Allergic rhinitis in Latin America: knowledge, attitudes, and clinical practices of specialists in allergy and clinical immunology— CAPRA-SLAAI study

Kuschnir, F , Mérida-Palacio, J , Arruda-Chaves, E et al. Allergologia Et Immunopathologia, 54(3), 141-154. https://doi.org/10.15586/aei.v54i3.1659

Abstract

Allergic rhinitis (AR) is highly prevalent in Latin America (LA), impairing quality of life and often coexisting with asthma. In spite of dissemination of international guidelines, regional differences in diagnosis and management persist. The “Conductas, Actitudes y Prácticas de la Sociedad Latinoamericana de Alergia e Inmunología” (CAPRA–SLAAI) study aimed to assess the knowledge, attitudes, and practices on AR of allergists and clinical immunologists affiliated with SLAAI. Between November 2022 and March 2023, a standardized ARIA-adapted questionnaire (validated in Spanish/Portuguese) was distributed online to specialists from 24 countries; 784 were eligible for analysis. Nearly three-quarters were from Brazil (49.7%) and Mexico (25.8%), with a mean age of 50 years. Awareness of ARIA guidelines was almost universal; however, only 41% knew the MASK-air® digital tool, and fewer than 12% reported regular use, with low uptake in Brazil. 

Multivariate analysis of the main knowledge about ARIA guidelines/mask-air according to the study groups

Brazilian (BR) specialists more often reported extra-nasal symptoms and greater impact on daily activities, suggesting differences in presentation or reporting.

The prevalence of alpha-gal IgE among patients with confirmed Lyme serology result

Kadkhoda K, Schwaben A, Dee M. Int Arch Allergy Immunol. 2026 Apr 30:1-6. doi: 10.1159/000552320.

Abstract

Given the significant rise in the incidence of alpha-gal syndrome alongside the geographical expansion of ticks in recent years, it is crucial to conduct studies aimed at raising awareness—particularly among patients with a history of, or current diagnosis of, Lyme disease, to improve their quality of life. Our study is unique in addressing this important intersection. Two groups composed of 200 residuals de-identified samples originally collected during the peak of tick activity season in Northeast Ohio were tested for alpha-gal IgE. The first group (n=100) was from patients with Lyme IgG western blot positive results, and the remainder were from healthy subjects only tested for immune status. Of the 200 samples, 17 tested positive for α-Gal IgE: 15 from the Lyme-positive group and 2 from the control group.

ARIA 2024–2025 systematic reviews group. Treatment Dose Increase Versus Co-Medication in Allergic Rhinitis: Systematic Review With Dose-Response Network Meta-Analysis

Sousa-Pinto B, Vieira RJ, Gil-Mata S et al.  Allergy. 2026 May 1. doi: 10.1111/all.70372. 

ABSTRACT

Background

To achieve adequate symptom control, patients with allergic rhinitis (AR) often need to increase their medication dose or add other treatments (co-medication). We aimed to perform a systematic review to compare the efficacy and safety of AR medications for increased dose versus co-medication.

Methods

We searched four bibliographic databases and three trial databases for randomised controlled trials assessing the effect of intranasal and/or oral medications in patients of all ages with seasonal or perennial AR. We performed pairwise meta-analysis based on direct evidence to compare (i) non-standard versus standard treatment doses, and (ii) co-medication strategies versus monotherapy using standard doses. Furthermore, we fitted dose–response network meta-analysis (NMA) to obtain projected estimates for comparisons involving two times the standard dose of AR medications in monotherapy versus co-medication with the standard dose of the same medications. We assessed the certainty of evidence using GRADE for NMA.

Results

Comparison between doubling the dose of the medication
on each row versus adding the medication of each column

We included 262 studies. Co-medication schemes involving oral antihistamines (OAH) + intranasal corticosteroids (INCS) resulted in higher improvements of nasal symptoms and quality of life than doubling the dose of OAH.

TNF Pathway-Mediated Tolerogenic T-Cell Trajectory Driven by Allergen Immunotherapy

H. S.Charles, A. A.Gabr, S.-H.Wang, et al. Allergy (2026): 1–14, https://doi.org/10.1111/all.70367.

ABSTRACT
Background
Allergen immunotherapy (AIT) is a therapeutic approach to restore allergen tolerance and prevent asthma progression. Previous studies have shown exhaustion of T cells and the induction of T cells expressing IL-17 and FOXP3 early in AIT, which are relevant for the clinical outcome. This study aims to investigate the dynamic transition from type-3 immunity to a regulatory state observed in the first year during allergic inflammation, as well as the subsequent dysfunction of effector cells during AIT.

