Peanut and tree nut allergies are leading causes of food-induced anaphylaxis in children. We aimed to examine early introduction and allergic characteristics in children with suspected severe peanut and/or tree nut allergy. Children aged 3-16 years with suspected severe peanut and/or tree nut allergy were recruited from Tampere University Hospital, Finland. Eligibility was based on a history of anaphylaxis and/or elevated specific immunoglobulin E (sIgE) to high-risk allergenic components. Data were collected through structured, physician-led interviews with participants and their caregivers. The study included 103 children (mean age 7.2 ± 3.0 years), of whom 47.6% had a history of anaphylaxis. Early nut introduction (< 6 months) did not occur at all among the participants. Additionally, nut introduction before 12 months was rare (< 2%). Peanut and cashew were the most introduced nuts and the most frequent anaphylaxis triggers. Parental food allergy was significantly more common among children without anaphylaxis compared to those with confirmed anaphylaxis (38.5% vs. 18.4%; p = 0.035). Early nut introduction was absent among children with suspected severe nut allergy, regardless of anaphylaxis history. Parental food allergy was more prevalent in children without anaphylaxis, suggesting it is not a reliable predictor of severe allergic reactions.

Short communication: Performance evaluation of beef calves fed different levels of colostrum replacer in tropical conditions.

Ambrosia trifida, known worldwide as an invasive species, threatens agriculture and ecosystems and causes severe allergic reactions in humans. As part of the effort to valorize this harmful plant, a phytochemical investigation of A. trifida led to the isolation of one new guaiane sesquiterpenoid (1S,7R,10R)-10,11-dihydroxy-4-guaien-3-one (1), together with two diastereomers (2 and 3). Their structures were elucidated using various spectroscopic methods, including NMR, HRMS, optical rotation, and ECD calculations. (1S,7R,10R)-11-Hydroxy-4-guaien-3-one (2) was isolated for the first time from nature. Its (1R,7R,10S)-diastereomer (3) has not been previously reported in the Compositae family. Based on network pharmacology and molecular docking analyses, the effects of 1-3 on inflammatory bowel disease (IBD) were examined. Among the isolates, only 2 exhibited anti-inflammatory and tight junction regulatory activities by targeting the JAK2/STAT3 signaling pathway in Caco-2 cells. In contrast, its diastereomer 3 was inactive, indicating that the stereochemical configuration at C-1 and C-10 plays a critical role in biological activity. This study suggests that guaiane sesquiterpenoids may be useful for the treatment of IBD, and the findings serve as a basis for a wide range of applications of this invasive plant as a useful resource.

ABSTRACTDexmedetomidine, propofol, and sevoflurane are widely used anesthetic agents, but reports of water metabolism disturbances—particularly drug‐induced diabetes insipidus (DI)—associated with their use remain extremely rare. We report a case of a 51‐year‐old Chinese man who developed abrupt high‐volume polyuria (> 600 mL/h; 24‐h output of 8750 mL), hypotonic urine (specific gravity 1.003; osmolality 175 mOsm/kg), progressive hypernatremia (peak 156 mmol/L), hemoconcentration, lactic acidosis, and hypotension following transurethral seminal vesiculoscopy performed under general anesthesia. The patient was initially suspected of having an anaphylactic reaction, but standard interventions were ineffective. After exclusion of other causes, a diagnosis of anesthetic‐associated DI with secondary hypovolemic shock was made. The patient responded to aggressive fluid and electrolyte replacement alongside norepinephrine support. Polyuria resolved within approximately 18 h, serum sodium normalized, and the patient was discharged from the ICU on postoperative Day 3. This case emphasizes that persistent dilute polyuria with rising serum sodium after anesthesia should prompt early evaluation for DI. When such complications arise, timely diagnosis, targeted fluid management, and hormone replacement therapy when appropriate can be crucial for preventing potentially life‐threatening outcomes.

Double proline- substituted porcine epidemic diarrhea virus full-length spike mRNA vaccine confers enhanced immunogenicity and protective efficacy compared to conventional inactivated vaccine.

