Frontiers in allergy最新文献

Objective: This study analyzes a case with a JAK1 (Janus Kinase 1) inhibitor was successfully employed to treat a patient with glucocorticoid-resistant acute severe urticaria (ASU), with the aim of improving clinical understanding of this condition.

Methods: A retrospective analysis was conducted on the clinical data, diagnosis, treatment, and prognosis of a patient with acute severe urticaria, who was admitted to the Allergy Department of Tangshan Workers' Hospital on March 10, 2025.

Results: The patient was a 50-year-old female who presented with widespread skin wheals and itching, along with a sensation of throat obstruction for two days. Upon admission, the patient had a body temperature of 38.5°C. Large, irregularly shaped wheals, up to 10 cm in diameter, were observed on the skin. These wheals were bright red with surrounding erythema and increased upon scratching. Laboratory tests indicated elevated levels of white blood cells (WBC), neutrophils percentage, neutrophils absolute value, total IgE, and interleukin-6 (IL-6). A diagnosis of acute severe urticaria was made. Prior to admission, the patient had been administered with betamethasone sodium phosphate, dexamethasone sodium phosphate, methylprednisolone succinate, diphenhydramine, and calcium gluconate at the emergency department without relief in wheals and itching. Upon admission, the patient was treated with glucocorticoids and JAK1 inhibitors, resulting in the complete regression of the rash and normalization of laboratory indicators.

Conclusion: This case suggests that JAK1 inhibitors can achieve satisfactory results in treating glucocorticoid-resistant acute severe urticaria.

Background: Allergy to animal epithelium is on the rise with an estimated 26% of European adults presenting to clinics for suspected inhalant allergy are sensitized to cats, and allergen avoidance measures are often difficult to implement and often ineffective.

Methods: Real-world, retrospective study to evaluate the effectiveness and safety of subcutaneous immunotherapy (SCIT) with depigmented, polymerized cat epithelium extract (Dpg-pol-cat) in adult patients with moderate to severe allergic rhinitis/rhinoconjunctivitis with or without controlled asthma due to cat epithelium sensitization. The primary endpoint was to evaluate the effectiveness of SCIT with Dpg-pol-cat under real-life conditions, as measured by improvement in health-related quality of life (HRQoL) using the validated ESPRINT-15 questionnaire 24 months after treatment initiation.

Results: The study included 28 patients. The median age was 35 years and the median duration of treatment with Dpg-pol-cat was 21.8 months. All patients had a 1-day rush build-up schedule. Significant and sustained improvements in all domains of the ESPRINT-15 questionnaire were observed from month 6 to month 24 of treatment, as well as in reduction of rescue medication use and better asthma control. Specific IgG4 levels increased significantly after 24 months of SCIT, although no significant change was observed in mean anti-Fel d 1 IgG4 levels. Most adverse reactions were local and mild, with systemic reactions, all grade <2 according to the 2010 World Allergy Organization grading system, occurring mainly during the build-up phase.

Conclusions: SCIT with Dpg-pol-cat proved to be effective with an excellent safety profile in this real-world study, making it a good treatment option for patients with rhinitis/rhinoconjunctivitis and asthma due to allergy to cat epithelium.

Background: Air pollution, including particulate matter smaller than 10 (PM₁₀) and 2.5 (PM_2.5) µm, increases the risk for heart and lung diseases, including asthma, but has not been extensively studied as a possible etiology in eosinophilic esophagitis (EoE). We aimed to estimate the associations between exposure to PM_2.5 or PM₁₀ and EoE.

Methods: In this case-control study, using a large national pathology database of esophageal biopsies, EoE cases were defined by having biopsies with ≥15 eosinophils per high-powered field in the absence of other histopathologic causes. Controls were all other patients with esophageal biopsies. Patient residential addresses were geocoded and exposure to PM_2.5 and PM₁₀ were estimated using National Emissions Inventory data at the county level for a 5-year period including the biopsy. We estimated the odds ratios (OR) for EoE as a function of PM_2.5 or PM₁₀ exposure in tons emitted per year air using mixed logistic regression models adjusted for individual- and census tract-level characteristics.

Results: Among 12,062 EoE cases and 229,397 non-EoE controls, the unadjusted OR for PM_2.5 was 1.12 (0.99-1.25) and the adjusted OR was 1.10 (95% CI, 0.99-1.23). The unadjusted OR for PM₁₀ was 1.04 (1.00-1.07) and the adjusted odds ratio was 1.02 (95% CI, 0.99-1.06).

Discussion: Exposure to higher levels of PM₂₅ and PM₁₀ was modestly associated with EoE case status but the association was attenuated by adjusting for potential confounders. The findings suggest any etiologic role for these particulates in EoE would be of small magnitude.

[This corrects the article DOI: 10.3389/falgy.2025.1631479.].

