Allergy Immunology Research Articles

Localized multisystem inflammatory syndrome in children (mis-c), faster recovery outcome: a case report

Backgrounds: MIS-C cases emerged approximately 4–5 weeks on average after the peak prevalence of COVID-19. The symptoms could be asymptomatic or mildly symptomatic with fever and cough. It was unknown if these infants’ exhibited symptoms of Kawasaki disease (KD) or toxic shock syndrome (TSS), or whether they represented a condition associated with the continuing COVID-19 epidemic. Objective: To describe clinical outcome and examination results of localized multisystem inflammatory syndrome in children. Case presentation: A 23-month-old boy was brought to the pediatric allergy immunology clinic as a referral from a pediatrician with complaints of lump on right preauricular region, which was redden and painful, feels warm, and difficulty opening mouth. There were also multiple small nodules in peri anal area. There was fever for 1 week before admitted, accompanied by a runny nose with clear secretions with no cough. Fever already resolved at presentation. Tonsils are enlarged to T3/T4 without hyperemic nor injection. The presence of fever, conjunctivitis and cracked lips mimicking Kawasaki disease, but electrocardiography and echocardiography were normal. The MISC panel was shown support for MISC, wherein CBC showed presence of lymphopenia, anemia, neutrophilia, and thrombocytosis. Other panel MISC like the erythrocytes sedimentation rate, quantitative CRP, D-dimer, and quantitative IgG SARS-COV-2 antibodies it was reported to be increased. The patient was treated with intravenous high doses methylprednisolone pulse 10 mg/kg, then tapered off before stopped. The lump was disappeared after the second dose of HDMP, and patient was discharged after 7 days of admission. Conclusion: We reported a localized Multisystem Inflammatory Syndrome (MIS-C) treated with high dose methylprednisolone resulting in fast recovery.

Initial study of trap and identification of environmental pollens and fungi spores in Samborondon, Ecuador

Initial study of trap and identification of environmental pollens and fungi spores in Samborondon, Ecuador Introduction: The identification of local aeroallergens in any geographical area is essential for the specific diagnosis and treatment of allergic diseases. Our objective was to identify and registry the most important aeroallergens trapped at the aerobiology station in the city of Samborondon, Ecuador.Material and methods:Pollen grains and fungal spore counts were performed according to the standardized technique with a Hirst-type collection equipment, Burkard spore trap for seven days, following the recommendations of the National Allergy Bureau (NAB) of the American Academy of Allergy Asthma and Immunology (AAAAI). The equipment was installed on the roof of the Universidad de Especialidades Espiritu Santo (UEES), 25 m above ground level, coordinates: 2°07 ́57 ́ ́S 79°52 ́06 ́ ́W, in the city of Samborondon. The sampling period was performed from November 2022 to April 2023.Results:We identified the following pollen families: Poaceae (258 grains/m3), Apocynaceae (Plumeria rubra pc) 214 grains/m3, Lamiaceae (180 grains/m3), Asteraceae - Ambrosía spp.- (60 grains/m3), Chenopodiacea (27 grains/m3), Myrtaceae (17 grains/m3), Pinaceae (11 grains/m3), Betulaceae (7 grains/m3).Also identified fungical spores: Fuzariella spp./Leptosphaeria spp. (1899/m3), Cladosporium spp. (1407/m3), Nigrospora spp. (1183/m3), Dreschlera/Helmintosporum spp. (329/m3), Alternaria spp. (98/m3), Pithomyces spp. (79/m3), Curvularia spp. (48/m3), Stemphylium spp. (46/m3).Conclusions:We reported the first study of aerobiology (capture and identification of environmental pollens and fungi) in the city of Samborondon. The inhabitants of this area are exposed to different aeroallergens with a predominance of Poaceaes pollen and Fuzzariella spp./Leptosphaeria spp. spores. The identified allergens should be part of the usual allergy studies. The results of this first preliminary study should be compared with information from the forthcoming years, which will help to identify variations in the concentration of seasonal aeroallergens, annual fluctuations, and extend the traps to other parts of the city.Key words: aerobiology, allergic rhinitis, allergic conjunctivitis, pollens.

