Desensitisation to cow’s milk, following partially or extensively hydrolysed formulae feeding regimens, in infants with allergy to cow’s milk: the DREAM RCT Synopsis (The DREAM study)

Guibas G, Brayshaw E, Brown M et al.   Efficacy Mech Eval 2026. https://doi.org/10.3310/GJGG7715

Background

Immunoglobulin E-mediated (immediate) cow’s milk allergy is one of the most frequent food allergies in infants, with a significant adverse impact on quality of life. There is no satisfactory treatment for cow’s milk allergy, and guidelines recommend milk avoidance, feeding with ‘hypoallergenic’ formulas (extensively hydrolysed formulas), emergency management of accidental reactions and waiting for the allergy to resolve spontaneously. Currently, the only potentially curative regimen is oral immunotherapy, that is, exposing patients to increasing doses of cow’s milk using a strictly controlled dose schedule. However, milk immunotherapy is not used in clinical practice due to risk of reactions. DREAM’s intention was to explore whether oral immunotherapy with a partially hydrolysed cow’s milk formula would be able to provide a safe and effective means of oral immunotherapy for milk-allergic infants.

Limitations

The trial was affected by a serious breach that led most of the participants to receive partially hydrolysed formula, even if randomised to extensively hydrolysed formula. It also ended prematurely due to unsatisfactory recruitment, and the main outcomes were not reached.

Methods

Trial flow chart. CM, cow’s milk; DBPCFC, double-blind placebo controlled food
challenge; eHF, extensively hydrolysed formula; OIT, oral immunotherapy;
pHF, partially hydrolysed formula; TC, telephone call; V1, visit 1; V2, visit 2.

DREAM was a two-arm, parallel-group, double-blind randomised controlled trial. Eligible patients were infants aged 6–12 months with convincing medical history of immunoglobulin E-mediated allergy to cow’s milk formula. Inclusion criteria included a titre of cow’s milk-specific immunoglobulin E equal or higher to 2 kU/l, or wheal equal or over 5 mm to skin prick test to milk.

Cockroach sensitization and its hidden links to mite and food allergens

Sobczak M, Kitlas P, Pawliczak R, Kowal K. Sci Rep. 2026 Mar 11. doi: 10.1038/s41598-026-44011-8.

Abstract

Correlation analysis of sensitization based on the results
of skin prick tests

Cockroach allergy is a common trigger of allergic reactions and may be a cause or a result of cross-reactions with other allergens. The aim of this study was to assess the pattern of sensitization to arthropod allergens in perennial allergic rhinitis (PAR) patients with positive skin prick test to cockroach. A group of PAR patients with positive skin prick test (SPT) result with cockroach extract (Blattella germanica) was selected. In addition to SPTs for other inhalant allergens, such as house dust mites (Dermatophagoides pteronyssinus and Dermatophagoides farinae), birch, grass, mugwort, cat, dog, and Alternaria, participants underwent the ALEX2 test which allowed for detection of sensitization to cockroach-specific and cross-reacting molecules.

Maternal immunization and early-life immunity: Mechanisms shaping neonatal protection

Portet Sulla V, Soussan S, Bizot E et al.  Vaccine. 2026 Mar 7;78:128423. doi: 10.1016/j.vaccine.2026.128423.

Highlights

• •
  Maternal immunization protects infants during the early-life immunity gap.
• •
  FcRn mediates placental IgG transport; FcγRs may modulate selectivity.
• •
  IgG transfer varies with maternal, placental and fetal factors.
• •
  Microchimerism and breast milk cells may shape neonatal immune maturation.
• •
  Maternal antibodies can transiently blunt infant vaccine immunogenicity.

Abstract

Graphical Abstract

Neonatal infections remain a leading cause of morbidity and mortality worldwide, reflecting the distinctive immunological state of early life, which prioritizes tolerance and regulatory/T helper 2 (Th2)-skewed responses over robust effector immunity. Protection during this vulnerable period relies largely on maternal immunity conveyed across the placenta and through breast milk. Transplacental IgG transport is mediated primarily by the neonatal Fc receptor (FcRn) and may be influenced by placental Fc gamma (Fcγ) receptors, IgG subclass distribution and Fc features, including glycosylation.

Future Perspectives for Artificial Intelligence in Allergy: Advances in Diagnosis, Monitoring, and Personalized Care.

Moreno E, Moreno V, Curto B, Dávila I. J Investig Allergol Clin Immunol. 2026 Mar 10:0. doi: 10.18176/jiaci.1154. 

Abstract

Primary areas of allergology where AI techniques have been applied. 

Artificial intelligence (AI) is significantly transforming the specialty of allergy by offering novel tools for diagnosis, risk prediction, disease monitoring, and personalized care. This narrative review comprehensively explores key advances in the application of AI techniques-expert systems, machine learning, deep learning, and natural language processing-across various allergic diseases such as asthma, anaphylaxis, atopic dermatitis, food allergy, allergic rhinitis, eosinophilic esophagitis, and drug hypersensitivity reactions.

