Pub Date : 2025-02-01DOI: 10.1016/j.jacig.2024.100369
Pedro A. Lamothe MD, PhD , Charles Lewis Humphrey Pruett MS , Natalia Smirnova MD , Aaron Shepherd MD , Martin C. Runnstrom MD , Jiwon Park BA , Rebecca H. Zhang MS , Leshan Zhao MS , Colin Swenson MD , F. Eun-Hyung Lee MD
Background
Allergic bronchopulmonary aspergillosis (ABPA) is a disease resulting from an overactive type 2 response to Aspergillus. Initial studies suggest that asthma biologics can effectively treat ABPA, but it is unclear which biologic class is superior.
Objective
We sought to compare the effectiveness of asthma biologics in the treatment of ABPA.
Methods
We performed a retrospective analysis of patients with ABPA treated with asthma biologics, and measured outcomes of respiratory exacerbations, daily oral corticosteroids, and antifungals. We assessed these variables while individuals were treated with 1 of 3 biologic classes: anti-IgE, anti–IL-5/IL-5 receptor alpha (IL-5Ra), anti–IL-4 receptor alpha (IL-4Ra).
Results
A total of 21 patients were included in our analysis. Anti–IL-4Ra was associated with a significantly lower number of exacerbations and oral corticosteroid use compared with anti-IgE or anti–IL-5/IL-5Ra therapies. Anti–IL-4Ra also had significantly lower antifungal use than anti-IgE, and there was a trend toward lower antifungal use when compared with anti–IL-5/IL-5Ra. In a subgroup of 10 patients treated with 2 or more biologics sequentially, we found that 8 of them achieved clinical control on anti–IL-4Ra therapy after failing anti-IgE and/or anti–IL-5/IL-5Ra therapies.
Conclusions
Dupilumab blocks the IL-4Ra, resulting in the downstream inhibition of both IL-4 and IL-13 effector pathways. Dupilumab may benefit patients with ABPA by inhibiting the generation of airway mucus (IL-13), and by reducing local B-cell differentiation into IgE antibody–secreting cells (IL-4). On the basis of our findings and with the known molecular mechanisms of dupilumab, we believe that anti–IL-4Rα–targeted therapy may be more effective than anti-IgE or anti–IL-5/IL-5Rα therapies to treat ABPA.
{"title":"Anti–IL-4Ra therapy is superior to other biologic classes in treating allergic bronchopulmonary aspergillosis","authors":"Pedro A. Lamothe MD, PhD , Charles Lewis Humphrey Pruett MS , Natalia Smirnova MD , Aaron Shepherd MD , Martin C. Runnstrom MD , Jiwon Park BA , Rebecca H. Zhang MS , Leshan Zhao MS , Colin Swenson MD , F. Eun-Hyung Lee MD","doi":"10.1016/j.jacig.2024.100369","DOIUrl":"10.1016/j.jacig.2024.100369","url":null,"abstract":"<div><h3>Background</h3><div>Allergic bronchopulmonary aspergillosis (ABPA) is a disease resulting from an overactive type 2 response to <em>Aspergillus</em>. Initial studies suggest that asthma biologics can effectively treat ABPA, but it is unclear which biologic class is superior.</div></div><div><h3>Objective</h3><div>We sought to compare the effectiveness of asthma biologics in the treatment of ABPA.</div></div><div><h3>Methods</h3><div>We performed a retrospective analysis of patients with ABPA treated with asthma biologics, and measured outcomes of respiratory exacerbations, daily oral corticosteroids, and antifungals. We assessed these variables while individuals were treated with 1 of 3 biologic classes: anti-IgE, anti–IL-5/IL-5 receptor alpha (IL-5Ra), anti–IL-4 receptor alpha (IL-4Ra).</div></div><div><h3>Results</h3><div>A total of 21 patients were included in our analysis. Anti–IL-4Ra was associated with a significantly lower number of exacerbations and oral corticosteroid use compared with anti-IgE or anti–IL-5/IL-5Ra therapies. Anti–IL-4Ra also had significantly lower antifungal use than anti-IgE, and there was a trend toward lower antifungal use when compared with anti–IL-5/IL-5Ra. In a subgroup of 10 patients treated with 2 or more biologics sequentially, we found that 8 of them achieved clinical control on anti–IL-4Ra therapy after failing anti-IgE and/or anti–IL-5/IL-5Ra therapies.</div></div><div><h3>Conclusions</h3><div>Dupilumab blocks the IL-4Ra, resulting in the downstream inhibition of both IL-4 and IL-13 effector pathways. Dupilumab may benefit patients with ABPA by inhibiting the generation of airway mucus (IL-13), and by reducing local B-cell differentiation into IgE antibody–secreting cells (IL-4). On the basis of our findings and with the known molecular mechanisms of dupilumab, we believe that anti–IL-4Rα–targeted therapy may be more effective than anti-IgE or anti–IL-5/IL-5Rα therapies to treat ABPA.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 1","pages":"Article 100369"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Primary or secondary hypogammaglobulinemia is associated with persistent norovirus and Campylobacter infections despite immunoglobulin replacement therapy. Allogeneic hematopoietic cell transplantation for hematologic indications can lead to immune reconstitution by correcting a previously undiagnosed concurrent primary immunodeficiency.
Pub Date : 2025-02-01DOI: 10.1016/j.jacig.2024.100372
Divya Shah MD , Gabriel Cojuc-Konigsberg BS , Stacy D. Brown PhD , Sergio E. Chiarella MD , Gerald W. Volcheck MD , Hirohito Kita MD , Lene H. Garvey MD, PhD (Professor) , Alexei Gonzalez-Estrada MD
Background
Chlorhexidine gluconate (CHX), a common cause of perioperative anaphylaxis, is frequently used for skin testing in allergy evaluations. Although CHX’s maximal nonirritating concentrations are known, the stability of its dilutions for skin testing remains unexplored, particularly when sterile water for injection (SWFI) or normal saline (NS) are used as diluents.
