Guidelines of care for the management of atopic dermatitis in pediatric patients

Davis DMR, Alikhan A, Bercovitch L et al. J Am Acad Dermatol. 2028 Apr 28:S0190-9622(26)00343-9. doi: 10.1016/j.jaad.2026.02.113.

Abstract

Background

Pediatric atopic dermatitis (AD) is a common, chronic inflammatory skin disorder that significantly impacts the quality of life of affected children and their families. Multiple therapies were approved to treat AD in children and adolescents since publication of the AAD's 2014 AD guidelines.

Objective

To provide evidence-based recommendations on the use of topical therapies, phototherapy, and systemic therapies for AD in children and adolescents.

Age-Related Differences in Efficacy and Safety of Subcutaneous Immunotherapy in Allergic Rhinitis: A Real-World Study

Jia, J., Yuan, X., Liu, L. et al.  (2026)  OTO Open, 10: e70229. https://doi.org/10.1002/oto2.70229

Abstract

Objective

To investigate age-related differences in efficacy and safety of subcutaneous immunotherapy (SCIT) among patients with allergic rhinitis (AR).

Study design

Retrospective cohort study.

Setting

Tertiary referral center.

Methods

AR patients who completed a 3-year course of dust mite SCIT with a 2-year post-SCIT follow-up were categorized into pediatric and adult groups. Baseline characteristics, SCIT efficacy, and adverse reactions were compared between groups. Multivariable logistic regression was used to identify independent predictors of SCIT efficacy and adverse reaction.

Results

Comparison of SCIT efficacy between children and adults.

889 patients were included, comprising 544 children and 345 adults. Adults exhibited higher baseline symptom burden, higher rates of former or current smoking and alcohol consumption, longer AR duration, more frequent dose adjustments during SCIT, and greater prevalence of comorbid asthma and urticaria. In contrast, children had higher frequencies of family history of allergy, monosensitization, food allergy, and secondary immunotherapy.

Antibody therapeutics with high affinity for FcγRs exacerbate anaphylaxis via FcγR-mediated capture by tumor-associated myeloid cells

Tang R, Aibai A, Tamemoto Y et al. Journal for ImmunoTherapy of Cancer. 2026;14:e013316. https://doi.org/10.1136/jitc-2025-013316

Abstract

Background Antibody therapeutics have revolutionized cancer treatment, but their use is increasingly associated with adverse events. Among these, anaphylaxis is particularly concerning due to its severity and unpredictability. Our previous studies demonstrated that repeated administration of anti-programmed death-ligand 1 antibodies to tumor-bearing mice induces antidrug antibodies (ADAs) and anaphylaxis. However, the specific characteristics of antibody therapeutics responsible for this effect and the underlying mechanism of ADA production remain poorly understood. This study aimed to identify the immunological and molecular determinants of ADA-associated anaphylaxis following antibody therapeutics in tumor-bearing hosts.

Methods CT26 and 4T1 tumor-bearing mice were repeatedly administered various therapeutic antibodies with differing affinities for Fcγ receptors (FcγRs). Anaphylaxis symptoms, body temperature, and mortality were evaluated. Serum ADA levels were quantified using ELISA. Antibody affinity for mouse FcγR was determined using surface plasmon resonance. Antibody distribution in the spleen was assessed via immunofluorescence staining, and antibody glycosylation was analyzed by liquid chromatography-mass spectrometry. Immune cell populations were examined using flow cytometry.

High-affinity FcγR-binding anti-PD-L1 antibody clone, 10F.9G2,
but not low-affinity clones nor deglycosylated 10F.9G2 induced anaphylaxis. 

Results Repeated administration of antibodies with high affinities for FcγRs to tumor-bearing mice induced robust ADA production and anaphylaxis, whereas antibodies with low affinities for FcγRs against the same target elicited only minimal ADA responses and did not trigger anaphylaxis.

Clinical Evaluation of Allergen Immunotherapy for Allergic Rhinitis

Catamerò F, Bragato MC, Lozano MA et al.  Vaccines. 2026; 14(4):326. https://doi.org/10.3390/vaccines14040326

Abstract

Background/Objectives: Allergen immunotherapy (AIT), involving subcutaneous (SCIT) or sublingual (SLIT) administration of the culprit allergen, is the only treatment capable of modifying the natural course of allergic diseases, and provides lasting benefits in terms of symptom reduction and medication use. AIT for allergic rhinitis is acknowledged as safe and effective in both adults and children; however, no studies have comprehensively evaluated the safety and efficacy of AIT in these populations, integrating results from randomized controlled trials (RCTs) and real-world evidence (RWE). 

Methods: We evaluated data in the literature including studies from RCTs and RWE in which the safety and efficacy of AIT in both children and adults have been analyzed. A narrative literature search was conducted in PubMed up to January 2026 using the following keywords for the search string: “allergen immunotherapy,” “AIT,” “safety,” “efficacy,” “clinical outcome,” and “clinical evaluation.” 

Efficacy and safety of allergen immunotherapy in allergic rhinitis.
AIT, allergen immunotherapy; SCIT, subcutaneous immunotherapy;
SLIT, sublingual immunotherapy.

