Wiley: Clinical & Experimental Allergy: Table of Contents

Asthma and Multimorbidity Amongst Ethnic Minority Groups in High Income Countries

Fri, 15 May 2026 00:11:46 -0700

There is a tight intersection between asthma, deprivation, ethnicity, multimorbidity and poor clinical outcomes. An integrated, holistic and culturally tailored approach is needed to improve clinical outcomes amongst ethnic minority groups with asthma and multimorbidity.

ABSTRACT

Asthma is one of the commonest noncommunicable diseases worldwide. Poor clinical outcomes have been reported in asthma amongst ethnic minority groups (EMGs) and reasons are likely to be multifactorial. There is a suggestion that underlying disease may behave differently amongst EMGs, alongside other factors including deprivation, cultural, religious, social, literacy, patient beliefs, healthcare access, treatment adherence, alongside greater burden of multimorbidity. Multimorbidity (presence of ≥ 2 long-term health conditions) in asthma is increasingly known to contribute to greater asthma burden, with differences in multimorbidity burden and patterns seen across ethnicities with a tight association with deprivation. Earlier onset of multimorbidity with relatively reduced survival has been reported amongst EMG patients, particularly those from a deprived background compared to White patients. Data regarding asthma, multimorbidity and ethnicity are scant, but emerging data suggest that multimorbidity is heterogenous, and that ethnic background is associated with variations in asthma outcomes and multimorbidity phenotypes. What is currently lacking is population-based research with a joined-up interrogation of primary care and secondary care databases to determine the prevalence and patterns of T2 and non T2 multimorbidity in asthma amongst EMGs, and analysis of patterns of associations and link to socio-demographic variables and clinical outcomes. Deeper insight into views of EMG patients and their carers regarding lived experiences of asthma and multimorbidity management, as well as those of healthcare professionals is needed, to allow development of culturally tailored resources. These studies are likely to shape a holistic culturally tailored multidimensional and an equitable approach to management of asthma with multimorbidity amongst EMGs.

Clinical Implications of Incidental Arg r 1 Sensitization Identified by Multiplex Allergy Testing

Wed, 13 May 2026 18:44:47 -0700

Clinical &Experimental Allergy, EarlyView.

Serum Eosinophil‐Derived Neurotoxin (EDN) as a Biomarker for Treatment Response in Atopic Dermatitis

J. I. Olydam, S. Sengkerij, S. Veenbergen, D. J. Hijnen — Tue, 12 May 2026 17:29:16 -0700

Clinical &Experimental Allergy, EarlyView.

Prenatal Air Pollution Exposure During Late Pregnancy Associates With Food Sensitization at 18 Months

Tue, 12 May 2026 04:41:26 -0700

Clinical &Experimental Allergy, EarlyView.

The Economic Value of Reducing Asthma Mortality in 64 Countries, 2000–2022, With Projections up to 2040: A Global Modelling Study

Tue, 12 May 2026 04:37:34 -0700

Clinical &Experimental Allergy, EarlyView.

Variants at 8p21.3 Mediate BMP1 Expression, Contributing to Higher Atopic Dermatitis Risk

Fri, 08 May 2026 18:58:48 -0700

Clinical &Experimental Allergy, EarlyView.

Fixed Very‐Low‐Dose Oral Immunotherapy in Infants and Toddlers With Low‐Threshold Egg, Milk or Wheat Allergy: A Prospective Cohort Study

Thu, 07 May 2026 05:45:53 -0700

Clinical &Experimental Allergy, EarlyView.

When a Positive IgE Test Is Not an Allergy: Distinguishing Sensitisation, Cross‐Reactivity and Irritant Responses in Clinical Practice

Neeraj Gupta, Sowmya Arudi Nagarajan — Wed, 06 May 2026 23:36:35 -0700

Clinical &Experimental Allergy, EarlyView.

Circulating 1‐Methylnicotinamide Predicts Dupilumab Response in Adult Asthma: A Prediction Model

Wed, 06 May 2026 17:05:10 -0700

Clinical &Experimental Allergy, EarlyView.

Comparison of Allergic Rhinitis Treatments on Utilities and Quality of Life: A MASK‐air Study

Wed, 06 May 2026 01:28:43 -0700

This mHealth study has shown that fixed combinations of intranasal antihistamines and corticosteroids were associated with higher quality of life than oral antihistamines and intranasal antihistamines. Both intranasal corticosteroids and oral antihistamines were associated with higher quality of life than intranasal antihistamines.

ABSTRACT

Background

Allergic rhinitis displays a relevant impact on quality of life. Medications used in the treatment of rhinitis have been assessed on their impact on rhinoconjunctivitis-related quality of life, but not on generic health-related quality of life metrics, such as utilities or EQ-5D visual analogue scale (VAS) levels. This study aimed to compare different medication classes and individual medications on utilities and EQ-5D VAS levels using data from a mobile app.

Methods

We conducted an observational study using direct patient data from the MASK-air mobile application, collected between May 2015 and December 2024. We compared rhinitis medication classes and individual medications on health utilities (computed from the EQ-5D-5L questionnaire) and the EQ-5D VAS. To account for confounding, we employed inverse probability treatment weighting based on propensity scores, adjusting for demographics, baseline symptom control, and asthma status.

Results

The study analysed 69,973 observations with EQ-5D VAS data and 842 observations with utility data. At the medication class level, fixed combinations of intranasal antihistamines and corticosteroids were associated with improvements in EQ-5D VAS (mean difference = 1.900; 95% CI = 1.316–2.484) and utilities (mean difference = 0.022; 95% CI = −0.015 to 0.059) compared with oral antihistamines (OAH). Intranasal antihistamines were associated with lower EQ-5D VAS and utility scores than other intranasal treatments. For individual medications, mometasone was associated with a lower EQ-5D VAS than budesonide and fluticasone furoate, while fexofenadine and levocetirizine tended to be associated with lower VAS values than other OAH.

Conclusion

Fixed combinations of intranasal antihistamines and corticosteroids were associated with better quality-of-life than oral antihistamines and intranasal antihistamines. These findings could support future cost-effectiveness analyses.

Plant‐Based Drinks for Children Aged 1 Year and Over

Aisling Phelan, Claudia Gore, Robert J. Boyle — Tue, 05 May 2026 15:00:09 -0700

Clinical &Experimental Allergy, EarlyView.

Fulminant Anaphylaxis

Paul A. Greenberger — Sun, 03 May 2026 00:00:00 -0700

Clinical &Experimental Allergy, Volume 56, Issue 5, Page 474-475, May 2026.

Issue Information

Sun, 03 May 2026 00:00:00 -0700

Clinical &Experimental Allergy, Volume 56, Issue 5, Page 471-473, May 2026.

Does ABPA Contribute to Bronchiectasis? A Structured Evaluation of Competing Hypotheses

Ritesh Agarwal, Inderpaul Singh Sehgal, Valliappan Muthu, Philip Bardin — Sun, 03 May 2026 00:00:00 -0700

Systematic evaluation of competing hypothesis suggests that ABPA contributes to bronchiectasis through antigen-driven type-2 immune injury in susceptible hosts.