Objective
Our aim was to evaluate the stability and precipitation of CHX when diluted with SWFI or NS for drug allergy skin testing.
Methods
CHX dilutions (5-0.002 mg/mL) were prepared using SWFI and NS. HPLC and UV-visible spectrophotometry were used to assess stability and precipitation over 48 hours. Turbidity was measured at various time points to monitor precipitation.
Results
HPLC analysis showed no significant differences in peak heights between CHX-SWFI and CHX-NS dilutions. However, visible precipitation and increased turbidity (>100 NTU) were observed in CHX-NS at higher concentrations (5 mg/mL) after 60 minutes. No precipitation occurred in CHX-SWFI at any concentration for 48 hours.
Conclusion
For CHX skin testing, SWFI is the preferred diluent at concentrations higher than 0.02 mg/mL to avoid precipitation. Using NS for the final dilution from 0.02 to 0.002 mg/mL is feasible and reduces injection pain. Except for CHX-NS at 5 mg/mL, reagents can be prepared up to 24 hours before testing.
{"title":"Stability of diluted chlorhexidine for skin testing in drug allergy evaluations","authors":"Divya Shah MD , Gabriel Cojuc-Konigsberg BS , Stacy D. Brown PhD , Sergio E. Chiarella MD , Gerald W. Volcheck MD , Hirohito Kita MD , Lene H. Garvey MD, PhD (Professor) , Alexei Gonzalez-Estrada MD","doi":"10.1016/j.jacig.2024.100372","DOIUrl":"10.1016/j.jacig.2024.100372","url":null,"abstract":"<div><h3>Background</h3><div>Chlorhexidine gluconate (CHX), a common cause of perioperative anaphylaxis, is frequently used for skin testing in allergy evaluations. Although CHX’s maximal nonirritating concentrations are known, the stability of its dilutions for skin testing remains unexplored, particularly when sterile water for injection (SWFI) or normal saline (NS) are used as diluents.</div></div><div><h3>Objective</h3><div>Our aim was to evaluate the stability and precipitation of CHX when diluted with SWFI or NS for drug allergy skin testing.</div></div><div><h3>Methods</h3><div>CHX dilutions (5-0.002 mg/mL) were prepared using SWFI and NS. HPLC and UV-visible spectrophotometry were used to assess stability and precipitation over 48 hours. Turbidity was measured at various time points to monitor precipitation.</div></div><div><h3>Results</h3><div>HPLC analysis showed no significant differences in peak heights between CHX-SWFI and CHX-NS dilutions. However, visible precipitation and increased turbidity (>100 NTU) were observed in CHX-NS at higher concentrations (5 mg/mL) after 60 minutes. No precipitation occurred in CHX-SWFI at any concentration for 48 hours.</div></div><div><h3>Conclusion</h3><div>For CHX skin testing, SWFI is the preferred diluent at concentrations higher than 0.02 mg/mL to avoid precipitation. Using NS for the final dilution from 0.02 to 0.002 mg/mL is feasible and reduces injection pain. Except for CHX-NS at 5 mg/mL, reagents can be prepared up to 24 hours before testing.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 1","pages":"Article 100372"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jacig.2024.100376
Lakshmi G. Nair MD , S. Shahzad Mustafa MD , Allison Ramsey MD
Background
Penicillin allergy is reported in 5% to 15% of the world population, with 3% to 10% of pregnant women reporting the same. However, more than 90% of these patients can tolerate penicillin after appropriate evaluation. Penicillin is indicated for various issues that arise in pregnancy, and a history of allergy can have negative individual and public health consequences.
Objective
Our aim was to prospectively evaluate the feasibility, safety, and select obstetric outcomes of obstetric penicillin allergy evaluations arranged through a direct referral phone line from obstetric practices to an employed allergy/immunology practice.
Methods
Patients were referred via direct phone line for evaluation during their antenatal visits between May 2019 and May 2022. Patients underwent skin prick testing, and those with a negative penicillin skin testing (PST) result were subjected to amoxicillin challenge. In select cases of patients with a low-risk history, direct oral challenge was performed. Data were analyzed using descriptive statistics.
Results
Of the 324 patients referred between May 2019 and May 2022, a total of 251 (77.5%) presented for in-office evaluations. Of those 251 patients, 239 (95.2%) underwent PST followed by oral challenge if the PST result was negative; 12 patients (4.8%) underwent direct challenge without skin testing, and all of them passed the challenge. Of the patients undergoing PST, 230 (97.2%) had a negative result and 229 tolerated subsequent oral amoxicillin doses, with 1 patient experiencing a delayed reaction to the amoxicillin. The group of patients who presented for evaluation included more people living in ZIP codes described as being of high socioeconomic status than in the no-show group (73.7% vs 63.3%).
Conclusion
To our knowledge, ours is the largest study to date to demonstrate the safety and feasibility of a phone line for obstetric penicillin allergy referrals. We demonstrate a better show rate than previous analyses, with most of the patients presenting for evaluation being successfully delabeled.
