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

{"title":"Evaluation of cephalosporin allergy: Survey of drug allergy experts","authors":"Anna Brameli MD ,&nbsp;Cosby A. Stone Jr. MD, MPH ,&nbsp;Elizabeth J. Phillips MD","doi":"10.1016/j.jacig.2024.100351","DOIUrl":"10.1016/j.jacig.2024.100351","url":null,"abstract":"<div><h3>Background</h3><div>Since the publication of the 2022 Drug Allergy Practice Parameters (DAPP) of the American Academy of Allergy, Asthma &amp; Immunology (AAAAI) and American College of Allergy, Asthma &amp; Immunology (ACAAI), it is unclear the extent to which the simplified and risk-stratified evaluation of cephalosporin allergy has been incorporated into allergy practice.</div></div><div><h3>Objective</h3><div>We aimed to assess current cephalosporin allergy testing practices using real case examples.</div></div><div><h3>Methods</h3><div>An 18-question REDCap survey was sent to the 136 members of the Adverse Reactions to Drugs, Biologics and Latex (ARDBL) Committee of the AAAAI between February and April 2023.</div></div><div><h3>Results</h3><div>Forty-six (33.8%) ARDBL members completed the survey after 3 email attempts. Most practiced in the United States (32, 69.6%), 6 (13.0%) in Canada, and the rest in Europe and Asia. Almost half (47.7%) reported that the 2022 DAPP had increased their use of direct oral challenge, and 91% would prescribe cephalosporins in the setting of low-risk penicillin allergy history without testing. For low-risk cephalosporin reactions, 68% would perform a direct oral challenge with the culprit drug. In severe immediate penicillin reactions, 23% would evaluate with penicillin skin test before assessing cephalosporin allergy. For cephalosporin-related anaphylaxis, 48% would perform cephalosporin-based tests. For perioperative anaphylaxis with cefazolin, 57% would perform cephalosporin-based tests. For positive skin test result to cefazolin, 79% chose to avoid the culprit drug with follow-up oral challenge to a structurally dissimilar cephalosporin.</div></div><div><h3>Conclusion</h3><div>Increased uptake of direct oral challenge represents the initial impact of the 2022 DAPP. However, there is significant variation in testing practices of cephalosporin allergy even among drug allergy experts, reflecting a need for a firmer evidence base to guide consensus around testing for higher-risk reactions.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 1","pages":"Article 100351"},"PeriodicalIF":0.0,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142654086","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}

{"title":"Health disparities in the Middle East: Representative analysis of the region","authors":"Amal Assa’ad MD ,&nbsp;Alon Y. Hershko MD, PhD ,&nbsp;Carla Irani MD ,&nbsp;Mahboobeh Mahdavinia MD, PhD ,&nbsp;David A. Khan MD ,&nbsp;Jonathan A. Bernstein MD","doi":"10.1016/j.jacig.2024.100350","DOIUrl":"10.1016/j.jacig.2024.100350","url":null,"abstract":"<div><div>Health care disparities refer to differences in health and health care between groups that are closely associated with governmental, social, economic, and/or environmental policies. To address this gap in knowledge, a forum to address health disparities in different regions of the world was developed as an American Academy of Allergy, Asthma &amp; Immunology (AAAAI) presidential initiative (under Dr Jonathan Bernstein) in partnership with the World Allergy Organization to better understand political and socioeconomic issues within different countries and how they affect their health care systems. The first region selected was the Middle East. Representatives from Egypt, Israel, Lebanon, and Iran were invited to speak at this forum. Although we were not able to be inclusive of all countries in this region, it is apparent that the health care systems for those that participated are heterogeneous as a result of socioeconomic, educational, and governmental infrastructures. However, all regions noted health disparities that appeared to be linked to social determinants of health. Unfortunately, conflict in this region has had an additional adverse effect on these health care systems, making solutions even more challenging. However, recognition of the problems that loom large for allergy/immunology in particular can provide an opportunity for international collaboration that focuses on providing patient and physician education and identifying strategies to improve access to specialized health care.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 1","pages":"Article 100350"},"PeriodicalIF":0.0,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142594044","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}