Initial study of trap and identification of environmental pollens and fungi spores in Samborondon, Ecuador

To identify and registry the most important aeroallergens trapped at the aerobiology station in the city of Samborondon, Ecuador. Pollen grains and fungal spore counts were performed according to the standardized technique with a Hirst-type collection equipment, Burkard spore trap for seven days, following the recommendations of the National Allergy Bureau (NAB) of the American Academy of Allergy Asthma and Immunology (AAAAI). The equipment was installed on the roof of the Universidad de Especialidades Espiritu Santo (UEES), 25 m above ground level, coordinates: 2°07 ́57 ́ ́S 79°52 ́06 ́ ́W, in the city of Samborondon. The sampling period was performed from November 2022 to April 2023. We identified the following pollen families: Poaceae (258 grains/m3), Apocynaceae (Plumeria rubra pc) (214 grains/m3), Lamiaceae (180 grains/m3), Asteraceae Ambrosía spp.- (60 grains/m3), Chenopodiacea (27 grains/m3), Myrtaceae (17 grains/m3), Pinaceae (11 grains/m3), Betulaceae (7 grains/m3). Also identified fungical spores: Fuzariella spp./Leptosphaeria spp. (1899/m3), Cladosporium spp. (1407/m3), Nigrospora spp. (1183/m3), Dreschlera/Helmintosporum spp. (329/m3), Alternaria spp. (98/m3), Pithomyces spp. (79/m3), Curvularia spp. (48/m3), Stemphylium spp. (46/m3). We reported the first study of aerobiology (capture and identification of environmental pollens and fungi) in the city of Samborondon. The inhabitants of this area are exposed to different aeroallergens with a predominance of Poaceaes pollen and Fuzzariella spp./Leptosphaeria spp. spores. The identified allergens should be part of the usual allergy studies. The results of this first preliminary study should be compared with information from the forthcoming years, which will help to identify variations in the concentration of seasonal aeroallergens, annual fluctuations, and extend the traps to other parts of the city.

The top 100 most cited articles in the past 30 years of wheat allergy: a bibliometric analysis.

Wheat allergy (WA), characterized by immunological responses to wheat proteins, is a gluten-related disorder that has become increasingly recognized in recent years. Bibliometrics involves the quantitative assessment of publications within a specific academic domain. We aimed to execute an extensive bibliometric study, focusing on the past 30 years of literature related to wheat allergy. We searched the Web of Science database on 5th Dec 2023. We used the keywords "wheat allergy or wheat anaphylaxis or wheat hypersensitivity," "gliadin allergy or gliadin anaphylaxis or gliadin hypersensitivity," "wheat-dependent exercise-induced anaphylaxis," and "baker's asthma" for our search. All items published between 1993 and 2023 were included. The top 100 most cited articles were identified and analyzed. Our study conducted an in-depth bibliometric analysis of the 100 most-cited articles in the field of wheat allergy, published between 2002 and 2019. These articles originated from 20 different countries, predominantly Japan and Germany. The majority of these articles were centered on the pathogenesis and treatment of wheat allergy (WA). The Journal of Allergy and Clinical Immunology (JACI) was the most prolific contributor to this list, publishing 14 articles. The article with the highest citation count was published by Biomed Central (BMC) and garnered 748 citations. The peak citation year was 2015, with a total of 774 citations, while the years 1998, 2001, and 2005 saw the highest publication frequency, each with 7 articles. Our study aims to provide physicians and researchers with a historical perspective for the scientific progress of wheat allergy, and help clinicians effectively obtain useful articles that have a significant impact on the field of wheat allergy.

Chronic cough in children: an evidence-based clinical practice guideline adapted for the use in Egypt using ‘Adapted ADAPTE’

BackgroundWe recently adopted a guideline for chronic cough in children in the Egyptian health system. Adapting clinical practice guidelines (CPGs) to the local healthcare setting is a valid alternative to de-novo development that can improve their uptake and implementation without demanding a substantial drain on resources. The objective of this study was to adapt evidence-based recommendations from global high-quality CPGs for children with a chronic cough to suit the Egyptian healthcare context.MethodsWe followed the Adapted ADAPTE methodological framework for guideline adaptation. This process includes three phases: set-up, adaptation, and finalization. A guideline adaptation group (GAG) and an external review group including clinical content experts and methodologists conducted the process.ResultsThe GAG adapted 10 sections of recommendations from three original CPG(s) including (i) the American College of Chest Physicians (ACCP) 2006–2020, (ii) the European Respiratory Society (ERS) 2019, (iii) the Korean Academy of Asthma, Allergy and Clinical Immunology (KAAACI) 2018. A set of CPG implementation tools was added to enhance implementability including an algorithm, a slide presentation for clinical diagnosis, investigations and treatment of chronic cough, patient education, and online resources.ConclusionThe adapted CPG provides pediatricians and related healthcare workers with applicable evidence-based recommendations for chronic cough in children in Egypt. The project also highlighted the utility of Adapted ADAPTE and the invaluable collaboration between the clinical and methodological experts for the adaptation of pediatric national guidelines.

