Efficacy and safety of Depemokimab in asthma with eosinophilic phenotype: a systematic review and meta-analysis of randomized controlled trials

Gill, B.A., Ijaz, A., Fatima, N. et al. BMC Immunol (2025). https://doi.org/10.1186/s12865-025-00777-6

Abstract

Introduction

Asthma is a complex and heterogeneous disease that significantly impacts quality of life. Eosinophilic asthma, characterized by elevated eosinophil levels, leads to inflammation and hypersensitivity. Many patients remain inadequately managed, resulting in frequent exacerbations and hospitalizations despite standard treatment options. Depemokimab, a long-acting monoclonal antibody that targets IL-5, could offer a novel approach for managing severe eosinophilic asthma.

Methods

A systematic search was conducted across the PubMed, Cochrane Library, Embase, ClinicalTrials.gov, and Scopus databases up to January 2025.

Allergic Rhinitis and Its Impact on Asthma (ARIA)-EAACI Guidelines—2024–2025 Revision: Part I—Guidelines on Intranasal Treatments

B. Sousa-Pinto, J. Bousquet, R. J. Vieira, et al. Allergy (2025): 1–23, https://doi.org/10.1111/all.70131.

ABSTRACT

Background

Allergic rhinitis (AR) impacts quality of life, work and school productivity. Over the last years, an important body of evidence resulting from mHealth data has led to a better understanding of AR. Such advances have motivated an EAACI-endorsed update of the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines (ARIA 2024–2025). This manuscript presents the ARIA 2024–2025 recommendations for intranasal treatments, one of the mainstays for AR management.

Methods

The ARIA 2024–2025 guideline panel issued recommendations following the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) evidence-to-decision framework.

Evaluation of the Quality and Reliability of ChatGPT-4's Responses on Allergen Immunotherapy Using Validated Instruments for Health Information Quality Assessment

Cherrez-Ojeda I, Zuberbier T, Rodas-Valero G, Sanchez J, Rudenko M, Dramburg S, Demoly P, Caimmi D, Gómez RM, Ramon GD, Fouda GE, Quimby KR, Chong-Neto H, Llosa OC, Larco JI, Monge Ortega OP, Faytong-Haro M, Pfaar O, Bousquet J, Robles-Velasco K.  Clin Transl Allergy. 2025 Dec;15(12):e70130. doi: 10.1002/clt2.70130.

ABSTRACT

Background

Chat Generative Pre-Trained Transformer 4 (ChatGPT-4) represents an advancing large language model (LLM) with potential applications in medical education and patient care. While Allergen Immunotherapy (AIT) can change the course of allergic diseases, it can also bring uncertainty to patients, who turn to readily available resources such as ChatGPT-4 to address these doubts. This study aimed to use validated tools to evaluate the information provided by ChatGPT-4 regarding AIT in terms of quality, reliability, and readability.

Methods

In accordance with EAACI clinical guidelines about AIT, 24 questions were selected and introduced in ChatGPT-4. Independent reviewers evaluated ChatGPT-4 responses using three validated tools: the DISCERN instrument (quality), JAMA Benchmark criteria (reliability), and Flesch-Kincaid Readability Tests (readability).

Emerging Role and Function of Th9 Cells in Allergic Inflammation

Kaminuma O, Kitamura N, Gotoh M.  J Inflamm Res. 2025 Nov 22;18:16385-16397. doi: 10.2147/JIR.S546234.

Abstract: 

Th9 cells have emerged as pivotal orchestrators of allergic inflammation across the airway, skin, and nasal mucosa, constituting a mechanistically distinct axis beyond canonical Th2 immunity. This review specifically highlights: (i) the Th9 axis as a unifying driver in asthma, atopic dermatitis, and allergic rhinitis; (ii) key mechanistic programs, including signal transducer and activator of transcription (STAT) 5/STAT6 licensing of the IL9 locus, peroxisome proliferator-activated receptor (PPAR) γ-mammalian target of rapamycin complex (mTORC) 1 metabolic wiring, and the IL-9-monocarboxylate transporter (MCT) 1 feedback loop; (iii) organ-level phenotypes such as eosinophil-independent bronchial hyperresponsiveness (BHR) and variable steroid responsiveness; and (iv) therapeutic implications, including biomarker-guided endotyping, Janus kinase (JAK) inhibition, TNF-like ligand (TL) 1A/death receptor (DR) 3 blockade, and metabolic or airway smooth muscle (ASM) tone modulation. Differentiating under the combined influence of interleukin (IL)‑4 and tumor growth factor (TGF)-β, Th9 cells secrete IL‑9, a pleiotropic cytokine that drives mast‑cell proliferation, goblet cell metaplasia, and airway remodeling. Their transcriptional program is epigenetically licensed by STAT5/STAT6, which opens chromatin at the IL9 locus and is metabolically sustained by a PPARγ-mechanistic/mTORC1-dependent glycolytic state. This bioenergetic wiring establishes an IL‑9-MCT1 feedback loop that reinforces effector function and durability. 