{"title":"Resident memory B cells are enriched in chronic rhinosinusitis with nasal polyps","authors":"Yohei Sato MD, PhD ,&nbsp;Natsuki Inoue MD, PhD ,&nbsp;Erika Osada BS ,&nbsp;Yasuhiro Tsunemi MD ,&nbsp;Daiki Nakashima MD ,&nbsp;Tomomitsu Hirota DDS, PhD ,&nbsp;Nobuyoshi Otori MD, PhD ,&nbsp;Mamoru Yoshikawa MD, PhD ,&nbsp;Shin-ichi Haruna MD, PhD ,&nbsp;Tsuguhisa Nakayama MD, PhD","doi":"10.1016/j.jacig.2024.100349","DOIUrl":"10.1016/j.jacig.2024.100349","url":null,"abstract":"<div><h3>Background</h3><div>Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic nasal and sinonasal inflammatory disease. Recently, resident memory B (BRM) cells have been identified in the lungs, although not in the sinonasal mucosa.</div></div><div><h3>Objective</h3><div>Our aim was to characterize memory B-cell phenotypes with regard to patients with CRSwNP and identify BRM cells in both normal sinonosal mucosa and samples from patients with CRSwNP.</div></div><div><h3>Methods</h3><div>CD19⁺ B cells were isolated from patients with CRSwNP and analyzed using flow cytometry and immunohistochemistry.</div></div><div><h3>Results</h3><div>Although BRM cells were found in the normal sinonasal mucosa, their numbers and frequencies tended to be limited. These findings were confirmed on the basis of immunohistochemical analyses indicating an upregulation of CD69/CD45RB in tissue sections from patients with CRSwNP, although not in normal sinonasal mucosa. Accordingly, BRM cells were established to be enriched in the nasal polyps isolated from patients with CRSwNP.</div></div><div><h3>Conclusion</h3><div>Our findings in this study reveal that BRM cells can be detected in normal sinonasal mucosa, although they are significantly enriched in nasal polyps derived from patients with CRSwNP. These findings can contribute to gaining a more comprehensive understanding of the immune reactions associated with CRSwNP and facilitate the identification of potential therapeutic targets, such as anti–B-cell therapy.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 1","pages":"Article 100349"},"PeriodicalIF":0.0,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142654089","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}

{"title":"Effect of prednisone on woodsmoke-induced sputum inflammation in healthy volunteers: A randomized, placebo-controlled pilot study","authors":"Terry L. Noah MD ,&nbsp;Neil E. Alexis PhD ,&nbsp;William D. Bennett PhD ,&nbsp;Michelle L. Hernandez MD ,&nbsp;Allison J. Burbank MD ,&nbsp;Haolin Li PhD ,&nbsp;Haibo Zhou PhD ,&nbsp;Ilona Jaspers PhD ,&nbsp;David B. Peden MD, MS","doi":"10.1016/j.jacig.2024.100347","DOIUrl":"10.1016/j.jacig.2024.100347","url":null,"abstract":"<div><h3>Background</h3><div>Inhalation of biomass smoke is associated with adverse respiratory effects in those with chronic pulmonary conditions. There are few published data regarding the effects of anti-inflammatory interventions on these outcomes.</div></div><div><h3>Objective</h3><div>Our aim was to assess the effects of postexposure prednisone on woodsmoke (WS)-induced sputum neutrophilia.</div></div><div><h3>Methods</h3><div>We carried out a randomized, placebo-controlled, crossover pilot study assessing the effect of a postexposure dose of 60 mg prednisone on induced sputum inflammation after controlled exposure to WS (500 μg/m³ for 2 hours) in healthy adults who had been identified in a separate screening protocol as being “PMN responsive” to WS. Secondary end points were sputum cytokine level and mucociliary clearance as measured by γ-scintigraphy.