Pub Date : 2025-11-01Epub Date: 2025-07-21DOI: 10.1016/j.jacig.2025.100539
Souvic Sarker PhD , Jin-Jia Yu MS , Xiaodan Pan PhD , Robert G. Hamilton PhD , Richard Cooper PhD , Changlu Wang PhD
Background
Recent studies have suggested that the effectiveness of environmental intervention is crucial in reducing levels of the mouse allergen Mus musculus (Mus m 1) in inner-city homes. However, the impact of mouse control alone on mouse allergen reduction has not been studied.
Objective
Our aim was to evaluate the effectiveness of 3 house mouse control programs on mouse allergen reduction.
Methods
A total of 18 buildings in 3 cities in New Jersey were randomly divided and assigned to 1 of 3 treatment groups: (1) trapping and baiting (T&B); (2) trapping, baiting, and rodent exclusion (T&B+E); and (3) existing pest control service with no or limited use of bait or glue boards (control). Dust samples from kitchen floors, bedroom floors, and beds were collected and analyzed for Mus m 1 levels at baseline, at 6 months, and at 12 or 24 months after the intervention. The T&B and T&B+E groups were combined for Mus m 1 analyses because there were no differences in mouse infestation rates after intervention between these groups.
Results
Compared with the control, T&B and T&B+E caused greater reduction in Mus m 1 allergen levels in the kitchens in all 3 cities (P < .05). After T&B and T&B+E, kitchen levels of Mus m 1 in New Brunswick, Trenton, and Paterson were reduced by 97.4%, 85.8%, and 34.9%, respectively. In contrast, the kitchen levels of Mus m 1 in the control were reduced by 61.4%, –671.4%, and –289.6%, respectively. However, no significant reduction was observed in the bedroom in the intervention group versus in the control group in any of the 3 cities at the end of the study period.
Conclusion
Effective mouse control alone greatly reduced mouse allergen levels compared with conventional pest control.
最近的研究表明，环境干预的有效性对于降低城市家庭中小鼠过敏原小家鼠（Mus musculus）的水平至关重要。然而，单独控制小鼠对小鼠过敏原减少的影响尚未得到研究。目的评价3种家鼠控制方案对减少小鼠过敏原的效果。方法将新泽西州3个城市18栋建筑物随机分为3个处理组：(1)诱捕和诱饵（T&；B）；(2)诱捕、诱捕和灭鼠（T&B+E）；(3)现有的除虫服务，不使用或限制使用诱饵或胶板（防治）。从厨房地板、卧室地板和床上收集灰尘样本，并在干预后的基线、6个月、12或24个月对Mus m1水平进行分析。T&；B和T&；B+E组合并进行Mus m 1分析，因为干预后两组之间的小鼠侵扰率没有差异。结果与对照组相比，T&；B和T&；B+E对3个城市厨房中Mus 1过敏原水平的降低作用更大（P < 0.05）。在T&；B和T&；B+E之后，新不伦瑞克省、特伦顿和帕特森的厨房Mus m1水平分别下降了97.4%、85.8%和34.9%。相比之下，对照组的厨房中Mus m1的水平分别下降了61.4%、-671.4%和-289.6%。然而，在研究结束时，在三个城市中的任何一个，干预组的卧室与对照组相比都没有明显的减少。结论与常规防治方法相比，单独有效防治可显著降低小鼠变应原水平。
{"title":"Effective pest control alone reduces mouse allergens in low-income housing","authors":"Souvic Sarker PhD , Jin-Jia Yu MS , Xiaodan Pan PhD , Robert G. Hamilton PhD , Richard Cooper PhD , Changlu Wang PhD","doi":"10.1016/j.jacig.2025.100539","DOIUrl":"10.1016/j.jacig.2025.100539","url":null,"abstract":"<div><h3>Background</h3><div>Recent studies have suggested that the effectiveness of environmental intervention is crucial in reducing levels of the mouse allergen <em>Mus musculus</em> (Mus m 1) in inner-city homes. However, the impact of mouse control alone on mouse allergen reduction has not been studied.</div></div><div><h3>Objective</h3><div>Our aim was to evaluate the effectiveness of 3 house mouse control programs on mouse allergen reduction.</div></div><div><h3>Methods</h3><div>A total of 18 buildings in 3 cities in New Jersey were randomly divided and assigned to 1 of 3 treatment groups: (1) trapping and baiting (T&B); (2) trapping, baiting, and rodent exclusion (T&B+E); and (3) existing pest control service with no or limited use of bait or glue boards (control). Dust samples from kitchen floors, bedroom floors, and beds were collected and analyzed for Mus m 1 levels at baseline, at 6 months, and at 12 or 24 months after the intervention. The T&B and T&B+E groups were combined for Mus m 1 analyses because there were no differences in mouse infestation rates after intervention between these groups.</div></div><div><h3>Results</h3><div>Compared with the control, T&B and T&B+E caused greater reduction in Mus m 1 allergen levels in the kitchens in all 3 cities (<em>P</em> < .05). After T&B and T&B+E, kitchen levels of Mus m 1 in New Brunswick, Trenton, and Paterson were reduced by 97.4%, 85.8%, and 34.9%, respectively. In contrast, the kitchen levels of Mus m 1 in the control were reduced by 61.4%, –671.4%, and –289.6%, respectively. However, no significant reduction was observed in the bedroom in the intervention group versus in the control group in any of the 3 cities at the end of the study period.</div></div><div><h3>Conclusion</h3><div>Effective mouse control alone greatly reduced mouse allergen levels compared with conventional pest control.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 4","pages":"Article 100539"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-08-27DOI: 10.1016/j.jacig.2025.100563
Alejandro Ferrer PhD , Mrunal Dehankar MS , Saurabh Baheti MS , Mrinal M. Patnaik MBBS , Thanai Pongdee MD
Background
Hypereosinophilic syndrome (HES) is a rare group of disorders characterized by eosinophilia in blood and/or tissues. The etiology of HES is largely unknown. Characterizing the molecular pathophysiology of HES may improve diagnostic and therapeutic methodology.
