December 10, 2025
Distribution and status of ragweed (Ambrosia spp.) in northwestern South America and its potential health and environmental impacts
Espinoza-Maticurena A, Vargas A, Rodas-Valero G et al. Sci Rep. 2025 Dec 9. doi: 10.1038/s41598-025-30840-6.
Ambrosia species, commonly known as ragweed, are among the most problematic invasive weeds worldwide due to their aggressive spread and highly allergenic pollen. While extensively studied in North America, Europe, and Asia, there is limited research on their presence in tropical South America. This article focuses on the distribution, status, and potential impacts of Ambrosia in Colombia, Ecuador, and Peru.
December 9, 2025
Penicillin allergy assessment pathway versus usual clinical care for primary care patients with a penicillin allergy record in the UK (ALABAMA): an open-label, multicentre, randomised controlled trial
Summary
Background
Penicillin allergy labels in medical records are common, often incorrect, and associated with increased antibiotic use and worse health outcomes. We aimed to establish whether a penicillin allergy assessment pathway initiated in primary care could safely improve use of penicillins.
Methods
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| Trial profile |
December 4, 2025
Efficacy and safety of Depemokimab in asthma with eosinophilic phenotype: a systematic review and meta-analysis of randomized controlled trials
Abstract
Introduction
Asthma is a complex and heterogeneous disease that significantly impacts quality of life. Eosinophilic asthma, characterized by elevated eosinophil levels, leads to inflammation and hypersensitivity. Many patients remain inadequately managed, resulting in frequent exacerbations and hospitalizations despite standard treatment options. Depemokimab, a long-acting monoclonal antibody that targets IL-5, could offer a novel approach for managing severe eosinophilic asthma.
Methods
A systematic search was conducted across the PubMed, Cochrane Library, Embase, ClinicalTrials.gov, and Scopus databases up to January 2025.
December 1, 2025
Allergic Rhinitis and Its Impact on Asthma (ARIA)-EAACI Guidelines—2024–2025 Revision: Part I—Guidelines on Intranasal Treatments
B. Sousa-Pinto, J. Bousquet, R. J. Vieira, et al. Allergy (2025): 1–23, https://doi.org/10.1111/all.70131.
ABSTRACT
Background
Allergic rhinitis (AR) impacts quality of life, work and school productivity. Over the last years, an important body of evidence resulting from mHealth data has led to a better understanding of AR. Such advances have motivated an EAACI-endorsed update of the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines (ARIA 2024–2025). This manuscript presents the ARIA 2024–2025 recommendations for intranasal treatments, one of the mainstays for AR management.
Methods
The ARIA 2024–2025 guideline panel issued recommendations following the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) evidence-to-decision framework.
Evaluation of the Quality and Reliability of ChatGPT-4's Responses on Allergen Immunotherapy Using Validated Instruments for Health Information Quality Assessment
ABSTRACT
Background
Chat Generative Pre-Trained Transformer 4 (ChatGPT-4) represents an advancing large language model (LLM) with potential applications in medical education and patient care. While Allergen Immunotherapy (AIT) can change the course of allergic diseases, it can also bring uncertainty to patients, who turn to readily available resources such as ChatGPT-4 to address these doubts. This study aimed to use validated tools to evaluate the information provided by ChatGPT-4 regarding AIT in terms of quality, reliability, and readability.
Methods
In accordance with EAACI clinical guidelines about AIT, 24 questions were selected and introduced in ChatGPT-4. Independent reviewers evaluated ChatGPT-4 responses using three validated tools: the DISCERN instrument (quality), JAMA Benchmark criteria (reliability), and Flesch-Kincaid Readability Tests (readability).