</div></div><div><h3>Results</h3><div>A total of 11 subjects yielded complete data for the primary analysis. At 24 hours after WS exposure, there was a significant increase in sputum percentage of PMNs (%PMN) versus at baseline after placebo (median = 42% [IQR = 31%-53%]) (<em>P</em> = .02) but not after prednisone (median = 32% [IQR = 18%-40%]) (<em>P</em> = .09). Prednisone reduced Δ%PMN at 24 hours, but this difference did not reach statistical significance. However, for the 8 of 11 subjects who were PMN responsive after placebo, prednisone reduced Δ%PMN significantly (<em>P</em> = .05). Prednisone had no significant effects on sputum levels of IL-1β, IL-6, IL-8, or TNF-α. WS exposure tended to reduce mucociliary clearance in the placebo arm but not in the prednisone arm.</div></div><div><h3>Conclusions</h3><div>Prednisone taken immediately after exposure to WS mitigated short-term increase in sputum %PMN among healthy volunteers selected for their underlying inflammatory responsiveness to WS. Our data support future studies assessing anti-inflammatory interventions and the role of mucus clearance in WS-induced respiratory health effects.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 1","pages":"Article 100347"},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527300","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}

{"title":"Atopic dermatitis and tobacco smoke exposure during childhood and adolescence","authors":"Noor A. Al-Alusi MD, MS ,&nbsp;Faustine D. Ramirez MD ,&nbsp;Leslie N. Chan MD ,&nbsp;Morgan Ye MPH ,&nbsp;Sinéad M. Langan FRCP, MSc, PhD ,&nbsp;Chuck McCulloch PhD ,&nbsp;Katrina Abuabara MD, MA, MSCE","doi":"10.1016/j.jacig.2024.100345","DOIUrl":"10.1016/j.jacig.2024.100345","url":null,"abstract":"<div><h3>Background</h3><div>Tobacco smoke may affect atopic dermatitis (AD) because of its known effects on humoral and cellular immunity, but prior studies lack data on disease severity and biomarkers over time.</div></div><div><h3>Objective</h3><div>We investigated the association between passive and active tobacco smoke exposure (TSE) during childhood and adolescence and the activity and severity of AD.</div></div><div><h3>Methods</h3><div>A birth cohort of 10,521 individuals was followed through adolescence as part of the Avon Longitudinal Study of Parents and Children. We used mixed-effect models to determine the risk of AD (based on repeated assessments) with passive smoke exposure during childhood, active TSE during adolescence, and using a serum biomarker of tobacco exposure (cotinine) at 3 time points.</div></div><div><h3>Results</h3><div>After adjusting for confounding factors, there was no evidence of a relationship between passive TSE and concurrent AD activity in childhood (adjusted odds ratio, 0.95; 95% confidence interval, 0.83, 1.07) or of an increased risk between active smoking and AD activity in adolescence (adjusted odds ratio, 0.57; 95% confidence interval, 0.44, 0.75). Secondary analyses demonstrated no dose–response relationship and no increased severity of AD with passive or active TSE. Furthermore, we found no increased risk of AD with a cumulative measure of passive TSE across childhood (adjusted relative risk ratio, 0.98; 95% confidence interval, 0.96, 1.00).</div></div><div><h3>Conclusion</h3><div>Neither active nor passive TSE was associated with AD during childhood and adolescence.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 1","pages":"Article 100345"},"PeriodicalIF":0.0,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527298","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}

{"title":"Racial and ethnic disparities in dupilumab for pediatric atopic dermatitis in Florida","authors":"Urdur Jonsdottir MD ,&nbsp;Emily S. Craver MS ,&nbsp;Tanvi Patel MD","doi":"10.1016/j.jacig.2024.100344","DOIUrl":"10.1016/j.jacig.2024.100344","url":null,"abstract":"<div><h3>Background</h3><div>Dupilumab is an mAb that has been shown to decrease symptoms and severity of atopic dermatitis (AD). It was approved for use in adolescents and children in a stepwise manner from 2019 to 2022. Racial and ethnic disparities have been described in access to emerging therapies in many conditions, including treatment with dupilumab for AD in adult patients.