The journal of allergy and clinical immunology. Global最新文献

{"title":"Untangling obese asthma: Design of proof-of-concept study of semaglutide in poorly controlled asthma","authors":"Alessandra Tomasello MD ,&nbsp;Leonard B. Bacharier MD ,&nbsp;Patrice M. Becker MD ,&nbsp;Caeden Dempsey MSN, MPH ,&nbsp;Pingsheng Wu PhD ,&nbsp;R. Stokes Peebles MD ,&nbsp;Kevin Niswender MD, PhD ,&nbsp;William D. Dupont PhD ,&nbsp;Gordon Bernard MD ,&nbsp;Katherine N. Cahill MD","doi":"10.1016/j.jacig.2025.100627","DOIUrl":"10.1016/j.jacig.2025.100627","url":null,"abstract":"<div><h3>Background</h3><div>The intersection of obesity and asthma represents a complex clinical challenge characterized by increased symptom burden, reduced treatment efficacy, and multifactorial pathophysiology. Obesity-associated asthma is a heterogeneous condition shaped by underlying metabolic dysfunctions such as insulin resistance and altered inflammatory processes.</div></div><div><h3>Objectives</h3><div>Current research often oversimplifies the relationship between obesity and asthma by relying primarily on body mass index as a measure, thereby overlooking key metabolic factors that may influence disease severity and treatment response. There is a critical need for clinical trials that account for this metabolic complexity, so we designed a proof-of-concept study with this in mind.</div></div><div><h3>Methods</h3><div>Using the GLP-1R Agonists in the Treatment of Adult, Symptomatic, Obese Asthma (GATA-3) trial (<span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> NCT05254314) as a conceptual framework, we propose an evolved model for future asthma research. While not a direct report of GATA-3 findings, it emphasizes the integration of comprehensive metabolic profiling—including insulin sensitivity and body composition—alongside traditional inflammatory and respiratory metrics in randomized controlled asthma trials.</div></div><div><h3>Results</h3><div>The GATA-3 study design serves as an example of the first placebo-controlled trial to evaluate the glucagon-like peptide 1 receptor pathway’s role in asthma management independent of weight loss. The trial underscores essential design elements such as accurate asthma diagnosis, recognition of endotype heterogeneity, and implementation of outcome measures tailored to this phenotype.</div></div><div><h3>Conclusion</h3><div>Advancing our understanding of obesity-associated asthma requires moving beyond body mass index–focused models to fully consider the metabolic complexity of the disease. Integrating detailed metabolic assessments into research and clinical practice will be vital for identifying responsive subpopulations, optimizing treatment strategies, and ultimately improving patient outcomes.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"5 2","pages":"Article 100627"},"PeriodicalIF":0.0,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927093","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}

{"title":"Differential alpha-gal expression during Amblyomma hebraeum and Rhipicephalus evertsi tick feeding and development: A driver for the development of alpha-gal syndrome in South Africa","authors":"Tatenda Murangi PhD ,&nbsp;Ben Mans PhD ,&nbsp;Ronel Pienaar PhD ,&nbsp;Maresa Botha MD ,&nbsp;Heidi Facey-Thomas DipNursCert ,&nbsp;Stephen Cunningham PhD ,&nbsp;Ali Halajian PhD ,&nbsp;Lokesh Joshi PhD ,&nbsp;Franco H. Falcone PhD ,&nbsp;William Horsnell PhD ,&nbsp;Michael E. Levin PhD","doi":"10.1016/j.jacig.2025.100623","DOIUrl":"10.1016/j.jacig.2025.100623","url":null,"abstract":"<div><h3>Background</h3><div>The presence of galactose-α-1,3-galactose (alpha-gal) in tick salivary antigens has been implicated to initiate host IgE responses resulting in sensitization to alpha-gal.</div></div><div><h3>Objective</h3><div>We sought to investigate the presence of alpha-gal in different anatomic locations in native South African tick species at different feeding and developmental stages and the ability of sera from our allergic cohort to bind to these tick proteins.