ABSTRACT

Whether allergic bronchopulmonary aspergillosis (ABPA) causes bronchiectasis or merely represents Aspergillus fumigatus colonisation of damaged airways remains debated. Establishing causality is challenging because airway damage is predominantly driven by host immune responses rather than by direct fungal invasion. We systematically evaluate four competing hypotheses: (i) ABPA causes bronchiectasis, (ii) reverse causation, with bronchiectasis predisposing to ABPA, (iii) a shared underlying factor independently producing both conditions and (iv) a spurious association. We evaluate radiological, pathological, immunological, temporal and therapeutic evidence in relation to these hypotheses. The characteristic radiological phenotype (central bronchiectasis and high-attenuation mucus), eosinophil-dominant histopathology and disease-specific immunological profile (typically absent in other forms of bronchiectasis despite Aspergillus colonisation) distinguish ABPA from incidental colonisation. Randomised controlled trials demonstrating that antifungal treatment or anti-inflammatory therapy (glucocorticoids and biological agents) improve clinical and immunological outcomes argue against a purely spurious association. Temporal observations indicate that ABPA precedes bronchiectasis in many cases. While uncertainty remains and host susceptibility is likely essential, the available evidence suggests that ABPA contributes to bronchiectasis through antigen-driven immune injury, supporting the use of appropriate antifungal and immunomodulatory therapy in selected patients.

‘What’ and ‘How’ to Measure in Allergy and Clinical Immunology: A Systematic Review of Core Outcome Sets and Outcome Harmonisation Processes

Sun, 03 May 2026 00:00:00 -0700

This systematic review maps core outcome sets and harmonisation efforts in allergy and clinical immunology. Despite shared priorities such as quality of life and symptoms, substantial gaps and methodological inconsistencies remain, underscoring the need for broader coverage and standardised outcome measurement to improve comparability and clinical relevance of future research.

ABSTRACT

Background

Heterogeneity in outcome reporting and inconsistent use of outcome measurement instruments in allergy and clinical immunology research affects the comparability, synthesis, and clinical applicability of study findings. Harmonisation efforts, particularly Core Outcome Set (COS) development, aim to address these challenges by establishing standardised, evidence-based and consensus-driven outcome recommendations. This systematic review aims to map available COS and other harmonisation processes (HP) in allergy and clinical immunology, evaluate their methodological approaches, and assess their alignment with established development standards.

Methods

We systematically searched MEDLINE, EMBASE, and the COMET Initiative database until June 7, 2024 to identify COS and HP. We included studies if they provided recommendations on ‘core’ outcomes and/or outcome measurement instruments. Data extraction included disease focus, methodological approach, stakeholder involvement, and adherence to the Core Outcome Set-STAndards for Development criteria. We synthesised the data at the initiative (process) level rather than the publication level because harmonisation initiatives are frequently iterative and reported across multiple papers (e.g., protocol, Delphi rounds, consensus statement, and subsequent instrument-selection outputs).

Results

A total of 15,612 records were identified, with 44 studies (representing 22 initiatives both finished and in development) meeting inclusion criteria. The majority of initiatives focused on asthma (n = 9), followed by eczema (atopic dermatitis n = 2; hand eczema = 1; eczema = 1), urticaria (n = 2), allergic rhinitis (n = 2), chronic rhinosinusitis (n = 1), celiac disease (n = 1), Immunoglobulin E (IgE)—mediated food allergy (n = 1), eosinophilic esophagitis (n = 1), and hereditary angioedema (n = 1). No COS or HP addressed drug allergy, anaphylaxis, or other immune-mediated allergic conditions. ‘Quality of life’ was consistently included in all COS with ‘signs and symptoms’, ‘exacerbations’ and ‘disease control’ frequently selected as well. Methodological approaches to COS development varied widely, with most employing Delphi surveys, consensus meetings, and stakeholder involvement, though levels of engagement differed. COS developers inconsistently adhered to Core Outcome Set-STAndards for Development criteria, with some initiatives demonstrating rigorous methodology while others lacked transparency in key developmental steps.

Conclusion

This review highlights growing efforts to harmonise outcome assessment in allergy and clinical immunology. Major gaps remain in coverage and methodological rigour. Quality of life and patient-reported symptoms are frequently recommended outcomes, yet definitions and measurement tools are inconsistent. Strengthening methodological consistency and expanding COS development to neglected areas are critical next steps to improve outcome reliability and comparability in the field.

Isolated Mast Cell–Mediated Angioedema: Clinically Different but Endotypically Similar to Chronic Spontaneous Urticaria

Sun, 03 May 2026 00:00:00 -0700

Clinical &Experimental Allergy, Volume 56, Issue 5, Page 562-564, May 2026.

Natural History of Nonsteroidal Anti‐Inflammatory Drug‐Exacerbated Respiratory Disease: A Retrospective, Single‐Centre Study

María José Peñalver, Celine Galleani, Consuelo Fernández, Jesús F. Crespo — Sun, 03 May 2026 00:00:00 -0700

Clinical &Experimental Allergy, Volume 56, Issue 5, Page 569-571, May 2026.

Pro‐Inflammatory Dietary Patterns Are Associated With Atopic but Not Non‐Atopic Dermatitis in Asian Adults: Evidence From a Cross‐Sectional Study

Sun, 03 May 2026 00:00:00 -0700

Clinical &Experimental Allergy, Volume 56, Issue 5, Page 582-584, May 2026.

Comparative Efficacy of Biologicals for Chronic Rhinosinusitis With Nasal Polyps: A Systematic Review and Bayesian Network Meta‐Analysis

Sun, 03 May 2026 00:00:00 -0700

Clinical &Experimental Allergy, Volume 56, Issue 5, Page 579-581, May 2026.

A Role for Non‐Canonical Caspases in Fungal Allergic Airway Disease

Sun, 03 May 2026 00:00:00 -0700

Clinical &Experimental Allergy, Volume 56, Issue 5, Page 576-578, May 2026.

Basophil Activation Test for the In Vitro Diagnosis of Tocilizumab Hypersensitivity

Ana Koren, Luka Dejanović, Peter Korošec, Peter Kopač — Sun, 03 May 2026 00:00:00 -0700

Clinical &Experimental Allergy, Volume 56, Issue 5, Page 559-561, May 2026.

Global Variation in Anaphylaxis Treatment: A Scoping Review Protocol

Sun, 03 May 2026 00:00:00 -0700

Clinical &Experimental Allergy, Volume 56, Issue 5, Page 556-558, May 2026.

Human Plasma‐Derived C1 Inhibitor for Short‐Term Prophylaxis in Hereditary Angioedema With Normal C1 Inhibitor

Sun, 03 May 2026 00:00:00 -0700

Clinical &Experimental Allergy, Volume 56, Issue 5, Page 565-568, May 2026.

High Sensitisation but Low Clinical Reactivity to Edible Insects in Shellfish‐Allergic Individuals

Sun, 03 May 2026 00:00:00 -0700

Clinical &Experimental Allergy, Volume 56, Issue 5, Page 572-575, May 2026.