</div></div><div><h3>Objective</h3><div>We sought to assess racial and ethnic disparities in moderate to severe AD treatment with dupilumab in the pediatric population.</div></div><div><h3>Methods</h3><div>This retrospective study identified 12,918 patients with AD aged 0 to 17 years who had at least a 6-month follow-up period between January 2020 and September 2023. The primary end point of dupilumab prescription was compared between racial and ethnic groups and a reference group of non-Hispanic White patients while adjusting for confounders.</div></div><div><h3>Results</h3><div>Among the patients, 18.1% were Black, 40.5% Hispanic, 28.9% non-Hispanic White, and 12.4% Other race. Black (odds ratio, 0.43; <em>P</em> = .006) and Hispanic (odds ratio, 0.46; <em>P</em> &lt; .001) patients had significantly lower odds of receiving dupilumab compared with the reference group.</div></div><div><h3>Conclusions</h3><div>This study may indicate a racial and ethnic disparity negatively affecting access to treatment with dupilumab for Black and Hispanic children and adolescents with AD. Because previous studies have not indicated decreased severity of AD in these patient populations, less frequent use is likely due to other underlying factors such as differential access to care, cultural differences, language barriers, and socioeconomic factors. The contributing factors must be further identified and addressed to ensure health equity in pediatric AD.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"3 4","pages":"Article 100344"},"PeriodicalIF":0.0,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142427956","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}

{"title":"Distinguishing DRESS syndrome from drug rash and eosinophilia: Beyond RegiSCAR criteria","authors":"Grace Thompson MBBS ,&nbsp;Syed Ali MBBS ,&nbsp;Michelle Trevenen PhD ,&nbsp;Philip Vlaskovsky PhD ,&nbsp;Kevin Murray PhD ,&nbsp;Michaela Lucas MD","doi":"10.1016/j.jacig.2024.100346","DOIUrl":"10.1016/j.jacig.2024.100346","url":null,"abstract":"<div><h3>Background</h3><div>Diagnosing drug reaction with eosinophilia and systemic symptoms (DRESS) can be challenging.</div></div><div><h3>Objectives</h3><div>We sought to identify clinical and laboratory features outside of the Registry of Severe Cutaneous Adverse Reaction (RegiSCAR) criteria that distinguish patients with probable DRESS (RegiSCAR ≥ 4) from those with drug rash and eosinophilia (DRE).</div></div><div><h3>Methods</h3><div>Using international coding classifications of drug-induced fever, generalized skin eruption due to medications, and eosinophilia, a retrospective audit from 2008 to 2023 of hospitalized patients was performed.</div></div><div><h3>Results</h3><div>Forty-four cases of DRESS were compared to 80 cases of DRE. In addition to the RegiSCAR distinguishing factors for DRESS were longer drug latency before symptom onset (median 21 vs 5 days, <em>P</em> &lt; .001) and higher alanine transaminase levels (increase by a factor of 2.49 [95% confidence interval, 1.56, 4.00; <em>P</em> = .009]). Follow-up (mean 5.67 years) revealed a low rate of statewide drug alert reporting (29.6%) and drug allergy testing in DRESS (20.5%). Inadvertent reexposure to a culprit or structurally related drug resulted in recurrent DRESS in 3 patients (7.5%), and tolerance of structurally related drugs occurred in 8 patients (17.5%).</div></div><div><h3>Conclusion</h3><div>In this large study evaluating DRE patients whose disease does not meet the RegiSCAR criteria for DRESS, we found that additional factors outside the RegiSCAR criteria may help clinicians differentiate DRESS, which is critical for optimal and timely patient management. Our study also highlights the need for development of local protocols to ensure appropriate allergy labeling and testing are performed to prevent recurrent DRESS.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"3 4","pages":"Article 100346"},"PeriodicalIF":0.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142445507","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}