背景：青霉素过敏报告占世界人口的5%至15%，其中3%至10%的孕妇报告同样的情况。然而，经过适当的评估，90%以上的患者可以耐受青霉素。青霉素适用于妊娠期间出现的各种问题，过敏史可能对个人和公共健康产生负面影响。目的：我们的目的是前瞻性地评估产科青霉素过敏评估的可行性、安全性和选择产科结果，这些评估通过直接转诊电话从产科诊所安排到过敏/免疫学诊所。方法：于2019年5月至2022年5月期间，通过电话直接转介患者进行产前检查。患者进行皮肤点刺试验，青霉素皮肤试验（PST）阴性的患者进行阿莫西林刺激。在有低风险病史的患者中，直接进行口腔攻击。数据分析采用描述性统计。结果：在2019年5月至2022年5月期间转诊的324例患者中，共有251例（77.5%）进行了现场评估。在这251名患者中，239名（95.2%）接受了PST检查，如果PST结果为阴性，则再进行口腔穿刺；12例（4.8%）患者直接激射，未进行皮肤试验，均通过激射。在接受PST治疗的患者中，230例（97.2%）结果为阴性，229例后续口服阿莫西林耐受，1例患者出现阿莫西林延迟反应。与未就诊组相比，就诊组中居住在被描述为高社会经济地位的邮政编码地区的患者更多（73.7% vs 63.3%）。结论：据我们所知，我们的研究是迄今为止最大的研究，以证明产科青霉素过敏转诊电话线路的安全性和可行性。我们证明了一个更好的显示率比以前的分析，大多数患者提出评估被成功地去标签。
{"title":"Obstetric penicillin allergy evaluations","authors":"Lakshmi G. Nair MD , S. Shahzad Mustafa MD , Allison Ramsey MD","doi":"10.1016/j.jacig.2024.100376","DOIUrl":"10.1016/j.jacig.2024.100376","url":null,"abstract":"<div><h3>Background</h3><div>Penicillin allergy is reported in 5% to 15% of the world population, with 3% to 10% of pregnant women reporting the same. However, more than 90% of these patients can tolerate penicillin after appropriate evaluation. Penicillin is indicated for various issues that arise in pregnancy, and a history of allergy can have negative individual and public health consequences.</div></div><div><h3>Objective</h3><div>Our aim was to prospectively evaluate the feasibility, safety, and select obstetric outcomes of obstetric penicillin allergy evaluations arranged through a direct referral phone line from obstetric practices to an employed allergy/immunology practice.</div></div><div><h3>Methods</h3><div>Patients were referred via direct phone line for evaluation during their antenatal visits between May 2019 and May 2022. Patients underwent skin prick testing, and those with a negative penicillin skin testing (PST) result were subjected to amoxicillin challenge. In select cases of patients with a low-risk history, direct oral challenge was performed. Data were analyzed using descriptive statistics.</div></div><div><h3>Results</h3><div>Of the 324 patients referred between May 2019 and May 2022, a total of 251 (77.5%) presented for in-office evaluations. Of those 251 patients, 239 (95.2%) underwent PST followed by oral challenge if the PST result was negative; 12 patients (4.8%) underwent direct challenge without skin testing, and all of them passed the challenge. Of the patients undergoing PST, 230 (97.2%) had a negative result and 229 tolerated subsequent oral amoxicillin doses, with 1 patient experiencing a delayed reaction to the amoxicillin. The group of patients who presented for evaluation included more people living in ZIP codes described as being of high socioeconomic status than in the no-show group (73.7% vs 63.3%).</div></div><div><h3>Conclusion</h3><div>To our knowledge, ours is the largest study to date to demonstrate the safety and feasibility of a phone line for obstetric penicillin allergy referrals. We demonstrate a better show rate than previous analyses, with most of the patients presenting for evaluation being successfully delabeled.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 1","pages":"Article 100376"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jacig.2024.100381
Jane C.Y. Wong MBBS , Dorothy L.Y. Lam MSc , Jackie S.H. Yim MSc , Elaine Lee MSc , Weihong Shi MMed , Valerie Chiang MBBS , Philip H. Li MD
Background
Hereditary angioedema (HAE) is a rare genetic disorder with potentially life-threatening consequences, traditionally diagnosed by conventional laboratory methods that can be resource intensive and inconvenient. Incorporating dried blood spot (DBS) tests may be a promising alternative for diagnosing HAE and family screening.
Objective
This study aimed to validate DBS with conventional laboratory assays among confirmed C1 esterase inhibitor (C1-INH) HAE patients and assess the utility of DBS in a Screening Programme Providing Outreach for Testing Hereditary Angioedema (SPPOT-HAE).
Methods
In part 1, 16 Chinese C1-INH-HAE patients from 7 families participated in the validation of DBS for detecting C4, C1-INH, and functional C1-INH (fC1-INH). The results were compared with conventional laboratory assays. In part 2, DBS was utilized in family screening for HAE in a large Chinese family with relatives previously refusing testing.
Results
The study found strong correlation between conventional assays and DBS in measuring C4 (r = 0.870, P < .0001), C1-INH (r = 0.978, P < .0001), and fC1-INH (r = 0.756, P < .0001). There were no false-negative results from the DBS for C4, C1-INH or fC1-INH. SPPOT-HAE successfully recruited 9 additional relatives for family screening, of whom 22% were confirmed to have HAE. The use of DBS in an outreach program overcame barriers of prior family screening initiatives.
Conclusion
This is the first study to validate measurement of fC1-INH using DBS in C1-INH-HAE with conventional assays. An outreach program using DBS is a promising strategy overcoming previous barriers of family screening. Further large-scale, multicenter studies are required to establish the role of DBS, compare cost-effectiveness with prior strategies, and maximize diagnosis in resource-constrained countries.