Pertussis remains a global threat for infants, and recent increases in notifications have renewed interest in optimising vaccination strategies and improving vaccines. At the biological level, the rationale for maternal pertussis immunization extends beyond passive antibody transfer alone and may also involve broader maternal-infant immune interactions; however, at the population level these mechanisms are operationalized through policy adoption, timing recommendations, and coverage. We compared incidence constructs from WHO routine notifications and Global Burden of Disease (GBD) modelled estimates and assessed how associations with vaccination policy indicators change across outcome definitions. Trends were characterised with Joinpoint regression; policy associations were estimated using Bayesian hierarchical models fitted separately to each dataset with Universal Health Coverage stratified random intercepts. Incidence levels and trends differed markedly between WHO and GBD. Unadjusted analyses showed heterogeneous, sometimes opposing, associations for maternal immunization and schedule timing. After adjustment, most schedule parameters were small and imprecise, whereas DTP3 coverage remained strongly inversely associated with incidence in GBD but not in WHO. Surveillance and modelled estimates should not be interpreted interchangeably; harmonized constructs and routine implementation and ascertainment metadata are needed for robust cross-country inference.

Introduction:Oral mite anaphylaxis (OMA) is an uncommon form of food-induced anaphylaxis caused by ingestion of foods contaminated with house dust mites. Exercise may act as a cofactor, sometimes mimicking food-dependent exercise-induced anaphylaxis (FDEIA).Case Presentation:We describe a 14-year-old boy with atopic dermatitis, allergic rhinitis, and mild asthma who experienced three episodes of anaphylaxis. Each reaction occurred 30-60 min after eating wheat-based foods, followed by physical activities such as football or basketball. Symptoms started with urticaria and progressed to cough and abdominal pain. Notably, he tolerated the same foods in the absence of exercise. Skin prick testing and specific IgE showed strong sensitization to Dermatophagoides pteronyssinus and Dermatophagoides farinae, but not to wheat. Multiplex component testing confirmed broad mite sensitization. Evaluation for primary immunodeficiency was unremarkable. The patient was prescribed an epinephrine auto-injector, and asthma therapy was optimized with budesonide/formoterol. Over 6 months of follow-up, no further episodes occurred, asthma control improved (Asthma Control Test score 24-25), and rhinitis symptoms subsided with intranasal antihistamines.Discussion:The clinical picture, together with negative wheat-specific IgE and strong mite sensitization, supported OMA rather than classical food allergy or FDEIA. Component-resolved diagnostics were especially helpful in confirming the diagnosis.Conclusion:This case underlines the importance of considering OMA in children with exercise-related anaphylaxis after wheat-based meals, particularly in patients who may initially appear to have idiopathic anaphylaxis. Careful history, use of CRD, and close follow-up are essential. Education, asthma control, and preventive measures remain key to reducing recurrence risk.

BackgroundMast cell (MC) activation (MCA) disorders (MCAD) include diseases in which MCs excessively release mediators leading to recurrent manifestations of MCA. MCAD encompasses MCA syndrome (MCAS) which is defined by (i) documented systemic symptoms of MCA, (ii) a 20% increase in serum tryptase level from the individual's baseline plus 2 ng/mL and (iii) a symptom response to MC‐stabilizing drugs. MCAD not fulfilling mastocytosis or all MCAS criteria are referred to as MCAD not otherwise specified (MCAD‐NOS). The aim was to describe the clinical, laboratory characteristics and outcomes of the first pediatric‐onset non‐mastocytosis MCAD cohort.MethodsAll children with the criteria of non‐mastocytosis MCAD managed at the French National Referral Center for MCAD were included. Clinical, laboratory data, and outcomes were recorded.ResultsForty‐four MCAD patients (mean age at onset: 4.3 years) were identified including 36 MCAD‐NOS and 8 idiopathic MCAS. Hereditary‐α‐tryptasemia was identified in 5/33 (15.2%) patients. The spectrum of symptoms concerned most frequently both the skin (100% of children, with urticaria, angioedema, pruritus, and/or flushing) and the gastrointestinal tract (93% patients). We identified two clinical profiles, according to the age at onset. Before 3 years of age, MCAD was associated with persistent gastrointestinal symptoms triggered by various foods (leading to a drastically limited diet), and after 3 years of age with episodic, recurrent, idiopathic, anaphylactic reactions. The administration of H1 and/or H2 antihistamines drugs +/− a leukotriene receptor antagonist resulted in a marked reduction in symptoms.ConclusionThe description of the clinical profiles of pediatric‐onset non‐mastocytosis MCAD may help to avoid diagnostic delay.