Background: Introducing baked egg into the diet of children with hen's egg allergy (HEA) has been shown to potentially accelerate the development of tolerance to non-heated egg. However, there is no standardized egg ladder (EL) protocol, and different scientific societies across countries recommend varying versions. This study aims to assess the efficacy and safety of the four-step EL (4-EL) compared with the five-step EL (5-EL) in children with IgE-mediated HEA.

Methods: We will perform an open-label randomized trial with two-parallel arms in two departments if the same academic hospital. A total of 84 children with IgE-mediated HEA will be allocated in 1:1 ratio to introduce hen's egg allergy into their diet according to either 4-EL or 5-EL with 4-week break period between subsequent steps. Oral food challenge (OFC) with tested products at each subsequent step of the EL will be conducted in hospital settings. The primary outcome will be the percentage of children with tolerance to non-heated hen's egg proteins defined as non-allergic reaction to raw hen's egg (0.5-1 egg, depending on the age of the patient) during the last OFC; measured at the end of the 18-week observation period for the 4-EL and 24-week observation period for the 5-EL. Secondary outcomes will include the percentage of children with negative OFC to each EL step; the percentage of children with anaphylaxis (including the percentage of those who were treated with epinephrine); the percentage of children with exacerbation of atopic dermatitis; growth; compliance; and quality of life of the caregivers and parents anxiety about adverse events during their child's OFC.

Discussion: This rigorously designed RCT will provide evidence on the efficacy and safety of the 4-EL in children with IgE-mediated HEA. The findings will inform guideline development groups and further confirmatory trials.

Trial registration number: NCT07040111, date of registration: 27 June 2025.

Background: Netherton syndrome (NS) is a rare, autosomal recessive disease resulting from a mutation in the pathogenic variants in the Kazal type 5 (SPINK5) gene. In recent years, the targeted treatment of biological agents has increasingly emerged as a focal point of research.

Case reports: We reported a 4-month-old child and 19-year-old female, both presenting with symptoms including erythema, scaling, and recurring episodes. Subsequently, genetic testing identified a defective SPINK5 gene, leading to a diagnosis of NS. The child received treatment with dupilumab, while the 19-year-old woman alternated between using dupilumab and secukinumab. Both patients had swift and enduring enhancement of skin lesions during the follow-up period.

Conclusion: NS is an uncommon and frequently misdiagnosed hereditary dermatological disease. The management strategies for this condition are diverse, and no consensus exists. We implemented various biologic regimens for distinct patients, all demonstrating favorable outcomes and satisfactory tolerance. Besides, monitoring and evaluating the long-term safety of biologics in combination is essential.

[This corrects the article DOI: 10.3389/falgy.2025.1599797.].

Background: Shrimp allergy (SA) represents a significant public health concern, yet its overall prevalence remains unclear.

Method: A systematic search of PubMed, Web of Science, and Embase through September 30, 2024 identified 40 studies that reported SA prevalence using self-reported symptoms, physician diagnosis, skin prick tests, specific IgE, or food challenge tests.

Results: The pooled prevalence was estimated at 1.90% for self-reported symptomatic SA and 1.94% for self-reported physician-diagnosed SA, while testing via skin prick or specific IgE yielded a prevalence of 2.76%. Notably, symptomatic testing showed a lower prevalence of 0.43%, and food challenge tests confirmed a prevalence of 0.50%. Considerable heterogeneity was observed across studies, with prevalence varying by region and age group, and no publication bias was detected.

Conclusion: These findings indicate that the prevalence of SA varies with diagnostic criteria, age, and region, underscoring the need for harmonized diagnostic standards to improve prevalence estimates and guide public health strategies.

Systematic review registration: identifier [CRD420251003956].

Introduction: Allergic asthma is characterized by airway hyperresponsiveness due to a biased Th2 immune response against harmless environmental substances. While most current treatments alleviate symptoms without altering the disease's progression, allergen-specific immunotherapy (AIT) is the only clinically approved strategy known to modify the natural course of allergic disease. However, AIT has limitations, highlighting the need for improved formulations that provide safer, faster, and more effective immune modulation.

Methods: In this study, we designed bio-mimetic nanoparticles and evaluated their effects in a mouse model of experimental allergic inflammatory airways disease (EAIAD). Mice were sensitized with ovalbumin (OVA) and treated with liposomes or virosomes conjugated with OVA and the TLR7/8 agonist 3M-052. Lung function, inflammatory cell recruitment, cytokine profiles, and immunoglobulin levels were analyzed post-treatment.

Results: Among the tested formulations, liposomes co-delivering OVA and 3M-052 (Lipo-OVA) led to partial improvements in lung mechanics, including lower airway resistance (Rrs) and preserved forced expiratory volume (FEV0.1). Immune profiling revealed formulation-specific effects on eosinophil and macrophage populations, and modest shifts in cytokine secretion patterns. However, no formulation fully resolved airway inflammation or significantly reduced Th2 cytokines or total IgE levels.

Discussion: These findings support the feasibility of nanoparticle-based AIT strategies, while also highlighting the need for further optimization to enhance efficacy, minimize sensitization, and promote sustained long-term immune tolerance.