Treatment Of Allergy Research Articles

AI-Enhanced Allergy Diagnostics: Streamlining Healthcare and Reducing Costs

Abstract Issue/Problem WHO projects a shortfall of 10 million health workers by 2030. One area particularly lacking technological support is allergy diagnostics. The World Allergy Organization recognizes skin tests as the gold standard for allergy diagnostics, yet these tests are still manually assessed. General practitioners lack the time and tools, leading them to focus on treating the symptoms without addressing the causes. Description of the problem Symptomatic treatment of allergy can lead to the development of asthma in 30-40% of patients, increasing healthcare costs and causing lost productivity. The shortage of allergists further exacerbates this issue in many countries. Results Research conducted by the Military Institute of Medicine in Warsaw, in collaboration with a company producing automated allergy testing systems, explored a solution for allergy diagnostics, analyzing the entire process from the patient’s initial visit to desensitization therapy. The solution uses AI algorithms to reusable existing patient data and analyze patient history, correlate symptoms, medications, and allergen exposure, streamlining diagnostics and treatment. Patients at high risk undergo a computer-assisted interview to determine allergen panels. The only manual step is applying allergens to the skin, after which AI performs the reading and diagnosis. Clinical trials involving around 300 patients demonstrated high sensitivity and specificity, along with significant time savings for allergists and other medical staff, averaging 40 minutes per patient. The HTA evidence base will be ready by the end of this year. Lessons The integration of this AI-supported diagnostic method can eliminate bottlenecks in allergy diagnostics, improving health outcomes and reducing healthcare costs. However, its effectiveness depends on having at least few years of patient treatment data available. Without access to patient data, the method can be used in part to objectify PRICK test readings. Key messages • AI-supported diagnostics streamline allergy testing, reducing time and costs in the healthcare system. • The most accurate technique currently available for the automated reading of test results is that which evaluates the response to an allergen in the dermis in two spectra.

Allergy to aquatic biological resources as food

The review reveals the problem of allergies to fish and other highly allergenic foods. First of all, the products obtained from aquatic organisms are considered. The world production of fish of various species is discussed with the presentation of FAO statistics for recent years in this article. The role of aquaculture in the production of fish, shellfish and crustaceans is considered. In particular, the trends of fishing in the Black Sea and the growth of aquaculture production in Russia are analyzed. Generalized data indicate an increase in the importance of aquatic biological resources (ABR) in a balanced human diet. The study demonstrates the role of parvalbumin in the mechanism of development of allergies to products from ABR. Examples of other allergenic proteins that contain epitopes that trigger allergic reactions in the human body are given. The mechanism of these reactions is briefly described. Attention is drawn to cross-allergic reactions. Anthropogenic factors that can exacerbate allergies to fish products are discussed. These are pesticides, herbicides, antibiotics, detergent components, changes in chemical composition, and food storage conditions. Pseudoallergens with the ability to cause allergic reactions are also mentioned. Allergy symptoms can range from skin rashes and itching to respiratory problems and anaphylaxis. Treatment of fish allergy is similar to treatment for allergies to other foods. It includes the use of antihistamines, corticosteroids and sorbents. Heredity plays a major role in the development of allergic reactions. It is important to pay attention to the purity and quality of products, cooking methods, and also follow a diet. Due to the potentially higher cumulative toxicity of freshwater species, it is recommended that marine fish be preferred.

A Mixture of Four Probiotic Strains (Probiatop®) Mitigates Food Allergy to Ovalbumin in Mice.

Food allergy is a pathological condition caused by a disruption of oral tolerance. This condition leads to a pro-inflammatory environment that culminates in symptoms that varies from abdominal pain to anaphylaxis and death. The gold standard treatment consists of removing the food that triggers the allergy from diet. However, this conduct can cause nutritional impairment and social restrictions. Therefore, the need for new treatment strategies is notorious. In this context, probiotics are investigated due to their immunomodulatory mechanisms. Therefore, the objective of the present work is to investigate the probiotic potential of a mixture of four probiotic strains (Probiatop®) in an in vivo model of food allergy to ovalbumin (OVA). Our results demonstrated that oral administration of Probiatop® attenuated weight loss and diminished significantly anti-OVA IgE and IgG1 levels. Furthermore, it mitigated proximal jejunum injury, neutrophil recruitment and local IL17 levels. In addition, the probiotic mixture modulated positively the gut microbiota composition by decreasing the levels and frequency of Staphylococcus and yeast. In summary, our data suggest that Probiatop® has the potential to alleviate important symptoms of IgE-mediated food allergy, suggesting its probiotic potential as an adjuvant in the treatment of ovalbumin food allergy.