背景：遗传性血管性水肿（HAE）是一种罕见的遗传性疾病，具有潜在的危及生命的后果，传统上通过传统的实验室方法诊断，这可能是资源密集和不方便的。结合干血斑（DBS）试验可能是诊断HAE和家庭筛查的一种有希望的替代方法。目的：本研究旨在通过常规实验室检测在确诊的C1酯酶抑制剂（C1- inh） HAE患者中验证DBS，并评估DBS在遗传性血管性水肿（spot -HAE）筛查计划中的应用。方法：在第一部分中，来自7个家庭的16例中国C1-INH- hae患者参与了DBS检测C4、C1-INH和功能性C1-INH （fC1-INH）的验证。结果与常规实验室检测结果进行了比较。在第2部分中，DBS被用于一个亲属先前拒绝检测的中国大家庭的HAE家庭筛查。结果：常规方法测定C4 （r = 0.870, P < 0.0001）、C1-INH （r = 0.978, P < 0.0001）、fC1-INH （r = 0.756, P < 0.0001）与DBS有较强相关性。DBS检查C4、C1-INH或fC1-INH均无假阴性结果。spot -HAE成功招募了9名额外的亲属进行家庭筛查，其中22%被证实患有HAE。在推广项目中使用DBS克服了先前家庭筛查倡议的障碍。结论：这是第一个用DBS检测C1-INH-HAE患者fC1-INH的研究。使用DBS的外展计划是一种有希望的策略，克服了以前家庭筛查的障碍。需要进一步开展大规模、多中心的研究，以确定DBS的作用，比较与先前策略的成本效益，并在资源受限的国家最大限度地提高诊断。
{"title":"Validating and utilizing dried blood spots for family screening: Screening Programme Providing Outreach for Testing Hereditary Angioedema (SPPOT-HAE)","authors":"Jane C.Y. Wong MBBS , Dorothy L.Y. Lam MSc , Jackie S.H. Yim MSc , Elaine Lee MSc , Weihong Shi MMed , Valerie Chiang MBBS , Philip H. Li MD","doi":"10.1016/j.jacig.2024.100381","DOIUrl":"10.1016/j.jacig.2024.100381","url":null,"abstract":"<div><h3>Background</h3><div>Hereditary angioedema (HAE) is a rare genetic disorder with potentially life-threatening consequences, traditionally diagnosed by conventional laboratory methods that can be resource intensive and inconvenient. Incorporating dried blood spot (DBS) tests may be a promising alternative for diagnosing HAE and family screening.</div></div><div><h3>Objective</h3><div>This study aimed to validate DBS with conventional laboratory assays among confirmed C1 esterase inhibitor (C1-INH) HAE patients and assess the utility of DBS in a Screening Programme Providing Outreach for Testing Hereditary Angioedema (SPPOT-HAE).</div></div><div><h3>Methods</h3><div>In part 1, 16 Chinese C1-INH-HAE patients from 7 families participated in the validation of DBS for detecting C4, C1-INH, and functional C1-INH (fC1-INH). The results were compared with conventional laboratory assays. In part 2, DBS was utilized in family screening for HAE in a large Chinese family with relatives previously refusing testing.</div></div><div><h3>Results</h3><div>The study found strong correlation between conventional assays and DBS in measuring C4 (<em>r</em> = 0.870, <em>P</em> < .0001), C1-INH (<em>r</em> = 0.978, <em>P</em> < .0001), and fC1-INH (<em>r</em> = 0.756, <em>P</em> < .0001). There were no false-negative results from the DBS for C4, C1-INH or fC1-INH. SPPOT-HAE successfully recruited 9 additional relatives for family screening, of whom 22% were confirmed to have HAE. The use of DBS in an outreach program overcame barriers of prior family screening initiatives.</div></div><div><h3>Conclusion</h3><div>This is the first study to validate measurement of fC1-INH using DBS in C1-INH-HAE with conventional assays. An outreach program using DBS is a promising strategy overcoming previous barriers of family screening. Further large-scale, multicenter studies are required to establish the role of DBS, compare cost-effectiveness with prior strategies, and maximize diagnosis in resource-constrained countries.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 1","pages":"Article 100381"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jacig.2024.100384
Federica Pulvirenti MD, PhD , Cinzia Milito MD, PhD , Francesco Cinetto MD, PhD , Giulia Garzi MD , Germano Sardella MD , Giuseppe Spadaro MD , Francesca Lippi MD , Valentina Guarnieri MD , Bianca Laura Cinicola MD , Maria Carrabba MD, PhD , Daniele Guadagnolo MD , Giovanna Fabio MD , Baldassarre Martire MD , Caterina Cancrini MD, PhD , Giulia Lanzoni MD , Andrea Finocchi MD, PhD , Gigliola Di Matteo MD, PhD , Eva Pompilii MD , Simona Ferrari BD, PhD , Isabella Quinti MD, PhD
Background
Many patients with X-linked agammaglobulinemia (XLA) nowadays have reached adulthood, as well as their sisters, possibly carriers of a deleterious Bruton tyrosine kinase variant. Studies on motherhood outcomes in families with XLA are lacking.
Objective
We sought to investigate adherence to carrier status screening, interest in preconception and prenatal genetic counseling, and reproductive decisions in relatives with XLA.
Methods
In this multicenter, retrospective cohort study, we collected a 3-generation pedigree and data on mothers and sisters of patients with XLA, including carrier status and pregnancy outcome.
Results
Data on 53 adults with XLA, 52 mothers, and 33 sisters were collected. All XLA sisters received genetic counseling. Forty percent of the sisters chose to undergo carrier status determination, and 60% of them chose invasive prenatal testing. The main reasons for the sisters to decide not to undergo genetic testing were their young age and the willingness to carry on with the pregnancy regardless of the outcome of the genetic test, followed by the willingness to postpone the decision at the time of pregnancy and the decision to not have children. Prenatal testing resulted in 5 XLA diagnoses, with 2 pregnancy terminations, 1 miscarriage, and 2 XLA live births. Three carriers refused prenatal testing and had 6 live births, including 3 XLA-affected sons. One sister was diagnosed as a carrier after the birth of an XLA-affected son. In total, 9 XLA diagnoses were made, including 6 live births.