Wiskott-Aldrich syndrome protein expression in female WAS carriers: A flow cytometry study from North India.

Wiskott-Aldrich syndrome (WAS) is a rare X-linked inborn error of immunity characterized by microthrombocytopenia, infections, eczema, and increased predisposition to develop autoimmunity and malignancy. Flow cytometric assay for determining WAS protein (WASp) is a rapid and cost-effective tool for detecting patients. However, very few studies described WASp expression in female carriers. Most WAS carriers are clinically asymptomatic. Active screening of female family members helps identify female carriers, distinguish de novo mutations, and to select appropriate donor prior to curative stem cell transplantation. This study was undertaken to evaluate the diagnostic capability of flow cytometry-based WASp expression in peripheral blood cells to identify carriers and compare WASp expression in different blood cell lineages. Female patients, heterozygous for WAS gene, were enrolled in this study conducted at Pediatric Allergy Immunology Unit, Advanced Pediatric Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India. Flow cytometric assessment of WASp expression in lymphocytes, monocytes, and neutrophils was carried out and compared with healthy control and affected patients. The results were expressed in delta (Δ) median fluorescence intensity (MFI) as well as stain index (SI), which is the ratio of ΔMFI of patient and ΔMFI of control. Thirteen mothers and two sisters of genetically confirmed WAS patients were enrolled in the study. All enrolled females were clinically asymptomatic and did not have microthrombocytopenia. Low WASp expression (SI<1) was seen in lymphocytes and monocytes in 10 (66.6%) carriers. Females with variants in proximal exons (exons 1 and 2) were found to have lesser expression than those with distal (exons 3-12) variants. Flow cytometry is a rapid, easily available, cost-effective tool for WASp estimation. Lymphocytes followed by monocytes are the best cell lineages for WASp estimation in carrier females. However, genetic testing remains the gold standard, as carrier females with variants in distal exons may have normal WASp expression.

Allergic march: findings of Japanese Society of Pediatric Allergy and Clinical Immunology surveys

Allergic march: findings of Japanese Society of Pediatric Allergy and Clinical Immunology surveys

Health-related quality of life in patients with inborn errors of immunity: a bibliometric analysis.

Inborn Errors of Immunity (IEI) are characterized by a heightened susceptibility to infections, allergies, and various other health complications. Health-Related Quality of Life (HRQOL) in patients with IEI is a critical area of research that demands attention due to the impact of IEI on patients' lives. This study utilized bibliometric methods, aiming to comprehensively explore the research content and hotspots in the field of HRQOL in patients with IEI. This bibliometric analysis utilized data from the Science Citation Index Expanded (SCIE) and Social Sciences Citation Index (SSCI) within the Web of Science core datasets up to January 1, 2024. The study focused on literature that addressed HRQOL in IEI patients, involving a total of 1,807 authors and 309 articles published across 112 journals. The analysis included publication volume and growth trends, country and institutional contributions, authorship, and journal analysis. The research found that despite the importance of HRQOL in IEI, the volume of publications in this field remains consistently low, with no significant increase in trend. The USA leads in publication and citation volumes, reflecting a geographical imbalance in research contributions. Key journals in this field include the Journal of Clinical Immunology, Frontiers in Immunology, and the Journal of Allergy and Clinical Immunology. The study highlights that while treatments like hematopoietic stem cell transplants and gene therapy have improved patient IEI survival rates, they still often come with significant side effects impacting HRQOL. The analysis underlines the need for comprehensive HRQOL assessments in IEI, considering the physical and psychological impacts of treatments. This study represents a bibliometric analysis focusing on HRQOL in patients with. It underscores the need for more extensive and systematic research in this area, emphasizing the importance of a multidisciplinary approach. Despite advancements in medical treatments for IEI, there is a crucial need to focus on HRQOL to enhance patient satisfaction and overall well-being. The findings advocate for more personalized treatment plans and a better understanding of the psychosocial needs of patients with IEI to improve their quality of life.

