Regional Patterns in the Prevalence of Patient-Reported Urticaria Aggravating Factors: A Multinational Mobile Health Study

N. Lourenço-Silva, A. G. Arnau, I. Cherrez-Ojeda, et al. Clinical and Translational Allergy (2026): e70220, https://doi.org/10.1002/clt2.70220.

ABSTRACT

Background

In chronic spontaneous urticaria (CSU), exacerbations are often associated with aggravating factors. However, the prevalence of patients having aggravating factors has been insufficiently studied. This mHealth study aimed to (i) estimate the prevalence of patient-reported perceived aggravating factors for CSU across 10 countries, and (ii) identify factors associated with such triggers.

Methods

We performed a cross-sectional analysis of data from users of the CRUSE mobile application. The study included patients aged 15–74 years with self-reported CSU. We assessed the frequency of reporting at least one of the following perceived aggravating factors: stress, food, exercise, low or high temperature, rubbing of the skin, infection, and medication.

Onset of Action of Azelastine 0.15% Versus Olopatadine/Mometasone for Allergen-Induced Rhinitis: An EEU Crossover Study

Bousquet J, Klimek L, Kuhl HC et al.  Clin Transl Allergy. 2026 Nov;16(11):e70213. doi: 10.1002/clt2.70213. 

ABSTRACT

Background

The aim of this study was to compare the onset of action (primary), and overall efficacy (secondary) of azelastine nasal spray 0.15% (AZE 0.15%) with mometasone/olopatadine combination therapy (OloMom) in subjects with allergen-induced rhinitis under controlled allergen exposure conditions in an Environmental Exposure Unit (EEU).

Method

This was a randomized, double-blind, placebo-controlled, three-period Williams cross-over study. Participants were randomized to receive AZE 0.15%, OloMom, or placebo. Efficacy was assessed during two pollen challenge sections in an EEC, after a single dose and after 3.5 days of treatment.

Contribution of a Digital Immunotherapy Management System Focusing on Improved Patient Adherence and Clinical Outcomes in House Dust Mite Rush Subcutaneous Immunotherapy Evaluated with a Before-After Design

Xu Y, Gao Y, Long Y, Wang C et al.  Patient Prefer Adherence. 2026 Oct 22;20:641358. doi: 10.2147/PPA.S641358.

Background: Rush subcutaneous immunotherapy (RIT) requires frequent injections, strict treatment intervals, and long-term follow-up. Digital management integrates injection scheduling, reminders, treatment records, and patient-reported follow-up.
Objective: This study aimed to evaluate the association of a digital immunotherapy management system with adherence and clinical outcomes in patients undergoing RIT.

Methods: This single-center retrospective conventional treatment (Before) followed by digital treatment (After) study design was used to evaluate patients who underwent house dust mite (HDM) RIT at a tertiary hospital in China between January 2022 and May 2025. Patients treated before implementation of the digital immunotherapy management system were assigned to the conventional management group (CMG), whereas those treated after implementation were assigned to the digital management group (DMG).

Precision Diagnosis and Differentiation of Eosinophilic Colitis and Inflammatory Bowel Disease Using a Tissue-Based Molecular Gene Expression Panel

R, Yamaguchi M, Denson L et al. Journal of Allergy and Clinical Immunology, 2026; 0

Abstract
Background
Eosinophilic colitis (EoC) and eosinophil-predominant inflammatory bowel disease (IBD) can show overlapping clinical and histologic features, creating diagnostic uncertainty. Whether tissue gene expression can objectively distinguish these conditions in the setting of colonic eosinophilia remains unclear.
Objective
We sought to develop and validate a tissue-based molecular diagnostic panel to quantify eosinophilic inflammation and differentiate EoC from IBD-associated colonic eosinophilia.
Methods

Graphical Abstract

This multi-center study analyzed 88 colonic biopsies from a cohort enriched for children and young adults, including 74 patients with EoC or IBD and non-disease controls. We developed a 96-gene qPCR-based platform, the Colonic Eosinophilia Diagnostic Panel (CEDP), and generated molecular EoC and IBD scores.