Objective
We sought to identify somatic gene variants associated with idiopathic HES using exome sequencing.
Methods
Exome sequencing (SureSelect capture kit, 80× average depth) was performed using either PBMCs or bone marrow cytogenetic pellets from 31 patients with idiopathic HES. We used Mutect2 in tumor-only mode with gnomAD as the germline resource and FilterMutectCalls for confident somatic variant calling. Variants selected had at least 20 supporting reads, variant allele frequency below 35%, high Clinical Annotation of Variants impact, and minor allele frequency of <1% in gnomAD and Mayo Clinic Biobank.
Results
A total of 332 unique variants in 310 genes were identified at least in 1 patient. Of these, 5 genes were found recurrently mutated (present in at least 10% of samples): PRTFDC1 (16%), TYRO3 (16%), TDG (12.9%), TYW1B (12.9%), and ZNF880 (12.9%). Pathway enrichment analysis using the Kyoto Encyclopedia of Genes and Genomes and Gene Ontology databases utilizing all variants identified in the cohort found significant enrichment in pathways related to cell cycle and PI3K-Akt signaling (Kyoto Encyclopedia of Genes and Genomes) and RAS signal transduction (Gene Ontology).
Conclusions
Several somatic mutations were identified in our cohort of patients with idiopathic HES. Increasing the number of patients through collaborative efforts and pursuing functional testing of these variants will help elucidate the importance of these genes in idiopathic HES.
{"title":"Idiopathic hypereosinophilic syndrome: Potential pathologic somatic gene variants identified by exome sequencing","authors":"Alejandro Ferrer PhD , Mrunal Dehankar MS , Saurabh Baheti MS , Mrinal M. Patnaik MBBS , Thanai Pongdee MD","doi":"10.1016/j.jacig.2025.100563","DOIUrl":"10.1016/j.jacig.2025.100563","url":null,"abstract":"<div><h3>Background</h3><div>Hypereosinophilic syndrome (HES) is a rare group of disorders characterized by eosinophilia in blood and/or tissues. The etiology of HES is largely unknown. Characterizing the molecular pathophysiology of HES may improve diagnostic and therapeutic methodology.</div></div><div><h3>Objective</h3><div>We sought to identify somatic gene variants associated with idiopathic HES using exome sequencing.</div></div><div><h3>Methods</h3><div>Exome sequencing (SureSelect capture kit, 80× average depth) was performed using either PBMCs or bone marrow cytogenetic pellets from 31 patients with idiopathic HES. We used Mutect2 in tumor-only mode with gnomAD as the germline resource and FilterMutectCalls for confident somatic variant calling. Variants selected had at least 20 supporting reads, variant allele frequency below 35%, high Clinical Annotation of Variants impact, and minor allele frequency of <1% in gnomAD and Mayo Clinic Biobank.</div></div><div><h3>Results</h3><div>A total of 332 unique variants in 310 genes were identified at least in 1 patient. Of these, 5 genes were found recurrently mutated (present in at least 10% of samples): <em>PRTFDC1</em> (16%), <em>TYRO3</em> (16%), <em>TDG</em> (12.9%), <em>TYW1B</em> (12.9%), and <em>ZNF880</em> (12.9%). Pathway enrichment analysis using the Kyoto Encyclopedia of Genes and Genomes and Gene Ontology databases utilizing all variants identified in the cohort found significant enrichment in pathways related to cell cycle and PI3K-Akt signaling (Kyoto Encyclopedia of Genes and Genomes) and RAS signal transduction (Gene Ontology).</div></div><div><h3>Conclusions</h3><div>Several somatic mutations were identified in our cohort of patients with idiopathic HES. Increasing the number of patients through collaborative efforts and pursuing functional testing of these variants will help elucidate the importance of these genes in idiopathic HES.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 4","pages":"Article 100563"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145219175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-07-01DOI: 10.1016/j.jacig.2025.100528
Signe Voss Vahlkvist PhD , Elana Lavine MD, FRCPC (Clinical Immunology and Allergy), FRCPC (Paediatrics) , Thomas Houmann Petersen MD , Mercedes Romano Rodriguez MSc, MBA , Mark Aagren MSc , Anne Sofie L. Loftager MSc , Mette Bøgelund MSc , Jose Alexandre da Graca da Maia e Costa MD, PGCert Allergy, PGCert Paediatric Allergy
Background
Allergic rhinitis (AR) affects up to 40% of children in the United States and Europe. AR is often associated with asthma and has a negative impact on quality of life for the children and their families.
Objective
We investigated the AR burden in children with moderate to severe perennial AR in Canada, Denmark, and the United Kingdom, focusing on the role of concomitant asthma. We assessed the health impact on the children, their receipt of allergy medication and health care services, and the impact on their families.
Methods
An online survey was distributed to caregivers of children aged 5 to 17 with moderate to severe perennial AR (both with and without asthma) and to a control group of caregivers of children without allergies.
Results
In total, 877 and 855 caregivers of children with perennial AR and without allergies, respectively, completed the survey. Children with AR and asthma, compared with those without asthma, experienced more sleep disturbances (69% vs 58%), schoolwork limitations (33% vs 22%), daily activities restrictions (55% vs 41%), and missed school hours (7.2 vs 4.6 hours per month). Children with AR and asthma had a higher receipt of allergy medication compared with those without asthma, and they also visited their general practitioner more often (4.6 vs 3.5 times a year). Overall, 32% of all caregivers of children with AR expressed dissatisfaction with allergy medication.
Conclusion
Perennial AR, especially with concomitant asthma, imposes a substantial disease burden in children and their families, highlighting the need for long-term disease control.
