Chronic Symptomatic Dermographism in a Young Atopic Adult With Fluctuating Serum IgE Levels and no Correlation to Disease Activity: A Case Report

A. A. Shaju, S. Sadaf, M. Hasanuzzaman, and N. Nawal.  Clinical Case Reports 14, no. 8 (2026): e73352, https://doi.org/10.1002/ccr3.73352.

ABSTRACT

Chronic symptomatic dermographism is a challenging dermatologic condition characterized by recurrent wheals triggered by nonspecific physical stimuli, and management typically begins with H1-antihistamines, escalating as needed, with anti-IgE therapy such as omalizumab reserved for refractory cases based on clinical response rather than serum IgE levels. We report a 20-year-old male with a long-standing history of symptomatic dermographism and childhood atopy, provoked by minimal mechanical stimuli such as friction from clothing or light stroking of the skin, which significantly impaired his daily activities and academic performance. 

Multiple erythematous, raised, and edematous wheals of varying
sizes involving the extensor aspect of the forearm, with
ill-defined borders and blanching on pressure.

Diagnosis was made clinically and by exclusion of systemic disease, with laboratory investigations revealing fluctuating serum IgE levels over multiple measurements, ranging from markedly elevated to near-normal, without correlation to disease severity, highlighting the limitations of using IgE to guide therapy. Standard management included up-dosed second-generation H1-antihistamines (up to fourfold the standard dose) and intermittent short courses of oral corticosteroids resulting in partial disease control.

Common Food Emulsifiers Impair Epithelial Barrier Integrity and Trigger Pro-Inflammatory Responses and IgE Production

Yazici D, Hayashi Y, Pat Y et al. Allergy. 2026 Aug 8. doi: 10.1111/all.70473. 

ABSTRACT

Graphical Abstract

The global rise in allergic and autoimmune diseases since the 1960s has been associated with environmental disruptions of epithelial barriers, particularly in the gastrointestinal tract. Among the implicated factors are food emulsifiers, which have become increasingly prevalent in processed foods such as peanut butter. This study investigates the biological effects of two commonly used food emulsifiers in peanut butter, soy lecithin and diacetyl tartaric acid esters of mono- and diglycerides (DATEM), on gastrointestinal tissue responses and immune responses using advanced in vitro gut-on-a-chip models, human adult stem cell-derived colon organoids-on-a-chip, and murine models.

Microneedles for allergy skin testing: Comprehensive analysis of agreement, accuracy, and pain

Sirichuwong M, Kanchanapoomi K, Piboonpocanun S et al. J Allergy Clin Immunol Glob. 2026 Jul 23;5(5):100765. doi: 10.1016/j.jacig.2026.100765. 

Abstract

Background

The skin prick test (SPT) is a standard method for identifying allergic sensitization. However, pain and needle phobia often compromise pediatric compliance. Microneedle devices offer a minimally invasive alternative to conventional lancets.

Objective

We evaluated the agreement, diagnostic accuracy, and patient tolerability of a novel microneedle compared to a lancet for SPT.

Schematic illustration of novel microneedle device and SPT procedure.

Methods

Subjects with allergic rhinitis underwent SPT using both devices with Dermatophagoides pteronyssinus (Dp) extract, histamine, and saline controls. Net mean wheal diameters (MWD) were calculated by subtracting the saline MWD from the Dp and histamine MWDs. Agreement was assessed by Bland-Altman analysis and Cohen kappa (k), diagnostic performance by receiver operating characteristic analysis, and pain by a visual analog scale.

Results

Bland-Altman plots showing difference versus average
of MWDs between microneedle device and lancet. 

Of 150 subjects (aged 8-60 years), 53.3% were sensitized to Dp. Both devices produced significantly larger Dp and histamine MWDs than saline MWD (P < .001). Median [interquartile range] Dp MWD was smaller with microneedle (2 [0-8.13] mm) than lancet (4 [0-12.5 mm], P < .001).

EAACI Guidelines on Environmental Science for Allergy and Asthma—Evidence-Based Recommendations for Prevention and Public Health Action to Mitigate the Impact of Pollen Exposure on Respiratory Allergy

L. Cecchi, I. Annesi-Maesano, B. Biagioni, et al.  Allergy (2026): 1–25, https://doi.org/10.1111/all.70423.

ABSTRACT

Developed using the GRADE methodology, these EAACI guidelines provide evidence-based recommendations on the effectiveness of pollen reduction/avoidance strategies for allergic rhinitis (AR) and asthma, the utility of biomarkers for monitoring pollen-induced asthma and the efficiency of mitigation measures and of public health strategies. Systematic and narrative reviews and health economic analysis support the recommendations. According to GRADE, the certainty of evidence was moderate to very low, therefore conditional recommendations are provided to guide healthcare professionals, patients, and policymakers in developing personalized, preventive, and scalable interventions.