Refining atopic dermatitis pathogenesis: Early-life trajectories, noncanonical cytokines, and JAK–STAT signaling

Signer B, Schlapbach C. Journal of Allergy and Clinical Immunology, 2026; 0

Abstract

Atopic dermatitis (AD) is increasingly understood as a biologically heterogeneous disease in which barrier dysfunction, type 2 inflammation, neuroimmune dysregulation, and intracellular signaling abnormalities interact in dynamic and context-dependent ways. This review highlights three concepts that have advanced the field in recent years. First, studies in early life suggest that AD harbors measurable preclinical abnormalities, developmental trajectories, and potential opportunities for targeted intervention. Second, recent work has refined the cytokine architecture of AD beyond interleukin (IL)-4 and IL-13 by identifying noncanonical cytokine circuits that shape distinct aspects of the disease phenotype, including upstream pathogenic T helper type 2 (TH2) cell activation, epidermal dysfunction, and itch.

Preliminary evidence for IRAK2 as a potential biomarker and in vitro pro-inflammatory mediator in allergic rhinitis

Sun, H., Li, R. BMC Immunol (2026). https://doi.org/10.1186/s12865-026-00926-5

Abstract

Background

Allergic rhinitis (AR) is a common chronic nasal mucosal inflammation with limited treatment options. IRAK2 regulates allergic airway inflammation, but its expression, clinical value, and mechanism in AR remain unexplored. This study screened AR-related candidate genes using bioinformatics, verified serum IRAK2 expression and its clinical significance in AR patients, and explored its functional mechanism in vitro.

Methods

GEO datasets were used to screen differentially expressed genes and candidate genes related to AR. Serum samples were collected from 100 AR patients and 100 healthy controls. Serum IRAK2 levels were detected, and correlation analysis, ROC curve analysis and logistic regression analysis were performed.

Maternal Vaccination vs Nirsevimab Use and Respiratory Syncytial Virus Infection Among Full-Term Infants

Jacobson KB, Watson AJ, Liao LD et al. JAMA Netw Open. 2026 Oct 1;9(10):e2636760. doi: 10.1001/jamanetworkopen.2026.36760.

Key Points

Question  What is the relative product effectiveness (rPE) of maternal vaccination (RSVpreF) vs infant nirsevimab against respiratory syncytial virus (RSV) infection and hospitalization in infants?

Findings  In this cohort study of 15 124 matched infants, there was no statistically significant difference in RSV infection or hospitalization between infants exposed to maternal RSVpreF vaccination vs infants who received nirsevimab.

Meaning  The findings of this study support current US guidelines for either maternal RSVpreF or infant nirsevimab use to protect all infants from RSV.

Abstract

Importance  Since 2023, infants can be protected from respiratory syncytial virus (RSV) through a vaccine (RSVpreF) for pregnant persons or a monoclonal antibody (nirsevimab) for infants.

Real-world safety of personalized telemedicine-delivered sublingual immunotherapy: reported adverse events across 18,398 patient-years

Tharpe, C., Mardaga, K., Davidson, J. et al.  Allergy Asthma Clin Immunol (2026). https://doi.org/10.1186/s13223-026-01079-1

Abstract

Background

Sublingual immunotherapy (SLIT) is an effective disease-modifying treatment for allergic respiratory disease. Despite its increased utilization in the United States, Real-world safety data for personalized SLIT delivered through fully remote care remain limited.

Methods

This retrospective longitudinal study evaluated patients receiving personalized SLIT through a US telemedicine platform between 2020 and 2026. Patients who completed at least one survey after shipment receipt were included. Reported adverse events were graded using CTCAEv5.0. Shipment-derived exposure, capped at the administrative cutoff, was adjusted for self-reported adherence.

Association between the IL-33/ST2 pathway and downstream inflammatory factors in the context of allergic rhinitis

Lin, Y., Wang, Y., Guo, Z. et al.  Allergy Asthma Clin Immunol (2026). https://doi.org/10.1186/s13223-026-01065-7

Abstract

Objective

This was a single-centre, prospective cross-sectional observational study conducted between February and June 2025. Serum levels of IL-33, ST2, TNF-α, and IL-6 were quantified in patients diagnosed with allergic rhinitis (AR) and compared against healthy control subjects. This study aimed to compare serum levels of IL-33, ST2, TNF-α, and IL-6 between patients with AR and healthy controls, and to examine their association with symptom severity.

