Clinical applications and methodology updates in HLA typing

Feng, K., Chang, L., Yan, Y. et al. BMC Immunol (2026). https://doi.org/10.1186/s12865-026-00845-5

Abstract

The Human Leukocyte Antigen (HLA) system is a key component of the immune system, involving aspects such as autoimmune reactions, transplant rejection reactions, and related diseases. HLA typing technology enables precise decision-making in clinical tissue matching, disease susceptibility assessment, and drug response prediction. Therefore, this article summarizes the genetic characteristics of HLA, several commonly used methods for typing, including serological methods and molecular biology methods. It also explores the clinical applications of HLA typing, such as in organ and stem cell transplantation, blood transfusion, and disease association studies. In addition, in recent years, the combination of Single Nucleotide Polymorphism (SNP) and PCR technology has shown its potential application in various gene typing.

Long-term benefits of upadacitinib for Atopic Dermatitis: deep responses in patient-reported outcomes over 140 weeks from the Measure Up 1 and Measure Up 2 clinical trials

Simpson, E. L., Prajapati, V. H., Bunick, C. G. et al. Journal of Dermatological Treatment, 37(1). https://doi.org/10.1080/09546634.2026.2665961

Abstract

Objectives

Atopic dermatitis (AD), a chronic, immune-mediated inflammatory disease, is characterized by intense itch, eczematous rash, and skin pain, which can have negative impacts to quality-of-life (QoL), sleep, and mental health (especially anxiety and depression). Evaluation of the impacts of AD on the patient’s lived experience are most accurately assessed by the patient, making measures of patient-reported outcomes (PROs) indispensable. The objective of the current study was to assess the long-term impact of upadacitinib, a once-daily oral selective Janus kinase inhibitor approved for the treatment of moderate-to-severe AD, on patient-reported outcomes, providing a comprehensive in-depth evaluation of results of patient experience across multiple domains.

Methods

Using integrated data from the Measure Up 1 & 2 trials, the current study characterizes the efficacy of upadacitinib on several measures that assess the impact of AD on patients’ lives, including patient-reported disease and symptom severity, sleep, emotional well-being, daily activities, QoL, and treatment satisfaction.

Integrating Planetary Health in Health Guidelines (GRADE Guidance 46)

Piggott T, Saadat P, Herrmann A et al.  Ann Intern Med. 2026 May 12. doi: 10.7326/ANNALS-25-04761. Epub ahead of print.

Abstract

GRADE framework for integrating planetary health in health guidelines.

Human health and natural systems are intrinsically linked—stable natural systems enable healthy human life. Health systems aim to promote, restore, and maintain health. Health systems may promote human health while having detrimental effects on natural systems, contributing to the transgression of planetary boundaries, such as biosphere integrity, climate change, and the introduction of new entities like microplastics. To date, the health guideline field lacks methods to assess the impacts of health interventions on planetary boundaries. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) Working Group established the Planetary Health Project Group in 2023 to develop formal GRADE guidance for integrating planetary health into guideline recommendations to address this gap.

Actual use of PROMs in asthma and rhinitis recommended by guidelines in clinical settings: PROMUSE respiratory study

Cherrez-Ojeda I, Bousquet J, Zuberbier T et al.   Front Allergy. 2026 Apr 24;7:1666241. doi: 10.3389/falgy.2026.1666241. 

Abstract

Rationale: Guidelines advise for the implementation of patient-reported outcomes (PROMs) to provide crucial insights into patients' perceptions of their disease burden, treatment needs, and quality of life. Despite their proven benefits in managing chronic respiratory diseases like asthma, allergic rhinitis (AR), and rhinosinusitis (RS), there is limited data on their adoption among physicians treating these conditions.

Objectives: Our objective is to identify the utilization patterns of PROMs, together with the reasons for their usage and the barriers to their adoption among practitioners managing patients with asthma, AR, and RS.

Methods: This was a cross-sectional observational study using a questionnaire encompassing all pertinent PROMs and disseminated to practitioners associated with the ARIA, UCARE, ADCARE, and ACARE networks. Individuals unfamiliar with PROMS or lacking prior experience with it were eliminated. Descriptive and analytical data were utilized, categorized by the frequency and type of PROMs applied. Stata 18.0 was utilized, with p < 0.05 indicating statistical significance.