Food allergy in children: treatment challenges and outcome standardization

Relevance. Food allergy (FA) is an important public health concern, particularly among children, with an increasing prevalence. It is associated with a significant decrease in the quality of life for patients and their families due to the need to avoid allergens and the risk of severe allergic reactions, such as anaphylaxis. Despite active research, the primary treatment remains elimination diets, which limit patients’ options and highlight the need for new therapeutic solutions.Aim of the review. This review aims to summarize the current treatment methods for food allergy, discuss the challenges in evaluating the effectiveness of interventions, and highlight the importance of standardizing outcomes in clinical trials to improve comparability and practical relevance.Content. The review discusses modern therapeutic approaches for food allergy, such as oral, epicutaneous, and sublingual immunotherapies, which have shown positive results in achieving tolerance to allergens. Special attention is given to safety concerns, particularly for children, emphasizing the need for further research. The potential use of biological agents, such as omalizumab, in food allergy treatment is also explored. The review addresses challenges in choosing and standardizing endpoints in clinical trials, where most focus on desensitization and immunological markers, while patient-centered outcomes, such as quality of life, remain under-researched. The implementation of “core outcome sets” is highlighted as an important step toward improving data comparability and forming a more objective basis for clinical recommendations.Conclusions. The review emphasizes significant progress in food allergy treatment but notes the need for further research to ensure the safety of new therapies, particularly for children. Standardizing outcomes in clinical trials plays a key role in improving the quality and comparability of research, which will, in turn, help develop more effective clinical guidelines and improve patients’ quality of life.

B-044 Development and Evaluation of an Assay for the Detection of Human Total IgE in Serum on the Fully Automated Chemiluminescence Immunoassay Platform - Autolumo® 2000 Plus Analyzer

Abstract Background The escalating prevalence of allergic diseases on a global scale, affecting approximately 20% of the world’s population, has become a significant health concern. Clinical determination of total IgE in serum and plasma is used as an aid to the diagnosis of allergic diseases. The tIgE CLIA Microparticles Kit is a chemiluminescent microparticle immunoassay for the quantitative determination of total IgE concentrations in human serum. This kit, integrated with the AutoLumo® 2000 Plus Analyzer, offers an automated, cutting-edge platform for total IgE detection. This streamlined combination provides clinicians with a reliable tool for comprehensive and efficient allergic diseases diagnosis. Methods The performance of tIgE CLIA Microparticles Kit was evaluated on AutoLumo® A2000 Plus automated chemiluminescence analyzer and compared to a well-characterized platform (Elecsys IgE II on Cobas e601, Roche). This assay is based upon the two-step sandwich method. During detection, the patient sample and the anti-IgE coated microparticles solution were added sequentially. Unbound components were washed off after incubation. The formation of a complex occurred with the subsequent addition of a HRP conjugated anti-IgE antibody solution. The catalysis of chemiluminescent substrates by this complex generated a measurable light signal recorded as RLUs (Relative Light Units). A 2-point calibrator was used to analyze the tIgE antibody concentrations in the serum sample. The limit of blank (LoB), limit of detection (LoD), limit of quantitation (LoQ), accuracy, repeatability, linearity, specificity, on-board stability and real-time stability of the assay kit were evaluated. Serum samples (n=220) that had been previously well characterized were used for method comparisons. Results The tIgE CLIA Microparticles assay demonstrated a measurement range of 5-2500 IU/mL, with LoB, LoD, and LoQ values of ≤3 IU/mL, ≤4 IU/mL, and ≤5 IU/mL, respectively. The accuracy of the assay kit was assessed by trueness and precision following CLSI EP15-A2 and EP5-A2 guidelines. The trueness was evaluated using WHO IRP 11/234 as the reference standard, the estimate %bias between the expected and measured mean value was ≤5%. The average %CV of the intra-run and inter-run precision were 5.00% and 3.24% respectively, with a linearity of R≥0.990. The specificity to tIgE is evident, with no cross-reactivity to IgA, IgG, and IgM (≤100 μg/mL), and minimal interference from rheumatoid factor (RF) and anti-nuclear antibodies (ANA) (<10%). Furthermore, based on the CLSI EP7-A2 guideline, it showed no endogenous interference with bilirubin (30 mg/dL), hemoglobin (250 mg/dL), and triglycerides (3000 mg/dL) and no exogenous interferences with 14 commonly used allergy treatment drugs except Omalizumab (360μg/mL). Notably, the assay remains stable on-board for 28 days and exhibits real-time stability for up to 12 months at 2-8ᵒC. Clinical evaluation, involving 220 samples covering the linearity range of 5.0-2500 IU/mL, reveals a strong correlation (R>0.990) and the bias was within 15% when compared to a reference kit according to the CLSI EP9-A2 guideline. Conclusions Autolumo® Analyzers, in conjunction with the tIgE CLIA Microparticles Assay, presents a fully automated chemiluminescence immunoassay platform for accurate and cost-effective screening to aid allergic diseases diagnostics with excellent specificity, precision, and on-board stability.

