A Systematic Review and Meta-Analysis on the Induction of Confirmed Eosinophilic Esophagitis as a Side Effect of Allergen Immunotherapy: An EAACI Task Force Report

Rossi CM, Terreehorst I, Apostolidou E et al. Allergy. 2025 Dec 16. doi: 10.1111/all.70183.

ABSTRACT

Risk of bias (RoB) domains for the randomized controlled trials (RCT)
on the development of eosinophilic esophagitis (EoE) after allergen
immunotherapy (AIT).

The European Academy of Allergy and Clinical Immunology (EAACI) established a Task Force to assess the existing data on the relationship between eosinophilic esophagitis (EoE) and allergen immunotherapy (AIT). This systematic review and meta-analysis aimed to study the incidence of confirmed EoE, developing as a side effect of AIT to food or airborne allergens, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 guidelines. The literature search was performed in three databases (PubMed, Embase and Scopus). Databases were searched from inception to March 31st, 2023. A total of 17 studies met the criteria for inclusion in the review.

Unravelling allergic rhinitis: exploring pathophysiology, advances in treatment, and future directions.

Singh AK, Shaili S, Siddiqui A et al. Front Allergy. 2025 Dec 4;6:1636415. doi: 10.3389/falgy.2025.1636415.

Abstract

The pathophysiology of AR results in typical examination findings 
(A) the allergic salute. (B) Allergic shiners. (C) Dennie-Morgan lines.
 (D) Facial grimacing or twitching. This is related to nasal itching. 
(E) Nasal creasing related to the allergic salute. (F) Allergic facies. 
(G) Typical nasal mucosa.

Allergic rhinitis (AR) is a complex, multifactorial condition that continues to pose significant clinical and public health challenges, despite the availability of established therapeutic strategies. It significantly contributes to a lower quality of life by causing sleep issues, mental fatigue, and a decline in productivity. A thorough grasp of AR is crucial to enhancing diagnosis and treatment results because of its pervasive effects and ongoing management gaps. This review covers a wide range of topics, such as classification schemes, historical perception, and physical consequences of AR.

Comparative efficacy of omalizumab, dupilumab, and remibrutinib in chronic spontaneous urticaria: a network meta-analysis of randomized control trials

Xiong G, Rayner DG, Kim L et al. J Dermatolog Treat. 2025 Dec;36(1):2580374. doi: 10.1080/09546634.2025.2580374.

Abstract
Introduction

Chronic spontaneous urticaria (CSU) is a skin condition that significantly impairs quality of life. While omalizumab remains the standard treatment for patients who have failed antihistamines, emerging therapies show promise in randomized control trials (RCTs). This study aims to compare the relative efficacy of omalizumab, dupilumab, and remibrutinib in CSU.

Methods
Four databases were searched for RCTs evaluating omalizumab (75/150/300 mg Q4W), dupilumab (300 mg Q2W), or remibrutinib (25 mg BID) in CSU. Urticaria Activity Score (UAS7), Itch Severity Score (ISS7), Dermatology Life Quality Index (DLQI; DLQI 0/1), disease control (UAS7 ≤ 6), and symptom remission (UAS7 = 0) were assessed at weeks 12/24. Frequentist random-effects network meta-analysis were conducted in R.

Results

Forest plot depicting reduction in UAS7 compared to placebo
at week 12 of dupilumab 300 mg biweekly, omalizumab 300 mg,
150 mg, or 75 mg every four weeks, and remibrutinib 25 mg
twice daily.

Fifteen studies (4,913 patients) were included. Omalizumab 300 mg demonstrated the greatest efficacy in UAS7, ISS7, symptom remission, and disease control at both timepoints. Remibrutinib showed the greatest DLQI improvement and second-highest UAS7 reduction and odds of symptom remission.