Frequency of use of specific PROMs across asthma,
allergic rhinitis, and chronic rhinosinusitis

Results: A total of 439 practitioners participated, with PROMs predominantly utilized by physicians certified for over 30 years and by respiratory specialists (16.67% and 12.46%, respectively; p < 0.05). Pulmonologists exhibited the greatest utilization of asthma PROMs at 86%, while allergists predominantly employed AR and RS PROMs at 38.42% and 33.33%, respectively (p < 0.001). ACT (66.74%), RCAT (27.79%), and SNOTT22 (15.26%) were the predominant PROMs utilized primarily for asthma (79.19%), AR (51.23%), and RS (57.26%), respectively (p < 0.001). The foremost purposes for their application were disease control monitoring (93.39%) and evaluation of performance of therapy approaches (90.2%). The most significant barrier identified was time constraint, rated at 75.40% (p > 0.05 across all groups).

Conclusions: The use of PROMs is suboptimal, primarily due to time limitations. It is imperative that methods be swiftly implemented to include these techniques into the therapeutic environment to attain enhanced outcomes.

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Broad-Spectrum Grass Pollen Immunotherapy: Revisiting the Role of Species Diversity in Allergy Treatment

Feindor, M., Hewings, S., Goodman, J. et al. Curr Treat Options Allergy 13, 4 (2026). https://doi.org/10.1007/s40521-026-00412-8

Abstract

Purpose of Review

This review examines whether allergen immunotherapy (AIT) for grass pollen allergy should expand beyond the recent trend towards a mono-species approach based on Phleum pratense. It explores whether multi-species formulations better reflect natural exposure and could improve clinical outcomes.

Recent Findings

Group 5 homologues identified in individual extracts and a mixed
extract of 13 species of Poaceae family grasses, using a
monoclonal antibody

Research from aerobiology and immunology shows that grass pollen exposure involves diverse species with distinct flowering periods, influenced by climate and geography. Molecular analyses reveal species-specific allergen profiles, including unique peptides and variations in major allergens such as Group 1 and 5.https://media.springernature.com/w120/springer-static/cover-hires/journal/40521?as=webp

The era of advanced therapeutics for pediatric atopic dermatitis – can early systemic intervention reduce the type 2 inflammatory response and modify the atopic march?

Vroman F, de Graaf M.  Curr Opin Pediatr. 2026 May 7. doi: 10.1097/MOP.0000000000001576. 

Abstract

Purpose of review 

This figure demonstrateds the concept of disease modification
in pediatric atopic dermatitis showing the window of opportunity for
early systemic intervention to modify/attenuate the atopic march.

The recent development of advanced systemic treatment options for pediatric atopic dermatitis (AD) means that achieving long-term, off-therapy remission, so-called disease modification, has become a subject of discussion. Emerging evidence suggests that early intervention during a potential ‘window of opportunity’ could alter the natural course of AD. If such a window could be identified, early and targeted treatment might induce long-term disease remission and might reduce the risk of the development of highly burdensome atopic comorbidities.

Recent findings 

Among currently available therapies, dupilumab, targeting interleukin (IL)-4 and IL-13 signaling, provides the most compelling evidence for potential disease modification.

Extracellular Vesicles in Allergy: From Cellular Communication to Clinical Implications

Sysak, A., Górska, S.  Clinic Rev Allerg Immunol 69, 38 (2026). https://doi.org/10.1007/s12016-026-09161-7

Abstract

Extracellular vesicles (EVs) are lipid bilayer-enclosed particles released by both eukaryotic and prokaryotic cells and represent an evolutionarily conserved system of intercellular communication. By transporting bioactive cargo, including proteins, lipids, microRNAs, EVs enable the transfer of molecular signals between cells, thereby regulating immune homeostasis and inflammatory responses. In allergic diseases, EVs have emerged as key mediators linking epithelial barriers, immune cells, and the microbiome. EVs derived from epithelial, immune, and microbiota-associated cells may contribute to the initiation, amplification, and persistence of allergic inflammation by modulating barrier integrity, immune cell polarization, and cytokine signaling pathways.

EVs derived from asthmatic patients contribute
to the progression of the disease.

Disease-specific alterations in EV cargo reflect underlying pathogenic mechanisms, positioning EVs as promising non-invasive biomarkers for disease diagnosis, stratification, and monitoring.

Trace Elements in Allergy: Narrative Review

M.Ordak, M.Zemelka-Wiacek, A.Kosowska, et al., Allergy (2026): 1–18, https://doi.org/10.1111/all.70383.

ABSTRACT

Conceptual overview of major mechanistic pathways
linking trace elements to allergic diseases.

Allergic diseases are increasing worldwide and reflect a complex interplay between genetic susceptibility and environmental exposures. Among environmental determinants, trace elements contribute to epithelial barrier dysfunction, tissue remodeling, redox homeostasis, and immune regulation and may influence the development and severity of allergic diseases. This narrative review summarizes current mechanistic, epidemiological, and clinical evidence on the role of essential and non-essential trace elements in allergy.