Community and academic allergists’ perspectives on integrating biologics into food allergy care: A qualitative study

BackgroundBiologics are an important area of research and development, including for treatment of food allergy (FA). However, how allergists perceive the risks and benefits of biologics to treat FA remains largely unknown. ObjectiveTo explore how US-based allergists perceive the use of biologics in FA treatment. MethodsUsing a combination of purposive and snowball sampling, providers were recruited through direct solicitation by email to participate in a telephone or Zoom interview about their perceptions of the risks and benefits of current and future FA treatment options. Interviews were transcribed, deidentified, and coded to conduct a thematic analysis. ResultsWe conducted 60 interviews with providers from 34 states working either in community practice (53.3%) or academic medical centers (46.7%). Our sample was primarily non-Hispanic White (60.0%) and men (56.7%). The plurality was in their 40s (41.7%). Our findings clustered in the following 4 main themes: (1) perceived benefits of biologics, (2) ideal use of biologics, (3) concerns about biologics, and (4) biologics as the perceived future of FA. Community and academic providers had largely similar views, but academic providers more often emphasized the benefits of biologics, and community providers were, on the whole, more supportive of using biologics as an adjunct to oral immunotherapy rather than as monotherapy. ConclusionThis study indicates that providers hold mixed views about the use of biologics to treat FA. However, most were enthusiastic about prescribing biologics for FA while also being highly concerned about the cost to patients and the health care system.

An overview of hidden food allergens: need for change to the priority food allergen lists?

Many food allergens not actually included in the European priority list of allergenic foods have the potential to cause severe allergic reactions and could escape correct identification and behave as "hidden allergens". Moreover, the adoption in recent years of novel diets based on plant products and new sustainable foods or the use of specific food additives have contributed to the onset of new emerging allergens of public health importance. The knowledge of hidden allergens is important both for physicians and for patients to improve the prevention, diagnosis and treatment of food allergies, in order to decrease eventual improper diagnosis of idiopathic anaphylaxis. In this review, the characteristics of the most frequent hidden allergens and their diagnostic tools are described. A detailed history with a careful review of the ingredient lists, an understanding of possible cross-reactions or contaminations with other foods, together with an allergological evaluation consisting of in vivo or in vitro tests and, where necessary, an oral food challenge, are recommended for the successful identification of the culprit allergen. In future, it will be very important to implement these diagnostic tools, especially in the field of molecular allergology, and reporting allergens on labels should become mandatory.

Efficacy and tolerability of house dust mites subcutaneous immunotherapy with monomeric allergoid: an Italian multicenter study.