Conclusions
A number of XLA sister carriers decided to carry on with their pregnancy after receiving the diagnosis of an affected fetus or after refusing prenatal testing. We propose to initiate a more extensive collaborative study to verify the effect of genetic counseling on families with XLA in other cohorts from different countries.
{"title":"The dilemma of X-linked agammaglobulinemia carriers","authors":"Federica Pulvirenti MD, PhD , Cinzia Milito MD, PhD , Francesco Cinetto MD, PhD , Giulia Garzi MD , Germano Sardella MD , Giuseppe Spadaro MD , Francesca Lippi MD , Valentina Guarnieri MD , Bianca Laura Cinicola MD , Maria Carrabba MD, PhD , Daniele Guadagnolo MD , Giovanna Fabio MD , Baldassarre Martire MD , Caterina Cancrini MD, PhD , Giulia Lanzoni MD , Andrea Finocchi MD, PhD , Gigliola Di Matteo MD, PhD , Eva Pompilii MD , Simona Ferrari BD, PhD , Isabella Quinti MD, PhD","doi":"10.1016/j.jacig.2024.100384","DOIUrl":"10.1016/j.jacig.2024.100384","url":null,"abstract":"<div><h3>Background</h3><div>Many patients with X-linked agammaglobulinemia (XLA) nowadays have reached adulthood, as well as their sisters, possibly carriers of a deleterious Bruton tyrosine kinase variant. Studies on motherhood outcomes in families with XLA are lacking.</div></div><div><h3>Objective</h3><div>We sought to investigate adherence to carrier status screening, interest in preconception and prenatal genetic counseling, and reproductive decisions in relatives with XLA.</div></div><div><h3>Methods</h3><div>In this multicenter, retrospective cohort study, we collected a 3-generation pedigree and data on mothers and sisters of patients with XLA, including carrier status and pregnancy outcome.</div></div><div><h3>Results</h3><div>Data on 53 adults with XLA, 52 mothers, and 33 sisters were collected. All XLA sisters received genetic counseling. Forty percent of the sisters chose to undergo carrier status determination, and 60% of them chose invasive prenatal testing. The main reasons for the sisters to decide not to undergo genetic testing were their young age and the willingness to carry on with the pregnancy regardless of the outcome of the genetic test, followed by the willingness to postpone the decision at the time of pregnancy and the decision to not have children. Prenatal testing resulted in 5 XLA diagnoses, with 2 pregnancy terminations, 1 miscarriage, and 2 XLA live births. Three carriers refused prenatal testing and had 6 live births, including 3 XLA-affected sons. One sister was diagnosed as a carrier after the birth of an XLA-affected son. In total, 9 XLA diagnoses were made, including 6 live births.</div></div><div><h3>Conclusions</h3><div>A number of XLA sister carriers decided to carry on with their pregnancy after receiving the diagnosis of an affected fetus or after refusing prenatal testing. We propose to initiate a more extensive collaborative study to verify the effect of genetic counseling on families with XLA in other cohorts from different countries.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 1","pages":"Article 100384"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jacig.2024.100392
Victor Gonzalez-Uribe MD, MSc , Luis A. Hernandez-Zarate MD , Cesar F. Pozo Beltran MD , Christian R. Alcocer-Arreguin MD , Paola de Baro Alvarez MD, MEd , Natalia Coello-Niembro MD , Pablo Jimenez-Feria MD , Zaira S. Mojica Gonzalez MD , Carlos Andres Gomez-Nuñez MD , Ricardo Martinez-Tenopala MD , Martín R. Basile-Alvarez MD , Berenice Velasco-Benhumea MD , Roberto Fernandez-Soto MD , Daniela E. García-Fajardo MD , Herberth Perez-Avilés MD , Cesar Pinto-Solis MD , Luis A. Rios-Villalobos MD , Roberto Ureña-Ortiz MD , Leticia Lezama-Vazquez MD , Patricio Acosta-Rodriguez-Bueno MD, MSc , Blanca Estela Del Rio-Navarro MD
Background
Eosinophilic esophagitis (EoE) is a chronic immune-mediated condition characterized by eosinophil infiltration in the esophagus, leading to symptoms such as food impaction and growth delays. Despite its increasing recognition, there is significant variability in diagnostic and treatment practices, particularly in pediatric populations.
Objectives
This study aimed to evaluate the current diagnostic and treatment practices for EoE in children across multiple centers in Mexico, identify common clinical presentations, and assess the role of IgG4 in EoE.
Methods
A retrospective analysis was conducted on 32 pediatric patients diagnosed with EoE. Data on clinical symptoms, endoscopic findings, histologic analysis, allergy assessments, and treatment approaches were collected. The presence of IgG4-positive plasma cells was also evaluated.
Results
The median age was 10.6 years, with a diagnostic delay of 15.5 months. Acute food impaction was the most common symptom, and 82% had a personal history of atopy. Endoscopic abnormalities were observed in 71% of patients. Histologic analysis confirmed EoE in 83.8% of biopsy samples, with eosinophil counts averaging 17 to 24 per high-power field. IgG4-positive plasma cells were present in 76.5% of patients. Treatment varied, with many receiving proton pump inhibitors and topical corticosteroids, but patients treated with dupilumab showed significant improvement.