Differential Expression Profile of Circulating microRNAs and Regulatory Cytokines in Infants With Cow's Milk Allergy

Sun, 03 May 2026 00:00:00 -0700

Clinical &Experimental Allergy, Volume 56, Issue 5, Page 585-588, May 2026.

Airway, Breathing or Circulation Failure in Fatal Food Anaphylaxis: A Nationally Representative Case Series

John Coveney, Tom Roberts, Sylvia Stoianova, Nicholas Sargant — Sun, 03 May 2026 00:00:00 -0700

Clinical &Experimental Allergy, Volume 56, Issue 5, Page 547-549, May 2026.

Prehospital Care in Fatal Food Anaphylaxis: A Nationally Representative Case Series

John Coveney, Tom Roberts, Sylvia Stoianova, Nicholas Sargant — Sun, 03 May 2026 00:00:00 -0700

Clinical &Experimental Allergy, Volume 56, Issue 5, Page 550-552, May 2026.

Allergy and Anaphylaxis Preparedness in Oregon Public School Districts

Mallory deCampos‐Stairiker, Karen Anstey — Sun, 03 May 2026 00:00:00 -0700

Clinical &Experimental Allergy, Volume 56, Issue 5, Page 553-555, May 2026.

Localised Perioral Reactions in Infancy: Supportive Real‐World Data to Inform Implementation of the ASCIA Guideline Infant Feeding for Food Allergy Prevention

Miranda Crealey, Oscar Pan, Jonathan Hourihane — Sun, 03 May 2026 00:00:00 -0700

Clinical &Experimental Allergy, Volume 56, Issue 5, Page 589-590, May 2026.

Markedly Increased Diamine Oxidase During Acute Anaphylaxis Is Associated With an Underlying Clonal Mast Cell Disorder

Sun, 03 May 2026 00:00:00 -0700

We provide the first evidence that pronounced release of DAO during anaphylaxis is restricted to patients with clonal mast cell disorder. This finding offers possible functional support for the reported association between KIT p.D816V and anaphylaxis severity. Measuring DAO during acute anaphylaxis may help identify individuals at the highest risk.

ABSTRACT

Introduction

Diamine oxidase (DAO) degrades histamine, the key mediator in anaphylaxis, yet its relationship with clonal mast cell disorder (CMD) in the context of anaphylaxis is unclear. We evaluated whether DAO during anaphylaxis differs by CMD status.

Methods

We enrolled 35 emergency-department patients with acute anaphylaxis to drugs (7 patients), food (2 patients), or Hymenoptera venom (26 patients). Tryptase, DAO, and histamine degradation were measured during anaphylaxis and convalescence. CMD was defined by detecting KIT p.D816V in peripheral blood leukocytes using highly sensitive qPCR. Post-mortem DAO and tryptase were also compared in two fatal Hymenoptera venom-triggered anaphylaxis (HVA) cases with CMD versus 13 non-anaphylaxis controls.

Results

KIT p.D816V was detected in 6 (17%); all had severe HVA and normal basal tryptase. During anaphylaxis, DAO increased markedly in CMD (median 1142%), but only modestly in KIT p.D816V-negative patients (median 20%; p < 0.0001), independent of trigger or severity. Acute DAO was ~5-fold higher in CMD (median 101 vs. 18 U/mL), while convalescent DAO was similar (both 14 U/mL). Despite markedly elevated DAO, we observed impaired histamine degradation in acute anaphylaxis plasma. Receiver-operating-characteristic analyses showed strong discrimination for CMD using acute DAO (AUC 0.92; cut-off 53 U/mL; sensitivity 83%; specificity 97%) and percentage increase from convalescence (AUC 0.97; cut-off 223%; sensitivity 83%; specificity 100%). Post-mortem DAO lacked specificity, whereas post-mortem tryptase supported the diagnosis of fatal anaphylaxis and CMD.

Conclusion

DAO concentrations rise markedly during anaphylaxis in CMD and may help identify individuals at the highest risk. Further studies should refine the diagnostic utility and elucidate the mechanisms by which DAO may amplify anaphylaxis in CMD.

Optimal Treatment for Dysfunctional Breathing in Adults: An International Delphi Study

Janet Bondarenko, Jean Bremner, Brenda Button, Mark Hew, Anne E. Holland — Sun, 03 May 2026 00:00:00 -0700

This international Delphi study identified five essential interventions for treating dysfunctional breathing, with assessment and home practice essential for delivery. The findings provide guidance for treatment options for both researchers and clinicians.

ABSTRACT

Background and Objectives

Dysfunctional breathing (DB) is common and impairs quality of life. Various non-pharmacological interventions have been identified, but there is a lack of agreement regarding essential treatment components and delivery methods. This study aimed to gain consensus from experts and people with DB regarding the critical components, optimal format and delivery methods of non-pharmacological DB interventions.

Methods

A two-round Delphi process was conducted involving international experts, with each round followed by a consumer focus group. Online surveys were distributed using the Qualtrics platform. Components were defined as essential (median ≥ 4 on a 5-point Likert scale, interquartile range [IQR] = 0), desirable (median = 5, IQR > 0), or optional (median = 4, IQR > 0). In the 2nd round, components with a median score ≤ 3 and IQR = 0 were eliminated, and components without consensus (IQR > 0) were rescored.

Results

Participants in Round 1 included 46 experts and 5 focus group patients with DB, and in Round 2, 44 experts and 4 patients. Essential components for treating DB were a comprehensive assessment, breathing retraining with or without biofeedback, education, manual therapy, psychological therapy, and home practice of techniques. Desirable components were individualised home programs and information materials, and re-assessment. Optional components were individualised modes of treatment delivery and exercise therapy.

Conclusion

This study identified five essential interventions for treating DB, with assessment and home practice essential for treatment delivery. Individualisation of interventions and treatment format is suggested. The findings provide a basis for the development of treatment options for people with DB.

Early Detection of Lower Adherence to Long‐Term e‐Diary Recording: A Checkpoint to Target Early Educational Intervention in Seasonal Allergic Rhinitis?

Sun, 03 May 2026 00:00:00 -0700

Adherence to e-Diary reporting was investigated in a blended care setting among pollen allergic patients with heterogeneous cultural backgrounds. A stable ‘higher’ and a more variable ‘lower’ adherence cluster were identified. Early identification of lower adherence is possible and might inform early interventions to improve patient adherence.

ABSTRACT

Background

Digital symptom monitoring via e-Diary apps can support the diagnosis and management of chronic diseases with trigger-induced exacerbations such as pollen allergies. Attrition is a major challenge for continuous e-Diary usage with an unsupervised approach.

Objective

To investigate adherence to e-Diary reporting, its early determinants and predictors in a blended care setting among pollen allergic patients with heterogeneous cultural backgrounds.