Background. Subcutaneous immunotherapy is an effective treatment of respiratory allergy and allergoids offer a treatment option characterized by reduced IgE-binding properties to improve the safety profile. Purpose of this study was to investigate the efficacy and the safety of an injective monomeric allergoid in patients with moderate to severe persistent allergic rhinitis due to house dust mites. Methods. in a perspective, controlled, observational study a suspension of 0.70 mL at 10 BU/mL containing a mixture of carbamylated extract of Dermatophagoides was injected monthly for 12 months, following a 5-weeks build-up phase (0.10-0.20-0.30-0.50-0.70 mL weekly), to 58 patients (mean age 25.1 ± 12.7). A matching group of 60 patients (mean age 34.0 ± 14.2) was observed as control, and both groups were allowed to assume standard pharmacotherapy. After one year, changes from baseline in visual analogue scale for symptoms and drugs intake were compared; satisfaction rate was based on patients' and physicians' judgements. Results. In respect to baseline both groups showed an improvement in symptoms with a significant difference in favor of immunotherapy. Drugs intake was significantly lower in patients receiving injections. High level of agreement was found between doctors and patients on their rate of satisfaction. No serious reactions occurred, and at least a mild episodic local or systemic reaction was reported by a limited number of patients. Conclusions. In routine practice injective monomeric allergoid of house dust mites was safe and associated with a perceived significant clinical benefit in persistent rhinitis shown by objective and subjective outcomes.

Cow's milk allergy treatment. An expert consensus

The treatment of cow's milk protein allergy is based on the complete elimination of cow's milk protein from the diet. To achieve remission of symptoms and future tolerance, exclusion must be total. In formula fed infants the extensively hydrolysed formula is the most appropriate option in mild or moderate forms, while those based on amino acids are reserved for the most severe cases. The treatment time, the acquisition of tolerance and the moment for the oral provocation test will vary according to the clinical picture, the immunological mechanism involved and the age of the patient. The aim of this consensus has been to reflect the updated knowledge together with the experience of neonatologists, pediatricians, experts in allergy, nutrition and gastroenterology.

Ovalbumin-induced food allergy suppression via regulatory T cell expansion mediated by a TNFR2 agonist in mice

Food allergies represent a growing health concern worldwide, characterized by abnormal immune responses to specific dietary antigens. This condition is often associated with a dysregulation of immune tolerance, especially within the intestinal mucosa. Regulatory T cells (Tregs), a crucial subset of lymphocytes, play a central role in maintaining peripheral immune tolerance and are abundant in the intestinal lamina propria. Recent studies have highlighted Treg dysfunction in patients with food allergies, suggesting a potential connection between impaired Treg function and allergy onset. Therefore, strategies to adequately control and activate Tregs could offer new avenues for the prevention and treatment of food allergies. Our research focuses on targeting the regulatory molecule, tumor necrosis factor receptor type 2 (TNFR2), a key modulator of Treg function. We have developed a TNFR2 agonist, scR2agoTNF-Fc, characterized by high TNFR2-stimulating activity and enhanced blood retention in vivo for Treg expansion. In this study, we utilized an ovalbumin (OVA)-induced food allergy mouse model to verify the therapeutic potential of scR2agoTNF-Fc in modulating allergic responses and restoring immune balance. The results showed that scR2agoTNF-Fc promoted the expansion of Treg population in vivo in mice. In addition, scR2agoTNF-Fc reduced diarrhea caused by the food allergy. This was consistent with the molecular mechanisms of suppression of blood immunoglobulins and Th2 cells. Therefore, it was shown that quantitative and functional enhancement of Tregs by the TNFR2 agonist, scR2agoTNF-Fc, may be effective in treating food allergies.

Allergen immunotherapy using recombinant Culicoides allergens improves clinical signs of equine insect bite hypersensitivity.

Insect bite hypersensitivity (IBH) is an IgE-mediated allergic dermatitis of horses caused by bites of Culicoides spp., sharing some common features with human atopic dermatitis. Allergen immunotherapy (AIT) using Culicoides whole-body extracts has limited efficacy. This study aimed to evaluate AIT with a pool of major Culicoides recombinant allergens in a prospective, double-blinded, placebo-controlled study. The IBH lesion score was assessed during a pre-treatment year and first treatment year (May-October) in 17 horses and in May and July of a second treatment year. Nine horses were immunized subcutaneously 3× with a combination of nine r-allergens (20 μg each/injection) in alum and monophosphoryl lipid A (MPLA). Eight horses received a placebo. The immunization was repeated twice the following year. The specific antibody response to one of the AIT Culicoides r-allergens was assessed. In the first treatment year, the decrease in average IBH lesion score was significantly larger in the AIT compared to the placebo group, with 67% of the AIT group and 25% of the placebo horses reaching >50% improvement of the average IBH lesion score. The response to the AIT was enhanced in the 2nd treatment year when 89% of the AIT vs. 14% of the placebo horses showed an improvement (p ≤ 0.01). IgG antibodies of all subclasses were induced, with IgG4/7 showing the most significant differences between groups. The post-AIT sera showed IgE blocking activity. AIT using only a few injections of small amounts of r-allergens in alum and MPLA as immunomodulators seems a promising approach for the treatment of insect bite allergy.