{"title":"Disease burden in children with moderate to severe perennial allergic rhinitis and concomitant asthma in Canada, Denmark, and the United Kingdom","authors":"Signe Voss Vahlkvist PhD , Elana Lavine MD, FRCPC (Clinical Immunology and Allergy), FRCPC (Paediatrics) , Thomas Houmann Petersen MD , Mercedes Romano Rodriguez MSc, MBA , Mark Aagren MSc , Anne Sofie L. Loftager MSc , Mette Bøgelund MSc , Jose Alexandre da Graca da Maia e Costa MD, PGCert Allergy, PGCert Paediatric Allergy","doi":"10.1016/j.jacig.2025.100528","DOIUrl":"10.1016/j.jacig.2025.100528","url":null,"abstract":"<div><h3>Background</h3><div>Allergic rhinitis (AR) affects up to 40% of children in the United States and Europe. AR is often associated with asthma and has a negative impact on quality of life for the children and their families.</div></div><div><h3>Objective</h3><div>We investigated the AR burden in children with moderate to severe perennial AR in Canada, Denmark, and the United Kingdom, focusing on the role of concomitant asthma. We assessed the health impact on the children, their receipt of allergy medication and health care services, and the impact on their families.</div></div><div><h3>Methods</h3><div>An online survey was distributed to caregivers of children aged 5 to 17 with moderate to severe perennial AR (both with and without asthma) and to a control group of caregivers of children without allergies.</div></div><div><h3>Results</h3><div>In total, 877 and 855 caregivers of children with perennial AR and without allergies, respectively, completed the survey. Children with AR and asthma, compared with those without asthma, experienced more sleep disturbances (69% vs 58%), schoolwork limitations (33% vs 22%), daily activities restrictions (55% vs 41%), and missed school hours (7.2 vs 4.6 hours per month). Children with AR and asthma had a higher receipt of allergy medication compared with those without asthma, and they also visited their general practitioner more often (4.6 vs 3.5 times a year). Overall, 32% of all caregivers of children with AR expressed dissatisfaction with allergy medication.</div></div><div><h3>Conclusion</h3><div>Perennial AR, especially with concomitant asthma, imposes a substantial disease burden in children and their families, highlighting the need for long-term disease control.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 4","pages":"Article 100528"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144931835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-07-21DOI: 10.1016/j.jacig.2025.100543
Jordon Jaggers MD , Cosby Stone Jr. MD, MPH , Matthew Krantz MD , Elizabeth Phillips MD
Background
Diagnosis and management of intravenous iron reactions is often challenging, as skin testing has unproven utility and most reactions are non–IgE-mediated.
Objective
We aimed to identify clinical patterns and tolerability predictors in patients with reactions to intravenous iron.
Methods
We conducted a retrospective cohort study of patients with reactions to intravenous iron who were referred to the Vanderbilt University Medical Center Drug Allergy Clinic from April 2014 through January 2025 and administered a follow-up survey via RedCap to evaluate patient outcomes with future intravenous iron administration.
Results
Of the 51 patients presenting for adverse reactions to intravenous iron, 48 had skin testing performed. The skin testing results were deemed negative in all 48 cases (100%). Notable laboratory test results within 1 year of reaction were low vitamin D level (47%), high parathyroid hormone level (46%), and low phosphorus level (10%). Many patients (56%) were dermatographic, and their drug alert labels included opioids (31%), fluoroquinolones (14%), and radiocontrast dye (8%). Following assessment, 31 patients received intravenous iron (61%) using formulations that were the same as (n = 15 [48%]) and/or different from (n = 17 [55%]) the forumlation initially implicated, with the various modifications including antihistamines, slower infusion rate, and intravenous fluid pretreatment. Of these 31 patients, 27 (87%) tolerated the infusions. Additionally, following evaluation, the patients were surveyed regarding subsequent intravenous iron administrations, eliciting a 29% response rate (n = 15). Of the responders, 7 patients (47%) reported receiving intravenous iron after evaluation; all 7 reported tolerance.
Conclusion
Most reactions to intravenous iron are non–IgE-mediated; however, our study introduces 2 novel observations, namely, a high frequency of dermatographism (56%) and common colabeling of these patients with drug alerts to Mas-related G protein–coupled receptor X2 (MRGPRX2)-activating drugs, suggesting a possible shared pathophysiologic mechanism.
{"title":"Intravenous iron reactions: Insights from an allergy and immunology perspective","authors":"Jordon Jaggers MD , Cosby Stone Jr. MD, MPH , Matthew Krantz MD , Elizabeth Phillips MD","doi":"10.1016/j.jacig.2025.100543","DOIUrl":"10.1016/j.jacig.2025.100543","url":null,"abstract":"<div><h3>Background</h3><div>Diagnosis and management of intravenous iron reactions is often challenging, as skin testing has unproven utility and most reactions are non–IgE-mediated.</div></div><div><h3>Objective</h3><div>We aimed to identify clinical patterns and tolerability predictors in patients with reactions to intravenous iron.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of patients with reactions to intravenous iron who were referred to the Vanderbilt University Medical Center Drug Allergy Clinic from April 2014 through January 2025 and administered a follow-up survey via RedCap to evaluate patient outcomes with future intravenous iron administration.</div></div><div><h3>Results</h3><div>Of the 51 patients presenting for adverse reactions to intravenous iron, 48 had skin testing performed. The skin testing results were deemed negative in all 48 cases (100%). Notable laboratory test results within 1 year of reaction were low vitamin D level (47%), high parathyroid hormone level (46%), and low phosphorus level (10%). Many patients (56%) were dermatographic, and their drug alert labels included opioids (31%), fluoroquinolones (14%), and radiocontrast dye (8%). Following assessment, 31 patients received intravenous iron (61%) using formulations that were the same as (n = 15 [48%]) and/or different from (n = 17 [55%]) the forumlation initially implicated, with the various modifications including antihistamines, slower infusion rate, and intravenous fluid pretreatment. Of these 31 patients, 27 (87%) tolerated the infusions. Additionally, following evaluation, the patients were surveyed regarding subsequent intravenous iron administrations, eliciting a 29% response rate (n = 15). Of the responders, 7 patients (47%) reported receiving intravenous iron after evaluation; all 7 reported tolerance.</div></div><div><h3>Conclusion</h3><div>Most reactions to intravenous iron are non–IgE-mediated; however, our study introduces 2 novel observations, namely, a high frequency of dermatographism (56%) and common colabeling of these patients with drug alerts to Mas-related G protein–coupled receptor X2 (MRGPRX2)-activating drugs, suggesting a possible shared pathophysiologic mechanism.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 4","pages":"Article 100543"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144813994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-08-20DOI: 10.1016/j.jacig.2025.100558
Angela J. Tsuang MD, MSc , Sharon A. Chung MD, MAS , Lisa M. Wheatley MD, MPH , Audrey G. Plough RN, MSN , Joy Laurienzo Panza RN, BSN , Michelle L. Sever PhD , Angela Bianco MD , Noel K. Strong MD , M. Cecilia Berin PhD , Jose C. Clemente PhD , Hugh A. Sampson MD
Background
Food allergy is increasingly common in the United States. Studies suggest that rising cesarean delivery rates are associated with many immune disorders, including allergic diseases. A preceding proof-of-concept study showed that the microbiota of infants born by cesarean delivery could be partially restored via vaginal microbiome exposure at birth via “vaginal seeding”.
