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

Background

β-Lactams remain the most reported drug allergy globally, with the volume and diversity of related drug allergy research continuing to accumulate. Recognizing evolving research trends can help inform future directions and encourage synergistic collaborations.

Objective

We conducted a comprehensive bibliometric analysis of all publications relevant to β-lactam allergy, with a focus on longitudinal publication rates, international collaborations, and key word/trend analysis.

Methods

Meta-data from all original articles, letters, and reviews relevant to β-lactam allergy on the Web of Science Core Collection up until December 31, 2023, were analyzed.

Results

From 1966 to 2023, there were 4451 records (3536 articles, 631 reviews, and 284 letters) from 78 countries. There was an exponential increase in publications, especially during the past decade, with half of all publications on β-lactam allergy published during this time (50.6% [2252 of 4452]). Overall, 18.1% of the publications (805 of 4452) involved international coauthorships, with a significant increase since the previous decade (12.7% vs 23.3% [P < .001]). The most frequent key words in the first published half of articles were skin testing (84 of 1919), IgE (57 of 1919), and anaphylaxis (49 of 1919); in contrast to the key word skin testing (137 of 3351), the key words drug provocation test (121 of 3351), antimicrobial resistance (120 of 3351), and antimicrobial stewardship (118 of 3351) were the most frequent key words in the latter half.

Conclusion

There has been a surge in publications, international collaboration, and shifting paradigms in β-lactam allergy research. The field has evolved beyond focusing on in vitro tests or desensitization toward antimicrobial stewardship. However, there still seems to be relatively fewer collaborations with non-Western countries. Further international collaborations to harmonize delabeling strategies against the threat of mislabeled β-lactam allergy should be encouraged.

Background

Hymenoptera venom allergy is a public health issue and has an undeniable impact on quality of life. Allergen immunotherapy (AIT) has shown long-term efficacy in this severe and potentially lethal allergy. However, no biomarker can predict the effectiveness of this treatment.

Objectives

We evaluated the contribution of IgE blocking activity, a functional biomarker carried out in our center using flow cytometry, to predict the efficacy of AIT.

Methods

This retrospective study from 1985 to 2022 describes in detail the demographic, clinical, and biological characteristics of patients who benefited from AIT with Hymenoptera venom at the University Hospital of Limoges. The outcome measure used was the presence of anaphylactic reaction (grade I to IV according to Ring and Messmer) in case of a new sting after discontinuation of AIT.

Results

Our study, mainly composed of patients allergic to Vespula wasp venom, did not emphasize the interest of IgE blocking activity in the prediction of a relapse after a new sting. However, this inhibition showed a significant correlation with the amount of IgG₄ antibodies.

Conclusion

There is no biomarker that can help make the decision of stopping AIT. However, low levels of IgE blocking activity may suggest a likelihood of relapse. Serum IgG₄, in correlation with IgE blocking activity, could be useful for monitoring treatment response. Additional studies are necessary to gain a thorough understanding of the composition of inhibitory antibodies.

Background

The American Thoracic Society has published general guidelines for sterility when testing for bronchodilator responsiveness. However, the extent to which practicing allergists implement sterility measures is currently unknown.

Objective

This study aims to understand the adherence to the American Thoracic Society guidelines for sterility among practicing allergists.

Methods

In 2015, a questionnaire was approved and distributed by the American Academy of Allergy, Asthma & Immunology to all its members. The anonymous responses were recorded and tabulated after a 3-week period.

Results

Of the 6800 allergists who received surveys from the American Academy of Allergy, Asthma & Immunology members, 496 participated in the survey (response rate 7.3%). Using metered dose inhalers with a spacer and nebulizers were the most common bronchodilator administration techniques, as indicated by 59.35% and 58.52% of responses, respectively. Whereas 69.25% of the allergists considered their bronchodilator administration techniques to be sterile, 14.05% did not consider their administration technique to be sterile and 16.70% were unsure. For maintaining sterility, 38.75% of the respondents indicated using a new disposable attachment for reused inhalers, 18.71% indicated using a new inhaler for each patient, and 9.13% reported wiping inhalers with a cleaning agent.