Methods

The @IT.2020 observational multicenter study recruited patients with diagnosed seasonal allergic rhinitis from seven Southern European/Mediterranean countries. Baseline characteristics were investigated through questionnaires, skin prick tests and serum specific IgE measurements. The study doctors asked patients to record their allergy symptoms via e-Diary (AllergyMonitor, TPS) daily during the clinically relevant season of pollination and increased mould concentrations.

Results

Among 815 patients (467 adults, 348 children), the average prescribed e-Diary recording period was 106 (SD 47.1) days, with an average completion rate of 75.2% (SD 21.2%). Children (≥ 10 years) filled 73.8% (95% CI 68.1–79.4) of prescribed days without parental support. We identified a stable ‘higher’ and a more variable ‘lower’ adherence cluster. Adherence was weakly associated with disease severity, but not with age, gender, country, education or digital literacy. Short-term (first 3 weeks) adherence was strongly associated with long-term adherence (partial R ² = 0.387, p < 0.001), with 87.6% of lower adherent patients remaining poorly adherent beyond 3 weeks.

Conclusion

In a blended care setting, adherence to e-Diary compilation among pollen allergic patients is high, irrespective of age and cultural background. Early identification of lower adherence is possible and might inform early interventions to improve patient adherence.

Mechanism of Cardiac Arrest in Fatal Anaphylaxis

Sun, 03 May 2026 00:00:00 -0700

This population-based retrospective cohort study of clinical deterioration in anaphylaxis deaths identifies bronchospasm as the preponderant cause of cardiac arrest, especially in food and drug allergen exposures. The clinical implication is that anaphylaxis guidelines require appropriate emphasis on respiratory involvement and treatment to prevent deaths.

ABSTRACT

Introduction

Anaphylaxis is a short duration, potentially catastrophic allergic reaction where a rapid return to a person's baseline can be expected if vital organ function can be supported. Fatal anaphylaxis is a rare but potentially preventable cause of death at all ages. The three main mechanisms of rapid organ system failure leading to cardiac arrest in anaphylaxis are upper airway obstruction, lower respiratory obstruction principally from bronchospasm and cardiovascular failure. We aimed to measure the frequency and timing of each organ failure type leading to fatal anaphylaxis to further inform treatment recommendations.

Methods

We performed a population-based retrospective cohort analysis for the period 1 January 2003 to 31 December 2022 using Australian clinical data contained within the National Coronial Information System. The primary outcome was the primary organ that failed leading to initial physiological decompensation. Secondary objectives were to compare the time course of deterioration and complications between allergen groups. Multivariate logistic regression was used to quantify adjusted odds ratios between allergen categories for each of the three organ failure types.

Results

There were 371 anaphylaxis deaths for the study period (mean age 55.7 years, male 58.5%) with the primary outcome recorded in 250 (67.4%). In overall all-cause anaphylaxis fatalities, the most common organ failure was bronchospasm-induced respiratory failure (n = 153, 61.2%). Cardiovascular failure was less common (n = 73, 29.2%) and upper airway obstruction occurred in 24 (9.6%). There were significant differences in the primary organ system failure according to allergen trigger categories. Fatal food anaphylaxis was exclusively associated with respiratory failure (bronchospasm 94.8%, upper airway 5.2%).

Conclusion

We found that respiratory failure rather than cardiovascular failure was the most common cause of cardiorespiratory arrest in fatal anaphylaxis. Death from food-triggered anaphylaxis appears to be exclusively a primary respiratory event. International anaphylaxis guidelines require appropriate emphasis on respiratory symptoms and treatment to further reduce the risk of anaphylaxis fatalities.

The Gap Between Prescription and Practice: Adrenaline Autoinjector Carriage in an Australian Cohort

Sat, 02 May 2026 00:25:54 -0700

Clinical &Experimental Allergy, EarlyView.

Reframing Mechanistic Inference in Carrageenan‐Induced Epithelial Injury

Man Sun, Dan Zang, Jun Chen — Fri, 01 May 2026 02:36:53 -0700

Clinical &Experimental Allergy, EarlyView.

Aeroallergen Sensitization Phenotypes and Multimorbidity in Allergic Rhinitis and Asthma: A Large Urban Cluster Analysis

Fri, 01 May 2026 02:30:00 -0700

Clinical &Experimental Allergy, EarlyView.

Sustained Clinical Improvement in Birch Pollen Allergy After Two Pre‐Seasonal Short Courses of Allergen‐Specific Immunotherapy: A Long‐Term Open‐Label Extension Study

Thu, 30 Apr 2026 00:00:00 -0700

3 years follow-up study to a DBPC dose-finding trial investigating subcutaneous immunotherapy with T502 in birch-pollen induced allergic rhinoconjunctivitis. 154 birch-pollen allergic adults received short-course treatment of 10,000 mTU/mL of T502 for 2 years and were observed during the next season without treatment. The treatment with mannan-conjugated birch pollen polymerised allergoid resulted in a sustained reduction of CSMS, also in the group having received only two pre-seasonal courses of treatment. CSMS, combined symptom and medication score; DBPC, Double-blind, placebo-controlled trial; mTU/mL: Mannan therapeutic units per millilitre.

ABSTRACT

Background

Mannan-conjugated allergoids represent an effective option for treating allergic diseases. This study evaluated the clinical impact of the mannan-conjugated, polymerised birch pollen allergoid EP-088_T502 in patients with birch pollen-induced allergic rhinoconjunctivitis over 3 years.

Methods

Following up to a double-blind, placebo-controlled dose-finding study, in this open, long-term extension study, 154 birch pollen-allergic patients were enrolled in Germany. Patients were treated with a cumulative dose of 48,000 mTU EP-088_T502 administered subcutaneously over five pre-seasonal visits in each of the two treatment years (2021, 2022) with a subsequent follow-up year in 2023. The primary efficacy endpoint was the combined symptom and medication score (CSMS) during the peak birch pollen season, which was compared with the CSMS of the placebo group during the peak pollen season of 2020. Safety, tolerability, and immunogenicity were also analysed.

Results

Compared to the placebo group of the preceding study, median CSMS during the peak birch pollen seasons showed reductions of 47.5% in 2021 (p < 0.001), 51.8% in 2022 (p < 0.001), and 36.5% in 2023 (p < 0.001). Median daily symptom scores were reduced by 40.7% in 2021 (p < 0.001), 40.7% in 2022 (p < 0.001), and 25.6% in 2023 (p < 0.010). Median daily medication scores reached 0.07 in 2021 and 0.04 in 2022 (p < 0.001) and were reduced by 65.9% in 2023 (p < 0.003). Immunological responses showed a 4.82-fold increase in Bet v1 sIgG4 (p = 0.001) and a marked decrease (−65.5%, p = 0.001) in the sIgE/sIgG4 ratio after the first treatment phase. EP-088_T502 demonstrated good safety and tolerability, with only six mild to moderate systemic allergic reactions (Grade I/II). No epinephrine was used.

Conclusion

In this open-label study, two consecutive years of pre-seasonal short-course allergen immunotherapy (AIT) with EP-088_T502 markedly reduced symptoms and medication need in patients with birch pollen-induced rhinoconjunctivitis. Persistent therapeutic effects observed during the follow-up year, although limited by attrition of the study population, suggest sustained clinical improvement and indicate the potential disease-modifying impact of this treatment regimen.

