Allergic Rhinitis and Its Impact on Asthma (ARIA)-EAACI Guidelines-2024-2025 Revision: Part II-Guidelines on Oral and Ocular Treatments

Vieira RJ, Sousa-Pinto B, Bousquet J et al.  Allergy. 2026 Mar 24. doi: 10.1111/all.70305. 

Abstract

Background: Oral and ocular medications are frequently used in the treatment of allergic rhinitis (AR). As part of the update of the Allergic Rhinitis and its Impact on Asthma (ARIA)-EAACI guidelines, this manuscript presents the ARIA-EAACI 2024-2025 recommendations for oral and ocular treatments.

Methods: The ARIA-EAACI 2024-2025 guideline panel issued recommendations following the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) evidence-to-decision framework. Several sources of evidence were used to inform panel judgements and recommendations, including systematic reviews, mHealth and pharmacovigilance data as well as a survey on costs.

Comparison of the recommendations on oral and ocular treatments
of the ARIA 2024–2025 and of the ARIA 2010/2016 guidelines.

Results: Eight guideline questions concerning oral treatments for AR and three questions concerning ocular treatments were addressed. These questions led to the recommendations. Overall, these questions concern the choice between different classes of medication.

Feasibility and efficacy of nasal rehabilitation on nasal symptoms in patients with chronic allergic rhinitis: A pilot study

Tendulkar S, Venkatesan P, Mysore S, Lakshmi R V.  J Allergy Clin Immunol Glob. 2026 Feb 17;5(3):100674. doi: 10.1016/j.jacig.2026.100674. 

Abstract

Background

Chronic allergic rhinitis (CAR) is a highly prevalent condition characterized by nasal symptoms and mouth breathing. The detrimental effects of frequent pharmacologic treatment necessitate a nonpharmacologic treatment approach for patients with CAR.

Objective

We sought to assess the feasibility, acceptability, safety, and preliminary effects of a nasal rehabilitation program in patients with CAR.

Methods

A pilot study was conducted with 35 patients who underwent a nasal rehabilitation program for 5 weeks. The feasibility of the intervention from patient and therapist perspectives, adherence to the treatment, and occurrence of adverse events was recorded posttreatment. The preliminary effects of the treatment on nasal and mouth-breathing symptoms and disease-specific quality of life were assessed at baseline and after 5 weeks of treatment.

Results

Effect of 5 weeks of nasal rehabilitation treatment. 
A, Amount of change (mean ± SD) in TNSS, NOSE, and RQLQ outcomes. 
B, Amount of change (mean ± SD) in subdomains of RQLQ outcome.

An adherence of 92.5% was observed for the treatment. The nasal rehabilitation techniques were feasible for patients and the therapist without any adverse events.

Cost-Effectiveness of Oral Immunotherapy Treatments vs No Treatment for Peanut Allergy in Children

Huang L, Lloyd M, Franz A et al. JAMA Netw Open. 2026 Mar 2;9(3):e262410. doi: 10.1001/jamanetworkopen.2026.2410. 

Key Points

Question  Are oral immunotherapy (OIT) treatments cost-effective for managing peanut allergy in children?

Findings  This economic evaluation conducted alongside a clinical trial involving 201 children found that both probiotic peanut OIT (PPOIT) and peanut OIT were cost-effective compared with no treatment when remission was the effectiveness outcome. When effectiveness was assessed using quality-adjusted life years, PPOIT offered the best value.

Meaning  These findings suggest that PPOIT and OIT present good value compared with no treatment for achieving remission.

Abstract

Importance  The first peanut oral immunotherapy (OIT) for children was approved by the US Food and Drug Administration (FDA) in 2020.

Recommended Vaccines for Immunocompetent Older Adults: Work Group Report of the AAAAI Allergy and Asthma in Older Adults Committee

 

Slimovitch J, Lockey RF, Arroyo AC et al.  J Allergy Clin Immunol Pract. 2026 Mar 12:S2213-2198(26)00123-6. doi: 10.1016/j.jaip.2025.09.040.

Abstract

Adults 65 years or older are more susceptible to infectious diseases, representing a significant public health concern worldwide. Although newer vaccines have been developed for older adults, confusion over frequently changing guidelines often contributes to vaccine hesitancy and low vaccination rates. An American Academy of Allergy, Asthma & Immunology work group was convened to provide a clearer summary of these guidelines from the Advisory Committee on Immunization Practices and the Centers for Disease Control and Prevention. This article reviews the epidemiology and pathology of key infectious diseases in older adults, the mechanism of action of the vaccines targeting these diseases, commercially available vaccines, their potential side effects, and current vaccination recommendations for adults 65 years or older.