Th9 Axis Across Allergic Diseases: Pathobiology,
Biomarkers, and Therapeutic Implications

Clinically, Th9 signatures align with BHR, which can be eosinophil-independent and variably responsive to inhaled corticosteroids; experimental models further demonstrate that Th9‑mediated BHR persists in eosinophil-deficient contexts and displays relative glucocorticoid resistance.

Pediatric anaphylaxis: age-related symptom trends and the limited role of allergen molecules: a retrospective analysis

Kucharek, I., Przystał-Dyszyński, K., Godyńska, A. et al. Allergy Asthma Clin Immunol (2025). https://doi.org/10.1186/s13223-025-01000-2

Abstract

Background

Emerging evidence suggests that specific allergen molecules may influence the clinical phenotype of anaphylaxis in children, but robust data are scarce. This study aimed to rigorously test the molecule-phenotype association in a large pediatric cohort and to determine the relative influence of the sensitizing molecule versus patient age on symptom presentation.

Methods

A retrospective analysis was conducted on 184 pediatric patients (0–18 years) hospitalized for anaphylaxis. Molecular allergen-specific immunoglobulin E (IgE) profiles were determined using the ALEX2 test. Symptom frequencies across different organ systems were analyzed in relation to allergen molecules and age groups using Cochran’s Q and Pearson’s χ2 tests.

Results

The most frequent molecular triggers were Ara h 2 (18.79%), Gal d 1 (9.09%), and Ana o 3 (9.09%). While significant differences in symptom distribution were observed within individual allergen molecules (p < 0.05), no molecule-specific symptom pattern was identified.

Trimethoprim-Sulfamethoxazole and Acute Respiratory Failure in Adolescents and Young Adults

Ahmadi F, McArthur E, Garcia-Bournissen F et al.  JAMA Netw Open. 2025;8(11):e2545251. doi:10.1001/jamanetworkopen.2025.45251

Key Points

Question  Is the use of trimethoprim-sulfamethoxazole (TMP-SMX) associated with an increased 30-day risk of hospital visits for acute respiratory failure among healthy adolescents and young adults compared with amoxicillin or cephalosporins?

Findings  In this cohort study of adolescents and young adults aged 10 to younger than 25 years in Ontario, Canada, initiation of TMP-SMX was associated with a significantly higher 30-day risk of a hospital visit for acute respiratory failure compared with amoxicillin and cephalosporins. The absolute risk increase was small (0.02%) but consistent across sensitivity analyses.

Meaning  These findings support the US Food and Drug Administration’s warning regarding the risk of acute respiratory failure with TMP-SMX in healthy adolescents and young adults, and clinicians and regulators should carefully weigh this risk when prescribing TMP-SMX and consider updates to prescribing guidelines and product labeling.

Abstract

Importance  The US Food and Drug Administration (FDA) has issued a warning and a label change regarding a potential association between trimethoprim-sulfamethoxazole (TMP-SMX) and acute respiratory failure in healthy adolescents and young adults.

Clinical outcomes after switching from omalizumab to anti-IL-5/IL-5R biologics in severe asthma: a retrospective cohort study

Akkuş, F.A., Çölkesen, F., Önalan, T. et al. BMC Pulm Med (2025). https://doi.org/10.1186/s12890-025-04044-7

Abstract

Background

Severe asthma (SA) is a heterogeneous disease composed of various clinical phenotypes, and criteria for selecting the most appropriate biological agent remain unclear. Therefore, when optimal control cannot be achieved with the initial biological therapy, switching between biological drugs is often performed.

Methods

This real-world study evaluated patients with severe asthma who initiated omalizumab treatment. Based on their treatment response, patients were divided into two groups: those who continued omalizumab and those who switched to mepolizumab or benralizumab. Clinical data were evaluated before biological treatment, after omalizumab therapy, and following the second biological therapy. Additionally, factors influencing the decision to switch and the effectiveness of the switch were analyzed.

Results

Of the total 51 patients, 45.1% (n = 23) switched to a second biological agent due to inadequate response to the initial treatment.

Comparative efficacy and safety of biologics and systemic immunomodulatory treatments for chronic urticaria: Systematic review and network meta-analysis

Chu AWL, Oykhman P, Chu X et al.  J Allergy Clin Immunol. 2025 Oct;156(4):1008-1023. doi: 10.1016/j.jaci.2025.06.004.

Abstract

Background

Chronic urticaria is a common skin condition characterized by itchy wheals (hives), angioedema, or both, lasting for 6 weeks or more. Beyond antihistamines, multiple systemic treatments are available, but there is uncertainty regarding their comparative effects on chronic urticaria outcomes.

Objective

We systematically synthesized the comparative benefits and harms of systemic treatments for chronic urticaria.

Methods

As part of updating the AAAAI/ACAAI JTFPP chronic urticaria guidelines, we searched Medline, Embase, Central, Chinese Biomedical Databases (CBM), China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), and Wanfang from inception to February 4, 2025, for randomized trials addressing systemic immunomodulatory treatments, including phototherapy, for chronic urticaria.