A retrospective cohort study on the association between allergic rhinitis, sublingual immunotherapy, and COVID-19 symptomatology

Zhang, YY., Lu, MP., Chen, YB. et al. Sci Rep (2025). https://doi.org/10.1038/s41598-025-31902-5

Abstract

The impacts of allergic rhinitis (AR) and allergen-specific sublingual immunotherapy (SLIT) on coronavirus disease 2019 (COVID-19) have not been fully understood. Therefore, the aim of this study was to investigate the effects of AR and SLIT on symptoms of COVID-19 within one month after Chinese authorities adjusted their COVID-19 response measures. The study enrolled 1368 participants, including 746 AR patients and 622 controls without allergic diseases. SLIT was administered to 122 infected AR patients (AR with SLIT group), while it was not administered to the other 483 infected AR patients (AR without SLIT group). Patients’ outcomes were compared after propensity score matching (PSM). The data showed that AR played a dual role in COVID-19, acting as both a protective factor against respiratory symptoms and a risk factor increasing the likelihood of olfactory/gustatory dysfunctions and fever, compared to non-allergic individuals.

Nirsevimab vs RSVpreF Vaccine for Respiratory Syncytial Virus–Related Hospitalization in Newborns

Jabagi M, Bertrand M, Gabet A et al.  JAMA. Published online December 22, 2025. doi:10.1001/jama.2025.24082

Key Points

• Question  How does maternal vaccination with the respiratory syncytial virus prefusion F protein (RSVpreF) vaccine compare with passive infant immunization with nirsevimab for the prevention of RSV-related hospitalization?
• Findings  In this French nationwide study, infant immunization with nirsevimab was associated with a lower risk of RSV-related hospitalization compared with maternal vaccination with the RSVpreF vaccine (hazard ratio, 0.74). The risk of severe outcomes, including admission to the pediatric intensive care unit and requiring ventilator support or oxygen therapy, was also lower.
• Meaning  Compared with maternal vaccination with the RSVpreF vaccine during the first RSV season in France, infant immunization with nirsevimab was associated with a lower risk of RSV-related hospitalization.

Abstract

Importance  Respiratory syncytial virus (RSV) is a leading cause of hospitalization in infants. The comparative effectiveness of 2 recently introduced preventive strategies (infant immunization through placental antibody transfer after maternal vaccination with the RSV prefusion F protein [RSVpreF] vaccine and passive infant immunization with nirsevimab) remains unknown.

Objective  To compare the associations of maternal vaccination with the RSVpreF vaccine vs passive infant immunization with nirsevimab for the prevention of RSV-related hospitalization.

Design, Setting, and Participants  This population-based cohort study used data from the French National Health Data System. Maternal vaccination with the RSVpreF vaccine occurred during 32 to 36 weeks’ gestation among infants born in mainland France between September 1 and December 31, 2024. Passive infant immunization with nirsevimab occurred prior to hospital discharge. Infants were matched 1:1 by maternity ward discharge date, sex, gestational age, and region. Follow-up ended at the time of RSV hospitalization or death or on February 28, 2025.

Exposures  Maternal immunization with the RSVpreF vaccine and passive infant immunization with nirsevimab.

Main Outcomes and Measures  The primary outcome was hospitalization for RSV-associated lower respiratory tract infection. The secondary outcomes included admission to the pediatric intensive care unit (PICU), admission to high-dependency unit, ventilator support, and oxygen therapy. The hazard ratios (HRs) were estimated using conditional Cox proportional hazards models with inverse probability of treatment weighting.

Comparative Analysis for Primary Outcome of Hospitalization
for Respiratory Syncytial Virus (RSV)–Associated Lower Respiratory
Tract Infection and Secondary Outcomes Among Matched Infants

Results  A total of 42 560 infants (mean age, 3.7 [SD, 1.4] days; 51.7% male) were included in the study (21 280 per group) with a median follow-up of 84 days (IQR, 70-99 days). Of the 481 hospitalizations for RSV-associated lower respiratory tract infection, 212 (44.1%) occurred in the nirsevimab group vs 269 (55.9%) in the RSVpreF vaccine group (between-group difference, −11.8% [95% CI, −18.1% to −5.5%]).