Conclusions

When asked about the sterility of the techniques used by them, nearly one-third of the allergists either stated that the measures used by them were unsterile or stated that they were were unsure. To increase adherence to sterility measures among North American allergists, promoting guideline awareness and proposing updated guidelines focused on the most common bronchodilator administration techniques is essential.

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Background

Anaphylaxis in response to edible mushrooms is uncommon, and sensitization may be independent of occupational exposure. Globally, Agaricus bisporus is one the most cultivated mushroom species, comprising the button, portobello, and Swiss brown varietals.

Objective

Our aim was to describe a case of anaphylaxis in an older nonatopic patient following ingestion of A bisporus and undertake a review of the literature.

Methods

A 77-year-old female was referred to the allergy clinic with a history of grade 3 hypotensive anaphylaxis following ingestion of a mushroom omelette. Her tryptase level 4 hours following acute symptoms was elevated. She continued to consume all other omelette ingredients with the exception of mushroom. Additional investigations included specific IgE testing as well as comprehensive skin prick testing (SPT) to raw and boiled mushrooms.

Results

One month after her index reaction, the result of SPT to boiled button mushroom was positive. The patient’s baseline tryptase level was normal. The results of further SPT with other commonly available boiled mushrooms (the A bisporus mushrooms portobello and Swiss brown, as well as enoki, oyster, and shiitake mushrooms) were also positive.

A review of the literature revealed 27 other cases, with an average patient age of 28.8 years (range 8-68 years) and no gender predisposition. Cases from Europe (n = 14, 51.8%) and Asia (n = 12, 44.4%) comprised the majority of the reports. A bisporus was reported in more than one-third of the cases (n = 10, 37.1%) from Australia, India, Portugal, Spain, and the United Kingdom. Cross-sensitization among the edible mushroom species was evident for those individuals who were tested, but no clear and consistent pattern was identified. In some cases, further diagnostics identified α-mannosidase, α-trehalose, mannitol, and ribosomal protein as specific mushroom allergens.

Conclusion

Clinicians should be aware of mushroom as a cause for anaphylaxis, especially in nonatopic and de novo presentations.

An episode of the common cold can have a significant negative impact on quality of life, mood, and daily activities. In line with this fact, there is a growing demand for health care and treatments associated with the common cold. Current treatments aim to (1) inhibit symptom severity and (2) shorten the duration of an episode of the common cold. These products include analgesics, antihistamines, and decongestants. In addition, various supplements, including vitamins, minerals, and herbs, are marketed to treat the common cold. The current products marketed for treating the common cold may reduce the severity of some (but not all) common cold symptoms, but they usually do not shorten the common cold episode. The recent indication that phenylephrine is not effective means that it will ultimately need to be removed from the over-the-counter monograph. Manufacturers will consequently need to reformulate their products and withdraw oral phenylephrine-containing products. Several newly developed common cold products are currently under investigation. These clinical trials should evaluate their efficacy and safety, as there remains a clear need for common cold products that significantly reduce both the symptom severity and the duration of episodes of the common cold.

Daratumumab-based treatment could control severe, treatment-refractory, life-threatening angioedema due to acquired C1-inhibitor deficiency associated with monoclonal gammopathy.

Soy-dependent exercise-induced anaphylaxis is likely underdiagnosed and potentially on the rise. As soy gains popularity in Western diets, we highlight it as a hidden allergen in a variety of processed foods, including those marketed toward exercise enthusiasts.

Dupilumab-induced psoriatic dermatitis and arthritis in a patient with atopic dermatitis were effectively managed with upadacitinib, highlighting the use of Janus kinase inhibitors as a possible treatment for biologic therapy side effects.