{"title":"A RESPONSE to anti–IL-5 therapy in comorbid patients with chronic rhinosinusitis with nasal polyps and severe asthma: Study protocol","authors":"Petros Bakakos PhD ,&nbsp;Isam Alobid PhD ,&nbsp;Jannis Constantinidis PhD ,&nbsp;Peter Hellings PhD ,&nbsp;Oliver Pfaar PhD ,&nbsp;Camille Taillé PhD ,&nbsp;David Bañas-Conejero MSc ,&nbsp;Konstantina Kallinikou PhD ,&nbsp;Peter Howarth DM ,&nbsp;Florence Schleich PhD","doi":"10.1016/j.jacig.2024.100343","DOIUrl":"10.1016/j.jacig.2024.100343","url":null,"abstract":"<div><h3>Background</h3><div>Chronic rhinosinusitis with nasal polyps (CRSwNP) and severe asthma (SA) are 2 frequently coexisting conditions that are, in most cases, associated with eosinophilic inflammation. The concurrence of both diseases has a negative synergistic impact on disease severity and patients’ health-related quality of life. Thus, a holistic, collaborative management of these patients is a critical unmet need. Mepolizumab, a systemic anti–IL-5 therapy, has been shown to be effective as an add-on treatment in both SA and CRSwNP, with more literature available on asthma outcomes than on CRSwNP.</div></div><div><h3>Objectives</h3><div>The primary objective of the study is to evaluate the real-world effectiveness of mepolizumab in improving the health-related quality of life of comorbid patients at 12 months using the SNOT-22 questionnaire. Secondary objectives include safety and efficacy outcomes of mepolizumab treatment in the 2 populations, which are expected to have variable severity of the respective comorbid conditions.</div></div><div><h3>Methods</h3><div>RESPONSE is a European real-world prospective cohort study designed to assess the effectiveness of mepolizumab in 2 cohorts of adult patients: one with SA as primary diagnosis with (secondary diagnosis) comorbid CRSwNP, and another with CRSwNP as primary diagnosis with (secondary diagnosis) comorbid asthma. Up to 350 patients receiving newly prescribed mepolizumab will be followed up for 12 months as per the investigators’ standard of care.</div></div><div><h3>Conclusion</h3><div>This study will report the effects of anti–IL-5 therapy in both diseases investigated and the respective comorbidity, as well as the consequence of treating milder forms of asthma and CRSwNP with mepolizumab, supporting the emerging evidence on early treatment optimization.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 1","pages":"Article 100343"},"PeriodicalIF":0.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142553386","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}

{"title":"Association between asthma and IgG levels specific for rhinovirus and respiratory syncytial virus antigens in children and adults","authors":"Marion Mauclin MSc ,&nbsp;Alicia Guillien PhD ,&nbsp;Katarzyna Niespodziana PhD ,&nbsp;Anne Boudier MSc ,&nbsp;Thomas Schlederer PhD ,&nbsp;Maja Bajic MSc ,&nbsp;Peter Errhalt MD ,&nbsp;Kristina Borochova PhD ,&nbsp;Isabelle Pin MD ,&nbsp;Frédéric Gormand MD ,&nbsp;Raphaël Vernet MD ,&nbsp;Jean Bousquet MD, PhD ,&nbsp;Emmanuelle Bouzigon MD, PhD ,&nbsp;Rudolf Valenta MD, PhD ,&nbsp;Valérie Siroux PhD","doi":"10.1016/j.jacig.2024.100342","DOIUrl":"10.1016/j.jacig.2024.100342","url":null,"abstract":"<div><h3>Background</h3><div>Viral infections in childhood, especially to rhinovirus (RV) and respiratory syncytial virus (RSV), are associated with asthma inception and exacerbation. However, little is known about the role of RV- and RSV-specific antibodies in childhood versus adult asthma.</div></div><div><h3>Objective</h3><div>We sought to investigate associations between RV- and RSV-specific IgG levels and asthma phenotypes in children and adults.</div></div><div><h3>Methods</h3><div>The analysis included 1771 samples from participants of the Epidemiological Study on the Genetics and Environment of Asthma (530 children; age [mean ± SD], 11.1 ± 2.8, and 1241 adults; age [mean ± SD], 43.4 ± 16.7, among whom 274 and 498 had ever asthma, respectively). RSV- and RV-specific IgG levels were determined using microarrayed virus-derived antigens and peptides. Cross-sectional associations between standardized RSV- and RV-specific IgG levels and asthma phenotypes were estimated by multiple regression models.