Optimising allergic rhinitis management in primary care using the respiratory allergy optimiser: results from the AERO study

van Geer-Postmus, I., Ryan, D., Arling, C. et al.  npj Prim. Care Respir. Med. (2026). https://doi.org/10.1038/s41533-026-00551-0

Abstract

Digital tools may support healthcare professionals in providing guideline-directed management for patients with allergic rhinitis (AR). This study aimed to develop and implement the Respiratory Allergy Optimiser, a digital decision-support tool aligned with AR guideline recommendations, and evaluate its effect on symptom severity in primary care. The AERO study was an interventional study conducted in 11 general practices in the Netherlands (August-November 2025). Adult patients with a diagnosis of AR and/or allergic conjunctivitis and/or prescribed AR medication (past three years) were eligible. The Respiratory Allergy Optimiser assessed symptom severity using a visual analogue scale (VAS, 0–100 mm) and collected information on patient and disease characteristics, symptoms, medication use, adherence, and nasal spray technique.

CD4 CTLs in supercentenarians: Signs of adaptive expansion in healthy aging

Hashimoto K, Kojima-Ishiyama M, Inokuchi H et al. Cell Reports, 2026; 0

Highlights

•

CD4 CTLs expand around age 100 without signs of exhaustion

•

A CD27−CD28+ state marks the intermediate helper-to-killer transition

•

Large private CD4 CTL clones suggest repeated antigen exposure

•

Single clones diversify cytokine profiles after ex vivo stimulation

Summary

Graphical Abstract

Our previous study identified CD4 cytotoxic T lymphocytes (CD4 CTLs) as a hallmark of supercentenarians. CD4 CTLs have primarily been studied in disease contexts; however, their role in healthy aging remains unclear. Using single-cell immune profiling, we analyzed T cells from supercentenarians and found that CD4 CTLs begin to expand around the age of 100, characterized by sequential CD27/CD28 loss without exhaustion.

ARIA-EAACI 2025: Person-Centred, Digitally Enabled and Artificial Intelligence-Assisted Change Management in Airway Diseases

J. Bousquet, B. Sousa-Pinto, M. H. Shamji, et al. Clinical and Translational Allergy (2026): e70192, https://doi.org/10.1002/clt2.70192.

ABSTRACT

Person-centred, digitally enabled, AI-assisted care
pathways based on ARIA-EAACI guidelines
using MASK-air as a common tool:
 OECD Best Practice. AI, artificial intelligence;
AIT, allergen immunotherapy;
IPCRG, International Primary Care Respiratory Group;
IPF, International Pharmacist Federation;
OTC, over-the-counter.

Allergic Rhinitis and its Impact on Asthma (ARIA) was, up until 2017, a guideline using the best evidence (Grading of Recommendations, Assessment, Development and Evaluation, GRADE) and developed as a change management strategy. A second change management strategy—in collaboration with the European Academy of Allergy and Clinical Immunology (ARIA-EAACI)—was developed as a person-centred, digitally enabled, artificial intelligence-assisted care (person-centred care) with strong political involvement. The digital tools of ARIA are mainly based on MASK-air, an Organisation for Economic Co-operation and Development (OECD) Best Practice for integrated care for chronic diseases.

Maternal influences on infant gut microbiome and health

Sinha, T., Brushett, S., Fernández-Pato, A. et al.  Nature (2026). https://doi.org/10.1038/s41586-026-10922-9

Abstract

Mother-to-infant gut microbial transmission.

The establishment of the infant gut microbiome is critical for later health, yet how it is shaped by maternal and early-life factors remains unclear. Here we metagenomically sequenced 4,526 longitudinal faecal samples from 714 mother–infant pairs in the Dutch birth cohort Lifelines NEXT, spanning 12 weeks of pregnancy to 1 year postpartum. We integrated these data with 474 clinical and exposure variables, and with ultra-deep sequencing of breast milk and vaginal microbiomes. We observe that the maternal gut microbiome undergoes only subtle changes during pregnancy and postpartum, influenced by diet, infections and pre-pregnancy smoking.