Pharmacokinetics and pharmacodynamics of neffy, epinephrine nasal spray, in pediatric allergy patients

Fleischer DM, Li HH, Talreja N et al. J Allergy Clin Immunol Pract. 2025 Mar 20:S2213-2198(25)00269-7. doi: 10.1016/j.jaip.2025.03.019.

Abstract

Background: Epinephrine is the gold-standard treatment for severe allergic reactions, including anaphylaxis and is typically administered via intramuscular injection. Despite epinephrine's well-documented safety and efficacy, patients may be hesitant to administer/receive injections, thereby increasing the risk of complications. neffy epinephrine nasal spray was developed to provide an additional option that may reduce dosing hesitancy.

Objective: This study was conducted to characterize neffy's pharmacokinetic and pharmacodynamic profiles in pediatric subjects, and to compare profiles between pediatric and adult subjects.

Hidden in plain sight: the impact of human rhinovirus infection in adults

Morelli, T., Freeman, A., Staples, K.J. et al. Respir Res 26, 120 (2025). https://doi.org/10.1186/s12931-025-03178-w

Abstract

Background

Impact of rhinovirus infection in adults

Human rhinovirus (HRV), a non-enveloped RNA virus, was first identified more than 70 years ago. It is highly infectious and easily transmitted through aerosols and direct contact. The advent of multiplex PCR has enhanced the detection of a diverse range of respiratory viruses, and HRV consistently ranks among the most prevalent respiratory pathogens globally. Circulation occurs throughout the year, with peak incidence in autumn and spring in temperate climates. Remarkably, during the SARS-CoV-2 pandemic, HRV transmission persisted, demonstrating its resistance to stringent public health measures aimed at curbing viral transmission.

Combination therapy blocking TNF superfamily members 14 and 15 reverses pulmonary fibrosis

Hope Steele, Ashley Willicut, Garrison Dell, Andrew Ghastine, Xinh-Xinh Nguyen, Paul Lembicz, Hailey Doerflein, Therese Suchoski, Elizabeth Kato, Carol Feghali-Bostwick, Michael Croft, Rana Herro, The Journal of Immunology, 2025;, vkaf002, https://doi.org/10.1093/jimmun/vkaf002

Abstract

Blocking LIGHT and TL1A in vivo protects against acute bleomycin-induced PF. 

Currently, anti-inflammatory drugs fail to reduce pulmonary fibrosis and tissue remodeling in the clinic. Thus, there is an unmet need to develop novel antifibrotic drugs capable of reversing disease. Our lab has identified two novel mediators of pulmonary fibrosis belonging to the tumor necrosis factor superfamily (TNFSF), LIGHT (TNFSF14) and TL1A (TNFSF15). Aside from their inflammatory roles, LIGHT and TL1A can directly activate structural cells involved in fibrosis, which express their receptors.

Hereditary Angioedema with Normal C1 Inhibitor: an Updated International Consensus Paper on Diagnosis, Pathophysiology, and Treatment

Zuraw, B.L., Bork, K., Bouillet, L. et al. Clinic Rev Allerg Immunol 68, 24 (2025). https://doi.org/10.1007/s12016-025-09027-4

Abstract

Hereditary angioedema (HAE) has been recognized for almost 150 years. The newest form of HAE, where C1 inhibitor levels are normal (HAE-nC1INH), was first described in 2000. Over the last two decades, new types of apparent non-mast cell–mediated angioedema with normal quantity and activity of C1INH have been described, in some cases with proven genetic pathogenic variants that co-segregate with angioedema expression within families. Like HAE due to C1INH deficiency, HAE-nC1INH patients are at risk of serious morbidity and mortality. Therefore, proactive management and treatment of HAE-nC1INH patients after an expert physician diagnosis is critically important.