Conclusions
The study highlights the challenges in diagnosing and managing EoE in children, emphasizing the need for standardized practices and comprehensive evaluations. The presence of IgG4-positive plasma cells suggests a potential role in EoE pathophysiology. Further research is needed to establish effective treatment guidelines and confirm the potential of dupilumab as a therapeutic option.
{"title":"Eosinophilic esophagitis in children: A multicenter study evaluating current practices in Mexico","authors":"Victor Gonzalez-Uribe MD, MSc , Luis A. Hernandez-Zarate MD , Cesar F. Pozo Beltran MD , Christian R. Alcocer-Arreguin MD , Paola de Baro Alvarez MD, MEd , Natalia Coello-Niembro MD , Pablo Jimenez-Feria MD , Zaira S. Mojica Gonzalez MD , Carlos Andres Gomez-Nuñez MD , Ricardo Martinez-Tenopala MD , Martín R. Basile-Alvarez MD , Berenice Velasco-Benhumea MD , Roberto Fernandez-Soto MD , Daniela E. García-Fajardo MD , Herberth Perez-Avilés MD , Cesar Pinto-Solis MD , Luis A. Rios-Villalobos MD , Roberto Ureña-Ortiz MD , Leticia Lezama-Vazquez MD , Patricio Acosta-Rodriguez-Bueno MD, MSc , Blanca Estela Del Rio-Navarro MD","doi":"10.1016/j.jacig.2024.100392","DOIUrl":"10.1016/j.jacig.2024.100392","url":null,"abstract":"<div><h3>Background</h3><div>Eosinophilic esophagitis (EoE) is a chronic immune-mediated condition characterized by eosinophil infiltration in the esophagus, leading to symptoms such as food impaction and growth delays. Despite its increasing recognition, there is significant variability in diagnostic and treatment practices, particularly in pediatric populations.</div></div><div><h3>Objectives</h3><div>This study aimed to evaluate the current diagnostic and treatment practices for EoE in children across multiple centers in Mexico, identify common clinical presentations, and assess the role of IgG<sub>4</sub> in EoE.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 32 pediatric patients diagnosed with EoE. Data on clinical symptoms, endoscopic findings, histologic analysis, allergy assessments, and treatment approaches were collected. The presence of IgG<sub>4</sub>-positive plasma cells was also evaluated.</div></div><div><h3>Results</h3><div>The median age was 10.6 years, with a diagnostic delay of 15.5 months. Acute food impaction was the most common symptom, and 82% had a personal history of atopy. Endoscopic abnormalities were observed in 71% of patients. Histologic analysis confirmed EoE in 83.8% of biopsy samples, with eosinophil counts averaging 17 to 24 per high-power field. IgG<sub>4</sub>-positive plasma cells were present in 76.5% of patients. Treatment varied, with many receiving proton pump inhibitors and topical corticosteroids, but patients treated with dupilumab showed significant improvement.</div></div><div><h3>Conclusions</h3><div>The study highlights the challenges in diagnosing and managing EoE in children, emphasizing the need for standardized practices and comprehensive evaluations. The presence of IgG<sub>4</sub>-positive plasma cells suggests a potential role in EoE pathophysiology. Further research is needed to establish effective treatment guidelines and confirm the potential of dupilumab as a therapeutic option.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 1","pages":"Article 100392"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143174676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-31DOI: 10.1016/j.jacig.2025.100429
Elham Sagheb MS , Chung-Il Wi MD , Katherine S. King MS , Bhavani Singh Agnikula Kshatriya MS , Euijung Ryu PhD , Hongfang Liu PhD , Miguel A. Park MD , Hee Yun Seol MD , Shauna M. Overgaard PhD , Deepak K. Sharma PhD , Young J. Juhn MD , Sunghwan Sohn PhD
Background
Childhood asthma often continues into adulthood, but some children experience remission. Utilizing electronic health records (EHRs) to predict asthma prognosis can aid health care providers and patients in developing effective prioritized care plans.
Objective
We aimed to develop artificial intelligence (AI) models using various clinical variables extracted from EHRs to predict childhood asthma prognosis (remission vs no remission) in different age groups.
Methods
We developed AI models utilizing patients’ EHRs during the first 6, 9, or 12 years of their lives to predict their asthma prognosis status at ages 6 to 9, 9 to 12, or 12 to 15 years, respectively. We first developed the models based on a manually annotated birth cohort (n = 900). We then leveraged a larger birth cohort (n = 29,594) labeled automatically (with weak labels) by a previously validated natural language processing algorithm for asthma prognosis. Different models (logistic regression, random forest, and XGBoost [eXtreme Gradient Boosting]) were tested with diverse clinical variables from structured and unstructured EHRs.
Results
The best AI models of each age group produced a prediction performance with areas under the receiver operating characteristic curve ranging from 0.85 to 0.93. The prediction model at age 12 showed the highest performance. Most of the AI models with weak labels showed enhanced performance, and models using the top 10 variables performed similarly to those using all of the variables.
Conclusions
The AI models effectively predicted asthma prognosis for children by using EHRs with a relatively small number of variables. This approach demonstrates the potential to enhance prioritized care plans and patient education, improving disease management and quality of life for asthmatic patients.