Methods
Human and experimental models of allergic airway inflammation were used to assess the impact of AIT on Treg, Tr17 and Th17 cell populations using flow cytometry and proliferation assays. Additionally, human blood samples were analysed using single-cell transcriptomics to characterise transcriptional signatures associated with the transition from pro-inflammatory to regulatory states.

Graphical Abstract

Results
AIT restored balance of Tr17 and Treg populations and increased their proliferative capacity, whereas Th17 cells remained functionally impaired. Single-cell transcriptomics identified Tr17 cells as intermediate states between pro-inflammatory and regulatory T-cell programs after AIT.

Effects of Live and Heat-Treated Bifidobacterium longumCECT 7347 in Adults With Allergic Rhinitis: A Randomised, Double-Blind, Placebo-Controlled Trial

A.Cardoso, M.Naghibi, E.Climent, et al. Allergy (2026): 1–13, https://doi.org/10.1111/all.70360.

ABSTRACT

Background

Allergic rhinitis (AR) is an increasingly common chronic inflammatory condition of the nasal mucosa. While conventional anti-allergy treatments are widely used, they can come with side effects and are not always effective. As a result, AR remains a significant concern for many millions of people worldwide, affecting quality of life and social functioning.

Objective

To investigate clinical evidence for the role of probiotics and postbiotics in reducing AR symptoms.

Graphical Abstract

Methods

In this single-centre, randomized, double-blind, placebo-controlled clinical trial, 72 adults aged 18–60 years with moderate–severe AR, taking first-line medication, were studied. The primary outcome of the trial was to determine the effects of supplementation with the probiotic Bifidobacterium longum CECT 7347 (PRO) and the heat-treated postbiotic of the same strain (POST) on symptoms associated with AR as assessed using the Combined Symptom and Medication Score (CSMS).

Evaluation of Itch Intensity Scales in Atopic Dermatitis: Differential Measurement Properties and Associations with Relevant Cytokines

Witte F, Wiegmann H, Teitge E et al. J Invest Dermatol. 2026 Apr 20:S0022-202X(26)01046-8. doi: 10.1016/j.jid.2026.04.005.

Abstract

Improvement and comparison of itch intensity scales.
Worst itch intensity scales demonstrated significant improvement in itch after dupilumab
therapy in ADpatients (left: initial assessment/IA, right: follow up/FU, respectively).
The worst itch numerical rating scale/24h and visual analogue scale/4 weeks
reached significantly higher ratings than the visual analogue scale/24h at IA and FU.

Itch is the cardinal symptom contributing to patient burden in atopic dermatitis (AD). Multiple validated itch scales are used in clinical trials, generating heterogeneous data sets. In addition, recent studies suggest an association between cytokine levels and disease severity in AD. This study aimed to compare the performance of different validated itch instruments and their relationship to blood cytokine profiles. 49 adults with severe AD and severe itch were treated with dupilumab 300mg for 16 weeks. At initial assessment and after treatment, itch intensity and quality of life were evaluated using various assessment tools.

Biomarkers in Bronchiectasis - Infographic

Biomarkers are important to describe inflammatory and molecular endotypes that pave the way for individualized therapeutic targets. This infographic from the Bronchiectasis Section of the CHEST Airways Disorders Network describes biomarkers in bronchiectasis.

Learn more: https://hubs.la/Q04drBQf0

Long-Term Dupilumab Treatment Is Not Associated with an Increased Overall Risk of Infections in Adults with Moderate-to-Severe Atopic Dermatitis: Results from an Open-Label 5-Year Extension Study

Beck, L.A., Simpson, E.L., Thaçi, D. et al.  Adv Ther (2026). https://doi.org/10.1007/s12325-026-03582-8

Abstract

Introduction

Patients with atopic dermatitis (AD) are at an increased risk for infections. Here, we report a confirmatory follow-up study analyzing the incidence of infections in adults with moderate-to-severe AD treated with dupilumab for up to 5 years.

Methods

Infections in adults with moderate-to-severe AD treated with dupilumab 300 mg weekly (qw) or every 2 weeks (q2w; approved regimen) were assessed for up to 5 years in the open-label extension study, LIBERTY AD OLE. Topical corticosteroids (TCS) and calcineurin inhibitors (TCI) were permitted. Exposure-adjusted incidence rates [number of patients with at least one event per 100 patient-years (nP/100 PY)] are reported. Since the OLE had no control arm, safety results from the placebo + TCS arm of the 1-year LIBERTY AD CHRONOS study are included for comparisons.

Results

Of the 2677 patients included, 2207 (82.4%) completed up to week 52, 557 (20.8%) up to week 148, and 334 (12.5%) up to week 260; 226 patients (8.4%) switched from qw to q2w during the trial due to a protocol amendment.