Methods

A total of 81 participants diagnosed with AR were recruited from the Otolaryngology and Pulmonology Departments of the Third Affiliated Hospital of Chengdu University of Traditional Chinese Medicine (Chengdu, Sichuan, China).

Type 2 Inflammation in Chronic Spontaneous Urticaria: Presentation, Role, and Management

Makris M, Papapostolou N, Koumprentziotis IA, Gregoriou S. J Inflamm Res. 2026;19:546295 https://doi.org/10.2147/JIR.S546295

Proposed integration of type 2 inflammation, autoimmune endotypes, and neuroimmune signaling in chronic spontaneous urticaria.

Abstract: Chronic spontaneous urticaria (CSU) is a heterogeneous inflammatory skin disease characterized by recurrent wheals, angioedema, and pruritus, with substantial effects on quality of life. Although mast-cell activation remains the central effector event, increasing evidence implicates type 2 inflammatory pathways in CSU and suggests that the disease shares biological features with established type 2 inflammatory disorders, including atopic dermatitis, asthma, chronic prurigo, and chronic rhinosinusitis with nasal polyps.

Lonvoguran Ziclumeran - In Vivo CRISPR Gene Editing in Hereditary Angioedema

Cohn DM, Gurugama P, Longhurst HJet al. N Engl J Med. 2026 Oct 15;395(15):1471-1482. doi: 10.1056/NEJMoa2600931. 

Abstract

Background

Hereditary angioedema is a rare and potentially life-threatening genetic condition characterized by recurrent and debilitating swelling attacks. Lonvoguran ziclumeran (lonvo-z) — an investigational, in vivo gene-editing treatment based on clustered regularly interspaced short palindromic repeats (CRISPR) — is being developed as a single-dose treatment for hereditary angioedema.

Methods

In a phase 3, double-blind trial, we randomly assigned, in a 2:1 ratio, patients who were 16 years of age or older and had hereditary angioedema with C1 inhibitor deficiency to receive a single intravenous infusion of lonvo-z (at a dose of 50 mg) or placebo. The primary end point was the number of investigator-confirmed hereditary angioedema attacks per month (the monthly attack rate) from week 5 through week 28 after infusion.

Results

Research Summary

A total of 80 patients underwent randomization; 52 were assigned to receive lonvo-z and 28 to receive placebo. As of February 10, 2026, the median duration of follow-up was 7.5 months (range, 4.9 to 12.8).

Real-world safety and clinical outcomes of cluster subcutaneous immunotherapy with olive pollen extracts, with or without grass pollen, in patients with allergic rhinoconjunctivitis and/or asthma

Alcántara-Villar, M., Martín-Casañez, E., Rodríguez, M.T.P. et al. Allergy Asthma Clin Immunol (2026). https://doi.org/10.1186/s13223-026-01074-6

Abstract

Background

Allergen immunotherapy (AIT) is the only treatment capable of modifying the natural course of IgE-mediated allergic diseases induced by aeroallergens. Cluster schedules for subcutaneous AIT (SCIT) with hypoallergenic depot extracts enable faster dose escalation while maintaining a favorable safety profile. However, specific data on the use of Olea europaea extracts, alone or combined with grass pollen, remain limited, particularly in Mediterranean populations.

Methods

The OLGA study was a multicenter, retrospective, real-world analysis conducted in 16 allergy centers across Spain. Patients with IgE-mediated allergic rhinoconjunctivitis and/or asthma sensitized to Olea europaea, with or without grass pollen, received SCIT administered according to a cluster schedule.

Feeding characteristics in young children with IgE-mediated food allergies: A cross-sectional observational study

Kefford J, Ward EC, Packer RL, et al.  Pediatr Allergy Immunol. 2026; 37:e70508. doi:10.1111/pai.70508

Abstract

Background

Research is limited regarding the intersection between Immunoglobulin-E (IgE)-mediated food allergies and paediatric feeding Disorder (PFD). The impact on caregivers managing a child with both conditions also remains poorly understood.

Objective

This study aimed to explore feeding characteristics in young children with IgE-mediated food allergies to identify the proportion of children who may be at risk of PFD, and to examine associations between risk of PFD and caregiver-reported stress and feeding-related quality of life.