Allergies to Allergens from Cats and Dogs: A Review and Update on Sources, Pathogenesis, and Strategies

Inhalation allergies caused by cats and dogs can lead to a range of discomforting symptoms, such as rhinitis and asthma, in humans. With the increasing popularity of and care provided to these companion animals, the allergens they produce pose a growing threat to susceptible patients’ health. Allergens from cats and dogs have emerged as significant risk factors for triggering asthma and allergic rhinitis worldwide; however, there remains a lack of systematic measures aimed at assisting individuals in recognizing and preventing allergies caused by these animals. This review provides comprehensive insights into the classification of cat and dog allergens, along with their pathogenic mechanisms. This study also discusses implementation strategies for prevention and control measures, including physical methods, gene-editing technology, and immunological approaches, as well as potential strategies for enhancing allergen immunotherapy combined with immunoinformatics. Finally, it presents future prospects for the prevention and treatment of human allergies caused by cats and dogs. This review will improve knowledge regarding allergies to cats and dogs while providing insights into potential targets for the development of next-generation treatments.

Epicutaneous immunotherapy for the treatment of peanut allergy.

Peanut allergy treatment options remain limited, but novel approaches are being studied, including epicutaneous immunotherapy (EPIT). EPIT uses the cutaneous immune system to promote tolerance to food allergens. Viaskin™ Peanut, an approach to EPIT in late-stage clinical development uses an occlusive patch with a condensation chamber that enables natural epidermal water loss to solubilize dry antigen on the patch, which is then absorbed and captured by skin Langerhans cells. This form of EPIT does not require disruption of the skin barrier, thus avoiding a proinflammatory cytokine response by targeting the nonvascularized epidermis and limiting systemic allergen exposure. Extensive preclinical research suggests that Viaskin Peanut has a distinct mechanism of desensitization, including the potential for disease modification, driven by a unique population of regulatory T cells. Numerous clinical studies of Viaskin Peanut have demonstrated desensitization and reductions in reaction severity, particularly in children aged 1 through 11 years, as well as a favorable safety profile with mostly mild-to-moderate skin reactions that were observed to decrease over time. EPIT with Viaskin Peanut may be a potential therapeutic option for peanut allergy that is clinically practical with long-term efficacy and tolerability.

Design and Statistical Optimization of Fast-Dissolving Buccal Films of Doxylamine Succinate for Allergy Treatment

Design and Statistical Optimization of Fast-Dissolving Buccal Films of Doxylamine Succinate for Allergy Treatment

Peanut Allergy in Children-Is Prevention Better than Cure?

Peanut allergy, one of the most frequently occurring allergies, usually starts in childhood and rarely subsides-often persisting throughout adult life. Accidental exposure to peanuts can often result in adverse reactions ranging from mild to life-threatening, such as anaphylactic shock. Historically, food avoidance and the use of rescue drugs have remained a fundamental management mechanism for dealing with food allergy. However, prevention of adverse reactions to food allergy is playing an increasing role. This is possible through the early introduction of peanuts into the diet, especially in infants at risk of this allergy. In recent years, specific immunotherapy has been used to develop desensitisation and, in some patients, tolerance-defined as a persistent state of clinical non-reactivity to the allergen after therapy is finished. The aim of this article is to summarise the current state of knowledge on the prevention and treatment of peanut allergy, with a focus on clinical trials, current guidelines, and recent experimental studies. This review may be particularly useful for paediatricians and general practitioners.