November 28, 2025
Emerging Role and Function of Th9 Cells in Allergic Inflammation
Abstract:
Th9 cells have emerged as pivotal orchestrators of allergic inflammation across the airway, skin, and nasal mucosa, constituting a mechanistically distinct axis beyond canonical Th2 immunity. This review specifically highlights: (i) the Th9 axis as a unifying driver in asthma, atopic dermatitis, and allergic rhinitis; (ii) key mechanistic programs, including signal transducer and activator of transcription (STAT) 5/STAT6 licensing of the IL9 locus, peroxisome proliferator-activated receptor (PPAR) γ-mammalian target of rapamycin complex (mTORC) 1 metabolic wiring, and the IL-9-monocarboxylate transporter (MCT) 1 feedback loop; (iii) organ-level phenotypes such as eosinophil-independent bronchial hyperresponsiveness (BHR) and variable steroid responsiveness; and (iv) therapeutic implications, including biomarker-guided endotyping, Janus kinase (JAK) inhibition, TNF-like ligand (TL) 1A/death receptor (DR) 3 blockade, and metabolic or airway smooth muscle (ASM) tone modulation. Differentiating under the combined influence of interleukin (IL)‑4 and tumor growth factor (TGF)-β, Th9 cells secrete IL‑9, a pleiotropic cytokine that drives mast‑cell proliferation, goblet cell metaplasia, and airway remodeling. Their transcriptional program is epigenetically licensed by STAT5/STAT6, which opens chromatin at the IL9 locus and is metabolically sustained by a PPARγ-mechanistic/mTORC1-dependent glycolytic state. This bioenergetic wiring establishes an IL‑9-MCT1 feedback loop that reinforces effector function and durability.
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| Th9 Axis Across Allergic Diseases: Pathobiology, Biomarkers, and Therapeutic Implications |
Pediatric anaphylaxis: age-related symptom trends and the limited role of allergen molecules: a retrospective analysis
Abstract
Background
Emerging evidence suggests that specific allergen molecules may influence the clinical phenotype of anaphylaxis in children, but robust data are scarce. This study aimed to rigorously test the molecule-phenotype association in a large pediatric cohort and to determine the relative influence of the sensitizing molecule versus patient age on symptom presentation.
Methods
A retrospective analysis was conducted on 184 pediatric patients (0–18 years) hospitalized for anaphylaxis. Molecular allergen-specific immunoglobulin E (IgE) profiles were determined using the ALEX2 test. Symptom frequencies across different organ systems were analyzed in relation to allergen molecules and age groups using Cochran’s Q and Pearson’s χ2 tests.
Results
The most frequent molecular triggers were Ara h 2 (18.79%), Gal d 1 (9.09%), and Ana o 3 (9.09%). While significant differences in symptom distribution were observed within individual allergen molecules (p < 0.05), no molecule-specific symptom pattern was identified.
November 27, 2025
Trimethoprim-Sulfamethoxazole and Acute Respiratory Failure in Adolescents and Young Adults
Key Points
Question Is the use of trimethoprim-sulfamethoxazole (TMP-SMX) associated with an increased 30-day risk of hospital visits for acute respiratory failure among healthy adolescents and young adults compared with amoxicillin or cephalosporins?
Findings In this cohort study of adolescents and young adults aged 10 to younger than 25 years in Ontario, Canada, initiation of TMP-SMX was associated with a significantly higher 30-day risk of a hospital visit for acute respiratory failure compared with amoxicillin and cephalosporins. The absolute risk increase was small (0.02%) but consistent across sensitivity analyses.
Meaning These findings support the US Food and Drug Administration’s warning regarding the risk of acute respiratory failure with TMP-SMX in healthy adolescents and young adults, and clinicians and regulators should carefully weigh this risk when prescribing TMP-SMX and consider updates to prescribing guidelines and product labeling.
Abstract
Importance The US Food and Drug Administration (FDA) has issued a warning and a label change regarding a potential association between trimethoprim-sulfamethoxazole (TMP-SMX) and acute respiratory failure in healthy adolescents and young adults.