Graphical Abstract

Methods

A cross-sectional cohort (N = 107) of caregivers of children aged 0;6–4;11 years, with at least one diagnosed IgE-mediated food allergy, was recruited from three paediatric allergy clinics. Validated caregiver-reported questionnaires were used to assess feeding behaviours, caregiver stress and feeding-related quality of life.

Comparison between as-needed versus regular treatment for allergic rhinitis: Protocol for a systematic review

Catarina Ferreira, Vítor Henrique Duarte, Nicky Akbarian et al. Allergologie select. 2026; 10: 296-302. doi: 10.5414/ALX02654E.

Abstract

Background: Allergic rhinitis (AR) impairs quality of life. While most trials assess regular regimen medication use, mobile-Health (mHealth) data suggest that most patients use treatments on an as-needed basis.

Objectives: Protocol for a systematic review comparing as-needed versus regular AR treatment regimens regarding efficacy and safety.

Materials and methods: We will conduct a systematic review and network meta-analysis (NMA) of randomized controlled trials involving patients of any age with perennial or seasonal AR.

Trial of a Maternal Diet Rich in Eggs and Peanuts to Reduce Infant Allergy

Palmer DJ, Campbell DE, Nanan R et al.  N Engl J Med. 2026 Sep 17;395(11):1090-1099. doi: 10.1056/NEJMoa2605659.

Abstract

Background

Immune responses leading to food allergy may develop early in life, potentially before the introduction of solid foods. Exposures to food allergens in utero and through breast milk have been proposed as a strategy to prevent food allergies in infants, but evidence from randomized trials is lacking.

Methods

In this multisite, randomized trial, pregnant women whose unborn child had at least two biologic family members with medically diagnosed allergic disease were eligible to participate. Participants were assigned in a 1:1 ratio to follow either a diet high in eggs and peanuts that included at least 6 eggs and 60 peanuts per week (high egg–peanut group) or a standard (control) egg and peanut diet that included no more than 3 eggs and 30 peanuts per week (standard-diet group), from before 23 weeks’ gestation until 4 months postnatally during lactation. The primary outcome was IgE-mediated egg or peanut allergy in the infant at 1 year of age.

Results

A total of 1070 participants were assigned to the high egg–peanut group, and 1067 were assigned to the standard-diet group.

Gaps in Current Chronic Spontaneous Urticaria (CSU) Management

Angèle Soria. British Journal of Dermatology, 2026  https://doi.org/10.1093/bjd/ljag389

Abstract

Graphical Abstract

Despite advances in therapy, chronic spontaneous urticaria (CSU) remains a challenging disease with a significant impact. Although antihistamines, anti-IgE therapy and immunosuppressants form the basis of treatment, there are still substantial gaps in diagnosis, endotyping, prediction of therapeutic response and implementation of international guidelines.

Newly licensed CSU therapeutic agents, such as Bruton tyrosine kinase (BTK) inhibitors and anti-interleukin-4 receptor alpha (anti-IL4Rα) agents, offer hope to patients who do not respond to treatment.

Respiratory Syncytial Virus Vaccine Effectiveness Among US Older Adults, 2023-2024 Season

Lu Y, Smith ER, McEvoy R, et al.  JAMA Netw Open. 2026;9(9):e2634788. doi:10.1001/jamanetworkopen.2026.34788

Key Points

Question  What is the estimated effectiveness of the respiratory syncytial virus (RSV) vaccines against RSV-related hospitalization and death among US adults 65 years or older?

Forest Plot of Vaccine Effectiveness (VE) Estimates and Respiratory
Syncytial Virus (RSV)–Related Death Outcomes

Findings  In this cohort study of 14 819 226 Medicare fee-for-service beneficiaries, both the RSVPreF3+AS01 and RSVpreF RSV vaccines provided substantial protection against RSV-related hospitalization (81.8%) and death (85.0%) during the 2023-2024 season. Effectiveness did not change significantly with age and was also substantial among immunocompromised individuals.

Meaning  This study suggests that both RSV vaccines provided substantial protection among US older adults across all ages 65 years or older and for immunocompromised individuals.

Abstract

Importance  Respiratory syncytial virus (RSV) causes a substantial number of hospitalizations and deaths among older adults. Two RSV vaccines for individuals aged 60 years or older were approved in 2023; it was important to monitor their clinical effectiveness during routine care in the first RSV season after regulatory approval.