A survey study on antibiotic prescription practices for acute asthma exacerbations: An European academy of allergy and clinical immunology task force report.

Guidelines recommend treating asthma exacerbations (AAEs) with bronchodilators combined with inhaled and/or systemic corticosteroids. Indications for antibiotic prescriptions for AAEs are usually not incorporated although the literature shows antibiotics are frequently prescribed. To investigate the antibiotic prescription rates in AAEs and explore the possible determining factors of those practices. A digital survey was created to determine the antibiotic prescription rates in AAEs and the influencing factors for the prescription practices. The survey was distributed among European academy of allergy and clinical immunology (EAACI) members by mass emailing and through regional/national societies in the Netherlands, Italy, Greece, and Poland. Furthermore, we retrieved local antibiotic prescription rates. In total, 252 participants completed the survey. Respondents stated that there is a lack of guidelines to prescribe antibiotics in AAEs. The median antibiotic prescription rate in this study was 19% [IQR: 0%-40%] and was significantly different between 4 professions: paediatrics 0% [IQR: 0%-37%], pulmonologists 25% [IQR: 10%-50%], general practitioners 25% [IQR: 0%-50%], and allergologists 17% [IQR: 0%-33%]) (p=0.046). Additional diagnostic tests were performed in 71.4% of patients before prescription and the most common antibiotic classes prescribed were macrolides (46.0%) and penicillin (42.9%). Important clinical factors for health care providers to prescribe antibiotics were colorised/purulent sputum, abnormal lung sounds during auscultation, fever, and presence of comorbidities. In 19% of patients with AAEs, antibiotics were prescribed in various classes with a broad range among different subspecialities. This study stresses the urgency to compose evidence-based guidelines to aim for more rational antibiotic prescriptions for AAE.

Ecological competition in the oral mycobiome of Hispanic adults living in Puerto Rico associates with periodontitis

Background: Fungi are a major component of the human microbiome that only recently received attention. The imbalance of indigenous fungal communities and environmental fungi present in the oral cavity may have a role in oral dysbiosis, which could exacerbate oral inflammatory diseases. Methods: We performed a cross-sectional study and recruited 88 participants aged 21 to 49 from sexually transmitted infection clinics in Puerto Rico. A full-mouth periodontal examination following the NHANES protocol defined periodontal severity (CDC/AAP). ITS2 (fungal) genes were amplified and sequenced for mycobiota characterization of yeast and environmental fungi. Environmental outdoor spore levels were measured daily by the American Academy of Allergy Asthma and Immunology San Juan station and defined by quartiles as spore scores. Results: Our data indicate polymicrobial colonization of yeast and environmental fungi in the oral cavity. Dominant taxa associated with periodontal disease included Saccharomyces cerevisiae, Rigidoporus vinctus, and Aspergillus penicilloides, while Candida albicans were found to be ubiquitous. Fungal aerosols were found to impact the oral cavity biofilm, likely due to competition and neutralization by inhaled outdoor and indoor fungal spores. Conclusion: To our knowledge, this is the first report showcasing the ecological competition of measured outdoor environmental fungi with the human oral mycobiota.

Anafilaksiye Güncel Yaklaşım

Anaphylaxis is the most important acute systemic allergic reaction. The incidence of anaphylaxis has been increasing in recent years. Therefore, all healthcare providers should know the diagnosis and management of anaphylaxis. In this article, the current approach to anaphylaxis is presented, considering the criteria accepted by the World Allergy Organization (WAO) and the European Academy of Allergy and Clinical Immunology (EACCI). Intramuscular epinephrine is the first-line treatment for anaphylaxis. However, it is still not used at the desired level. Children at risk of anaphylaxis should be trained to use adrenaline autoinjectors. After anaphylaxis develops, children should be referred to an allergist to investigate the underlying causes.