Association between yellow dust, PM2.5, and hay fever: A large-scale crowdsourced observational study using the AllerSearch smartphone application

Nagino K, Inomata T, Ebihara N et al. Allergol Int. 2025 Dec 16:S1323-8930(25)00127-3. doi: 10.1016/j.alit.2025.11.008.

Abstract

Background

This large-scale crowdsourced observational study investigated the association between yellow dust, particulate matter 2.5 (PM2.5), and hay fever symptoms using the AllerSearch smartphone application.

Methods

Participants with hay fever were divided into four groups based on combinations of high and low pollen and PM2.5/yellow dust dispersion levels. Nine hay fever symptom scores and quality of life (QoL) scores were compared among the groups. Multivariate analysis evaluated independent associations between pollen and PM2.5/yellow dust dispersion levels and hay fever symptom and QoL scores. Risk factors for individuals experiencing worsening hay fever symptoms during PM2.5/yellow dust dispersion were evaluated using multivariate logistic regression analysis.

Results

Heatmaps showing the distribution of the number of participants,
pollen dispersion levels, and PM2.5/yellow dust dispersion levels
 by prefecture in Japan from February to May.

This analysis included 6468 participants. All hay fever symptom scores except “ear and/or mouth itching,” and all QoL scores were significantly higher in the “low pollen and moderate-to-high PM2.5/yellow dust” group versus the “low pollen and low PM2.5/yellow dust” group.

Aspergillus fumigatus sensitization is associated with high-risk bronchiectasis

Tiew PY, Narayana JK, Jaggi TK et al.  Chest. 2025 Dec 10:S0012-3692(25)05826-X. doi: 10.1016/j.chest.2025.12.001. 

Abstract

Background: Fungal sensitization is an increasingly recognized endophenotype in chronic respiratory disease, however, its role in bronchiectasis remains poorly defined. This study aims to provide the most comprehensive evaluation to date of fungal sensitization and its clinical relevance in bronchiectasis using an expanded panel of crude and recombinant fungal allergens.

Research question: What is the prevalence and clinical implications of fungal sensitization in bronchiectasis?

Study design and methods: We conducted an international, multi-centre evaluation of fungal sensitization across six tertiary centres in four countries (Singapore, Malaysia, United Kingdom and Italy) prospectively recruiting N=277 individuals with bronchiectasis. Using a comprehensive, expanded allergen panel including 11 crude and 24 recombinant fungal allergens (total: 35 allergens and 9,695 individual assays), we assessed sensitization responses in relation to clinical characteristics, exacerbation frequency and geographic origin. Low baseline exacerbations is defined as < 3, and high as ≥ 3 in the preceding 12 months of study recruitment.

Polysensitization to recombinant Aspergillus fumigatus (rAsp f)
12, 15 and 17 associates with 587 increased severe
(hospitalized) exacerbations in bronchiectasis. 

Results: Sensitization to recombinant Aspergillus fumigatus (rAsp f) links to bronchiectasis severity. Measurable responses to rAsp f allergens 12, 15, and 17 associates with severe (hospitalized) exacerbations. particularly in those with low baseline exacerbations (low-risk) .

Cardiovascular Events 1 Year After Respiratory Syncytial Virus Infection in Adults

Hviid A, Fischer TK, Biering-Sørensen T, Bech Svalgaard I.  JAMA Netw Open. 2025;8(12):e2547618. doi:10.1001/jamanetworkopen.2025.47618

Key Points

Question  Is respiratory syncytial virus (RSV) infection in adults aged 45 years or older associated with an increased risk of cardiovascular events beyond the immediate acute phase?

Findings  In this cohort study in 17 494 matched patients with and without RSV infection, RSV infection was associated with 4.69 additional cardiovascular events for every 100 older individuals with infection in the year following RSV infection.

Meaning  These findings suggest that public health measures, such as vaccination, may prevent not only acute respiratory disease but also cardiovascular disease.

Abstract

Importance  Respiratory syncytial virus (RSV) infection has recently been recognized as common among adults, but data on the burden of cardiovascular disease (CVD) beyond the immediate acute phase are lacking.