Glucose is the primary energy substrate for the human fetus, essential for brain development and overall growth. Traditionally, fetal glucose supply has been attributed to the maternal-fetal glucose gradient. However, emerging evidence indicates that the placenta plays an active role in regulating glucose availability through its own metabolic processes. This brief review aims to synthesize current knowledge on placental glucose handling in uncomplicated human pregnancies, emphasizing mechanisms beyond passive transfer and quantitative aspects. The placenta exhibits dynamic glucose metabolism, including consumption, storage, and endogenous production. Glycogen pools within placental cells are more likely endogenous sources of glucose than gluconeogenesis. Placental endogenous glucose may represent an auxiliary system that safeguards fetal glucose supply during maternal hypoglycemia and/or increased fetal demand. In vivo studies demonstrate that up to 70% of glucose released to the fetus can originate from placental sources at certain time points. Aerobic glycolysis (with lactate production) is a prominent feature of placental metabolism, with substantial lactate export to the maternal circulation. This energy loss is partly compensated for by uptake of maternal ketone bodies and acetate, highlighting the placenta's flexibility in substrate utilization. These adaptations underscore the placenta's dual role: maintaining its own structural and functional integrity while ensuring fetal oxygen and energy needs. Understanding these mechanisms is critical for defining the partition of energy between the placenta and fetus and its implications for fetal growth, particularly under conditions of maternal nutrient restriction. Insights into placental glucose metabolism may inform strategies for understanding and managing growth deviations and guide development of artificial placental systems.

Lower serum IgG concentrations in Montbéliarde neonatal: A comparative study on breed-specific passive transfer success.

Passive and active heat transfer enhancements of the slot nozzle using a rotating insert

Peanut allergy represents one of the most severe and prevalent food allergies worldwide, posing a significant challenge to public health, regulatory compliance, and food industry practices. Given that strict avoidance remains the only effective preventive strategy, the reliable detection of trace peanut allergens in complex food matrices is essential to protect allergic consumers and to ensure accurate allergen labeling. In this context, electrochemical biosensors have emerged as powerful analytical tools that complement or overcome the limitations of conventional methods such as ELISA, PCR, and LC–MS, offering rapid response, high sensitivity, low cost, and suitability for on-site analysis. This comprehensive review critically examines recent advances in electrochemical biosensing strategies for peanut allergen detection, with a particular focus on major allergens such as Ara h1, Ara h2, and Ara h6. Both biosensors for protein allergen detection (including immunosensors and aptasensors) and genosensors for allergen-specific DNA detection are discussed, highlighting their respective biorecognition elements, transduction mechanisms, signal amplification approaches, and analytical performance. Special attention is given to the role of nanomaterials—including metallic nanoparticles, carbon-based nanostructures, magnetic beads, and hybrid nanocomposites—in enhancing sensitivity, selectivity, and robustness against matrix effects. The applicability of these platforms is evaluated through their successful validation in real food samples, ranging from baked goods and chocolate products to highly processed matrices. Finally, current challenges and future perspectives are addressed, including the need for improved resistance to food matrix interferences, harmonization with regulatory standards, and the integration of miniaturized, user-friendly, and multiplexed platforms. Overall, this review underscores the strong potential of electrochemical biosensors as next-generation tools for peanut allergen monitoring, paving the way toward reliable point-of-need testing and improved safety for allergic individuals. • Electrochemical biosensors enable rapid and sensitive peanut allergen detection. • Immunosensors and aptasensors dominate protein-based peanut analysis. • DNA-based genosensors overcome limitations of protein denaturation. • Nanomaterials dramatically enhance sensitivity and matrix tolerance. • Portable electrochemical platforms enable point-of-need allergen monitoring.

Fungal food allergy syndrome: A rare cause of anaphylaxis

Hymenoptera venom immunotherapy is an established treatment for severe allergic reactions, aiming to modulate the immune response and reduce allergen sensitivity. However, traditional methods such as skin tests and specific IgE quantification often lack precision and fail to capture the multidimensional nature of clinical data. We investigated the relationships between wheal surface area, specific IgE levels, and patient age in allergic reactions to Hymenoptera venom, assessing immunotherapy effects before and after treatment. Data were retrospectively collected from 30 patients who underwent intradermal testing before and after immunotherapy. Wheal surface areas were measured using the semiautomated method (SAM), and specific IgE levels via immunoassays. K-means clustering, an unsupervised machine learning technique, was applied to identify patient subgroups on the basis of an integrated analysis of the 3 variables. Data normalization ensured comparability across different units. A positive correlation between wheal surface area and specific IgE was observed before and after treatment, both showing reductions after immunotherapy. Age showed no significant influence. Clustering revealed two consistent profiles: response and partial response. The Müller scale confirmed clinical improvement with reduced reaction severity. Immunotherapy reduces allergic response, as shown by decreased wheal size and IgE level. The integration of SAM and machine learning enables robust analysis of clinical data, supporting personalized allergy management.