{"title":"AI model for predicting asthma prognosis in children","authors":"Elham Sagheb MS , Chung-Il Wi MD , Katherine S. King MS , Bhavani Singh Agnikula Kshatriya MS , Euijung Ryu PhD , Hongfang Liu PhD , Miguel A. Park MD , Hee Yun Seol MD , Shauna M. Overgaard PhD , Deepak K. Sharma PhD , Young J. Juhn MD , Sunghwan Sohn PhD","doi":"10.1016/j.jacig.2025.100429","DOIUrl":"10.1016/j.jacig.2025.100429","url":null,"abstract":"<div><h3>Background</h3><div>Childhood asthma often continues into adulthood, but some children experience remission. Utilizing electronic health records (EHRs) to predict asthma prognosis can aid health care providers and patients in developing effective prioritized care plans.</div></div><div><h3>Objective</h3><div>We aimed to develop artificial intelligence (AI) models using various clinical variables extracted from EHRs to predict childhood asthma prognosis (remission vs no remission) in different age groups.</div></div><div><h3>Methods</h3><div>We developed AI models utilizing patients’ EHRs during the first 6, 9, or 12 years of their lives to predict their asthma prognosis status at ages 6 to 9, 9 to 12, or 12 to 15 years, respectively. We first developed the models based on a manually annotated birth cohort (n = 900). We then leveraged a larger birth cohort (n = 29,594) labeled automatically (with weak labels) by a previously validated natural language processing algorithm for asthma prognosis. Different models (logistic regression, random forest, and XGBoost [eXtreme Gradient Boosting]) were tested with diverse clinical variables from structured and unstructured EHRs.</div></div><div><h3>Results</h3><div>The best AI models of each age group produced a prediction performance with areas under the receiver operating characteristic curve ranging from 0.85 to 0.93. The prediction model at age 12 showed the highest performance. Most of the AI models with weak labels showed enhanced performance, and models using the top 10 variables performed similarly to those using all of the variables.</div></div><div><h3>Conclusions</h3><div>The AI models effectively predicted asthma prognosis for children by using EHRs with a relatively small number of variables. This approach demonstrates the potential to enhance prioritized care plans and patient education, improving disease management and quality of life for asthmatic patients.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 2","pages":"Article 100429"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-31DOI: 10.1016/j.jacig.2025.100428
Kimberly Arcoleo PhD, MPH , Colleen McGovern PhD, MPH, RN , Elizabeth Allen MD , Mary Kay Irwin EdD , Musmulyono Musmulyono MHPA, BSN, RN , Ian Dela Cruz BS , Alli Walsh BSN, RN , Katia Noyes PhD, MPH , Peter Veazie PhD , Holly McGregor PhD , Samantha M. Harden PhD , Jill S. Halterman MD, MPH
Background
Undertreatment and poor adherence remain prevalent for children with persistent asthma. School-based asthma therapy (SBAT) provides guideline-based treatment by systematic school-based asthma screenings and direct administration of daily controller medications.
Objective
We examined asthma control and health care utilization for children enrolled in the SBAT program in Columbus, Ohio, from 2013 to 2019.
Methods
Six-year retrospective medical records were reviewed for 1 year before and 1 year after SBAT enrollment for children aged 5 to 19 years from 2 metropolitan school districts. Asthma control was assessed by the Asthma Control Test (ACT) and health care provider (HCP) ratings. Information was collected regarding asthma-related health care utilization, including emergency department (ED), urgent care, and acute care visits; hospitalizations; and pediatric intensive care unit (PICU) admissions.
Results
Percentage increases in well-controlled asthma were 37% (ACT) and 56% (HCP). Asthma-related ED visits decreased by 49%, hospitalizations 50%, PICU admissions 71%, urgent care visits 41%, and acute care visits 38%. Black and Latino children had significant improvements. Black children saw 40% (ACT) and 66% (HCP) increases in well-controlled asthma, with reductions of 42% in ED and urgent care visits, 52% in acute care visits, and 49% and 67% declines in hospitalizations and PICU admissions, respectively. Latino children had 55% (ACT) and 33% (HCP) asthma control improvements, with 62%, 81%, and 50% drops in ED, urgent care, and acute care visits, respectively; hospitalizations decreased by 40% and PICU admissions by 100%.
Conclusions
The SBAT program would serve well as a model for enhancing controller medication adherence, reducing morbidity, and bridging the health disparities gap for children with poorly controlled asthma.
{"title":"School-based asthma therapy: Improving medication adherence, asthma control, and health care utilization","authors":"Kimberly Arcoleo PhD, MPH , Colleen McGovern PhD, MPH, RN , Elizabeth Allen MD , Mary Kay Irwin EdD , Musmulyono Musmulyono MHPA, BSN, RN , Ian Dela Cruz BS , Alli Walsh BSN, RN , Katia Noyes PhD, MPH , Peter Veazie PhD , Holly McGregor PhD , Samantha M. Harden PhD , Jill S. Halterman MD, MPH","doi":"10.1016/j.jacig.2025.100428","DOIUrl":"10.1016/j.jacig.2025.100428","url":null,"abstract":"<div><h3>Background</h3><div>Undertreatment and poor adherence remain prevalent for children with persistent asthma. School-based asthma therapy (SBAT) provides guideline-based treatment by systematic school-based asthma screenings and direct administration of daily controller medications.</div></div><div><h3>Objective</h3><div>We examined asthma control and health care utilization for children enrolled in the SBAT program in Columbus, Ohio, from 2013 to 2019.</div></div><div><h3>Methods</h3><div>Six-year retrospective medical records were reviewed for 1 year before and 1 year after SBAT enrollment for children aged 5 to 19 years from 2 metropolitan school districts. Asthma control was assessed by the Asthma Control Test (ACT) and health care provider (HCP) ratings. Information was collected regarding asthma-related health care utilization, including emergency department (ED), urgent care, and acute care visits; hospitalizations; and pediatric intensive care unit (PICU) admissions.</div></div><div><h3>Results</h3><div>Percentage increases in well-controlled asthma were 37% (ACT) and 56% (HCP). Asthma-related ED visits decreased by 49%, hospitalizations 50%, PICU admissions 71%, urgent care visits 41%, and acute care visits 38%. Black and Latino children had significant improvements. Black children saw 40% (ACT) and 66% (HCP) increases in well-controlled asthma, with reductions of 42% in ED and urgent care visits, 52% in acute care visits, and 49% and 67% declines in hospitalizations and PICU admissions, respectively. Latino children had 55% (ACT) and 33% (HCP) asthma control improvements, with 62%, 81%, and 50% drops in ED, urgent care, and acute care visits, respectively; hospitalizations decreased by 40% and PICU admissions by 100%.</div></div><div><h3>Conclusions</h3><div>The SBAT program would serve well as a model for enhancing controller medication adherence, reducing morbidity, and bridging the health disparities gap for children with poorly controlled asthma.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 2","pages":"Article 100428"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bronchial asthma (BA) and chronic obstructive pulmonary disease (COPD) are often misdiagnosed or undiagnosed, highlighting the need for more noninvasive and accessible diagnostic tools. Although exhaled breath condensate (EBC) is recognized as a biomarker resource for respiratory diseases, nontargeted proteomics of extracellular vesicles (EVs) in EBC has not been explored.