Results: RCTs and meta-analyses showed that both SCIT and SLIT significantly reduced allergic symptoms and medication use and improved quality of life (QoL). Large SLIT tablet trials have confirmed its efficacy in adults and children, whereas RWE supports its effectiveness in broader populations.

Etiologic diagnosis of seasonal allergic rhinitis supported by artificial intelligence: the @IT-2020 project

Matricardi PM, Monnati F, Palmieri L et al.  J Allergy Clin Immunol. 2026 Mar 26:S0091-6749(26)00215-0. doi: 10.1016/j.jaci.2026.03.011. 

ABSTRACT

Background

A precise etiological diagnosis of seasonal allergic rhinitis (SAR) is essential for a tailored prescription of its only curative treatment, allergen-specific immunotherapy (AIT). This is a challenging task in temperate climates, where most patients are polysensitized to multiple pollen with overlapping seasons.

Objective

The study aims to develop a modular, flexible and validated Clinical Decision Support System (CDSS) generated with Artificial Intelligence for the etiologic diagnosis of SAR.

Methods

Study Workflow

In the context of the @IT-2020 Project, we developed a CDSS for SAR etiological diagnosis. We aimed to automate the CDSS by integrating Machine Learning (ML) algorithms. The CDSS adopts three progressive diagnostic modules: (a) clinical history and Skin Prick Tests (SPT), (b) plus molecular specific Immunoglobulin E (sIgEmol) tests, (c) plus an electronic clinical and environmental Diary. To this end, three raters identified, following international guidelines and a Delphi-like procedure, the culprit pollen on 100 SAR patients in Rome (Italy).

Results

Three models best performing (AUROC >95%) have been then generated by ML training and tested on 2/3 and 1/3 patients, respectively.

Analysis of the results of specific IgE detection for cat and dog dander allergens in 141, 165 tests with allergic diseases

Li, Y., Xu, M., Li, J. et al.  BMC Immunol (2026). https://doi.org/10.1186/s12865-026-00825-9

Abstract

Objective

The incidence of pet allergies continues to rise. This study investigates the clinical distribution characteristics and changes of cat and dog dander allergens among all outpatients and inpatients treated at Hangzhou First People’s Hospital from 2016 to 2024. It aims to provide data support for clinical allergen screening, individualized avoidance strategies, and precision diagnosis and treatment.

Methods

A retrospective cohort study was conducted. All outpatients and inpatients who underwent serum allergen-specific IgE (sIgE) antibody testing at Hangzhou First People’s Hospital from January 2016 to December 2024 were retrospectively included. The study analyzed each test individually, repeated tests performed at different time points for the same patient were included in the analysis. The characteristics and trends of cat and dog dander allergens were analyzed over a nearly 9-year period, encompassing a total of 141,165 test instances.

Rebound Pruritus and Urticaria After Discontinuation of Chronic Antihistamine Use—A Scoping Review

J. J. B.Seng, P.Oka, and N. C.Tan,  Clinical & Experimental Allergy (2026): 1–10, https://doi.org/10.1111/cea.70291.

ABSTRACT

Background

Rebound pruritus and urticaria have been increasingly reported following discontinuation of chronic antihistamines, particularly with cetirizine and levocetirizine, prompting the United States Food and Drug Administration to issue a recent safety warning for these two medications. Currently, there are significant gaps regarding the risk factors, course and optimal management of rebound pruritus and urticaria after discontinuation of chronic antihistamine use, and if this represents a class-specific adverse effect. This review aimed to map the literature related to rebound pruritus and urticaria after discontinuation of chronic antihistamine use.

Methods

A scoping review was conducted across four major literature databases (PubMed, Embase, Web of Science and Cochrane database) and grey literature (GreySource, OpenGrey, Google Scholar) from inception to December 2025. Articles describing rebound pruritus following discontinuation of chronic antihistamine use in paediatric or adult populations were included. Antihistamines evaluated included all first- and second-generation histamine-1 antagonists.

Patient-Perceived Benefits of Named-Patient Product Sublingual Immunotherapy in Allergic Rhinitis and Asthma: Primary Results From the ERAPP Real-World Cohort Study

Caimmi D, Abouelfath A, Lassalle R et al. Allergy. 2026 Mar 8. doi: 10.1111/all.70270.

ABSTRACT
Background
Named-patient product sublingual immunotherapy (NPP-SLIT) is widely used in France, yet real-world evidence on patient-perceived benefit remains limited.
Objective
To assess treatment expectations and patient-perceived benefit over 12–15 months among recent NPP-SLIT initiators using the Patient Benefit Index (PBI) and validated patient-reported outcome measures (PROMs).
Methods
ERAPP is a prospective, multicenter, observational study in children and adults with IgE-mediated respiratory allergy. Initiators (≤ 6 months on NPP-SLIT at baseline) completed digital PROMs at baseline, Month 6, and Month 12–15. The primary endpoint was the proportion with PBI ≥ 1 at Months 12–15. Secondary endpoints were changes in PROMs; exploratory analyses examined higher PBI thresholds and item-level fulfillment.
Results
Of 9439 enrolled, 4794 were initiators (950 children; 3844 adolescents/adults). At Month 12–15, PBI ≥ 1 was achieved by 83.8% of children and 84.0% of adolescents/adults.