Improvement of daily allergy control by sublingual immunotherapy: A MASK-air® study

Bousquet J, Sousa-Pinto B, Shamji MH, et al. Clin Exp Allergy. 2023 Apr 17. doi: 10.1111/cea.14318. Epub ahead of print. 

To the Editor

Allergen immunotherapy (AIT) is an effective treatment for allergic rhinitis and has been hypothesised as rapidly effective.1 Rush subcutaneous AIT to pollen and mites reduces skin test reactivity to allergens within days, in a dose-dependent and time-independent manner. Venom rush AIT is also effective within days. The tolerance of beekeepers to bee stings fades in some individuals and is also re-installed after a few stings in a dose-dependent and time-independent manner. Finally, desensitisation to drug allergy is effective within hours and there is a refractory period after tolerance. These short-term clinical sequences cannot be explained by an adaptive immune response (immunotherapy) but may be related to rapid and short-lasting cell downregulation responses (desensitisation).

Associations between fetal or infancy pet exposure and food allergies: The Japan Environment and Children’s Study

Okabe H, Hashimoto K, Yamada M, Ono T, Yaginuma K, et al. (2023) PLOS ONE 18(3): e0282725. https://doi.org/10.1371/journal.pone.0282725

Abstract

The hygiene hypothesis suggests that pet exposure is effective in preventing allergic disease, and some studies have reported the beneficial effects of dog exposure during fetal development or early infancy on food allergy. However, the effects of exposure to pets other than dogs on the kinds of food allergies remains unaddressed. This study aimed to explore the effect of exposure to various species of pets on the risk of food allergies. We obtained information on pet exposure and food allergy from the Japan Environment and Children’s Study, a nationwide, prospective birth cohort study that included 97,413 mothers and their children. We examined the associations between exposure to various species of pets during fetal development or early infancy and the incidence risk of food allergies.

Efficacy and safety of baricitinib in combination with topical corticosteroids in pediatric patients with moderate-to-severe atopic dermatitis with inadequate response to topical corticosteroids: results from a phase 3, randomized, double-blind, placebo-controlled study (BREEZE-AD PEDS)

Torrelo A, Rewerska B, Galimberti M, Paller A, Yang CY, Prakash A, Zhu D, Pontes Filho MAG, Wu WS, Eichenfield L. Efficacy and safety of baricitinib in combination with topical corticosteroids in pediatric patients with moderate-to-severe atopic dermatitis with inadequate response to topical corticosteroids: results from a phase 3, randomized, double-blind, placebo-controlled study (BREEZE-AD PEDS). Br J Dermatol. 2023 Mar 31:ljad096. doi: 10.1093/bjd/ljad096.

Abstract

Background

Baricitinib, an oral selective Janus kinase (JAK)1/JAK2 inhibitor, is approved in many countries for moderate-to-severe atopic dermatitis (AD) in adult patients who are candidates for systemic therapy.

Objectives

To evaluate the efficacy and safety of three doses of baricitinib in combination with low-to-moderate potency topical corticosteroids in pediatric patients with moderate-to-severe AD.

Timing of Allergenic Food Introduction and Risk of Immunoglobulin E–Mediated Food Allergy A Systematic Review and Meta-analysis

Scarpone R, Kimkool P, Ierodiakonou D, Leonardi-Bee J, Garcia-Larsen V, Perkin MR, Boyle RJ. Timing of Allergenic Food Introduction and Risk of Immunoglobulin E-Mediated Food Allergy: A Systematic Review and Meta-analysis. JAMA Pediatr. 2023 Mar 27:e230142. doi: 10.1001/jamapediatrics.2023.0142. 

Key Points

Question  Is the timing of introduction of allergenic foods to infants associated with their risk of developing immunoglobulin E–mediated food allergy?

Findings  This systematic review and meta-analysis of 23 randomized clinical trials with 13 794 participants found moderate-certainty evidence that introducing multiple allergenic foods from 2 to 12 months of age was associated with reduced risk of any food allergy but increased risk of withdrawal from the intervention. There was high-certainty evidence that earlier introduction of egg or peanut was associated with reduced risk of egg or peanut allergy, respectively.