Gender‐Dependent Differences in Serum Osteopontin Levels in Chronic Spontaneous Urticaria: A Link to Disease Activity in Females

Mon, 27 Apr 2026 20:10:36 -0700

Clinical &Experimental Allergy, EarlyView.

Correction to “Allergy in Australia”

Sun, 26 Apr 2026 21:27:12 -0700

Boyle, R.J. (2026), Allergy in Australia. Clin Exp Allergy, 56: 309–311. https://doi.org/10.1111/cea.70290.

The article did not acknowledge the collaborative nature of the Australian Government funding awarded to both the National Allergy Centre of Excellence (NACE) and the National Allergy Council (NAC), which is a partnership between the Australasian Society of Clinical Immunology and Allergy (ASCIA) and Allergy & Anaphylaxis Australia.

We apologize for this error.

Evaluating Basophil Histamine Content as a Biomarker for Omalizumab Responsiveness in Chronic Spontaneous Urticaria

Sun, 26 Apr 2026 21:25:12 -0700

Clinical &Experimental Allergy, EarlyView.

Unraveling the Natural History of Atopic Dermatitis: Prospective Disease Trajectories and Longitudinal IgE Sensitization from Birth to Adolescence

Sun, 26 Apr 2026 21:19:55 -0700

Clinical &Experimental Allergy, EarlyView.

Berotralstat and Health‐Related Quality of Life in Hereditary Angioedema: Pooled Analysis of the APeX‐2 and APeX‐J Trials

Sun, 26 Apr 2026 00:00:00 -0700

Pooled analysis of the phase 3 APeX-2 and APeX-J trials evaluated the impact of berotralstat 150 mg on health-related quality of life in patients with hereditary angioedema using the Angioedema Quality of Life (AE-QoL) questionnaire. Berotralstat significantly improved AE-QoL total and domain scores for daily functioning and fears/shame versus placebo through Week 24. Improvements in the berotralstat group were sustained through Week 96.

ABSTRACT

Background

In the phase 3 APeX-2 and APeX-J trials, improvements in health-related quality of life (HRQoL) were reported for berotralstat, the only oral, once-daily, long-term prophylaxis for hereditary angioedema (HAE). We conducted a post hoc trial analysis to evaluate the impact of berotralstat on HRQoL versus placebo through 24 weeks, and the long-term effects of treatment up to 96 weeks, using pooled APeX-2 and APeX-J patient data.

Methods

Patients receiving berotralstat 150 mg or placebo using the Angioedema QoL (AE-QoL) questionnaire; total and domain scores were analysed. Changes from baseline through Week 24 were compared using mixed models for repeated measures (MMRM) to estimate least squares mean differences (LSMDs) with 95% confidence intervals (CI) and nominal p-values. After Week 24, in the absence of a placebo comparator, long-term changes from baseline were evaluated using within-subject effect sizes (Cohen's d) through Week 96 in patients receiving berotralstat. Clinical meaningful improvements in AE-QoL total and domain scores were assessed by minimal clinically important difference (6-point reduction in AE-QoL total score) and distributional criterion methods, respectively. The manufacturer of berotralstat (BioCryst Pharmaceuticals) funded this study.

Results

Overall, 47 and 45 patients received berotralstat and placebo, respectively. At Week 24, berotralstat showed significantly greater improvement in AE-QoL total (LSMD: −7.4; 95% CI: −14.3, −0.6; p < 0.05), functioning domain (LSMD: −10.9; 95% CI: −19.6, −2.3; p = 0.013) and fears/shame domain (LSMD: −8.7; 95% CI: −17.2, −0.2; p = 0.046) scores compared with placebo. Among patients receiving berotralstat, consistent sustained improvements were observed across all AE-QoL domains up to Week 96. Analyses of meaningful improvement in total score and domains showed an increase over time in the proportion of patients achieving meaningful change.

Conclusion

Berotralstat significantly improved HRQoL versus placebo through 24 weeks and showed long-term beneficial effects through 96 weeks.

Incidence of New Asthma and Asthma Exacerbation Pre‐ and Post‐COVID‐19 Pandemic in the United States

Tue, 21 Apr 2026 22:55:55 -0700

Clinical &Experimental Allergy, EarlyView.

Institutional Trends in Penicillin Allergy: A New Era of Active Penicillin Allergy Delabeling

Tue, 21 Apr 2026 22:23:49 -0700

Clinical &Experimental Allergy, EarlyView.

Racial Differences in Patterns of Long‐Term Conditions Among Adults With Asthma

Tue, 21 Apr 2026 22:21:05 -0700

Clinical &Experimental Allergy, EarlyView.

Respiratory Viral Infections and the Tonsillar Transcriptome: An Exploratory Study

Mon, 20 Apr 2026 20:30:18 -0700

Clinical &Experimental Allergy, EarlyView.

T Cell O‐GlcNAcylation Increases in Patients With Allergic Rhinitis After the Natural Pollen Season

Mon, 20 Apr 2026 20:25:05 -0700

Clinical &Experimental Allergy, EarlyView.

Circulating Piwi‐Interacting RNAs Associate With Childhood Asthma ICS Response With Vitamin D Effect Modification

Mon, 20 Apr 2026 20:20:08 -0700

Circulating piRNAs correlate with inhaled corticosteroid (ICS) response in childhood asthma, modified by vitamin D status. piR-36241 predicts ICS responsiveness specifically in vitamin D–insufficient children (AUROC = 0.84). Mechanistically, piR-36241 targets immune pathways and shows differential expression in asthmatic bronchial cells, supporting its biomarker potential and biological relevance.

ABSTRACT

Background

Piwi-interacting RNAs (piRNAs) have been linked to type 2-high asthma phenotypes. Although vitamin D modulates inhaled corticosteroid (ICS) response via microRNAs, its potential role through piRNAs remains unknown.

Methods

Baseline plasma piRNA expression was profiled by small RNA sequencing in 492 participants from the Childhood Asthma Management Program (CAMP), with 187 children randomised to the ICS arm. Serum vitamin D levels were classified as insufficient (≤ 30 ng/mL) or sufficient (> 30 ng/mL). Linear regression was used to assess associations between piRNA expression and changes in prebronchodilator percent predicted forced expiratory volume in 1 s (FEV₁%) over 4 years, including interaction analyses with vitamin D status. Replication was performed in 375 ICS-treated participants from the Genetics of Asthma in Costa Rica Study (GACRS).

Results

Fourteen piRNAs were significantly associated with FEV₁% changes among vitamin D–insufficient children, six showing significant interactions with vitamin D status (p < 0.05). Four piRNAs were replicated in GACRS, with piR-36241 also confirmed in interaction analyses. Predicted targets of piR-36241 were enriched in immune- and respiratory-related pathways. piR-36241 demonstrated strong predictive performance for ICS response in vitamin D–insufficient children (AUROC = 0.84) and was detected in bronchial epithelial cells, where it was differentially expressed in asthma.