</div></div><div><h3>Methods</h3><div>Alpha-gal–containing proteins in laboratory-reared ticks at different feeding and developmental stages were detected through Western blotting and immunohistochemical staining. IgE and IgG4 toward the tick proteins were analyzed via ELISA.</div></div><div><h3>Results</h3><div>There is differential expression of alpha-gal in endemic South African ticks <em>Amblyomma hebraeum</em> and <em>Rhipicephalus evertsi</em>. Immunoblotting demonstrated an increase in the prominence of alpha-gal–containing protein bands in salivary glands to be proportional to feeding time. Alpha-gal in both fed and unfed ticks was localized in the salivary acini and testes. IgE and IgG4 to <em>A hebraeum</em> antigens were significantly raised in alpha-gal–allergic individuals. There was a correlation between anti–<em>A hebraeum</em> IgE and anti–alpha-gal IgE in the alpha-gal–allergic group. Inhibition of human serum anti–alpha-gal IgE to <em>A hebraeum</em> and <em>R evertsi</em> proteins was significantly reduced by the addition of bovine thyroglobulin.</div></div><div><h3>Conclusions</h3><div>We anticipate repeated exposure to differentially expressed <em>A hebraeum</em> and <em>R evertsi</em> alpha-gal–containing salivary proteins during feeding to cause alpha-gal sensitization.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"5 2","pages":"Article 100623"},"PeriodicalIF":0.0,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926993","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}

{"title":"Differences in immunoglobulin utilization when treating patients with primary immune disease in the United States","authors":"Roxanna Farzad MS ,&nbsp;Mei-Sing Ong PhD ,&nbsp;Jocelyn R. Farmer MD, PhD ,&nbsp;Nicholas L. Rider DO","doi":"10.1016/j.jacig.2025.100624","DOIUrl":"10.1016/j.jacig.2025.100624","url":null,"abstract":"<div><h3>Background</h3><div>Primary immune diseases (PI) encompass over 550 disorders that are associated with substantial risk of mortality and morbidity. Emerging evidence demonstrates significant survival disparities in PI among racial minoritized populations. However, published national data on treatment patterns are lacking.</div></div><div><h3>Objective</h3><div>We investigated variations in the use of immunoglobulin replacement therapy (IgGRT) across different geographic regions (Midwest, West, Northeast, South, and other/unknown) and racial groups (Black, Asian, White, and other/unknown) in the United States.</div></div><div><h3>Methods</h3><div>This study analyzed a subset of the Optum deidentified electronic health record dataset, focusing on 3 cohorts of PI patients: common variable immunodeficiency, hypogammaglobulinemia, and combined immunodeficiency (CID). The study compared the treatment status of IgGRT across regional and racial subgroups within each cohort.</div></div><div><h3>Results</h3><div>Regional differences in IgGRT status were observed among common variable immunodeficiency patients, with treatment rate highest in the West (53.8%) and Midwest (49.9%) and lowest in the South (41.1%) (<em>P</em> &lt; .005). Among patients with hypogammaglobulinemia, a higher proportion of patients in the West (55.8%) received IgGRT than in the South (40.3%) (<em>P</em> &lt; .005). Among patients with CID, those residing in the Midwest (44.4%) had a significantly higher rate of IgGRT utilization compared to the South (32.5%) (<em>P</em> &lt; .005). A greater proportion of White patients with CID (41.3%) received IgGRT compared to African American patients with CID (25.8%) (<em>P</em> &lt; .008).</div></div><div><h3>Conclusion</h3><div>Our results show differences in IgGRT utilization rates across regional and racial categories within each disease cohort, suggesting potential disparities.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"5 2","pages":"Article 100624"},"PeriodicalIF":0.0,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926920","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}

