Sublingual immunotherapy for allergy to shrimp: the nine-year clinical experience of a Midwest Allergy-Immunology practice

Theodoropoulou, L.M., Cullen, N.A.  Allergy Asthma Clin Immunol 20, 33 (2024). https://doi.org/10.1186/s13223-024-00895-7

Abstract

Background

Diet restrictions and fear of adverse reactions put a significant burden on the nutrition, growth and life style of children and adults with food allergies. While various disease-modifying options are pursued, there are so far no published clinical data on immunotherapy for crustaceans. The efficacy and safety of desensitization to crustaceans by means of sublingual immunotherapy is assessed for the first time in this study with a view of validating it as a clinical-practice modality.

Methods

Charts of a Midwest Allergy-Immunology practice from the period January 2014–June 2023 were reviewed to identify patients with allergy to shrimp treated with sublingual immunotherapy and to retrospectively evaluate their responses to oral challenge.

Results

Sixty-six patients were identified who had been treated by sublingual immunotherapy for either systemic or localized reactions to shrimp. Demographics and relevant comorbidities were consistent with those of the atopic population.

Polysensitisation is associated with more severe symptoms: The reality of patients with allergy

Cacheiro-Llaguno C, Mösges R, Calzada D, González-de la Fuente S, Quintero E, Carnés J. Clin Exp Allergy. 2024; 00: 1-14. doi:10.1111/cea.14486

Abstract

Background

Studying the sensitisation profiles of patients with allergies allows for a deeper understanding of the disease which may facilitate the selection of the best-personalised allergen immunotherapy. This observational, cross-sectional, multicentre study aimed to demonstrate the heterogeneity of the German population with allergies by analysing specific immunoglobulin E (sIgE) patterns towards aeroallergens and exploring the relationship between sensitisation and clinical symptoms.

Easy assessment of the avidity of polyclonal allergen-specific serum antibodies

Strobl MR, Demir H, Wozniak-Knopp G, Wangorsch A, Rüker F, Bohle B. Clin Exp Allergy. 2024; 54: 278-285. doi:10.1111/cea.14448

Abstract

Introduction

Allergen-specific IgE-blocking IgG antibodies contribute to successful allergen immunotherapy (AIT), however, not much is known about their affinity. Since affinity measurements of polyclonal antibodies in serum are technically challenging we evaluated the applicability of acidic disruption of antibody-allergen complexes by a modified ELISA protocol with monoclonal antibodies (mAbs) specific for the relevant major allergens Betv1 and Mald1. Then, AIT-induced blocking and non-blocking Mald1-specific antibodies in sera from individuals with or without reduced apple allergy were compared.

How to Define and Manage Low-Risk Drug Allergy Labels

Copaescu AM, Li L, Blumenthal KG, Trubiano JA. J Allergy Clin Immunol Pract. 2024 May;12(5):1095-1106. doi: 10.1016/j.jaip.2024.03.021. 

Abstract

Risk stratification in drug allergy implies that specific risk categories (eg, low, moderate, and high) classify historical drug hypersensitivity reactions. These risk categories can be based on reaction phenotypic characteristics, the timing of the reaction and evaluation, the required reaction management, and individual characteristics. Although a multitude of frameworks have been described in the literature, particularly for penicillin allergy labels, there has yet to be a global consensus, and approaches continue to vary between allergy centers.

Prevalence of omalizumab resistant chronic urticaria and real world effectiveness of dupilumab in omalizumab refractory chronic urticaria patients: a single center experience

Catherine Zhu, Hessah BinJadeed, Sofianne Gabrielli, Connor Prosty, Elham Rahme, Greg Shand, Michael Fein, Moshe Ben-Shoshan, Elena Netchiporouk. Clinical and Experimental Dermatology, 2024;, llae145, https://doi.org/10.1093/ced/llae145

Abstract

Chronic urticaria (CU) is characterized by wheals, angioedema, or both lasting for ≥ 6 weeks with chronic spontaneous urticaria (CSU) being the most common subtype. Omalizumab-resistant CSU cases represent an unmet clinical need. In this study, we aimed to assess the prevalence and predictors of omalizumab failure in a large cohort of CU patients and assess the effectiveness of dupilumab for omalizumab-recalcitrant CU. Of 338 CU patients, 33 received omalizumab. 69.7% (23 patients) were responders and 30.3% (10 patients) non-responders.

Intranasal combo: fixed-dose combination of mometasone furoate and olopatadine hydrochloride in therapeutic strategies for rhinosinusitis.

Samoliński B, Wojas O, Lipiec A et al.  Polish Journal of Otolaryngology. (2023);77(6):43-50. https://doi.org/10.5604/01.3001.0054.0941.

Abstract

A novel strategy for the treatment of allergic rhinitis results from the innovative combination of antihistamine and intranasal corticosteroid drugs. By combining two preparations with different mechanism of action, this novel approach facilitates quick and effective controls of all upper respiratory tract allergy symptoms. 

Children's food allergy: Effects of environmental influences and antibiotic use across critical developmental windows

Lu C, Jiang Y, Lan M, Wang L, Zhang W, Wang F.  J Hazard Mater. 2024 May 6;472:134506. doi: 10.1016/j.jhazmat.2024.134506.

Graphical Abstract

Highlights

• Postnatal exposure to outdoor CO, O3, SO2, and PM10 was related with children’s food allergy (FA).
• Renovation- and smoke-related indoor air pollution (IAP) elevated the risk of childhood FA.
• Dampness- and plant- related indoor allergens exposure increased risk of childhood FA.
• Life-time and early-life antibiotic use increased the risk of childhood FA.
• Children without using antibiotic had higher FA risk of outdoor and indoor environment exposure.

Abstract

Digitally-enabled, person-centred care (PCC) in allergen immunotherapy: An ARIA-EAACI Position Paper

Pfaar O, Sousa-Pinto B, Papadopoulos NG, et al.  Allergy. 2024; 00: 1-14. doi:10.1111/all.16135

Abstract

In rhinitis and asthma, several mHealth apps have been developed but only a few have been validated. However, these apps have a high potential for improving person-centred care (PCC), especially in allergen immunotherapy (AIT). They can provide support in AIT initiation by selecting the appropriate patient and allergen shared decision-making. They can also help in (i) the evaluation of (early) efficacy, (ii) early and late stopping rules and (iii) the evaluation of (carried-over) efficacy after cessation of the treatment course.

Daily improvement of allergy control by SLIT (regression coefficients)