Clinical outcomes after switching from omalizumab to anti-IL-5/IL-5R biologics in severe asthma: a retrospective cohort study
Abstract
Background
Severe asthma (SA) is a heterogeneous disease composed of various clinical phenotypes, and criteria for selecting the most appropriate biological agent remain unclear. Therefore, when optimal control cannot be achieved with the initial biological therapy, switching between biological drugs is often performed.
Methods
This real-world study evaluated patients with severe asthma who initiated omalizumab treatment. Based on their treatment response, patients were divided into two groups: those who continued omalizumab and those who switched to mepolizumab or benralizumab. Clinical data were evaluated before biological treatment, after omalizumab therapy, and following the second biological therapy. Additionally, factors influencing the decision to switch and the effectiveness of the switch were analyzed.
Results
Of the total 51 patients, 45.1% (n = 23) switched to a second biological agent due to inadequate response to the initial treatment.
November 25, 2025
Comparative efficacy and safety of biologics and systemic immunomodulatory treatments for chronic urticaria: Systematic review and network meta-analysis
Abstract
Background
Chronic urticaria is a common skin condition characterized by itchy wheals (hives), angioedema, or both, lasting for 6 weeks or more. Beyond antihistamines, multiple systemic treatments are available, but there is uncertainty regarding their comparative effects on chronic urticaria outcomes.
Objective
We systematically synthesized the comparative benefits and harms of systemic treatments for chronic urticaria.
Methods
As part of updating the AAAAI/ACAAI JTFPP chronic urticaria guidelines, we searched Medline, Embase, Central, Chinese Biomedical Databases (CBM), China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), and Wanfang from inception to February 4, 2025, for randomized trials addressing systemic immunomodulatory treatments, including phototherapy, for chronic urticaria.
November 24, 2025
Association between eye washing and ocular symptoms of hay fever: a mobile app-based prospective cohort study in Japan
Abstract
Large-scale analyses of the relationship between eyewash and hay fever symptoms after adjusting for factors associated with allergic symptoms have not yet been conducted. We aimed to evaluate the association between eyewash and ocular symptoms of hay fever. In this digital prospective observational cohort study, we used the AllerSearch smartphone application. Participants reported symptoms (eye itching, tearing, and redness) and their preventive behaviors such as eye washing. Multivariate regression analysis was used to determine the association; temporal changes in ocular symptoms were compared using a mixed-effects model.
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| Temporal changes in the estimated symptom scores for the eyewash and non-eyewash groups |
Endotypes of atopic dermatitis
Abstract
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| Pathogenetic pathways, immune endotypes, and targeted treatments in AD. |
November 22, 2025
Diagnosis and management of mast cell activation syndrome (MCAS) in Canada: a practical approach.
Abstract
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| Stepwise practical approach to diagnose and treat MCAS |
November 21, 2025
Azelastine Nasal Spray for Prevention of SARS-CoV-2 Infections: A Phase 2 Randomized Clinical Trial.
Key Points
Question Is regular application of azelastine nasal spray associated with reduced risk of SARS-CoV-2 infections?
Findings In this randomized placebo-controlled clinical trial that included 450 participants, the incidence of laboratory-confirmed SARS-CoV-2 infections was significantly lower with application of azelastine nasal spray compared with placebo treatment.
Meaning The use of azelastine nasal spray may help to reduce the risk of SARS-CoV-2 infections.
Abstract
Importance Limited pharmaceutical options exist for preexposure prophylaxis of COVID-19 beyond vaccination. Azelastine, an antihistamine nasal spray used for decades to treat allergic rhinitis, has in vitro antiviral activity against respiratory viruses, including SARS-CoV-2.
