Relationship of NSAID-hypersensitivity and Chronic Urticaria. Clinical Implications

Sánchez, J., Caraballo, A. & Diez, S.  Curr Treat Options Allergy 13, 15 (2026). https://doi.org/10.1007/s40521-026-00419-1

Abstract

Purpose of Review

In this review, we conducted a literature search seeking to better understand the relationship between chronic spontaneous urticaria (CSU) and nonsteroidal anti-inflammatory drugs hypersensitivity (NSAID-hypersensitivity) associated with NSAID exacerbated cutaneous diseases (NECD), its clinical course, and gain insight into the answers to clinical questions.

Recent Findings

CSU and NSAID cutaneous reaction interaction

The coexistence of CSU and NSAID-hypersensitivity specially NECD has been well documented. However, many questions remain unanswered: Why does this coexistence occur?

IL-37a facilitates allergen immunotherapy in a house dust mite-induced mouse model of allergic asthma

Jin, Z., Jing, X., Zeng, J. et al.  BMC Immunol (2026). https://doi.org/10.1186/s12865-026-00869-x

Abstract

Serum allergen-specific immunoglobulin levels measured by ELISA. 

In recent years, the incidence of allergic asthma has increased dramatically. Allergen immunotherapy (AIT) is an effective approach to achieve long-term remission of allergic asthma and has gained widespread attention. However, current AIT suffers from low efficacy and long treatment duration. In this study, we found that IL-37a transgenic mice with allergic asthma exhibited reduced pulmonary inflammation, decreased Th2 cytokines, and lower allergen-specific IgE following AIT.

In vitro IgE diagnostics in inhalant allergy: Plant and mold allergens

Regina Treudler. Allergologie select. 2026; 10: 151-157. doi: 10.5414/ALX02616E.

Abstract

Respiratory allergies represent one of the most prevalent immune-mediated disorders worldwide, such as allergic rhinitis and asthma. The advent of in vitro diagnostic methods, particularly those based on molecular allergology, has revolutionized the diagnostic approach to inhalant allergies by enabling precise identification of sensitizing allergens at the molecular level. This review presents an analysis of the current status of in vitro diagnostics in respiratory allergy to plants and molds, with emphasis on molecular diagnostics for key allergens from trees (e.g., birch/Betula verrucosa), grasses (Poaceae family), weeds (e.g.mugwort/Artemisia vulgaris, ragweed/Ambrosia artemisiifolia), and molds (e.g. Alternaria, Aspergillus). We discuss major allergenic proteins, diagnostic tools, implications for precision medicine, and integration with precision immunotherapy.

Trees, grasses, and weeds share common pan-allergens (i.e., profilins and polcalins), which can lead to false positive reactions in skin prick test or whole allergen extracts.

PDF

Diagnosing NSAID-Hypersensitivity/Allergy and NSAID-Exacerbated or Induced Food Allergy Phenotypes in Children and Adolescents

Valluzzi RL, Urbani S, Sciannamea M et al. J Allergy Clin Immunol Pract. 2026 Jul 8:S2213-2198(26)00582-9. doi: 10.1016/j.jaip.2026.06.044. 

Highlights Box

What is already known about this topic? Hypersensitivity reactions (HRs) to NSAIDs are common in children and adolescents, but in many of them NSAID hypersensitivity/allergy (NH/A) is excluded by testing.

What does this article add to our knowledge? NEFA/NIFA can be diagnosed in about 14% of children/adolescents reporting immediate HRs to NSAIDs, most of whom are sensitized to Pru p 3. Non-hypersensitive/allergic reactions to NSAIDs appear to be primarily related to infections with fever rather than to NSAID exposure itself.

How does this study impact current management guidelines? It supports the performance of targeted food allergy tests in children/adolescents reporting urticarial, angioedematous, and/or anaphylactic reactions to NSAIDs and highlights clinical predictors that help distinguish true NSAID HRs − diagnosed through drug challenges − from non-allergic/hypersensitive reactions in pediatric practice.

Graphical Abstract

Abstract

Ambulatory antibiotic prescribing for acute sinusitis: a multicenter, retrospective cohort study evaluating appropriateness

Arensman Hannan K, Ilges D, Le KT et al. Antimicrobial Stewardship & Healthcare Epidemiology. 2026;6(1):e193. doi:10.1017/ash.2026.10743

Abstract

Objective:

Antibiotics are frequently prescribed for acute sinusitis despite national guidelines recommending antibiotics only if specific symptom criteria are met. We aimed to define the proportion of acute sinusitis encounters meeting criteria for antibiotic prescribing, characterize prescribing practices, and identify factors associated with guideline-discordant prescribing.

