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.

Comparison of Respiratory Syncytial Virus (RSV)-Specific Antibody Durability in Pregnant/Postpartum Individuals and Older Adults After RSV Vaccination

Kachikis A, Frivold C, Pike M et al.  J Infect Dis. 2026 Mar 26:jiag111. doi: 10.1093/infdis/jiag111. 

Abstract

Box plots of respiratory syncytial virus (RSV) prefusion F protein
binding antibody titers (A) and neutralizing Ab titers (B), stratified by
study group and collection time point.
Abbreviation: AU, arbitrary units.

Respiratory syncytial virus (RSV) vaccination is recommended in pregnancy. Limited data exist regarding antibody (Ab) durability to inform revaccination timing. We conducted prospective cohort studies among pregnant and older adults after first RSV vaccination in 2023–2024. Longitudinal samples from 50 pregnant (36 vaccinated) and 16 vaccinated older adults were collected until 12–15 months after vaccination and tested for RSV binding and neutralizing Ab.

The importance of long-lived IgE plasma cells for protracted allergies

Robinson MJ. Trends Immunol. 2026 Mar 17:S1471-4906(26)00009-8. doi: 10.1016/j.it.2026.01.006.

Abstract

Advances in long-lived IgE plasma cell biology
revealed through fate mapping

IgE contributes to allergy, but its cellular sources are rare and hard to identify. Genetic fate mapping and single-cell sequencing approaches have now revealed that two cell populations maintain IgE: long-lived IgE plasma cells (PCs) and ‘type 2’ memory B cells. This forum piece discusses recent discoveries on long-lived IgE PCs.

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Baseline disease duration of chronic spontaneous urticaria participants in phase III clinical trials

Gupta, S., Rao, V., Xiong, G. et al. Allergy Asthma Clin Immunol (2026). https://doi.org/10.1186/s13223-026-01026-0

Abstract

Chronic spontaneous urticaria often follows a prolonged and variable course, yet baseline disease duration is inconsistently reported in clinical trials, limiting interpretation of treatment outcomes. Accordingly, this systematic review aimed to evaluate baseline disease duration and reporting practices in phase-III trials for chronic spontaneous urticaria. Of 36 trials identified, only 16 (44.4%) reported baseline disease duration (mean: 5.30 ± 1.81 years). 

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.