Objectives
Described here is the design of a clinical trial to evaluate the effects of vaginal seeding in infants born by cesarean delivery on food allergen sensitization (egg, milk, and peanut) at 12 months of age.
Methods
This study is supported by the Immune Tolerance Network in collaboration with the National Institute of Allergy and Infectious Diseases. ACTIVATE is a single-center, randomized, double-blind, placebo-controlled trial enrolling pregnant women and their newborns who have a first-degree relative with atopic disease (NCT03567707). Forty infants born vaginally and 80 infants born by cesarean delivery, randomized 1:1 to receive vaginal or placebo seeding, will be enrolled. Families are followed for 1 year, with an option to extend the follow-up for a total of 3 years.
Results
The study is currently underway with an enrollment goal of 120 mother–infant pairs. Surveys and samples are collected from mothers and infants during the follow-up period including blood, stool, skin swabs, oral swabs, nasal swabs, maternal vaginal swabs, and breast milk.
Conclusions
This pilot study will provide important data on the effects of vaginal seeding on allergen sensitization, the microbiome, and the development of immune responses in the first 3 years of life.
{"title":"Protocol design for the ACTIVATE clinical trial: Exposure to vaginal microbiome in cesarean-delivered infants at high risk for allergies","authors":"Angela J. Tsuang MD, MSc , Sharon A. Chung MD, MAS , Lisa M. Wheatley MD, MPH , Audrey G. Plough RN, MSN , Joy Laurienzo Panza RN, BSN , Michelle L. Sever PhD , Angela Bianco MD , Noel K. Strong MD , M. Cecilia Berin PhD , Jose C. Clemente PhD , Hugh A. Sampson MD","doi":"10.1016/j.jacig.2025.100558","DOIUrl":"10.1016/j.jacig.2025.100558","url":null,"abstract":"<div><h3>Background</h3><div>Food allergy is increasingly common in the United States. Studies suggest that rising cesarean delivery rates are associated with many immune disorders, including allergic diseases. A preceding proof-of-concept study showed that the microbiota of infants born by cesarean delivery could be partially restored via vaginal microbiome exposure at birth via “vaginal seeding”.</div></div><div><h3>Objectives</h3><div>Described here is the design of a clinical trial to evaluate the effects of vaginal seeding in infants born by cesarean delivery on food allergen sensitization (egg, milk, and peanut) at 12 months of age.</div></div><div><h3>Methods</h3><div>This study is supported by the Immune Tolerance Network in collaboration with the National Institute of Allergy and Infectious Diseases. ACTIVATE is a single-center, randomized, double-blind, placebo-controlled trial enrolling pregnant women and their newborns who have a first-degree relative with atopic disease (NCT03567707). Forty infants born vaginally and 80 infants born by cesarean delivery, randomized 1:1 to receive vaginal or placebo seeding, will be enrolled. Families are followed for 1 year, with an option to extend the follow-up for a total of 3 years.</div></div><div><h3>Results</h3><div>The study is currently underway with an enrollment goal of 120 mother–infant pairs. Surveys and samples are collected from mothers and infants during the follow-up period including blood, stool, skin swabs, oral swabs, nasal swabs, maternal vaginal swabs, and breast milk.</div></div><div><h3>Conclusions</h3><div>This pilot study will provide important data on the effects of vaginal seeding on allergen sensitization, the microbiome, and the development of immune responses in the first 3 years of life.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 4","pages":"Article 100558"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-07-03DOI: 10.1016/j.jacig.2025.100529
Claus Bachert MD, PhD , Guy Brusselle MD, PhD , José Antonio Castillo Vizuete MD, PhD , Ignacio Dávila MD, PhD , Martin Laudien MD, PhD , Veronica Seccia MD, PhD , Peter Schmid-Grendelmeier MD, PhD , Alessandra Vultaggio MD, PhD , Konstantina Kallinikou PhD , Laura Walrave PhD , Ludger Klimek MD, PhD
Background
Managing patients with severe asthma with an eosinophilic phenotype (SEA) with comorbid respiratory conditions such as chronic rhinosinusitis with nasal polyps (CRSwNP) continues to encounter significant challenges and lack of coordinated management among treating physicians.
Objective
The OverSEA study aims to provide insights into current clinical practices and formulate recommendations for managing these patients.
Methods
The two-round Delphi survey, conducted March-June 2023, was developed by a multidisciplinary 11-member Scientific Committee including pulmonologists, allergists, and ear, nose and throat specialists, and involved 205 experts from these specialties across 8 European countries. Consensus was defined as ≥70% agreement. Topics covered included the initial assessment, treatment, follow-up, and multidisciplinary management of patients with SEA and CRSwNP.