Meaning  In this study, earlier introduction of multiple allergenic foods was associated with a reduced risk of food allergy but with significant rates of withdrawal from the intervention.

Diagnostic accuracy of atopy patch test in children with cow’s milk allergy

Prapasri Kulalert, 

Padcha Pongcharoen, 

Paskorn Sritipsukho, 

Sukkrawan Intraakhao, 

Punnapat Piriyanon, 

Patcharapa Thaweekul, 

Sira Nanthapisal & 

Orapan Poachanukoon 

Clinical and Molecular Allergy volume 21, Article number: 2 (2023)

• details

Abstract

Background

The accuracy of an atopy patch test (APT) for fresh cow’s milk allergy is controversial. Few studies have focused on commercial extract solutions. We aimed to evaluate the diagnostic performance of the APT in cow’s milk allergic children using fresh cow’s milk and commercial extracts of cow’s milk and its components including casein, α-lactalbumin, and β-lactoglobulin.

Methods

A prospective study was carried out in children with a history of cow’s milk allergy.

Chronic Spontaneous Urticaria: The Role and Relevance of Autoreactivity, Autoimmunity, and Autoallergy

Asero R, Ferrer M, Kocaturk E, Maurer M.  J Allergy Clin Immunol Pract. 2023 Mar 1:S2213-2198(23)00226-X. doi: 10.1016/j.jaip.2023.02.022. 

Abstract

Chronic spontaneous urticaria (CSU) is a frequent and often severely disabling disease. A large number of studies were performed during the last 2 decades to clarify its pathogenesis. These studies shed light on the underlying autoimmune mechanisms of CSU pathogenesis and have led us to understand that different mechanisms may exist and, sometimes, coexist behind the same clinical presentation. The present article reviews the meaning of the terms autoreactivity, autoimmunity, and autoallergy, which have been variably used over the years to define different endotypes of the disease.

Pharmacokinetic and pharmacodynamic comparison of epinephrine, administered intranasally and intramuscularly An integrated analysis

Tanimoto S, Kaliner M, Lockey RF, Ebisawa M, Koplowitz LP, Koplowitz B, Lowenthal R. Ann Allergy Asthma Immunol. 2023 Apr;130(4):508-514.e1. doi: 10.1016/j.anai.2022.10.024.

Abstract

Background

Manual intramuscular epinephrine injection is the standard of care for treating severe allergic reactions and anaphylaxis. Epinephrine autoinjectors were approved on the basis of the assumption that their pharmacokinetic and pharmacodynamic profiles are equivalent to manual intramuscular injection; however, although there is emerging evidence for product-related differences in pharmacokinetic profiles, very little is known about the comparative pharmacodynamic profiles.

Objective

To compare pharmacokinetic and pharmacodynamic profiles of epinephrine delivered through manual intramuscular injection, autoinjectors, and intranasal spray.

Defining the window of opportunity and target populations to prevent peanut allergy

Roberts G, Bahnson HT, Du Toit G, O'Rourke C, Sever ML, Brittain E, Plaut M, Lack G. J Allergy Clin Immunol. 2022 Dec 12:S0091-6749(22)01656-6. doi: 10.1016/j.jaci.2022.09.042. 

Background

Peanut allergy affects 1% to 2% of European children. Early introduction of peanut into the diet reduces allergy in high-risk infants.

Objective

We aimed to determine the optimal target populations and timing of introduction of peanut products to prevent peanut allergy in the general population.

Methods

Data from the Enquiring About Tolerance (EAT; n = 1303; normal risk; 3-year follow-up; ISRCTN14254740) and Learning Early About Peanut Allergy study (LEAP; n = 640; high risk; 5-year follow-up; NCT00329784) randomized controlled trials plus the Peanut Allergy Sensitization (PAS; n = 194; low and very high risk; 5-year follow-up) observational study were used to model the intervention in a general population.