{"title":"High levels of nonblocking anti-interferon and anticytokine autoantibodies in individuals with mRNA vaccine–induced systemic allergic reactions","authors":"Muge Kalaycioglu MD ,&nbsp;Allan Feng ,&nbsp;Shaurya Dhingra MD ,&nbsp;Muhammad B. Khalid MD ,&nbsp;Kari C. Nadeau MD, PhD ,&nbsp;Paul J. Utz MD ,&nbsp;Pamela A. Frischmeyer-Guerrerio MD, PhD","doi":"10.1016/j.jacig.2025.100622","DOIUrl":"10.1016/j.jacig.2025.100622","url":null,"abstract":"<div><h3>Background</h3><div>Hypersensitivity reactions following coronavirus 2019 disease (COVID-19) mRNA vaccination, although rare, have raised public concern and contributed to vaccine hesitancy. The underlying mechanisms and cofactors that increase the risk of these adverse reactions remain poorly understood.</div></div><div><h3>Objective</h3><div>We aimed to investigate whether the presence of autoantibodies, particularly anticytokine autoantibodies (ACAs), correlates with systemic adverse events (SAEs) in response to mRNA COVID-19 vaccines.</div></div><div><h3>Methods</h3><div>We analyzed serum samples from 2 independent cohorts of individuals who experienced convincing SAEs after receiving their first dose of COVID-19 mRNA vaccine, including 16 individuals at the National Institutes of Health (NIH) and 18 at Stanford University. Individuals enrolled in the NIH cohort received subsequent vaccine doses under medical supervision. The control groups included vaccine-tolerant individuals. Bead-based autoantigen arrays were used to detect autoantibodies, whereas cell-based assays were used to assess the functional blocking activity of specific antibodies.</div></div><div><h3>Results</h3><div>Autoantibody positivity was detected in 81.2% of the NIH cohort and 38.8% of the Stanford cohort. Elevated levels of antibodies against IFN-λ1 were associated with repeated SAEs in the NIH cohort. Other notable targets included IL-1A, IL-4, IL-6, IL-11, IL-17, TNF-α, and IFN-γ. Despite elevated autoantibody levels, functional blocking activity was not detected in reporter assays.</div></div><div><h3>Conclusion</h3><div>Our findings reveal a potential link between cytokine-targeting autoantibodies, especially anti–IFN-λ1, and systemic adverse responses to mRNA vaccination. These results suggest a role for immune dysregulation in individuals with hypersensitivity to mRNA vaccines and highlight the need for further investigation to improve vaccine safety and tolerance.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"5 2","pages":"Article 100622"},"PeriodicalIF":0.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884882","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}

{"title":"Successful venom immunotherapy in a child with anaphylaxis to Hymenoptera skin testing","authors":"Ellen Conroy MD ,&nbsp;Mandi Bailey BA ,&nbsp;Jackie Garrett MD ,&nbsp;Ana Broyles MD","doi":"10.1016/j.jacig.2025.100619","DOIUrl":"10.1016/j.jacig.2025.100619","url":null,"abstract":"<div><div>Omalizumab has been used during venom immunotherapy primarily for high-risk adult patients. We report a similar approach in a child with anaphylaxis in response to Hymenoptera skin testing who successfully tolerated modified rush venom immunotherapy with concurrent use of omalizumab.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"5 2","pages":"Article 100619"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145753686","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}

{"title":"Patient perspectives of allergic rhinitis and allergen immunotherapy: A qualitative study","authors":"Joshua Jacob MD ,&nbsp;Caroline Joyce PhD ,&nbsp;Melanie Lloyd PhD ,&nbsp;Adrian Lowe PhD ,&nbsp;Constance Katelaris PhD","doi":"10.1016/j.jacig.2025.100621","DOIUrl":"10.1016/j.jacig.2025.100621","url":null,"abstract":"<div><h3>Background</h3><div>Allergic rhinitis (AR) is a highly prevalent condition associated with significant morbidity globally. Few recent studies have detailed the experiences of sufferers and explored their perspectives of treatment options. Allergen immunotherapy (AIT) is an effective treatment option that remains underused in eligible patient populations.</div></div><div><h3>Objective</h3><div>We sought to describe patient perspectives of AR and treatment options including AIT.