</div></div><div><h3>Results</h3><div>In children, ever asthma was associated with higher IgG levels specific to RV, especially to RV-A and RV-C, and to RSV (adjusted odds ratios [95% CI] for a 1 − SD increase in IgG levels were 1.52 [1.16-1.99], 1.42 [1.10-1.83], and 1.24 [0.99-1.54], respectively). These associations were stronger for moderate to severe asthma than for mild asthma. Conversely in adults, ever asthma was associated with lower RV-A, RV-B, and RV-C IgG levels (adjusted odds ratios [95% CI] were 0.86 [0.74-0.99], 0.83 [0.73-0.95], and 0.85 [0.73-0.99], respectively).</div></div><div><h3>Conclusions</h3><div>Our results suggest that the association between respiratory virus–specific antibody levels and asthma varies during life, with asthma associated with higher levels of IgG to RSV, RV-A, and RV-C in children and lower levels of IgG responses to RV-A/B/C in adults.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 1","pages":"Article 100342"},"PeriodicalIF":0.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527297","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}

{"title":"Effects of nonpharmaceutical interventions during COVID-19 pandemic on pediatric asthma exacerbations and viral infections","authors":"Katherine Caid MD ,&nbsp;Megan Tate MD ,&nbsp;Shahwar Yousuf MD ,&nbsp;Lillian Jones BS ,&nbsp;Robert D. Pesek MD ,&nbsp;Akilah A. Jefferson MD, MSc ,&nbsp;Tamara T. Perry MD ,&nbsp;Daniel Liu MD ,&nbsp;Grace Turner BA ,&nbsp;Ashton Ingold BS ,&nbsp;Susanna Hartzell BA ,&nbsp;Bobby L. Boyanton Jr. MD ,&nbsp;Kim Cobb MA, RRT-NPS, AE-C ,&nbsp;Haley Long BS, RRT, A-EC ,&nbsp;Suzanne House BA ,&nbsp;Dana Frederick MS ,&nbsp;Rachel A. Frenner MHA ,&nbsp;Erin Hathorn MSHI ,&nbsp;Jing Jin PhD ,&nbsp;Scott Stewart MS ,&nbsp;Joshua L. Kennedy MD","doi":"10.1016/j.jacig.2024.100340","DOIUrl":"10.1016/j.jacig.2024.100340","url":null,"abstract":"<div><h3>Background</h3><div>The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in March 2020 led to the implementation of nonpharmaceutical interventions (NPIs) to curb its spread. Studies have shown that adult asthma exacerbations and viral infections decreased during NPI use. However, few studies have shown the effects of NPIs on pediatric asthma exacerbations and infections during and after the pandemic.</div></div><div><h3>Objective</h3><div>This study aimed to understand the impact of NPIs on asthma exacerbations and viral respiratory infections in pediatric patients at our institution from March 2018 to December 2022.</div></div><div><h3>Methods</h3><div>The medical record numbers of children with asthma exacerbations seen at our institution between March 2018 and December 2022 were analyzed. Subjects were categorized on the basis of timing of their exacerbation in relation to NPI enforcement. We used the results from clinical testing with the BioFire Respiratory Panel (BRP) to detect up to 22 respiratory pathogens and then correlated these results with asthma exacerbation severity.</div></div><div><h3>Results</h3><div>There were 5,758 asthma exacerbations recorded, with a 50% decline in average weekly exacerbations during NPI enforcement. Of the 70,682 BRP tests performed, 87% returned a positive result for at least 1 pathogen. Several viruses (respiratory syncytial virus, parainfluenza, and influenza) had a decrease in positivity rate with NPIs, whereas rhinovirus/enterovirus positivity rates were unchanged throughout the pandemic. Asthma exacerbations with a positive BRP result required higher clinical levels of care during the admission.</div></div><div><h3>Conclusion</h3><div>NPIs were associated with significantly reduced numbers of asthma exacerbations and respiratory viral infections. The post-NPI period saw a return to prepandemic levels of asthma exacerbations and an unusual surge in respiratory syncytial virus infections, emphasizing the need for continuous monitoring and adaptive strategies in the postpandemic landscape.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"3 4","pages":"Article 100340"},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533198","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}