Background: Anaphylaxis is a severe systemic hypersensitivity reaction that occurs in diverse clinical contexts. Its broader comorbidity profile in population-based settings has not been well characterized. Objective: The objective was to evaluate the prevalence and spectrum of comorbid diseases in patients with anaphylaxis compared with matched controls in a nationwide population. Methods: We conducted a retrospective population-based matched case-control study by using electronic health record data from a nationwide health maintenance organization in Israel between 2001 and 2024. Anaphylaxis cases were confirmed by manual chart review according to World Allergy Organization criteria with documented epinephrine treatment. The controls were matched on age, sex, and calendar time, and had no history of anaphylaxis. Baseline comorbidities documented at least 3 months before the index date were analyzed by using conditional logistic regression. Multiple comparisons were addressed by using false discovery rate adjustment. Results: The study included 778 patients with anaphylaxis and 3112 matched controls. The patients with anaphylaxis had a significantly higher prevalence of atopic and allergic diseases, including asthma, allergic rhinitis, allergic conjunctivitis, atopic dermatitis, contact dermatitis, and chronic idiopathic urticaria. The composite atopic disease burden was markedly higher in the anaphylaxis group. Selected immune-mediated and cardiovascular conditions were also more prevalent, although the effect sizes were generally modest and several associations did not remain statistically significant after a multiple-comparison correction. An eliciting allergen was identified in 82.4% of the patients, with drugs as the most frequent triggers, followed by food and insect venom. Idiopathic anaphylaxis accounted for 17.6% of the patients. Baseline medication utilization was higher among the patients with anaphylaxis, particularly for allergic, respiratory, and gastrointestinal therapies. Conclusion: In this nationwide adult cohort, individuals with anaphylaxis demonstrated a higher prevalence of atopic disease and modest differences in selected systemic comorbidities compared with matched controls. These findings describe epidemiologic associations and do not imply causality. Further prospective studies are warranted.

Chlorhexidine is a widely used antiseptic in healthcare settings, particularly for catheter site preparation in hemodialysis patients. While generally considered safe, chlorhexidine can rarely cause severe IgE-mediated anaphylactic reactions. Here we report the case of a 47-year-old man on maintenance hemodialysis who experienced two episodes of severe allergic reactions during dialysis sessions. During the first episode the patient presented with dyspnea, hypotension, and pruritus, which we initially attributed to the dialyzer membrane reaction. After changing the dialyzer membrane, the patient remained asymptomatic for 19 sessions. However, a second, more severe episode occurred with urticaria, profound hypotension, and respiratory distress requiring intravenous adrenaline. Retrospective analysis revealed chlorhexidine antisepsis at the tunneled catheter site as the causative agent, confirmed by elevated serum IgE (285 IU/mL), with complete resolution after switching to povidone-iodine as an antiseptic instead. This case demonstrates a concept called "sensitization window" where compromised skin integrity at the catheter exit site facilitated chlorhexidine penetration despite three years of uneventful exposure of the same during fistula use. This case highlights the importance of considering chlorhexidine hypersensitivity in such unexplained dialysis-related allergic reactions. Early recognition and prompt antiseptic substitution are thereby crucial to prevent potentially fatal anaphylactic episodes in this vulnerable population.

Approximately 30% of long COVID patients still experience neurological symptoms (brain fog, pain, chronic fatigue) more than 4 months after the onset of COVID-19. This condition, known as 'neurological long COVID', remains poorly understood and might be explained by a persisting autoimmune response against nervous-derived self-antigens. The aim of this study is to determine whether IgG autoantibodies from long COVID patients with neurological sequelae can bind to central or peripheral nervous system epitopes and trigger neuropsychiatric symptoms upon passive transfer into mice, thereby mirroring patient-reported manifestations. Long COVID patients meeting the 2021 consensus WHO definition were included following a standardized neuropsychological assessment, while excluding patients with a medical history of autoimmune and neurological disorders. Age- and sex-matched asymptomatic individuals were used as healthy controls. Total IgGs were isolated using protein G purification and injected intraperitoneally into C57Bl6/J mice for four consecutive days. During the two weeks post-injections, behavioral tests assessed mechanical allodynia, thermal hyperalgesia, spatial working memory, depression, and anxiety. Mice injected with IgG from long COVID patients showed no difference with the control group in terms of anxiety or depression behaviors, short- or long-term spatial memories. However, they displayed a transient decrease of paw withdrawal threshold and thermal hypersensitivity during the first week. This effect was abolished when IgG-depleted serum or papain-digested IgGs were transferred. IgG from long COVID patients accumulated in the lumbar dorsal root ganglia of injected mice and colocalized with proprioceptive and nociceptive sensory neurons, without inducing local neuroinflammation or astrogliosis. When applied onto human post-mortem DRG tissue, patient-derived IgG also exhibited immunoaffinity for sensory neuron somata. These data demonstrate that IgGs from long COVID patients bind to peripheral sensory neurons and induce pain-related symptoms in mice. Our findings also support the hypothesis that autoantibodies mediate pain-related pathophysiology in the spectrum of long COVID symptoms.

