, the nasal epithelium plays a central role in respiratory health. Understanding its structural and functional changes is critical for clarifying immune responses and disease mechanisms. This review summarizes recent advances in human nasal epithelial cell (hNEC) models and their applications in respiratory research.

Recent findings: Submerged cultures are simple and suitable for basic assays but lack complexity, whereas air-liquid interface (ALI) cultures allow hNECs to differentiate into physiologically relevant models to preserve native epithelial signatures. It can be integrated with immune co-cultures to capture disease-specific inflammation, and are sensitive to culture expansion methods, underscoring the need for standardization. Patient-derived hNECs are increasingly used to investigate infection dynamics and provide mechanistic insight, while new apical-out organoid systems enable direct access to the epithelial surface, enhancing studies of differentiation, remodeling, and host-pathogen interactions. Nasal epithelial models, especially ALI cultures and organoids, provide powerful tools for investigating respiratory disease mechanisms and guiding therapeutic development.

Purpose of review: This review highlights current limitations of allergen-specific immunotherapy (AIT) methods and introduces microneedles (MNs) as an innovative transdermal platform to enhance AIT safety, efficacy, and patient adherence.

Recent findings: Conventional approaches such as Subcutaneous immunotherapy (SCIT), Sublingual immunotherapy (SLIT), and Oral immunotherapy (OIT) have shown clinical effectiveness but face challenges including systemic adverse reactions, prolonged treatment durations, poor adherence. Meanwhile, Epidermal allergen-specific immunotherapy (EPIT) and other skin-targeted AIT approaches is constrained by the limited epidermal penetration of allergens. Recent preclinical studies demonstrate that MN-based transdermal immunotherapy (MN-TDIT) effectively delivers allergen directly into immune-rich dermal layers, significantly enhancing allergen-specific immune responses, inducing a regulatory T-cell response, modulating Th1/Th2 balance, and decreasing allergic inflammation in preclinical respiratory, skin, and food allergy models. MN-TDIT exhibits clear advantages over existing AIT strategies, including improved immunogenicity, fewer side effects, ease of administration, and potential for self-administration. Further research should focus on resolving formulation stability issues, optimizing controlled allergen release, and validating safety and efficacy in large-scale clinical trials, thus facilitating MNs as a transformative strategy for improving AIT outcomes.

Purpose of review: Until recently, the management of anaphylaxis has been dependent on the avoidance of known triggers combined with the emergent treatment of immediate and, possibly, fatal hypersensitivity reactions. The approval of omalizumab for the prevention of food-induced anaphylaxis heralds a new era for the use of biologics to curtail anaphylactic reactions in susceptible individuals.

Recent findings: As more knowledge is gleaned about the immunologic mechanisms of anaphylaxis, the application of biologics for prophylaxis of anaphylaxis has accelerated. While omalizumab is currently the only approved biologic for averting anaphylaxis, data is accumulating for the use of other biologics as well. These include monoclonal antibodies that target IgE, mast cell receptors, cytokines, and alarmins.

Purpose of review: Central Compartment Atopic Disease (CCAD) is an emerging phenotype of chronic rhinosinusitis. The absence of a standardized diagnostic framework and the presence of heterogeneous reported characteristics underscore the importance of consolidating current knowledge on CCAD. This review aims to enhance understanding of the CCAD phenotype by focusing on its clinical and radiologic features, its association with inhalant allergies, and its therapeutic implications in comparison with other chronic rhinosinusitis phenotypes.

Methods: A systematic review was conducted through searches in five databases from 2017 to June 2025 following SWiM guidelines. The methodological quality and risk of bias of the included studies were evaluated using the Oxford Centre for Evidence-Based Medicine criteria. Data were analyzed using descriptive and qualitative synthesis.

Results: Seventeen studies were included for qualitative synthesis. CCAD diagnosis relied mainly on endoscopic and radiologic findings, often supported by allergy testing. Most patients showed lower rates of asthma, with variable allergic sensitization rates across populations and elevated blood and tissue eosinophils. Compared to other phenotypes, CCAD showed milder disease and favorable outcomes after endoscopic sinus surgery.

Conclusion: CCAD presents unique clinical and immunologic features that differ from other chronic rhinosinusitis subtypes. Standardized diagnostic criteria are needed to improve recognition and guide tailored management strategies.

Purpose of review: This review aims to synthesize existing literature on the genetics of sarcoidosis, including the genetic architectures associated with various clinical phenotypes, as well as current treatment options. It will also examine studies on phenotyping and endophenotyping sarcoidosis, along with offering new perspectives into pharmacogenetics and pharmacogenomics. The latter remains largely unexplored, which could potentially lead to new opportunities and further the goals of precision medicine.

Recent findings: Genetics and genomics have provided new insights into the study of sarcoidosis. According to current literature, there are variations in the genetic structure of sarcoidosis when categorized by phenotypic definitions. A common element among these findings is the HLA-DRB1 gene, which is associated with many autoimmune diseases. Genetic analysis is a valuable tool for identifying patient groups based on their genetic profiles, offering an opportunity to classify patients for targeted treatment approaches. Genetics can provide valuable insights that, when combined with other omics disciplines, can aid in diagnosing and managing sarcoidosis and help discover new disease biomarkers. Genetics improve the detection of sarcoidosis endophenotypes, and the combination of pharmacogenetics and pharmacogenomics will support the use of appropriate treatments and help eliminate unnecessary therapies in patients with specific genetic susceptibility.

Purpose of review: The capacity to rapidly and objectively detect impending anaphylaxis is a crucial unmet need in food allergy, as clinical impression remains the only means of anaphylaxis diagnosis. Changes in the cutaneous barrier during an allergic reaction might offer an objective, rapid, and accessible anaphylaxis detection method.

Recent findings: Changes in cutaneous temperature and skin permeability might serve as markers of anaphylaxis. Existing methods around facial thermography, cutaneous blood flow measurements, electrical impedance spectroscopy, and transepidermal water loss (TEWL) offer varied data as possible food anaphylaxis biomarkers. Further data is needed to validate these and other methods as a means to non-invasively detect anaphylaxis. This review describes key advances in anaphylaxis detection through the cutaneous barrier, most notably around skin barrier function in the context of atopic dermatitis and food allergy.