Risk factors associated with the incidence of asthma among adolescents in Ukraine

Background. Asthma is a common disease among children and adolescents. The purpose of this study was to describe the detailed characteristics of adolescents with asthma, identify risk factors associated with the development of asthma and to evaluate medical care for patients with asthma. Materials and methods. Asthma patients (n = 80) aged 12 to 18 years from the Allergology Department of the Kyiv City Children’s Clinical Hospital 2, the clinical base of the Department of Pediatrics 2 of the Bogomolets National Medical University, were included in the study. The control group consisted of 120 children without asthma. In the group of interviewed children, asthma was diagnosed based on clinical data and objective measurement of lung function. All children underwent spirometry and skin prick test with aeroallergens. During the clinical examination, weight and height were measured, and body mass index was calculated. The survey was conducted by a research doctor using a Google form. Results. Parents of 80 children with asthma were involved in our survey between September 2023 and May 2024. Asthma occurred more often in boys than in girls: odds ratio (OR) = 7.3 (95% confidence interval (CI) 3.84–14.16, P < 0.0001). 31.25 % respondents reported a history of atopic dermatitis, 26.25 % had atopic dermatitis at the time of the study. Food allergy was detected in 25 % children. 48.75 % children had concomitant allergic rhinitis, of which 33.75 % had seasonal, 15 % had perennial. We found that children living in the city had asthma more often: OR = 7.3 (95% CI 3.26–16.62, P < 0.0001). Having an older sibling was associated with a lower risk of asthma: OR = 3.6 (95% CI 1.86–6.92, P < 0.0001). Also, we found that cat owners were significantly more likely not to have asthma: OR = 7.7 (95% CI 3.96–14.99, P < 0.0001). Such data are most likely related to the refusal to own a cat due to the prevalence of cat allergy among children with asthma or at risk of cat allergy. We have not found a statistically significant difference in the group of children with asthma and in the control group in relation to the exposure to tobacco smoke in the atmosphere (passive smoking): OR = 1.4 (95% CI 0.79–2.59, P > 0.05). Conclusions. Treatment of allergies and atopic conditions should be considered an important component of asthma treatment, which may affect the frequency and severity of the disease. In adolescents and adults, smoking cessation, in particular, as a factor in the impact of passive smoking on a sick child can also significantly reduce the number of hospitalizations. Confirming the diagnosis of asthma, demonstrating good inhaler technique, and emphasizing adherence to preventive therapies such as inhaled glucocorticosteroids can improve asthma control and reduce overreliance on short-acting bronchodilators.

Modern Approaches to the Diagnosis o Food Allergy in Children: Oral Food Challenges (Review)

The diagnosis of food allergies significantly impacts the lives of patients and their families, restricting diets and social activities. A misdiagnosis can lead to severe allergic reactions, making accurate diagnosis crucial. Immunoglobulin E (IgE)-mediated food allergies are diagnosed using skin tests or serum-specific IgE levels. However, for most allergens, the only reliable method for confirming the diagnosis remains the oral food challenge (OFC). Objective — elucidation of the importance of oral provocation tests in the diagnosis of food allergy and their relevance for the future treatment of food allergy. Materials and methods. A search for information on OFC was conducted in scientometric databases such as Web of Science, Scopus, Google Scholar, ScienceDirect and PubMed using the following keywords: «food allergy», «oral food challenge», «children». After reviewing the publications, professional sources that met the query criteria and were published between 2017 and 2024 were selected for the review. Results and discussion. OFCs help determine allergen sensitivity and reaction severity, which is useful for further management. They also have therapeutic value, reducing anxiety related to food allergies and improving quality of life. Psychological aspects play an important role in food allergies, as the fear of severe reactions often exceeds actual risks.One limitation of OFCs is the need for substantial resources and specialized knowledge, available only in specialized medical centers. This leads to long waiting lists and delays in food introduction, increasing the risk of developing allergies. Additionally, OFCs are often conducted in controlled environments, which may not reflect real-world accidental exposures.OFC results can include false positives, false negatives, and inconclusive outcomes. They are also time-consuming and may affect school or work attendance for patients and caregivers. It is essential to standar­dize doses for each food according to portion sizes and patient age. Conclusions. The frequency of food allergies is currently increasing in Ukraine, highlighting the need for allergists to master the technique and implement oral food challenges in general allergy practice to establish food allergies in children.

IgE versus IgG and IgA: Differential roles of allergen-specific antibodies in sensitization, tolerization, and treatment of allergies.