Objective
Our aim was to identify protein signatures in EBC-derived EVs (EBC-EVs) and potential biomarkers for BA and COPD.
Methods
EBC-EVs were isolated from 8 patients with BA, 5 patients with COPD, and 9 healthy controls by using the phosphatidylserine affinity method. The isolated EBC-EVs were analyzed by using data-independent acquisition proteomics to identify differentially expressed proteins (DEPs) and their associations with clinical parameters.
Results
Overall, 2524 proteins were identified. In the patients with BA, 20 proteins were upregulated, and 34 were downregulated. In the patients with COPD, 46 proteins were upregulated and 67 were downregulated. Although the enriched pathways and protein networks showed similarities between BA and COPD, they also indicated distinct pathophysiologic differences. In all, 5 BA-DEPs and 2 COPD-DEPs correlated with clinical parameters. For BA, S100 calcium-binding protein P levels were inversely correlated with FEV1 value, and ribosomal protein S10 levels were inversely correlated with blood eosinophil count. Clathrin heavy chain 2 correlated with serum IgE levels. For COPD, 14-3-3 protein theta and galectin-related protein showed positive and negative correlations with FEV1 value, respectively.
Conclusions
Proteomics of EBC-EVs has enabled the identification of potential diagnostic biomarkers for BA and COPD. “Breathomics” of EBC-EVs offers a promising noninvasive approach for diagnosis and phenotyping of respiratory diseases.
{"title":"Potential asthma biomarkers identified by nontargeted proteomics of extracellular vesicles in exhaled breath condensate","authors":"Reina Hara MD , Yoshito Takeda MD, PhD , Takatoshi Enomoto MD , Hanako Yoshimura MD, PhD , Makoto Yamamoto MD , Satoshi Tanizaki MD , Yuya Shirai MD, PhD , Takahiro Kawasaki MD, PhD , Mana Nakayama , Saori Amiya MD , Yuichi Adachi MD , Yoshimi Noda MD , Takayuki Niitsu MD , Ryuya Edahiro MD, PhD , Moto Yaga MD, PhD , Yuki Hosono MD, PhD , Maiko Naito MD, PhD , Kentaro Masuhiro MD, PhD , Yujiro Naito MD, PhD , Takayuki Shiroyama MD, PhD , Atsushi Kumanogoh MD, PhD","doi":"10.1016/j.jacig.2025.100432","DOIUrl":"10.1016/j.jacig.2025.100432","url":null,"abstract":"<div><h3>Background</h3><div>Bronchial asthma (BA) and chronic obstructive pulmonary disease (COPD) are often misdiagnosed or undiagnosed, highlighting the need for more noninvasive and accessible diagnostic tools. Although exhaled breath condensate (EBC) is recognized as a biomarker resource for respiratory diseases, nontargeted proteomics of extracellular vesicles (EVs) in EBC has not been explored.</div></div><div><h3>Objective</h3><div>Our aim was to identify protein signatures in EBC-derived EVs (EBC-EVs) and potential biomarkers for BA and COPD.</div></div><div><h3>Methods</h3><div>EBC-EVs were isolated from 8 patients with BA, 5 patients with COPD, and 9 healthy controls by using the phosphatidylserine affinity method. The isolated EBC-EVs were analyzed by using data-independent acquisition proteomics to identify differentially expressed proteins (DEPs) and their associations with clinical parameters.</div></div><div><h3>Results</h3><div>Overall, 2524 proteins were identified. In the patients with BA, 20 proteins were upregulated, and 34 were downregulated. In the patients with COPD, 46 proteins were upregulated and 67 were downregulated. Although the enriched pathways and protein networks showed similarities between BA and COPD, they also indicated distinct pathophysiologic differences. In all, 5 BA-DEPs and 2 COPD-DEPs correlated with clinical parameters. For BA, S100 calcium-binding protein P levels were inversely correlated with FEV<sub>1</sub> value, and ribosomal protein S10 levels were inversely correlated with blood eosinophil count. Clathrin heavy chain 2 correlated with serum IgE levels. For COPD, 14-3-3 protein theta and galectin-related protein showed positive and negative correlations with FEV<sub>1</sub> value, respectively.</div></div><div><h3>Conclusions</h3><div>Proteomics of EBC-EVs has enabled the identification of potential diagnostic biomarkers for BA and COPD. “Breathomics” of EBC-EVs offers a promising noninvasive approach for diagnosis and phenotyping of respiratory diseases.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 2","pages":"Article 100432"},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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