</div></div><div><h3>Methods</h3><div>Twenty-five semistructured interviews were conducted with adult participants at a tertiary hospital center in Sydney, Australia. Authors used an inductive thematic analysis methodology to code and interpret the data.</div></div><div><h3>Results</h3><div>Three major themes emerged from the qualitative thematic analysis: (1) a prolonged journey with symptoms, (2) multiple trials of therapy with incomplete symptom control, and (3) diverse experiences with AIT. Several subthemes were identified: (1) delays to diagnosis and management, (2) underestimating the impact of symptoms, (3) substantially impaired quality of life, (4) limited efficacy of symptomatic pharmacotherapy, (5) perceptions of tolerance and dependence, (6) motivations to access AIT, (7) diverse expectations of AIT, and (8) barriers to AIT access.</div></div><div><h3>Conclusions</h3><div>Sufferers of AR experience an impactful symptom journey, with many achieving inadequate disease control despite symptomatic pharmacotherapy. The uptake of AIT is constrained by direct medication costs, insufficient public awareness, and limited prescriber availability. The findings of this study offer insights for health care professionals and policymakers to formulate strategies to enhance AR management and improve AIT access for eligible patients.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"5 2","pages":"Article 100621"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926978","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}

{"title":"COVID-19 mRNA revaccination is safe and well tolerated in individuals with previous adverse reactions to the vaccine and/or long COVID","authors":"Ian F. Slack MD ,&nbsp;Kelly M. O’Shea MD ,&nbsp;George E. Freigeh MD ,&nbsp;Lea M. Franco BS, MS ,&nbsp;Sara Jaafar MD ,&nbsp;Charles F. Schuler IV MD ,&nbsp;James R. Baker Jr. MD","doi":"10.1016/j.jacig.2025.100620","DOIUrl":"10.1016/j.jacig.2025.100620","url":null,"abstract":"<div><h3>Background</h3><div>Vaccine safety is a primary concern among those with a history of adverse reactions to coronavirus disease 2019 (COVID-19) mRNA vaccines. Retrospective data and cohorts of individuals with severe previous reactions suggest that revaccination is safe and well tolerated. However, prospective data are limited.</div></div><div><h3>Objective</h3><div>We sought to prospectively assess safety and tolerability of COVID-19 mRNA vaccines in individuals with a history of adverse vaccine reactions and in individuals with long COVID.</div></div><div><h3>Methods</h3><div>Adults with a self-reported adverse reaction to COVID-19 mRNA vaccination and/or long COVID underwent COVID-19 mRNA revaccination at the University of Michigan with 30-minute observations. Participants were contacted by telephone after 7 days to review interval adverse events.</div></div><div><h3>Results</h3><div>A total of 103 participants received COVID-19 mRNA revaccination—91 with history of adverse vaccine reaction, 20 with long COVID, and 8 with both. Mean age at enrollment was 41.8 years, and women were 67% of the cohort. Five individuals (4.9%) developed immediate symptoms with revaccination. All 5 events were mild (Consortium for Food Allergy Research severity level 1). Vital signs were assessed prevaccination and 30 minutes postvaccination. At 7-day follow-up, 77% of participants reported at least 1 adverse event, with fatigue (33.7%), headache (29.7%), and muscle pain (28.7%) most commonly reported. No follow-up reactions were severe. Five of the 103 participants had incidentally elevated baseline serum tryptase. None of these participants experienced immediate symptoms with revaccination.</div></div><div><h3>Conclusions</h3><div>Revaccination with COVID-19 mRNA vaccines was safe and well tolerated among individuals with previous adverse COVID-19 mRNA vaccine reaction and/or long COVID.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"5 2","pages":"Article 100620"},"PeriodicalIF":0.0,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884881","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}