The prevalence of asthma, rhinitis, and food allergies has increased dramatically over the last few decades. This increase originally started in western countries, but is now also evident in many other regions of the world. Given the fact that the increase is so quick, the noted increase cannot be linked to a genetic effect, and many environmental factors have been identified that are associated with increased or reduced prevalence of allergies, like changing dietary habits, increased urbanization, pollution, exposure to microorganisms and LPS, and the farming environment and raw milk consumption. Although the key role of allergen-specific IgE in allergies is well known, the role of allergen-specific IgG and IgA antibodies is less well defined. This review will provide an overview of the functions of allergen-specific IgE in allergy, the role of allergen-specific antibodies (IgG (4) and IgA) in allergen immunotherapy (AIT), the possibility to use allergen-specific antibodies for treatment of ongoing allergies, and the potential role of allergen-specific antibodies in tolerance induction to allergens in a preventive setting. In the last, more speculative, section we will present novel hypotheses on the potential role of allergen-specific non-IgE antibodies in allergies by directing antigen presentation, Th2 development, and innate immune training.

Anaphylactic Reaction to Penicillin in Malaria-Infected Patients: A Case Study and Implications for Clinical Management

Malaria remains a significant global health challenge, often necessitating a combination of antimalarial and antibiotic treatments to manage both the primary infection and secondary bacterial complications. This review focuses on a critical case study involving a 35-year-old male with recurrent malaria who experienced a severe anaphylactic reaction to penicillin, highlighting the complex interplay between malaria management and drug allergies. The patient, already compromised by malaria, developed anaphylaxis shortly after receiving penicillin for a suspected bacterial infection. Despite immediate treatment, including epinephrine, antihistamines, and corticosteroids, the patient’s condition worsened due to the exacerbation of symptoms of malaria, leading to a fatal outcome. This case underscores the diagnostic and management challenges of drug allergies in malaria-infected patients, emphasizing the need for improved allergy assessment protocols, better training for healthcare providers, and enhanced patient education. The review advocates for the development of comprehensive allergy management strategies, improved allergy history documentation, and ongoing research to refine drug allergy testing and treatment protocols. Effective management of drug allergies, particularly in complex infection scenarios, is essential for optimizing patient safety and treatment efficacy. Keywords: Anaphylaxis, Penicillin Allergy, Malaria, Drug Reactions, Allergy Management, Clinical Protocols.

Characterization of the Immune-Modulating Properties of Different β-Glucans on Myeloid Dendritic Cells.

In allergen-specific immunotherapy, adjuvants are explored for modulating allergen-specific Th2 immune responses to re-establish clinical tolerance. One promising class of adjuvants are β-glucans, which are naturally derived sugar structures and components of dietary fibers that activate C-type lectin (CLR)-, "Toll"-like receptors (TLRs), and complement receptors (CRs). We characterized the immune-modulating properties of six commercially available β-glucans, using immunological (receptor activation, cytokine secretion, and T cell modulating potential) as well as metabolic parameters (metabolic state) in mouse bone marrow-derived myeloid dendritic cells (mDCs). All tested β-glucans activated the CLR Dectin-1a, whereas TLR2 was predominantly activated by Zymosan. Further, the tested β-glucans differentially induced mDC-derived cytokine secretion and activation of mDC metabolism. Subsequent analyses focusing on Zymosan, Zymosan depleted, β-1,3 glucan, and β-1,3 1,6 glucan revealed robust mDC activation with the upregulation of the cluster of differentiation 40 (CD40), CD80, CD86, and MHCII to different extents. β-glucan-induced cytokine secretion was shown to be, in part, dependent on the activation of the intracellular Dectin-1 adapter molecule Syk. In co-cultures of mDCs with Th2-biased CD4+ T cells isolated from birch allergen Bet v 1 plus aluminum hydroxide (Alum)-sensitized mice, these four β-glucans suppressed allergen-induced IL-5 secretion, while only Zymosan and β-1,3 glucan significantly suppressed allergen-induced interferon gamma (IFNγ) secretion, suggesting the tested β-glucans to have distinct effects on mDC T cell priming capacity. Our experiments indicate that β-glucans have distinct immune-modulating properties, making them interesting adjuvants for future allergy treatment.