Conclusions

Circulating piRNAs are associated with ICS response in childhood asthma, with vitamin D acting as an effect modifier, which may serve as non-invasive biomarkers for ICS responsiveness, particularly in vitamin D–insufficient patients.

Trial Registration

ClinicalTrials.gov Identifier: NCT00000575 and NCT00021840

Residential Greenness and Incident Chronic Rhinosinusitis After SARS‐CoV‐2 Infection in South Korea: A Nationwide Cohort Study

Sun, 19 Apr 2026 18:54:49 -0700

Clinical &Experimental Allergy, EarlyView.

Low‐Dose, Slow‐Escalation Home‐Based and Sustainable Oral Immunotherapy for Walnut and Cashew Allergy: A Retrospective Case Series

Sun, 19 Apr 2026 18:48:34 -0700

Clinical &Experimental Allergy, EarlyView.

Active Paediatric Food‐Allergy Interventions Pursue Distinct Clinical Goals: A Brief, Goal‐Directed Synthesis

Ping Wei, Fenghui Yu, Yijun Liu, Sichu Yu, Wei Kou — Fri, 17 Apr 2026 22:35:08 -0700

Clinical &Experimental Allergy, EarlyView.

Dupilumab in Chronic Rhinosinusitis With Nasal Polyps Patients: Impact on Tissue Eosinophilic Inflammation and Eosinophil Subphenotypes

Fri, 17 Apr 2026 22:24:48 -0700

Clinical &Experimental Allergy, EarlyView.

Association Between Domestic Mold Detection and Clinical Outcomes in House Dust Mite Allergic Patients

Fri, 17 Apr 2026 22:19:01 -0700

Clinical &Experimental Allergy, EarlyView.

Building Tolerance Remotely: Telemedicine Support for Egg Ladder Completion in IgE‐Mediated Egg Allergy

Mayah Cousens, Aoife Gallagher, Caoimhe Cronin, Sadhbh Hurley, Juan Trujillo — Thu, 16 Apr 2026 18:32:17 -0700

Clinical &Experimental Allergy, EarlyView.

The Clinical Value of Measuring Nasal Nitric Oxide in Addition to Exhaled Nitric Oxide in Asthma Associated With Eosinophilic Chronic Rhinosinusitis

Thu, 16 Apr 2026 03:13:30 -0700

Clinical &Experimental Allergy, EarlyView.

Patterns of Mouse Allergen–Specific IgE and IgG4 in Contemporary Animal Research Environments

Thu, 16 Apr 2026 02:54:28 -0700

Clinical &Experimental Allergy, EarlyView.

Managing Renewed Food Avoidance Following an Allergic Reaction for Patients With Avoidant/Restrictive Food Intake Disorder

Kaitlin B. Proctor, Tanya Auguste‐Jones, William G. Sharp, Brian P. Vickery — Tue, 14 Apr 2026 00:00:00 -0700

ABSTRACT

Serious food restriction may occur following an allergic reaction. Individuals with a pre-existing feeding/eating disorder, avoidant/restrictive food intake disorder (ARFID), may be at particular risk for detrimental effects. This Clinical Question describes the relationship between reactions and restricted eating, provides practical clinical guidance for intervention, and articulates a call for future research advancing evidence-based care for patients following a reaction.

Functional Endoscopic Sinus Surgery in Adults With CRSwNP Treated With Mepolizumab: Airway Physiology Outcomes From a Randomised Controlled Trial

Mon, 13 Apr 2026 00:00:00 -0700

Clinical &Experimental Allergy, EarlyView.

Association Between Asthma and Chronic Bone Diseases: A Cross‐Sectional Analysis From the Longitudinal Ageing Study in India (LASI) Data

Arundhati Garud, Saibal Moitra, Subhabrata Moitra — Thu, 09 Apr 2026 17:04:40 -0700

Clinical &Experimental Allergy, EarlyView.

Novel CD8+ Regulatory T Cells Attenuate Eosinophilic Infiltration in a Murine Allergic Asthma Model

Jia‐Ning Fan, Tien‐Hsuan Chen, Bor‐Luen Chiang — Wed, 08 Apr 2026 18:30:29 -0700

Clinical &Experimental Allergy, EarlyView.

Association of Penicillin Allergy Label With Post‐COVID‐19 Condition and Subsequent Clinical Outcomes: A Population‐Based Cohort Study

Ubonphan Chaichana, Kenneth K. C. Man, Chengsheng Ju, Yogini H. Jani, Li Wei — Mon, 06 Apr 2026 19:45:44 -0700

Clinical &Experimental Allergy, EarlyView.

Effects of Common Food Additives Kappa‐, Iota‐ and Lambda‐Carrageenans on Intestinal Epithelial Cell Activation and Barrier Disruption

Mon, 06 Apr 2026 00:00:00 -0700

Carrageenans, widely used food additives, disrupted intestinal epithelial integrity in a gut-on-a-chip model. All types (κ-, ɩ-, λ-) induced cytotoxicity, inflammation and tight junction (TJ) disruption, triggering TNF-mediated immune responses. λ-Carrageenan had the most severe effects, supporting the Epithelial Barrier Theory linking food additives to chronic inflammatory diseases.

ABSTRACT

Background

The epithelial barrier theory has been proposed to link the onset of many chronic inflammatory diseases to the damaged epithelial barrier induced by numerous environmental factors, including food emulsifiers. This study aimed to investigate the effects of food emulsifiers kappa-, iota- and lambda-carrageenan on intestinal epithelial barrier integrity and the underlying mechanisms.

Methods

The cytotoxicity and apoptosis of carrageenans were determined using Hoechst/propidium iodide staining and FITC annexin V/propidium iodide staining, respectively. The gut-on-a-chip was established and transepithelial electrical resistance measurement, paracellular flux assay, immunofluorescence staining of tight junction proteins, RNA-sequencing and targeted proteomics were performed.

Results

Kappa-, iota- and lambda-carrageenans induced dose-dependent cytotoxicity, with lambda-carrageenan showing a more severe cytotoxic effect in relatively lower doses. All three carrageenans elicited a dose- and time-dependent decrease of gut epithelial barrier strength, a significant increase in the paracellular flux and irregular and heterogeneous staining of occludin and ZO-1 compared to the untreated group, suggesting the disruption of the intestinal epithelial barrier integrity. Transcriptomics data revealed that iota- and lambda-carrageenan induced more severe pro-inflammatory responses, which were associated with the upregulation of genes involved in TNF signalling, IL-17 signalling cellular response to chemokines, cholesterol metabolism and NF-kappa B signalling pathways. Targeted proteomics data from exposed gut-on-a-chips indicated an upregulation of inflammation- and immune response-related proteins for all three carrageenans.

Conclusions

The present study provides direct evidence for the detrimental effects of kappa-, iota- and lambda-carrageenans on gut epithelial cell activation and barrier integrity. The underlying mechanism of epithelial barrier disruption was largely attributed to the activation of innate immune responses by carrageenans, resulting in a pro-inflammatory response.