Design:

This retrospective cohort study included 1,000 randomly selected adult ambulatory encounters with a primary diagnosis of acute sinusitis between January 1, 2024 and March 31, 2024. Encounter notes were reviewed for appropriate antibiotic prescribing criteria as per national guidelines. Encounters were evaluated for drug selection and duration concordance based on local guidelines. A multivariable logistic regression analysis was performed to identify predictors of inappropriate antibiotic prescribing.

Setting:

Emergency departments, urgent care centers, and primary care clinics.

Results:

Antibiotic prescription characteristics

Antibiotic prescribing criteria were met for 67.6% of included encounters. Antibiotics were prescribed in 93.5% of encounters that met prescribing criteria, and 80.2% of encounters that did not. Both drug selection and duration were guideline-concordant in 49.2% of total encounters.

Effect of GLP-1RA on blood eosinophil levels in adults: a real-world study

Wu, Y., Lin, Y., Wu, J. et al.  BMC Pulm Med (2026). https://doi.org/10.1186/s12890-026-04469-8

Abstract

Background

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are widely used for glycemic control and weight management, especially semaglutide. Potential benefits of GLP-1RAs in asthma, especially in eosinophilic phenotypes, prompt growing scientific interest.

Objective

To investigate the impact of semaglutide on eosinophilic inflammation and to identify clinical and metabolic determinants of eosinophil reduction after treatment.

Methods

We conducted a retrospective, single-center study in Shanghai, China. Eligible subjects were those first prescribed semaglutide in our outpatient clinic. Demographic characteristics, complete blood counts, and lipid profiles before and after semaglutide treatment were collected from electronic medical records. Subgroup analyses were stratified using a blood eosinophil count (BEC) cut-off of 150/µL and a BMI threshold of 28 kg/m². Multiple linear regression analysis was employed to identify factors influencing the reduction in eosinophil counts.

Results

Among 371 participants included in the final analysis, BEC decreased significantly from 160(150)/µL at baseline to 110(100)/µL after semaglutide treatment (P < 0.001), and eosinophil percentage declined from 2.20(1.80)% to 1.60(1.40)% (P < 0.001).

Synergistic impacts of heat, pollen, and air pollution on allergic rhinitis and asthma under climate change: A 20-year time-series study

Ali EA, Aerts R, Vaes B et al. Environ Int. 2026 Jul;213:110330. doi: 10.1016/j.envint.2026.110330.

Abstract

Background: Climate changes are increasing the frequency of concurrent extremes in temperature, air pollution, and aeroallergens, yet evidence on their joint and synergistic health impacts remains limited. We aimed to quantify the independent, joint, and interactive short-term effects of temperature, air pollutants, and airborne pollen on allergic rhinitis and asthma using long-term general practitioner (GP) data.

 Methods: We conducted a population-based time-series study using 20 years of GP data. Daily maximum temperature, PM2.5, ozone, and pollen concentrations were linked to allergic rhinitis and asthma outcomes. We estimated cumulative relative risks (RR) over lag 0–14 days using distributed lag non-linear models, comparing high (95th percentile) versus median exposure levels. We evaluated effect modification through stratified analyses and quantified additive interaction for joint exposures at extreme levels (90th and 95th percentile) using relative excess risk due to interaction (RERI) and attributable proportion (AP).

Density distributions of environmental exposure values
restricted to days exceeding the 90th percentile of each
exposure-specific study-period distribution.

Findings: Pollen exposure was strongly associated with allergic rhinitis (RR=2.54, 95% CI: 2.40–2.69) and with asthma (RR=1.49, 95% CI: 1.38–1.61). In joint-effects analyses, co-exposure to extreme heat and high pollen concentrations was associated with an increased risk of allergic rhinitis (RR= 2.07, 95% CI: 1.77–2.41), with clear evidence of synergistic interaction on the additive scale (RERI=0.48, 95% CI: 0.32–0.64, AP=0.23, 95% CI: 0.17–0.30).

COVID-19 vaccination induces cross-neutralisation of sarbecoviruses related to SARS-CoV-2

West, G.E., Morse, R.B., Sievers, B.L. et al.  npj Vaccines 11, 125 (2026). https://doi.org/10.1038/s41541-026-01469-x

Abstract

Multi-dose vaccine schedules in a cohort of older individuals
with mixed infection histories induce strong humoral responses
against SARS-CoV-2 Wu-1 and early Omicron lineages.

The combined threats of future sarbecovirus zoonosis and continually emerging SARS-CoV-2 VOCs highlight the need to assess the breadth of existing SARS-CoV-2 vaccine-mediated protection. Here, we investigate a cohort of older individuals who received four COVID-19 vaccine doses, for potential cross-neutralisation against lentiviral particles bearing spikes from either Omicron VOCs or other sarbecoviruses. Despite recent fourth bivalent mRNA vaccine doses (encoding SARS-CoV-2 Wu-1 and Omicron spikes), neutralisation of Omicron lineage VOCs was reduced compared to Wu-1, consistent with an imprinted immune response.