Equine foals receive IgG from mare colostrum through passive transfer. Failure of passive transfer (FPT) is a significant risk to the foal's life, leaving them vulnerable to infection and sepsis. Radial Immunodiffusion (RID) and immunoturbidimetric assays quantify IgG present in a foal sample but require a laboratory to complete. Accurate, reproducible, stall-side testing to rapidly quantify IgG would allow for expedited clinical decisions, with potential to improve equine foal care and survival. To evaluate the analytical and clinical performance of a stall-side IgG lateral-flow test and reader (Sidekick), assessing its use as a point-of-care (POC) test to provide reliable results and agreement of IgG quantification with gold-standard methods. Retrospective cohort. Stall-side LFD IgG test (Sidekick) was assessed with serial diluted foal sample (0.8-20 g/L, three replicates) and Stall-side LFD was compared to RID and Immunoturbidimetric assay. Serum/plasma samples from 10 foals created two cohorts, one representing successful passive transfer and one representing failed passive transfer. Agreement in IgG quantification between matched blood and plasma samples by the stall-side LFD was tested in three foals. The Stall-side LFD IgG test showed excellent recovery and high repeatability, 96.3%-109.5% across the clinically relevant range of 4-8 g/L (CV% 3.7-10). Overall, there was strong agreement with the reference method and strong agreement between matched whole-blood and plasma samples. Small cohort (10 foals). The stall-side IgG assay (Sidekick) delivers repeatable results enabling on-the-spot decisions and reducing delays from sample processing, transport and result reporting, with potential to enable informed decision-making on whether to initiate or continue treatment for a foal with FPT.

Abstract Streptococcus iniae infects a wide range of fish species and causes significant losses in aquaculture. In Japan, commercial vaccines against S. iniae have been approved for use in marine fishes. In this study, we evaluated the efficacy of two commercial vaccines against S. iniae in three freshwater-farmed Oncorhynchus species—rainbow trout O. mykiss , masu salmon O. masou masou , and coho salmon O. kisutch —and examined the role of serum antibodies in vaccine-induced protection. All three species exhibited comparable susceptibility to S. iniae strain TB-0107. In each of the three species, the vaccinated groups showed significantly higher survival rates following S. iniae challenge than the control group, with a relative percentage survival exceeding 90%. The serum antibody titers were found to be significantly elevated in vaccinated fish across all of the species. Furthermore, passive transfer of serum from vaccinated fish conferred enhanced survival in recipients, which may suggest a contribution of antibodies to protection. These results indicate that commercial vaccines against S. iniae are effective in Oncorhynchus species, and that the induction of specific antibodies plays an important role in vaccine efficacy in these fish. Commercial vaccines are expected to prevent the mortality caused by S. iniae infection in Oncorhynchus species.

To investigate the safety and feasibility of deep sedation and general anaesthesia for cardiovascular magnetic resonance imaging in paediatric patients with congenital or acquired cardiac diseases. This retrospective study included all consecutive patients less than 18 years of age who had deep sedation for cardiovascular magnetic resonance examination at the University Hospital Schleswig-Holstein (Kiel, Germany) between 2010 and 2020 and cardiovascular magnetic resonance examination under general anaesthesia at the Royal Brompton Hospital (London, United Kingdom) between 2013 and 2022. Five-hundred twenty-two patients were in the deep sedation group and 171 in general anaesthesia group. Most of the patients had CHD (86% in deep sedation and 70% in general anaesthesia group). There were overall 14 adverse events (2%); 8 (1.5%) in the deep sedation group and 6 (3.5%) in the general anaesthesia group. This difference was not statistically significant (p = 0.122). Complications in the deep sedation group included mild anaphylactic reactions in three patients, a severe coughing fit in one patient, increasing cyanosis in three single-ventricle patients, and suspected aspiration in one patient. In the general anaesthesia group, hypotension requiring some intervention was present in three patients (four scans). One patient (0.6%) had inadvertent endobronchial intubation. Both deep sedation and general anaesthesia can be used for cardiovascular magnetic resonance scans in paediatric patients with a low rate of complications. This, however, requires highly skilled teams who adhere strongly to the safety policies and guidelines set up by each hospital.