Development and psychometric validation of the Chronic Rhinosinusitis Control Test

Cotter RA, Lee CW, Wilson K et al. Rhinology. 2026 Feb 1;64(1):38-50. doi: 10.4193/Rhin25.377.

Abstract

Background: Disease control assessment for chronic rhinosinusitis (CRS) remains a challenge. In this study, we develop and psychometrically validate a new patient-reported outcome measure, the Chronic Rhinosinusitis Control Test (CRCT), for assessing CRS control.

Graphical Abstract

Methodology: The CRCT, which includes 8 items and has a score that ranges from 0-31, incorporates the perspectives of key stakeholders (patients and healthcare providers) and was developed incorporating methodologic guidance from the COSMIN initiative and United States Food and Drug Administration. Psychometric validation was performed in line with recommendations from the COSMIN initiative to establish validity, reliability and responsiveness in a sample of 545 CRS patients and with the participation of 23 expert rhinologists.

Results: The CRCT has excellent face validity, content validity, concurrent validity, internal consistency, test-retest reliability, and responsiveness.

Characterising the allergen landscape in paediatric allergic rhinitis and/or asthma

Chen Y, Zhou X, Wang Y et al.  BMJ Open Respir Res. 2026 Mar 3;13(1):e003693. doi: 10.1136/bmjresp-2025-003693.

Abstract

Objective To characterise the allergen sensitisation profile and its demographic, seasonal and laboratory associations in children with allergic rhinitis (AR) and/or asthma in Guangdong, China.

Methods We retrospectively reviewed the records of children diagnosed with AR and/or asthma from January 2020 to December 2023. Serum allergen-specific Immunoglobulin E (IgE) measurements were used to identify allergens. Sensitisation patterns and their relationships with age, sex, season of visit, peripheral-blood cell counts and immune markers were assessed with χ² tests and Spearman correlation.

Distributional characteristics of allergens in 8080 children.

Results A total of 8080 children (median age, 7.0 years; 69.0% boys) were included; 89.1% had AR, 7.5% asthma and 3.4% both conditions. Overall, 76.5% were sensitised to inhalant allergens, 18.3% to food allergens and 5.2% to other allergens. Dermatophagoides farinae (93.2 %) and Dermatophagoides pteronyssinus (88.3 %) were the dominant inhalant allergens, whereas egg (14.2 %) and milk (11.9 %) prevailed among foods.

Organ failure type in fatal and near-fatal anaphylaxis: a systematic review

McKenzie B, Marshall SD, Sanci L, Poonian J, Nair R, J Selman C, Douglass JA. BMJ Open. 2026 Mar 9;16(3):e108996. doi: 10.1136/bmjopen-2025-108996.

Abstract

Objectives Anaphylaxis is a sudden onset multiorgan allergic reaction that infrequently but regularly causes fatalities which may be preventable with appropriate organ support. There is limited data about the type of organ failure leading to death or near-fatal episodes resulting in permanent neurological disability. To assist clinicians facing anaphylaxis in diverse clinical settings, we aimed to quantify the frequency of organ failure type contributing to death or neurological disability from anaphylaxis according to allergen trigger.

Design Systematic review of published peer-reviewed literature.

Data sources Three databases were searched to January 2025: MEDLINE from 1946, Embase from 1947 and Web of Science from 1900.

Eligibility criteria Studies were eligible if they contained data about the type of clinical deterioration during anaphylaxis resulting in death or permanent neurological disability. No language restriction was implemented. Exclusion criteria were: hydatid anaphylaxis; five or more stings from an insect; death from acute atheromatous myocardial infarction and where anaphylaxis was only a differential diagnosis.

Data extraction and synthesis We extracted information using pre-specified criteria to determine the primary organ failure involved: either upper airway obstruction, lower respiratory obstruction (bronchospasm) or cardiovascular failure. Baseline demographics including age and asthma status were collected along with the allergen trigger, time course and treatment. We reported frequencies according to allergen trigger for case reports and a narrative analysis of case series weighted by risk of bias assessment.

Anaphylaxis and loss of wheat tolerance after two weeks of wheat deprivation

Kin, H.M.B., Chan, E.S., Mak, R. et al.  Allergy Asthma Clin Immunol (2026). https://doi.org/10.1186/s13223-026-01023-3

Abstract

Background

The best practices for childhood allergy prevention are continually evolving. We do not know the optimal frequency for continued exposure of common allergenic foods after the initial introduction into a child’s diet. Home-based oral immunotherapy is a promising treatment avenue for childhood food allergies.

Case presentation

Skin Prick Test Results

We describe the case of a child who was tolerating wheat and underwent a 2-week unintentional deprivation period wherein they were not exposed to any wheat. After this period, they experienced an anaphylactic reaction to wheat upon re-introduction.