Component-resolved diagnosis of tree pollen allergen: identify key allergens to develop treatment plans

With the increasing global prevalence of tree pollen allergies, there has been a significant impact on the quality of life for populations. In North and Central China, birch pollen, cypress pollen, and plane tree pollen are the most common allergens for springtime pollen allergy sufferers. The distribution of plants and patterns of pollen transmission in different geographical areas result in varying pollen exposure outcomes, further complicating the challenges in diagnosis and individualized treatment. This article delves into the research progress and clinical application of tree pollen allergies based on the "Molecular Allergology User's Guide 2.0 (MAUG 2.0) " published by the European Academy of Allergy and Clinical Immunology (EAACI). It discusses major allergen families and component proteins of tree pollen such as PR-10 proteins, profilins, polcalcins, as well as cross-reactive components that may cause pollen-food allergy syndrome. Allergen component diagnostics can distinguish true allergy sufferers from those with multiple allergen reactions, enabling more targeted selection of allergens for specific immunotherapy, thus enhancing treatment effectiveness. Bet v 1 and Cup a 1, for instance, are specific indicators for immunotherapy in birch and cypress allergy patients. Overall, this article provides cutting-edge information for professionals in the field of tree pollen allergies, offering in-depth exploration of tree pollen allergen component proteins, clinical manifestations, and treatment-related research, aiding in better understanding and addressing the challenges of tree pollen allergies.

Mapping the intellectual structure of the research of omalizumab in chronic spontaneous urticaria: A bibliometric analysis

BackgroundGuidelines for treating Chronic Spontaneous Urticaria (CSU) recommend using the IgE-targeted biologic Omalizumab in patients with antihistamine-refractory disease. ObjectiveTo present a bibliometric review of publications related to Omalizumab and CSU over the past two decades. MethodsPublications that are relevant from 2003 to 2022 were extracted from the Science Citation Index-Expanded (SCI-EXPANDED) in the Web of Science Core Collection (WoSCC) database as of January 8, 2023. We utilized CiteSpace (version 6.1.R3), VOSviewer (version 1.6.18), and the R package (version 4.2.1) to analyze and visualize the data. The R package bibliometrix (version 4.2.1) was also used. ResultsBetween 2003 and 2022, a total of 566 articles were published. Since 2014, there has been a rapid increase in publication outputs. According to the collaboration network, the most influential country/institute/scholar was the USA, Charité Universitätsmedizin Berlin, and Maurer Marcus, respectively. The study identified the Journal of Allergy and Clinical Immunology: In Practice as the most productive journal and the Journal of Allergy and Clinical Immunology as the most co-cited journal. The analysis of keywords revealed that high-frequency terms such as angioedema, IgE, treatment, anti-IgE, asthma, and atopic dermatitis were present. Moreover, recent studies in this area have mainly concentrated on biomarkers, Dupilumab, and COVID-19. ConclusionThere has been a growing interest in the use of Omalizumab in CSU in recent years. The current trending topics in this research are the identification of biomarkers and the development of new monoclonal antibodies for the treatment of CSU.

Food allergy outside the eight big foods in Europe: A systematic review and meta‐analysis

AbstractBackgroundThe 2014 estimates of prevalence of food allergy (FA) in Europe published by the European Academy of Allergy and Clinical Immunology included only the eight so‐called big foods (cow's milk/egg/wheat/soy/peanut/tree nuts/fish/shellfish). Those estimates have recently been updated. Complementing this, we sought to identify and estimate the prevalence of allergy to other foods that have been reported during the last decade.MethodsSix databases were searched for studies published 2012–2021. Random‐effects meta‐analysis was performed to derive pooled prevalence of allergy to each food.ResultsTwenty‐seven studies were included, containing a total of 66 FAs. Among the most frequently reported FAs, the lifetime and point prevalence range of self‐reported kiwi allergy was 0.1%–1.0% and 0.2%–8.1%, respectively, while the food challenge (FC)‐verified kiwi allergy point prevalence range was 0.01%–0.10%. The point prevalence range for self‐reported peach allergy was 0.2%–3.2%, while the range for FC‐verified peach allergy was 0.02%–0.05%. The lifetime and point prevalence range for self‐reported tomato allergy was 0.01%–1.8% and 0.2%–2.1%, respectively.ConclusionAllergy to some foods traditionally not considered important are now emerging as relevant FAs. The focus on FA in Europe should not be limited to the so‐called eight big FA, but extended to other types of foods which need to be considered both for clinical purposes and population risk assessment.