Serum MRGPRX2 and substance P levels are biomarkers of disease activity rather than an antihistamine response in chronic spontaneous urticaria

Cuc, N.T.K., Minh, V.N., Lan, P.T. et al.  Sci Rep 15, 10014 (2025). https://doi.org/10.1038/s41598-025-94841-1

Abstract

In chronic spontaneous urticaria (CSU), the role of Mas-related G protein-coupled receptor X2 (MRGPRX2) and substance P (SP) as biomarkers of disease severity and the antihistamine response remains unclear. The study aims to examine the correlations between serum MRGPRX2 and SP levels, disease severity, and antihistamine response in patients with CSU. This study included 120 CSU patients and 30 healthy controls. Based on the Urticaria Activity Score over 7 days (UAS7), the patients with CSU were divided into two categories: severe (UAS7 ≥ 28) and non-severe (UAS7 < 28). Severe CSU patients received 20 mg of bilastine, titrated up to 80 mg based on Urticaria Control Test (UCT) results at days 15, 30, and 60. Serum MRGPRX2 and SP levels were measured at baseline for all participants and after two months in severe CSU patients.

Serum MRGPRX2 and SP concentrations between severe,
non-severe CSU and controls
(Kruskal-Wallis test with Dunn’s multiple comparison test). 

The Kruskal-Wallis test and Dunn’s corrections were used to examine differences in multiple comparisons.

Urticaria-Like Hypersensitivity Reaction Following Botulinum Toxin Injection: A Case Report of Possible Interaction with β-Lactam Antibiotics

Feng W, Liu H. Int Med Case Rep J. 2025;18:367-371 https://doi.org/10.2147/IMCRJ.S510203

Abstract: 

After injection, urticaria-like manifestations occurred on the
upper face, with redness, swelling, and wheal formation.

Botulinum toxin serotype A (BTX-A) is commonly used for treating facial dynamic wrinkles. The clinical safety of BTX-A has been proven, and it has few side effects; despite this, BTX-A has the potential to cause an allergic reaction. This case raises concerns about a possible interaction between botulinum toxin serotype A (CBTX-A) and β-lactam antibiotics, contributing to the limited literature on hypersensitivity reactions.

Comparative Evaluation of an Allergen Exposure Chamber and Nasal Allergen Challenge Versus In-Field Symptom Assessment in Patients With Allergic Rhinitis Triggered by Timothy Grass Pollen

Zemelka-Wiacek, M., Kosowska, A., Pfaar, O., Agache, I., Kujawa, K. and Jutel, M. (2025) Allergy. https://doi.org/10.1111/all.16518

ABSTRACT

Background

An allergen exposure chamber (AEC) is a specialized medical facility designed to expose individuals to allergens at precise and consistent concentrations within a controlled environment. This study aimed to correlate the assessment of clinical endpoints in patients with allergic rhinitis sensitized to timothy grass pollen (Phleum pratense) by comparing three different methods: AEC, nasal allergen challenge (NAC), and symptoms during natural exposure during the grass pollen season.

Methods

Fifteen allergic subjects and twelve healthy controls were evaluated in the ALLEC AEC; allergic symptoms were measured by subjective and objective methods, including total nasal symptom score (TNSS), acoustic rhinometry (AcR), peak nasal inspiratory flow (PNIF), and nasal discharge amount.

Maternal supplementation with α-tocopherol inhibits the development of offspring food allergy, H1R signaling and ultimately anaphylaxis early in life

Allison E Kosins, Haoran Gao, Ross L Blankenship, Lauren N Emmerson, Joel A Ochoa, Joan M Cook-Mills, The Journal of Immunology, Volume 214, Issue 2, February 2025, Pages 199–210, https://doi.org/10.1093/jimmun/vkae041

Abstract

Food allergy has had a rapid rise in prevalence, and thus it is important to identify approaches to limit the development of food allergy early in life. Because maternal dietary supplementation with α-tocopherol (α-T), an isoform of vitamin E, during pregnancy and nursing increases neonate plasma levels of α-T and can limit neonate development of other allergies, we hypothesized that α-T can limit development of food allergy. To assess this, male mice with mutations in their skin barrier genes (FT−/− mice) were mated with wild-type females that received a diet supplemented with α-tocopherol or a control diet. Starting at postnatal day 3, these FT+/− pups were sensitized 4 to 5 times over 2.5 weeks by skin co-exposure to the food allergen peanut extract (PNE) and the environmental allergen Alternaria alternata (Alt). Control pups were exposed to saline, PNE only or Alt only. Supplementation with α-T blocked Alt+PNE sensitization (anti-PNE-specific IgE), without blocking Alt+PNE-stimulated skin IL33, Areg, OSM, CCL11, TSLP or plasma MCPT1.