{"title":"Skin barrier function in children with eosinophilic esophagitis","authors":"Blake Civello BS ,&nbsp;Renée J. Crawford DO ,&nbsp;Cedria Wells ,&nbsp;Melissa Pecak RN, BSN ,&nbsp;Shauna Schroeder MD ,&nbsp;Cindy S. Bauer MD ,&nbsp;Kory Johnson PhD ,&nbsp;Alfred D. Doyle PhD ,&nbsp;Benjamin L. Wright MD","doi":"10.1016/j.jacig.2025.100617","DOIUrl":"10.1016/j.jacig.2025.100617","url":null,"abstract":"<div><h3>Background</h3><div>Eosinophilic esophagitis (EoE) is associated with epithelial barrier dysfunction of the esophagus. Studies suggest that the skin lipidomic profile is altered in EoE; therefore, we hypothesized that skin barrier function would be compromised in subjects with EoE.</div></div><div><h3>Objective</h3><div>We aimed to evaluate skin barrier function in subjects with EoE by assessing transepidermal water loss (TEWL).</div></div><div><h3>Methods</h3><div>We performed a single-center, case-control study of pediatric subjects with known EoE and controls without EoE. The subjects with EoE met consensus criteria for diagnosis. Patients receiving systemic biologic medications or prescription topical corticosteroids were excluded. A majority of the subjects with EoE underwent a concurrent esophageal string test or had a recent endoscopy near the time of TEWL assessment. In addition to comparing subjects with EoE and controls without EoE, we compared TEWL according to EoE disease activity.</div></div><div><h3>Results</h3><div>The subjects with EoE (n = 25) were older than the controls without EoE (n = 24) but similar from the standpoint of other demographic features. The controls were primarily atopic (79.2%). Rate of TEWL was comparable in the subjects with EoE and the controls (median =15.1 [interquartile range = 4.95] g/m² per hour vs median = 16.9 [interquartile range = 7.3] g/m² per hour [<em>P</em> = .18]); differences between those subjects with active EoE (n = 10) and those with inactive EoE (n = 14) were not observed. A subgroup analysis excluding patients with atopic dermatitis did not reveal differences in TEWL among the subjects with EoE.</div></div><div><h3>Conclusions</h3><div>Subjects with EoE did not have marked skin barrier dysfunction relative to the controls without EoE and TEWL did not vary according to disease activity. These findings suggest that the utility of TEWL as a biomarker of EoE is limited. Larger studies with defined atopic and nonatopic controls are needed to detect small to moderate differences in skin barrier function.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"5 2","pages":"Article 100617"},"PeriodicalIF":0.0,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145792286","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}

{"title":"Frequency and severity of 192 foods causing food allergy in adults","authors":"Emily J.J. Kallen MD ,&nbsp;Paco M.J. Welsing PhD ,&nbsp;Inge Nijenhuis MSc ,&nbsp;Ronald Van Ree PhD ,&nbsp;Andre C. Knulst MD, PhD ,&nbsp;Thuy-My Le MD, PhD","doi":"10.1016/j.jacig.2025.100616","DOIUrl":"10.1016/j.jacig.2025.100616","url":null,"abstract":"<div><h3>Background</h3><div>To date, studies have mainly focused on the frequency and severity of the so-called big 8 foods; less is known about other foods.</div></div><div><h3>Objective</h3><div>We investigated the frequency and severity of allergy to all foods reported to cause food allergic symptoms.</div></div><div><h3>Methods</h3><div>Adult patients with symptoms within 2 hours after ingestion of any food were included. Sensitization was measured by skin prick test and/or specific IgE for the culprit food(s) when possible.