Results
There was a consensus that evaluating for CRSwNP (88%), allergic rhinitis (79%), chronic rhinosinusitis without nasal polyps (77%), and aspirin/nonsteroidal anti-inflammatory-exacerbated respiratory disease (71%) is crucial for diagnosing upper respiratory tract comorbidities in patients with SEA. The necessity of a multidisciplinary approach for all stages of disease management (diagnosis, 82%; treatment decision-making, 83%, follow-up, 79%), and the usefulness of biologics in simultaneously managing asthma and CRSwNP symptoms (87%) were emphasized.
Conclusion
The OverSEA study is the largest European initiative providing recommendations for optimizing the management of patients with SEA and comorbid CRSwNP. It underscores the importance of evaluating patients with SEA for comorbid upper airways diseases, particularly CRSwNP, and promotes a multidisciplinary approach, encouraging pulmonologists, allergists, and otorhinolaryngologists to collaborate closely to streamline patient diagnosis, follow-up, and treatment decisions.
{"title":"Consensus from European experts on severe eosinophilic asthma and chronic rhinosinusitis with nasal polyps: Results from the OverSEA Delphi study","authors":"Claus Bachert MD, PhD , Guy Brusselle MD, PhD , José Antonio Castillo Vizuete MD, PhD , Ignacio Dávila MD, PhD , Martin Laudien MD, PhD , Veronica Seccia MD, PhD , Peter Schmid-Grendelmeier MD, PhD , Alessandra Vultaggio MD, PhD , Konstantina Kallinikou PhD , Laura Walrave PhD , Ludger Klimek MD, PhD","doi":"10.1016/j.jacig.2025.100529","DOIUrl":"10.1016/j.jacig.2025.100529","url":null,"abstract":"<div><h3>Background</h3><div>Managing patients with severe asthma with an eosinophilic phenotype (SEA) with comorbid respiratory conditions such as chronic rhinosinusitis with nasal polyps (CRSwNP) continues to encounter significant challenges and lack of coordinated management among treating physicians.</div></div><div><h3>Objective</h3><div>The OverSEA study aims to provide insights into current clinical practices and formulate recommendations for managing these patients.</div></div><div><h3>Methods</h3><div>The two-round Delphi survey, conducted March-June 2023, was developed by a multidisciplinary 11-member Scientific Committee including pulmonologists, allergists, and ear, nose and throat specialists, and involved 205 experts from these specialties across 8 European countries. Consensus was defined as ≥70% agreement. Topics covered included the initial assessment, treatment, follow-up, and multidisciplinary management of patients with SEA and CRSwNP.</div></div><div><h3>Results</h3><div>There was a consensus that evaluating for CRSwNP (88%), allergic rhinitis (79%), chronic rhinosinusitis without nasal polyps (77%), and aspirin/nonsteroidal anti-inflammatory-exacerbated respiratory disease (71%) is crucial for diagnosing upper respiratory tract comorbidities in patients with SEA. The necessity of a multidisciplinary approach for all stages of disease management (diagnosis, 82%; treatment decision-making, 83%, follow-up, 79%), and the usefulness of biologics in simultaneously managing asthma and CRSwNP symptoms (87%) were emphasized.</div></div><div><h3>Conclusion</h3><div>The OverSEA study is the largest European initiative providing recommendations for optimizing the management of patients with SEA and comorbid CRSwNP. It underscores the importance of evaluating patients with SEA for comorbid upper airways diseases, particularly CRSwNP, and promotes a multidisciplinary approach, encouraging pulmonologists, allergists, and otorhinolaryngologists to collaborate closely to streamline patient diagnosis, follow-up, and treatment decisions.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 4","pages":"Article 100529"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144813993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-07-08DOI: 10.1016/j.jacig.2025.100533
Carlo Mümmler MD , Alexandra Lenoir MD , Jeremias Götschke MD , Michael Gerckens MD , Merle Kaiser MD , Moritz Kayser MD , Nora Drick MD , Hendrik Suhling MD , Leonie Biener MD , Carmen Pizarro MD , Dirk Skowasch MD , Nikolaus Kneidinger MD, PhD , Jürgen Behr MD , Katrin Milger MD
Background
Dupilumab is an IL-4Rα antibody approved for treatment of severe asthma. Real-world data on the continuation and cessation patterns of dupilumab and long-term treatment efficacy are scarce.
Objective
We sought to analyze real-world, long-term treatment outcomes and to evaluate trajectories of patients continuing or discontinuing dupilumab therapy over a 3-year period.
Methods
This multicenter, retrospective, real-world cohort study included patients with severe asthma who started dupilumab before March 2021. Data on asthma control, medication, lung function, and annualized exacerbation rates were collected at baseline and 3, 12, and 36 months after initiation of dupilumab therapy. Asthma remission was assessed at 12 months and 36 months after dupilumab initiation.
Results
Of 160 included patients, 95 patients (59%) continued dupilumab therapy for 36 months; 65 patients (41%) discontinued therapy after a median time of therapy of 8 months. Patients who continued dupilumab for 36 months had significant reductions in annual exacerbations (−1; P < .0001) and oral corticosteroid dose (−5.5 mg/day; P < .001) as well as significant improvements in asthma control (asthma control test +5; P < .0001) and lung function (percent predicted of FEV1 +7%; P < .001) compared with baseline. Of patients who continued dupilumab, 30% achieved remission at 12 months, and 26% achieved remission at 36 months. Of the 65 patients who discontinued therapy, 55 switched to another antibody, and 10 did not receive further antibody treatment.
Conclusions
Dupilumab represents an effective long-term treatment option for patients with severe asthma, with sustained treatment effects up to 36 months. Importantly, a relevant proportion of patients achieved remission in this pretreated population.