Prevalence and Sociodemographic Variation of Allergic Diseases in Australia: Findings From the Australian National Health Survey

Sun, 05 Apr 2026 21:10:57 -0700

Using data from 17,093 participants in the 2022 Australian National Health Survey, this study is the first to report nationwide prevalence estimates for allergic rhinitis (23.9%), food allergy (7.0%), drug allergy (5.2%), eczema (1.6%) and diagnosed asthma (10.8%) across Australia. The report shows how allergy rates vary by age, geographic region and sociodemographic characteristics.

ABSTRACT

Background

The prevalence of allergic diseases across the Australian population, in all regions and age groups, is not well documented. This study aimed to describe the prevalence and distribution of five allergic diseases (allergic rhinitis, asthma, drug allergy, eczema, and food allergy) and examine differences by sociodemographic factors.

Methods

This study used data from the 2022 cross-sectional Australian National Health Survey. The survey randomly selected a sample of 13,095 households (with 17,093 participants) living in private dwellings in all Australian states and territories. Questionnaires were completed via face-to-face interviews. Allergic rhinitis, asthma, drug allergy, eczema, and food allergy were captured as self- or parent-reported long-term health conditions. Weighted estimates and relative standard errors were extracted and analysed. Prevalence was calculated using population data from the Australian 2021 Census.

Results

The prevalence of self-reported current allergic rhinitis in Australia was 23.9% (95% CI: 23.1%–24.8%), food allergy was 7.0% (95% CI: 6.5%–7.5%), drug allergy was 5.2% (95% CI: 4.7%–5.6%), eczema was 1.6% (95% CI: 1.3%–1.9%), and diagnosed asthma was 10.8% (95% CI: 10.2%–11.5%). Food allergy and asthma prevalence were similar across childhood and adulthood, whereas the prevalence of allergic rhinitis increased sharply during early adulthood. Eczema was more common in childhood, while drug allergy was more common in later adulthood. Higher rates of allergic rhinitis, food allergy, and eczema were reported among individuals with more advantaged socio-economic status. In general, allergic diseases were less commonly reported by Indigenous Australians compared to non-Indigenous Australians, and by individuals born overseas compared to those born in Australia; however, prevalence varied markedly by region of birth, with some regions exhibiting higher reported rates.

Conclusions

We identified a high overall prevalence of allergic diseases in Australia, with variations across populations. The differences across populations may reflect actual prevalence or disparities in disease recognition, reporting, or access to diagnostic services.

Reclassification of GST Allergens Based on Their Cross‐Reactivity in Two Divergent Cockroach Species

Thu, 02 Apr 2026 03:41:48 -0700

Clinical &Experimental Allergy, EarlyView.

Predictive Biomarkers for Sustained Unresponsiveness Following Oral Immunotherapy

Duan Ni, Ralph Nanan — Tue, 31 Mar 2026 00:01:59 -0700

Clinical &Experimental Allergy, EarlyView.

Rebound Pruritus and Urticaria After Discontinuation of Chronic Antihistamine Use—A Scoping Review

Jun Jie Benjamin Seng, Prawira Oka, Ngiap Chuan Tan — Mon, 30 Mar 2026 16:18:55 -0700

Rebound pruritus and urticaria have been reported after discontinuation of chronic cetirizine or levocetirizine use only. Symptoms typically occur within 0.5–5 days after stopping therapy and appear more frequently reported in female patients. Re-initiation of antihistamines is the most commonly effective management strategy, highlighting the need for clinician awareness when discontinuing long-term antihistamine therapy.

ABSTRACT

Background

Rebound pruritus and urticaria have been increasingly reported following discontinuation of chronic antihistamines, particularly with cetirizine and levocetirizine, prompting the United States Food and Drug Administration to issue a recent safety warning for these two medications. Currently, there are significant gaps regarding the risk factors, course and optimal management of rebound pruritus and urticaria after discontinuation of chronic antihistamine use, and if this represents a class-specific adverse effect. This review aimed to map the literature related to rebound pruritus and urticaria after discontinuation of chronic antihistamine use.

Methods

A scoping review was conducted across four major literature databases (PubMed, Embase, Web of Science and Cochrane database) and grey literature (GreySource, OpenGrey, Google Scholar) from inception to December 2025. Articles describing rebound pruritus following discontinuation of chronic antihistamine use in paediatric or adult populations were included. Antihistamines evaluated included all first- and second-generation histamine-1 antagonists. Non-English articles were excluded. A narrative synthesis was conducted to summarise the reported risk factors, clinical course and potential management strategies for rebound pruritus following antihistamine discontinuation.

Results

Of the 17,346 records retrieved, two retrospective studies, one case series and one case report were included in the review. The studies were conducted in the United States (n = 2), the Netherlands (n = 1) and Singapore (n = 1). The main antihistamines implicated in after discontinuation rebound pruritus were cetirizine (n = 327), levocetirizine (n = 39) and, both cetirizine and levocetirizine (n = 2). Among these patients, 85 patients experienced concomitant urticaria after discontinuation of chronic antihistamines. No report was noted for other antihistamines. The patients' age ranged from 6 to 71 years, with a female predominance (76.1%). Antihistamine use ranged from months to years, with pruritus developing between 1 to 5 days after discontinuation. Among the common treatment strategies adopted, cetirizine or levocetirizine re-initiation was the most effective (n = 136 of 137, 99.2%), while antihistamine tapering had the lowest rate of symptoms resolution (n = 11 of 33, 33.3%).

Conclusions

Rebound pruritus following discontinuation of chronic cetirizine or levocetirizine use represents a clinically relevant adverse effect that warrants careful monitoring and management. Future research is required to identify the optimal treatment strategy and if the discontinuation of other antihistamines could also lead to rebound pruritus.

Tezepelumab Reduces Alarmin Cytokine Levels in Upper Airway Epithelial Cells in Patients With Severe Asthma

Hazel Marriott, Adil Adatia, Subhabrata Moitra, Paige Lacy — Fri, 27 Mar 2026 20:30:22 -0700

Clinical &Experimental Allergy, EarlyView.

Sputum TGF‐β Level Is Increased in Allergic Rhinitis and Related to Small Airways Dysfunction

Wed, 25 Mar 2026 19:34:28 -0700

Clinical &Experimental Allergy, EarlyView.

Perinatal Exposures Are Related to Atopic Symptom Development in Early Childhood

Wed, 25 Mar 2026 05:00:55 -0700

Clinical &Experimental Allergy, EarlyView.

Prevalence, Incidence, and Persistence of Food Allergies Among U.S. Adults: A Longitudinal Population‐Based Study

Maurice M. Ohayon, Stéphanie Duhoux, Marie‐Lise Côté — Sun, 22 Mar 2026 17:50:12 -0700

Clinical &Experimental Allergy, EarlyView.

Common Causative Drugs of Paediatric Drug‐Induced Dermatitis: A Population‐Based Study

Hyeyone Hwang, Jiung Jeong, Soo Min Jeon, Jin‐Won Kwon, Juhee Ryu — Fri, 20 Mar 2026 00:30:52 -0700

Clinical &Experimental Allergy, EarlyView.