A systematic review and meta-analysis on absolute eosinophil counts and the risk of asthma in preschool children with wheezing: An EAACI Task Force Report.

Preschool children with wheezing disorders pose diagnostic and therapeutic challenges and consume substantial healthcare resources. Peripheral eosinophil blood count (EBC) has been proposed as a potential indicator for future asthma development. This review by the European Academy of Allergy and Clinical Immunology (EAACI) Preschool Wheeze Task Force aimed to provide systematic evidence for the association between increased EBC and the risk of future asthma, as well as to identify potential cutoff values. In February 2023, a search of PubMed, EMBASE, and Cochrane Library databases was conducted to identify studies comparing EBCs in preschool children with wheezing who continued to wheeze later in life and those who did not. Included observational studies focused on children aged <6 years with a wheezing disorder, assessment of their EBCs, and subsequent asthma status. No language or publication date restrictions were applied. Among the initial 3394 studies screened, 10 were included in the final analysis, involving 1225 patients. The data from these studies demonstrated that high EBC in preschool children with wheezing is associated with future asthma development, with odds ratios of 1.90 (95% CI: 0.45-7.98, p = .38), 2.87 (95% CI: 1.38-5.95, p < .05), and 3.38 (95% CI: 1.72-6.64, p < .05) for cutoff values in the <300, 300-449, and ≥450 cells/μL ranges, respectively. Defining a specific cutoff point for an elevated EBC lacks consistency, but children with EBC >300 cells/μL are at increased risk of asthma. However, further research is needed due to the limitations of the included studies. Future investigations are necessary to fully elucidate the discussed association.

Nutrition Status And Neuropsychiatric Disorders In Indonesian Childhood Lupus: Experience At A Single Tertiary Referral Center

NPSLE diagnosis is still challenging because of many SLE-related and non-SLE-related processes that can be presented in patient. The report of NPSLE in Indonesia is still limited. This study aim to describe the clinical features, nutrition status, and laboratory characteristics of Neuropsychiatric Systemic Lupus Erythematosus (NPSLE) and compared to non NPSLE case in Indonesian children. The study is a retrospective cohort study. Data were collected from the complete medical record of Juvenile Systemic lupus Erythematosus (jSLE) patients 2016 - 2020 at the Allergy Immunology Outpatient clinic at Dr. Soetomo General Academic Hospital. We include all patients with ages ranging from age 0-18 years old with a diagnosis of Systemic lupus Erythematosus (SLE). The diagnosis fo SLE based on American College of Rheumatology (ACR) criteria 1997 and Neuropsychiatric (NP) manifestations were classified using the standardized nomenclature and case definitions for the 19 NP manifestations linked to SLE developed in 1999 by the ACR ad hoc Committee. Disease activity SLE was defined according to the American Mexican-Systemic Lupus Erythematosus Disease Activity Index (Mex-SLEDAI) criteria. Statistical analysis conducted in this study was descriptive analysis, paired T-test (NPSLE vs. non-NPSLE as the dependent variable), Fischer exact test, and Pearson Chi-square test using SPSS ver. 21. A total of 90 patients with juvenile SLE were enrolled, but only 71 patients were eligible as participants with complete medical records obtained. Mex-SLEDAI score was significantly higher on NPSLE compared to non-NPSLE (p=0.001).

The Efficacy and Safety of High Dose (10 mg) of Desloratadine (Dazit® 10) in the Treatment of Chronic Spontaneous Urticaria in India: A Phase III, Multicentric, Open-Label, Single-Arm Study.