{"title":"Long-term outcomes of dupilumab therapy in severe asthma: A retrospective, multicenter, real-world study","authors":"Carlo Mümmler MD , Alexandra Lenoir MD , Jeremias Götschke MD , Michael Gerckens MD , Merle Kaiser MD , Moritz Kayser MD , Nora Drick MD , Hendrik Suhling MD , Leonie Biener MD , Carmen Pizarro MD , Dirk Skowasch MD , Nikolaus Kneidinger MD, PhD , Jürgen Behr MD , Katrin Milger MD","doi":"10.1016/j.jacig.2025.100533","DOIUrl":"10.1016/j.jacig.2025.100533","url":null,"abstract":"<div><h3>Background</h3><div>Dupilumab is an IL-4Rα antibody approved for treatment of severe asthma. Real-world data on the continuation and cessation patterns of dupilumab and long-term treatment efficacy are scarce.</div></div><div><h3>Objective</h3><div>We sought to analyze real-world, long-term treatment outcomes and to evaluate trajectories of patients continuing or discontinuing dupilumab therapy over a 3-year period.</div></div><div><h3>Methods</h3><div>This multicenter, retrospective, real-world cohort study included patients with severe asthma who started dupilumab before March 2021. Data on asthma control, medication, lung function, and annualized exacerbation rates were collected at baseline and 3, 12, and 36 months after initiation of dupilumab therapy. Asthma remission was assessed at 12 months and 36 months after dupilumab initiation.</div></div><div><h3>Results</h3><div>Of 160 included patients, 95 patients (59%) continued dupilumab therapy for 36 months; 65 patients (41%) discontinued therapy after a median time of therapy of 8 months. Patients who continued dupilumab for 36 months had significant reductions in annual exacerbations (−1; <em>P</em> < .0001) and oral corticosteroid dose (−5.5 mg/day; <em>P</em> < .001) as well as significant improvements in asthma control (asthma control test +5; <em>P</em> < .0001) and lung function (percent predicted of FEV<sub>1</sub> +7%; <em>P</em> < .001) compared with baseline. Of patients who continued dupilumab, 30% achieved remission at 12 months, and 26% achieved remission at 36 months. Of the 65 patients who discontinued therapy, 55 switched to another antibody, and 10 did not receive further antibody treatment.</div></div><div><h3>Conclusions</h3><div>Dupilumab represents an effective long-term treatment option for patients with severe asthma, with sustained treatment effects up to 36 months. Importantly, a relevant proportion of patients achieved remission in this pretreated population.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 4","pages":"Article 100533"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144780046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Despite the clinical relevance of mucus plugging, the role of spatial distribution of mucus plugs remains unclear in patients with asthma.
Objective
We sought to examine whether greater lower lobe mucus plug dominance is associated with more clinical and pathophysiological impairments in 2 cohorts, including patients with and without bronchiectasis.
Methods
Patients with asthma without and with clinical diagnosis of bronchiectasis underwent chest computed tomography at Kyoto University Hospital (Kyoto cohort) and Japanese multicenters (bronchiectasis and asthma [BEXAS] cohort), respectively. Mucus plugs in airways were visually scored on computed tomography, and the difference in mucus plug score between lower and upper-middle lobes (Δ mucus plug score) was calculated.
Results
Among 176 (Kyoto) and 42 (BEXAS) enrolled patients, 82 and 33 exhibited mucus plug scores greater than or equal to 1, respectively. Higher Δ mucus plug score was associated with lower percentage of the predicted FEV1 and the presence of exacerbation history in both cohorts. Higher Δ mucus plug score was associated with luminal narrowing of the fifth-generation, but not the third- or fourth-generation, lower lobe airways in the Kyoto cohort, and bronchiolitis score in the BEXAS cohort. In the multivariable model, higher Δ mucus plug score was associated with symptoms and exacerbations, independent of whole-lung mucus plug score in the Kyoto cohort.
Conclusions
Lower lobe–dominant mucus plugs were associated with lower lung function and exacerbations in patients with asthma, irrespective of comorbid bronchiectasis. The spatial distribution of mucus plugs additionally to whole-lung mucus plug score may help to understand clinical roles of mucus plugging in asthma.
{"title":"Clinical and pathophysiological roles of lower lobe–dominant mucus plugs on computed tomography in patients with asthma with and without bronchiectasis","authors":"Naoya Tanabe MD, PhD , Hisako Matsumoto MD, PhD , Natsuko Nomura MD, PhD , Yusuke Hayashi MD , Ryo Sakamoto MD, PhD , Mikio Toyoshima MD, PhD , Osamu Matsuno MD, PhD , Toshiyuki Kita MD, PhD , Nobuyuki Hizawa MD, PhD , Takuro Sakagami MD, PhD , Koichi Fukunaga MD, PhD , Mari Miki MD, PhD , Naozumi Hashimoto MD, PhD , Noboru Hattori MD, PhD , Sumito Inoue MD, PhD , Kazuto Matsunaga MD, PhD , Kojiro Otsuka MD, PhD , Takahiro Tsuburai MD, PhD , Hiroaki Iijima MD, PhD , Hiroyuki Nagase MD, PhD , Toyohiro Hirai MD, PhD","doi":"10.1016/j.jacig.2025.100566","DOIUrl":"10.1016/j.jacig.2025.100566","url":null,"abstract":"<div><h3>Background</h3><div>Despite the clinical relevance of mucus plugging, the role of spatial distribution of mucus plugs remains unclear in patients with asthma.</div></div><div><h3>Objective</h3><div>We sought to examine whether greater lower lobe mucus plug dominance is associated with more clinical and pathophysiological impairments in 2 cohorts, including patients with and without bronchiectasis.</div></div><div><h3>Methods</h3><div>Patients with asthma without and with clinical diagnosis of bronchiectasis underwent chest computed tomography at Kyoto University Hospital (Kyoto cohort) and Japanese multicenters (bronchiectasis and asthma [BEXAS] cohort), respectively. Mucus plugs in airways were visually scored on computed tomography, and the difference in mucus plug score between lower and upper-middle lobes (Δ mucus plug score) was calculated.</div></div><div><h3>Results</h3><div>Among 176 (Kyoto) and 42 (BEXAS) enrolled patients, 82 and 33 exhibited mucus plug scores greater than or equal to 1, respectively. Higher Δ mucus plug score was associated with lower percentage of the predicted FEV<sub>1</sub> and the presence of exacerbation history in both cohorts. Higher Δ mucus plug score was associated with luminal narrowing of the fifth-generation, but not the third- or fourth-generation, lower lobe airways in the Kyoto cohort, and bronchiolitis score in the BEXAS cohort. In the multivariable model, higher Δ mucus plug score was associated with symptoms and exacerbations, independent of whole-lung mucus plug score in the Kyoto cohort.</div></div><div><h3>Conclusions</h3><div>Lower lobe–dominant mucus plugs were associated with lower lung function and exacerbations in patients with asthma, irrespective of comorbid bronchiectasis. The spatial distribution of mucus plugs additionally to whole-lung mucus plug score may help to understand clinical roles of mucus plugging in asthma.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 4","pages":"Article 100566"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Respiratory allergies represent a major global public health concern.