Age-related molecular IgE sensitization to indoor and outdoor respiratory allergens: a two-step cross-sectional study in Algeria and Türkiye

Mahammed LL, Vrtala S, Akinfenwa O et al.  EBioMedicine. 2026 Sep 24:106484. doi: 10.1016/j.ebiom.2026.106484. 

Summary

Background

Immunoglobulin E-mediated allergy is the most important hypersensitivity disease affecting more than 30% of the population worldwide. The analysis of molecular IgE sensitization profiles in defined populations and age groups is important for the development of allergen-specific preventive and therapeutic interventions. The present study was performed to examine if there are differences regarding molecular IgE reactivity profiles in children and adults from two regions with similar climate and exposome.

Methods

This two-step cross-sectional study assessed molecular IgE reactivity profiles using an experimental allergen microarray comprising 105 allergen molecules. In the first step, an exploratory cross-sectional study, serum samples from 539 allergic patients (259 children, 280 adults) who were born and grew up in the Algiers region were analyzed. The second step was a prospective cross-sectional study performed in 272 Turkish allergic patients (133 children, 139 adults) from Istanbul and Samsun regions with a climate and allergen exposome similar to Algiers, with the goal of investigating the reproducibility of possible differences in molecular IgE sensitization profiles between children and adults.

Findings

Age-stratified molecular sensitization to (A, C) indoor and (B, D) outdoor
aeroallergens in children (N = 173; blue bars) and adults (N = 244; orange bars)
with respiratory allergy from Algiers (A, B) and children (N = 133; blue bars)
and adults (N = 139; orange bars) with respiratory allergy from Türkiye (C, D).

In both the exploratory Algiers study and the prospective Turkish study, significantly more children than adults with respiratory allergy were sensitized to major respiratory house dust mite allergens (Algiers: Der p 1, Der p 2: p < 0.001 and Der p 23: p = 0.001; Türkiye: Der p 1: p = 0.018 and Der p 2: p = 0.019) whereas significantly more adults than children were sensitized to regionally common respiratory outdoor allergens (Algiers: Ole e 1: p = 0.037; Phl p 1: p = 0.046; Türkiye: Ole e 1: p = 0.016; Amb a 1: p = 0.002; Amb a 8: p < 0.001). Asthma was significantly more common in children than in adult patients with respiratory allergy (Algiers: p < 0.001; Türkiye: p = 0.034).

Moderate-to-severe chronic spontaneous urticaria is associated with increased risk of immune-mediated diseases: A population-based study

Smart K, Ure A, Johnsen N, Aflatooni S et al. PLoS One. 2026 Sep 23;21(9):e0358883. doi: 10.1371/journal.pone.0358883.

Abstract

Forest plot showing odds ratios (ORs) and 95% confidence
intervals for immune-mediated comorbidities among patients
with chronic spontaneous urticaria (CSU).

Chronic spontaneous urticaria (CSU) is characterized by the idiopathic appearance of wheals and/or angioedema lasting more than six weeks. There is a critical need to evaluate whether the severity of CSU influences the risk of future immune-mediated comorbidities. We aim to evaluate if patients with moderate-to-severe chronic spontaneous urticaria (CSU) have an increased risk of developing immune-mediated comorbidities compared with matched patients with mild CSU.

Comparison of subcutaneous (SCIT) and sublingual (SLIT) immunotherapy in allergic rhinitis and allergic asthma

Perek A, Raszewska J, Jabłoński W, et al. Alergologia Polska - Polish Journal of Allergology. 2026. doi:10.5114/pja.2026.164983.

Abstract

Allergic rhinitis and allergic asthma are among the most prevalent chronic diseases, significantly impairing patients’ quality of life and generating substantial healthcare costs. Allergen immunotherapy (AIT), administered as subcutaneous (SCIT) or sublingual (SLIT) immunotherapy, remains the only treatment capable of modifying the natural course of allergic disease. The aim of this study was to compare the clinical efficacy, safety profile, adherence, and economic aspects of both AIT modalities based on current evidence. A narrative review of randomised clinical trials, meta-analyses, observational studies, and pharmacoeconomic analyses was conducted, with particular emphasis on treatment effectiveness, safety, adherence, and direct and indirect healthcare costs.