Increased TRPV6 Potentiates Interleukin‐13 Signalling in Epithelial Cells in Eosinophilic Chronic Rhinosinusitis With Nasal Polyps

Thu, 19 Mar 2026 01:59:35 -0700

Clinical &Experimental Allergy, EarlyView.

Unearthing Hereditary Angioedema in India—Epidemiology From Chandigarh and Reasi, India

Thu, 19 Mar 2026 01:53:03 -0700

Clinical &Experimental Allergy, EarlyView.

Development of an Enzyme Immunoassay for Detecting Urinary Tetranor‐PGDM in Patients With Food Allergy

Sun, 15 Mar 2026 11:00:00 -0700

Clinical &Experimental Allergy, EarlyView.

Healthy Diet Intervention for Treating Atopic Dermatitis: A Pilot Randomised Controlled Trial

Fri, 13 Mar 2026 04:26:03 -0700

Clinical &Experimental Allergy, EarlyView.

Asthma in Young Adults at High Risk for Allergies Is Traced Back to Immune and Microbiota Signatures in Early Childhood

Fri, 13 Mar 2026 04:23:37 -0700

Clinical &Experimental Allergy, EarlyView.

ELYFANT Study Protocol: An Observational Study to Assess Awareness of and Adherence to Advice on Early Introduction of Food Allergens and Whether It Is Preventing Food Allergy

Thu, 12 Mar 2026 00:57:51 -0700

Clinical &Experimental Allergy, EarlyView.

Are Phenotypic Baseline Characteristics Related to Abolition of AHR After Benralizumab and Dupilumab?

Philipp Suter, Robert Greig, Rory Chan, Brian J. Lipworth — Tue, 10 Mar 2026 22:25:12 -0700

Clinical &Experimental Allergy, EarlyView.

Depot Extracts for Venom Immunotherapy: A Delphi Consensus on Safety and Efficacy

Tue, 10 Mar 2026 09:39:49 -0700

Clinical &Experimental Allergy, EarlyView.

Patient‐Derived IgG Epitope Mapping of Bet v 1 Reveals Hypoallergenic Peptide Candidates for Safe and Next‐Generation Allergen Immunotherapy

Tue, 10 Mar 2026 09:25:34 -0700

Mapping IgG epitopes of the major birch allergen Bet v 1 identified patient-derived, hypoallergenic peptides that did not trigger degranulation. These findings support a novel, safer approach for peptide-based allergen immunotherapy that leverages naturally induced IgG specificities from allergic individuals.

ABSTRACT

Background

Allergen immunotherapy (AIT) is the only curative treatment for allergic diseases, primarily by inducing allergen-neutralising IgG antibodies. However, its use is limited by frequent allergic adverse events.

Objective

To facilitate the design of IgG-epitope-based peptide vaccines, this study aimed to identify IgG-binding regions on the major birch pollen allergen, Bet v 1, using patient-derived immune profiles.

Methods

Blood samples were collected from 30 birch pollen-allergic patients, both AIT-treated and untreated; healthy individuals were included as controls. Sera were analysed for allergen-specific IgE, IgG, and IgG4, and basophil degranulation inhibition was assessed in humanised RBL cells and blood from allergic individuals. We used DropMap microfluidics for single-cell affinity profiling of IgG- and IgG4-secreting B cells. IgG epitopes were mapped using overlapping peptides and CLIPS technology. Candidate AIT peptides were synthesised on solid phase via Fmoc strategy, and their allergenicity was assessed in basophil degranulation and cellular antigen stimulation assays.

Results

Sera from AIT-treated patients exhibited elevated IgG and IgG4 levels and enhanced inhibition of basophil degranulation. Single-cell analysis indicated IgG-affinity maturation with AIT. IgG-epitope mapping identified four distinct, non-overlapping IgG-binding regions on Bet v 1. Six peptides derived from these regions were successfully produced and did not induce basophil degranulation in vitro. The application of DropMap microfluidics allowed high-resolution single B-cell analysis, providing novel insights into allergen-specific B-cell responses and the effects of AIT at the clonal level.

Conclusion

This integrated approach identifies hypoallergenic peptides that selectively engage protective IgG responses and offers a framework for developing safer, next-generation immunotherapies for allergic disease.

Completion of the Icatibant Outcome Survey and What We Learned

Tue, 10 Mar 2026 00:00:00 -0700

Clinical &Experimental Allergy, EarlyView.

Global Prevalence of Sexual Dysfunction in Individuals With Atopic Dermatitis and Asthma: A Systematic Review and Meta‐Analysis

Sun, 08 Mar 2026 20:14:06 -0700

Sexual dysfunction is an often-overlooked aspect of allergic diseases. It was more frequently reported in asthma than in atopic dermatitis and was consistently higher among females. Estimates varied by assessment approach, highlighting the need to address sexual health and standardise evaluation methods.

ABSTRACT

Objective

Asthma and atopic dermatitis are associated with various physical and psychosocial outcomes, however, the prevalence of sexual dysfunction in these populations remains underexplored. This meta-analysis aimed to assess the prevalence of sexual dysfunction among individuals with asthma and atopic dermatitis.

Design

A systematic review and random-effects meta-analysis was conducted to estimate pooled prevalence with 95% confidence intervals (CIs). Subgroup analyses were conducted stratifying by sex, geographic regions and diagnostic tools.

Data Sources

PubMed/MEDLINE, Embase, Scopus and Cochrane Library were searched from inception to 1 July 2025.

Eligibility Criteria

Studies including adults with asthma or atopic dermatitis were eligible. Sexual dysfunction was defined as impairments in sexual desire or sexual response, identified via clinical diagnosis or validated questionnaires, including the Female Sexual Function Index and International Index of Erectile Function.

Results

A total of 19 studies comprising 10,851 participants, including 1577 patients with asthma or atopic dermatitis from 18 countries across five continents, were included. The pooled prevalence of sexual dysfunction was 54.3% (95% CI 45.9–64.3) in asthma and 19.1% (13.4–27.3) in atopic dermatitis. In both conditions, prevalence was substantially higher in females than males: 71.5% (95% CI 63.3–80.7) versus 29.6% (17.1–51.2) in asthma and 53.0% (36.4–77.1) versus 16.7% (7.3–38.2) in atopic dermatitis. Studies using validated tools reported higher prevalence than those relying on supportive methods or clinical diagnoses. Smoking status was not significantly associated with differences in prevalence among individuals with asthma. Among control groups, pooled prevalence was 9.7% (95% CI 0.6–169.6) for males and 30.1% (18.7–48.5) for females in asthma studies and 2.2% (0.16–28.8) overall in atopic dermatitis studies.

Conclusions

Sexual dysfunction was highly prevalent among individuals with asthma and atopic dermatitis, particularly in females. These findings highlight the need for greater clinical attention to sexual dysfunction in the management of allergic diseases.

Systematic Review Registration

PROSPERO (CRD420251115928).