</div></div><div><h3>Results</h3><div>A total of 1085 patients were included, of whom 66.9% had a probable food allergy (FA) (reported symptoms with sensitization) and 33.1% only a possible FA (reported symptoms, independent of sensitization). Patients reported symptoms to a total of 192 foods, and sufficient sensitization data were available for 45 foods. The ranking in frequency and severity of symptoms was comparable between probable and possible FA. Regarding possible FA, fruit was most commonly reported (68.8%), followed by nuts (63.0%), legumes (39.5%), vegetables (34.0%), and seeds or pits (14.4%). Severe symptoms were most frequently reported for seeds (39.8%), fish (39.2%), legumes (34.8%), nuts (31.9%), and crustaceans (31.3%), and least frequently for fruit (16.5%). Nevertheless, in absolute numbers, fruit ranked in position 3 (n = 125), with especially tropical fruit (eg, lychee) frequently causing severe symptoms. Regarding probable FA, severe symptoms were most common for sunflower seeds (80.0%), pine nut (66.7%), Brazil nut (60.0%), cashew (57.1%), and pistachio (51.7%).</div></div><div><h3>Conclusion</h3><div>Food allergies are caused by almost 200 different foods in adults. Although not mandatorily labeled, seeds most commonly cause severe symptoms, and fruit causes severe symptoms in a large number of patients. This study highlights the importance of food allergies outside the big 8.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"5 2","pages":"Article 100616"},"PeriodicalIF":0.0,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145792287","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}

{"title":"Application of a natural language processing algorithm to early asthma ascertainment for adults in the era of electronic health records","authors":"Chung-Il Wi MD ,&nbsp;Thanai Pongdee MD ,&nbsp;Hee Yun Seol MD ,&nbsp;Sunghwan Sohn PhD ,&nbsp;Elham Sagheb MS ,&nbsp;Bhavani Singh Agnikula Kshatriya MS ,&nbsp;Shauna M. Overgaard PhD ,&nbsp;Deepak K. Sharma PhD, MS ,&nbsp;Sungrim Moon PhD ,&nbsp;Elizabeth A. Krusemark AS ,&nbsp;Dave Watson PhD ,&nbsp;Sergio E. Chiarella MD ,&nbsp;Miguel A. Park MD ,&nbsp;Jason D. Greenwood MD, MS ,&nbsp;Randy M. Foss MD ,&nbsp;Zhandong Liu PhD ,&nbsp;Meera Gupta MD, MS ,&nbsp;Carla M. Davis MD ,&nbsp;Wade Schulz MD, PhD ,&nbsp;Hongfang Liu PhD ,&nbsp;Young J. Juhn MD, MPH","doi":"10.1016/j.jacig.2025.100618","DOIUrl":"10.1016/j.jacig.2025.100618","url":null,"abstract":"<div><h3>Background</h3><div>The natural language processing (NLP) algorithm for predetermined asthma criteria (NLP-PAC) was successfully developed and validated for automatically ascertaining pediatric asthma from electronic health record (EHRs) systems. A scalable, efficient, and automated tool for ascertaining adult asthma status from EHRs remains nonexistent.</div></div><div><h3>Objective</h3><div>We validated NLP-PAC enabling ascertainment and early identification of adult asthma status in their EHRs.</div></div><div><h3>Methods</h3><div>We applied the validated NLP-PAC to EHRs of a convenient sample (adult cohorts who participated in our previous population-based studies) in which a reference standard (ie, asthma status defined by manual chart review) is available. The performance of NLP-PAC was assessed by determining criterion validity against manual chart review and construct validity before and after the new EHR (Epic) system was implemented in 2018.</div></div><div><h3>Results</h3><div>The cohort consisted of 1,898 subjects, with 43% male and a median age at time of last follow-up of 65 years (interquartile range, 55-76). Manual chart review and NLP-PAC identified 97 (5.1%) and 98 (5.1%) subjects with asthma, respectively, with 89 subjects commonly identified by both methods. The sensitivity, specificity, positive predictive value, and negative predictive value of NLP-PAC were 92%, 99%, 91%, and 99%, respectively, before the new EHR system was implement, which remained similar after introducing the system (95%, 88%, 96%, and 85%, respectively). The risk factors for asthma identified either by NLP-PAC or manual chart review were similar.</div></div><div><h3>Conclusion</h3><div>Automatic asthma ascertainment for adults based on EHR data is feasible with our NLP algorithm, offering immense scientific and clinical value for large-scale clinical research and population management for adult asthma care.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"5 2","pages":"Article 100618"},"PeriodicalIF":0.0,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145753685","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}