Desensitisation to cow’s milk, following partially or extensively hydrolysed formulae feeding regimens, in infants with allergy to cow’s milk: the DREAM RCT Synopsis (The DREAM study)

Guibas G, Brayshaw E, Brown M et al.   Efficacy Mech Eval 2026. https://doi.org/10.3310/GJGG7715

Background

Immunoglobulin E-mediated (immediate) cow’s milk allergy is one of the most frequent food allergies in infants, with a significant adverse impact on quality of life. There is no satisfactory treatment for cow’s milk allergy, and guidelines recommend milk avoidance, feeding with ‘hypoallergenic’ formulas (extensively hydrolysed formulas), emergency management of accidental reactions and waiting for the allergy to resolve spontaneously. Currently, the only potentially curative regimen is oral immunotherapy, that is, exposing patients to increasing doses of cow’s milk using a strictly controlled dose schedule. However, milk immunotherapy is not used in clinical practice due to risk of reactions. DREAM’s intention was to explore whether oral immunotherapy with a partially hydrolysed cow’s milk formula would be able to provide a safe and effective means of oral immunotherapy for milk-allergic infants.

Limitations

The trial was affected by a serious breach that led most of the participants to receive partially hydrolysed formula, even if randomised to extensively hydrolysed formula. It also ended prematurely due to unsatisfactory recruitment, and the main outcomes were not reached.

Methods

Trial flow chart. CM, cow’s milk; DBPCFC, double-blind placebo controlled food
challenge; eHF, extensively hydrolysed formula; OIT, oral immunotherapy;
pHF, partially hydrolysed formula; TC, telephone call; V1, visit 1; V2, visit 2.

DREAM was a two-arm, parallel-group, double-blind randomised controlled trial. Eligible patients were infants aged 6–12 months with convincing medical history of immunoglobulin E-mediated allergy to cow’s milk formula. Inclusion criteria included a titre of cow’s milk-specific immunoglobulin E equal or higher to 2 kU/l, or wheal equal or over 5 mm to skin prick test to milk.

Cockroach sensitization and its hidden links to mite and food allergens

Sobczak M, Kitlas P, Pawliczak R, Kowal K. Sci Rep. 2026 Mar 11. doi: 10.1038/s41598-026-44011-8.

Abstract

Correlation analysis of sensitization based on the results
of skin prick tests

Cockroach allergy is a common trigger of allergic reactions and may be a cause or a result of cross-reactions with other allergens. The aim of this study was to assess the pattern of sensitization to arthropod allergens in perennial allergic rhinitis (PAR) patients with positive skin prick test to cockroach. A group of PAR patients with positive skin prick test (SPT) result with cockroach extract (Blattella germanica) was selected. In addition to SPTs for other inhalant allergens, such as house dust mites (Dermatophagoides pteronyssinus and Dermatophagoides farinae), birch, grass, mugwort, cat, dog, and Alternaria, participants underwent the ALEX2 test which allowed for detection of sensitization to cockroach-specific and cross-reacting molecules.

Maternal immunization and early-life immunity: Mechanisms shaping neonatal protection

Portet Sulla V, Soussan S, Bizot E et al.  Vaccine. 2026 Mar 7;78:128423. doi: 10.1016/j.vaccine.2026.128423.

Highlights

• •
  Maternal immunization protects infants during the early-life immunity gap.
• •
  FcRn mediates placental IgG transport; FcγRs may modulate selectivity.
• •
  IgG transfer varies with maternal, placental and fetal factors.
• •
  Microchimerism and breast milk cells may shape neonatal immune maturation.
• •
  Maternal antibodies can transiently blunt infant vaccine immunogenicity.

Abstract

Graphical Abstract

Neonatal infections remain a leading cause of morbidity and mortality worldwide, reflecting the distinctive immunological state of early life, which prioritizes tolerance and regulatory/T helper 2 (Th2)-skewed responses over robust effector immunity. Protection during this vulnerable period relies largely on maternal immunity conveyed across the placenta and through breast milk. Transplacental IgG transport is mediated primarily by the neonatal Fc receptor (FcRn) and may be influenced by placental Fc gamma (Fcγ) receptors, IgG subclass distribution and Fc features, including glycosylation.

Future Perspectives for Artificial Intelligence in Allergy: Advances in Diagnosis, Monitoring, and Personalized Care.

Moreno E, Moreno V, Curto B, Dávila I. J Investig Allergol Clin Immunol. 2026 Mar 10:0. doi: 10.18176/jiaci.1154. 

Abstract

Primary areas of allergology where AI techniques have been applied. 

Artificial intelligence (AI) is significantly transforming the specialty of allergy by offering novel tools for diagnosis, risk prediction, disease monitoring, and personalized care. This narrative review comprehensively explores key advances in the application of AI techniques-expert systems, machine learning, deep learning, and natural language processing-across various allergic diseases such as asthma, anaphylaxis, atopic dermatitis, food allergy, allergic rhinitis, eosinophilic esophagitis, and drug hypersensitivity reactions.