Methodology for the Development of the Allergic Rhinitis and Its Impact on Asthma (ARIA)-EAACI 2024–2025 Guidelines: From Evidence-to-Decision Frameworks to Digitalised Shared Decision-Making Algorithms
ABSTRACT
November 20, 2025
Staphylococcus aureus nasal carriage is associated with faster symptom resolution following nasal allergen challenge in ragweed-allergic participants: a subset of the Allergic Rhinitis Microbiome Study
Abstract
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| Clinical outcomes during nasal allergen challenge in ragweed-allergic participants with (carriers) and without (non-carriers) nasal Staphylococcus aureus. |
November 17, 2025
“ “Super-Responders” to Dupilumab Treatment in Patients With Primary Diffuse Chronic Rhinosinusitis With Nasal Polyps
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| Graphical Abstract |
Background
Dupilumab is effective in treating patients with type-2 dominant chronic rhinosinusitis with nasal polyps (T2-CRSwNP). Dosing starts at an interval of 1×/2 weeks (Q2W) with possible tapering upon disease control. Prolonging the interdose interval reduces patient burden and side effects and improves cost-effectiveness.
Objectives
(1) Analyze how many patients successfully reach and maintain extended tapering of at least 1×/12 weeks (Q12W), (2) evaluate differences in baseline characteristics and clinical measurements between patients who maintain disease control on ≥ Q12W (“super-responders”) and patients who do not; (3) compare characteristics of “super-responders” to patients reaching Q12W but losing disease control on that dose (“excellent responders”).
November 16, 2025
Key Predictors of Adherence to a Mobile Health App for Managing Chronic Spontaneous Urticaria
ABSTRACT
Background
Mobile health technologies may improve the management of chronic diseases, such as chronic spontaneous urticaria. However, effectiveness of mHealth tools largely depends on patient adherence, which can be influenced by various demographic, clinical, behavioural, psychosocial factors, and apps characteristics (appealing and simplicity of use). Understanding these adherence patterns is crucial for optimizing mHealth interventions. In this study, we aimed to assess adherence patterns associated to the use of CRUSE, a mHealth app designed for patients with CSU.
Methods
We assessed users of the CRUSE app with self-reported CSU or suggested by a physician. For each user, we evaluated the number of days they completed the CRUSE daily monitoring questionnaire (app adherence) within the first 3 months after installation. We constructed univariable and multivariable ordered beta regression models to identify predictors of 3-month adherence to the app.
Results
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| Directed acyclic graph (DAG) to select the independent variables to include in multivariable models |
Evaluation of the relationship between multiple inflammatory markers, disease severity and antihistamine response in chronic spontaneous urticaria
Atik Ö, Can A. Alergologia Polska - Polish Journal of Allergology. 2025. doi:10.5114/pja.2025.156073.
Introduction
Chronic spontaneous urticaria (CSU) is a skin condition marked by excessive immune system inflammation. The C-reactive protein (CRP)/albumin ratio (CAR), neutrophil/lymphocyte ratio (NLR), eosinophil/neutrophil ratio (ENR), and eosinophil/lymphocyte ratio (ELR) are recent biomarkers that indicate systemic inflammation.
Aim
This study aims to examine the role of these inflammatory markers in assessing the severity of CSU and predicting the response to antihistamine treatment.
Material and methods
The study included 246 CSU patients from our outpatient clinic.
November 15, 2025
Transepidermal Water Loss in Oral Food Challenges in Children With Peanut Allergy. A Randomized Clinical Trial
Key Points
- Question Can transepidermal water loss (TEWL) as a measure of skin barrier function be used to reduce anaphylaxis rates and severity during oral food challenges in children with peanut allergy?
- Findings In this randomized clinical trial that included 40 children aged 6 months to 5 years with peanut allergy, the anaphylaxis rate among participants with an allergic reaction during a peanut oral food challenge was lower in the group for which TEWL was used as a stopping criterion (63%) than in the control group (100%).
- Meaning The findings suggest TEWL can augment anaphylaxis prediction during oral food challenges.
Abstract
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| Visual Abstract. |
Objective To determine whether use of TEWL as a stopping criterion can prevent anaphylaxis during a peanut oral food challenge (OFC).
Design, Setting, and Participants This was a single-center randomized clinical trial of children aged 6 months to 5 years with a history of a clinical peanut allergic reaction and positive peanut skin prick and/or serum immunoglobulin E testing.
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