Objective
Our aim was to determine the prevalence of and factors associated with sensitization to common airborne allergens in the adult Cameroonian population.
Methods
This was a cross-sectional study conducted from December 2013 to April 2018. Participants aged 18 years or older were recruited through 3-stage cluster sampling in community settings. Sensitization to airborne allergens was assessed by using skin prick tests. Log-binomial regression analysis was used to identify factors associated with sensitization.
Results
Of the 870 participants, 458 (52.6%) were women. Their median age was 38 years (interquartile range = 30 years). Of the 879 participants, 602 (69.2%) resided in rural or semiurban areas. The prevalence of sensitization to airborne allergens was 19.4% (95% CI = 16.8%-22.0%). Sensitization to common mites (Dermatophagoides pteronyssinus, Dermatophagoides farinae, and Blomia tropicalis) was observed in 55.2%, 53.8%, and 42.6% of the participants, respectively. Among the 169 sensitized individuals, the prevalence of monosensitization was 42.6% (95% CI = 35.1%-50.1%) and the prevalence of polysensitization was 57.4% (95% CI = 49.9%-64.8%). Independent factors associated with sensitization were urban residence (prevalence ratio [PR] = 2.8 [95% CI = 1.8- 4.2]; P = .001), current asthma (PR = 2.4 [95% CI = 1.3- 4.5]; P = .004), and current allergic rhinitis (PR = 2.5 [95% CI = 1.4-4.7]; P = .001).
Conclusion
The prevalence of sensitization to airborne allergens in Cameroonian adults was 19.4%. Independent factors associated with sensitization to allergens included urban residence, current asthma, and current allergic rhinoconjunctivitis. These findings emphasize the need for public health strategies addressing sensitization to dust mite allergen in managing allergic diseases.
呼吸道过敏是一个主要的全球公共卫生问题。目的：我们的目的是确定喀麦隆成年人群中常见空气中过敏原的患病率及其致敏相关因素。方法2013年12月至2018年4月进行横断面研究。参与者年龄在18岁或以上，在社区环境中通过三阶段整群抽样招募。通过皮肤点刺试验评估对空气中过敏原的致敏性。采用对数二项回归分析确定与致敏相关的因素。结果870例患者中，女性458例（52.6%）。他们的年龄中位数为38岁（四分位数差= 30岁）。在879名参与者中，602名（69.2%）居住在农村或半城市地区。空气传播过敏原致敏率为19.4% （95% CI = 16.8%-22.0%）。分别有55.2%、53.8%和42.6%的参与者对常见螨（翼螨、粉螨和热带布洛米螨）过敏。169例致敏个体中，单致敏率为42.6% (95% CI = 35.1% ~ 50.1%)，多致敏率为57.4% （95% CI = 49.9% ~ 64.8%）。与致敏相关的独立因素为城市居住（患病率[PR] = 2.8 [95% CI = 1.8- 4.2]; P = 0.001）、当前哮喘（PR = 2.4 [95% CI = 1.3- 4.5]; P = 0.004）和当前变应性鼻炎（PR = 2.5 [95% CI = 1.4-4.7]; P = 0.001）。结论喀麦隆成人对空气源过敏原的致敏率为19.4%。与过敏原致敏性相关的独立因素包括城市居住、当前哮喘和当前变应性鼻结膜炎。这些发现强调了在管理过敏性疾病时需要解决尘螨过敏原致敏问题的公共卫生策略。
{"title":"Sensitization to airborne allergens in the adult Cameroonian population","authors":"Adamou Dodo Balkissou MD, MPH , Massongo Massongo MD, MPH , Laurent Mireille Endale-Mangamba MD , Virginie Poka-Mayap MD , Amadou Djenabou MD , Éric Walter Pefura-Yone MD, MPH, PhD","doi":"10.1016/j.jacig.2025.100552","DOIUrl":"10.1016/j.jacig.2025.100552","url":null,"abstract":"<div><h3>Background</h3><div>Respiratory allergies represent a major global public health concern.</div></div><div><h3>Objective</h3><div>Our aim was to determine the prevalence of and factors associated with sensitization to common airborne allergens in the adult Cameroonian population.</div></div><div><h3>Methods</h3><div>This was a cross-sectional study conducted from December 2013 to April 2018. Participants aged 18 years or older were recruited through 3-stage cluster sampling in community settings. Sensitization to airborne allergens was assessed by using skin prick tests. Log-binomial regression analysis was used to identify factors associated with sensitization.</div></div><div><h3>Results</h3><div>Of the 870 participants, 458 (52.6%) were women. Their median age was 38 years (interquartile range = 30 years). Of the 879 participants, 602 (69.2%) resided in rural or semiurban areas. The prevalence of sensitization to airborne allergens was 19.4% (95% CI = 16.8%-22.0%). Sensitization to common mites (<em>Dermatophagoides pteronyssinus</em>, <em>Dermatophagoides farinae</em>, and <em>Blomia tropicalis</em>) was observed in 55.2%, 53.8%, and 42.6% of the participants, respectively. Among the 169 sensitized individuals, the prevalence of monosensitization was 42.6% (95% CI = 35.1%-50.1%) and the prevalence of polysensitization was 57.4% (95% CI = 49.9%-64.8%). Independent factors associated with sensitization were urban residence (prevalence ratio [PR] = 2.8 [95% CI = 1.8- 4.2]; <em>P</em> = .001), current asthma (PR = 2.4 [95% CI = 1.3- 4.5]; <em>P</em> = .004), and current allergic rhinitis (PR = 2.5 [95% CI = 1.4-4.7]; <em>P</em> = .001).</div></div><div><h3>Conclusion</h3><div>The prevalence of sensitization to airborne allergens in Cameroonian adults was 19.4%. Independent factors associated with sensitization to allergens included urban residence, current asthma, and current allergic rhinoconjunctivitis. These findings emphasize the need for public health strategies addressing sensitization to dust mite allergen in managing allergic diseases.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 4","pages":"Article 100552"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-08-28DOI: 10.1016/j.jacig.2025.100562