Chronic spontaneous urticaria (CSU) is a debilitating affliction that affects diverse quality of life (QoL) parameters such as sleep, self-esteem, and daily activities. Second-generation antihistamines, such as desloratadine, are more effective and safer in managing CSU. Desloratadine is a nonsedating, potent, and highly selective H1 receptor antagonist. At its daily dose of 5 mg, almost half of CSU patients do not show symptomatic improvement. European Academy of Allergy and Clinical Immunology (EAACI)/Global Allergy and Asthma European Network (GA2LEN)/European Dermatology Forum (EDF) (EuroGuiDerm)/Asia Pacific Association of Allergy, Asthma and Clinical Immunology (APAAACI) guidelines recommend increasing the dosage to up to four times in such nonresponsive patients. However, there is insufficient clinical evidence in Indian settings. We evaluated the efficacy and safety of 10 mg desloratadine (OD) in 256 nonresponsive patients with moderate to severe CSU. The primary outcome was the change in Urticaria Activity Score (UAS7) from baseline to four weeks. Additionally, change in Chronic Urticaria Quality of Life (CU-Q2oL) scores during the course of treatment was also evaluated. The mean UAS7 scores showed a significant reduction from 31.9 ± 4.8 at baseline to 18.2 ± 8.1 at the end of the study (p < 0.0001). The use of a higher dose of desloratadine also decreased the CU-Q2oL scores significantly from 59.8 ± 14.7 at baseline to 35.4 ± 10 at four weeks (p < 0.0001). The incidence of adverse events (AEs) possibly linked to the drug was low (1.6%), and no serious adverse events were reported. Results indicated improvements in the disease severity as well as its positive impact on participants' QoL. This study confirms the efficacy and safety of daily use of a twofold dose of desloratadine in nonresponsive moderate to severe CSU patients.

AllergoOncology: Biomarkers and refined classification for research in the allergy and glioma nexus-A joint EAACI-EANO position paper.

Epidemiological studies have explored the relationship between allergic diseases and cancer risk or prognosis in AllergoOncology. Some studies suggest an inverse association, but uncertainties remain, including in IgE-mediated diseases and glioma. Allergic disease stems from a Th2-biased immune response to allergens in predisposed atopic individuals. Allergic disorders vary in phenotype, genotype and endotype, affecting their pathophysiology. Beyond clinical manifestation and commonly used clinical markers, there is ongoing research to identify novel biomarkers for allergy diagnosis, monitoring, severity assessment and treatment. Gliomas, the most common and diverse brain tumours, have in parallel undergone changes in classification over time, with specific molecular biomarkers defining glioma subtypes. Gliomas exhibit a complex tumour-immune interphase and distinct immune microenvironment features. Immunotherapy and targeted therapy hold promise for primary brain tumour treatment, but require more specific and effective approaches. Animal studies indicate allergic airway inflammation may delay glioma progression. This collaborative European Academy of Allergy and Clinical Immunology (EAACI) and European Association of Neuro-Oncology (EANO) Position Paper summarizes recent advances and emerging biomarkers for refined allergy and adult-type diffuse glioma classification to inform future epidemiological and clinical studies. Future research is needed to enhance our understanding of immune-glioma interactions to ultimately improve patient prognosis and survival.

Emergency treatment of peri-operative anaphylaxis: Resuscitation Council UK algorithm for anaesthetists.

Peri-operative anaphylaxis is a rare but potentially catastrophic event which must be considered whenever unexpected and significant cardiovascular or respiratory compromise occurs during anaesthesia. The Resuscitation Council UK algorithm for peri-operative anaphylaxis highlights the importance of early intravenous adrenaline and fluid resuscitation and provides guidance on the treatment of refractory anaphylaxis and immediate follow-up. This algorithm is endorsed by the Royal College of Anaesthetists, Association of Anaesthetists, British Society of Allergy and Clinical Immunology and Clinical Immunology Professional Network of the British Society for Immunology. This document was produced by the Perioperative Allergy Network steering committee in collaboration with the Resuscitation Council UK.

Molecular diagnostic strategies and management of dust mite allergy

Dust mites are one of the most important allergens, widely distributed around the world, especially in household environments. Dermatophagoides pteronyssinus, Dermatophagoides farinae and Blomia tropicalis are the most common species of dust mites. There are more than 35 known sensitization components of dust mites, among which Der p 1, Der p 2 and Der p 23 are the major components. Clinically, allergen skin test and serum specific immunoglobulin E (sIgE) detection are widely used in the preliminary diagnosis of dust mite allergy. However, these methods cannot accurately identify specific dust mite sensitization components. Considering that there are significant differences in the allergenic components of dust mites in different regions and populations, component-resolved diagnosis of dust mite is particularly important in accurately determining the allergenic components. This is not only of guiding significance for allergen avoidance, but also important for determining the immunotherapy regimen for dust mites. In order to strengthen the understanding of the molecular diagnosis of dust mites and promote the integration of allergy science in China with the international standards, this article interprets the "Allergy Molecular Allergology User's Guide 2.0" published recently by the European Academy of Allergy and Clinical Immunology.