Laurie Baert PhD , Matthew Wiest PhD , Agnes Yang BS , Katherine Upchurch PhD , Mark Millard MD , HyeMee Joo PhD , SangKon Oh PhD
Background
IgE plays a key role in asthma pathogenesis. To produce high-affinity IgE, B cells can undergo IgE class switching through an IgG1 intermediate stage with repeated antigenic stimulation. Nonetheless, the phenotype of B cells that holds IgE response in asthma patients remains to be fully investigated.
Objectives
We investigated whether IgG1+ B cells reflect the magnitude of the IgE response and correlate with asthma phenotype and disease severities in adult asthma patients.
Methods
The frequencies of IgG1+, CD23+, and CD23+IgG1+ B cells, along with surface CD23 expression levels in the blood of adult asthma patients (n = 40), were compared with those of nonasthmatic control subjects (n = 24). We then investigated whether the frequencies of individual B-cell populations and their surface CD23 expression levels were linked to serum IgE concentrations, eosinophil counts, and lung functions. Additionally, we also investigated whether serum IgE could affect the frequencies of these B-cell populations in patients with moderate-to-severe asthma (n = 16).
Results
Serum IgE concentrations correlated with CD23 expression levels on CD23+IgG1+ B cells, but not their numbers that were linked to blood eosinophil counts and lung functions (forced expiratory volume in 1 second). Neither the frequency of CD23+IgG1+ B cells nor the CD23 expression levels were affected by steroid treatment or leukotriene inhibitors. Neutralizing IgE with omalizumab did not alter the frequency of CD23+, IgG1+, or CD23+IgG1+ B cells in asthma patients.
Conclusions
Surface CD23 expression levels on CD23+IgG1+ B cells, but not their numbers, correlate with the magnitude of IgE response in adult asthma patients.
{"title":"Intensity of CD23 expression on IgG1+ B cells reflects serum IgE level in asthma","authors":"Laurie Baert PhD , Matthew Wiest PhD , Agnes Yang BS , Katherine Upchurch PhD , Mark Millard MD , HyeMee Joo PhD , SangKon Oh PhD","doi":"10.1016/j.jacig.2025.100562","DOIUrl":"10.1016/j.jacig.2025.100562","url":null,"abstract":"<div><h3>Background</h3><div>IgE plays a key role in asthma pathogenesis. To produce high-affinity IgE, B cells can undergo IgE class switching through an IgG<sub>1</sub> intermediate stage with repeated antigenic stimulation. Nonetheless, the phenotype of B cells that holds IgE response in asthma patients remains to be fully investigated.</div></div><div><h3>Objectives</h3><div>We investigated whether IgG<sub>1</sub><sup>+</sup> B cells reflect the magnitude of the IgE response and correlate with asthma phenotype and disease severities in adult asthma patients.</div></div><div><h3>Methods</h3><div>The frequencies of IgG<sub>1</sub><sup>+</sup>, CD23<sup>+</sup>, and CD23<sup>+</sup>IgG<sub>1</sub><sup>+</sup> B cells, along with surface CD23 expression levels in the blood of adult asthma patients (n = 40), were compared with those of nonasthmatic control subjects (n = 24). We then investigated whether the frequencies of individual B-cell populations and their surface CD23 expression levels were linked to serum IgE concentrations, eosinophil counts, and lung functions. Additionally, we also investigated whether serum IgE could affect the frequencies of these B-cell populations in patients with moderate-to-severe asthma (n = 16).</div></div><div><h3>Results</h3><div>Serum IgE concentrations correlated with CD23 expression levels on CD23<sup>+</sup>IgG<sub>1</sub><sup>+</sup> B cells, but not their numbers that were linked to blood eosinophil counts and lung functions (forced expiratory volume in 1 second). Neither the frequency of CD23<sup>+</sup>IgG<sub>1</sub><sup>+</sup> B cells nor the CD23 expression levels were affected by steroid treatment or leukotriene inhibitors. Neutralizing IgE with omalizumab did not alter the frequency of CD23<sup>+</sup>, IgG<sub>1</sub><sup>+</sup>, or CD23<sup>+</sup>IgG<sub>1</sub><sup>+</sup> B cells in asthma patients.</div></div><div><h3>Conclusions</h3><div>Surface CD23 expression levels on CD23<sup>+</sup>IgG<sub>1</sub><sup>+</sup> B cells, but not their numbers, correlate with the magnitude of IgE response in adult asthma patients.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 4","pages":"Article 100562"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145060124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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