A Multidimensional Diagnostic Approach for Chronic Obstructive Pulmonary Disease

COPDGene 2025 Diagnosis Working Group and CanCOLD Investigators.  JAMA. Published online May 18, 2025. doi:10.1001/jama.2025.7358

Key Points

Question  Does incorporating chest computed tomographic imaging abnormalities and respiratory symptoms into the chronic obstructive pulmonary disease (COPD) diagnostic schema improve identification of individuals with poor respiratory outcomes?

Findings  Among 9416 participants enrolled in a multicenter cohort study, those with newly diagnosed COPD had greater all-cause and respiratory-specific mortality, more frequent exacerbations, and faster decline of forced expiratory volume in the first second of expiration compared with individuals classified as not having COPD based on the new classification schema.

Infection risk in atopic dermatitis patients treated with biologics and JAK inhibitors: BioDay results

van der Gang LF, Atash K, Zuithoff NPA, Haeck I, Boesjes CM, Bacoş-Cosma OI, et al. J Eur Acad Dermatol Venereol. 2025; 00: 1–13. https://doi.org/10.1111/jdv.20674

Abstract

Background

Limited data exist on the comparative risk of infections during biologic and Janus kinase inhibitor (JAKi) treatment for atopic dermatitis (AD) in daily practice.

Objective

To assess the differential infection risk of biologic and JAKi treatment in patients with moderate-to-severe AD in a real-world setting.

Methods

This prospective, multicentre study evaluated treatment-emergent infections in patients (age ≥ 12 years) using biologics or JAKi from the BioDay registry from October 2017 to July 2024. Crude incidence rates were calculated per 100 patient-years (PY) per treatment. Cox regression for recurrent events, adjusted for potential confounders, was used to estimate hazard ratios (HR) for the rate of infections, with subgroup and sensitivity analyses in bio-/JAKi-naïve patients.

Results

Graphical Abstract

In total 1793 patients were included (4044.1 PY; 1886 biologic treatment episodes (TEs); 480 JAKi), with 794 infections. JAKi showed higher infection rates (58.4–65.5/100 PY) compared to biologics (13.6–22.0), especially for herpes infections (n = 195, 24.6%; JAKi 13.6–19.8 vs. biologicals 3.0–3.6). Cox regression indicated increased rates with JAKi (abrocitinib HR 4.1, 95% CI: 3.1–5.5; baricitinib HR 4.2, 95% CI: 2.9–6.2; upadacitinib HR 4.0, 95% CI: 3.2–5.0; all p < 0.0001) and a slight increase with tralokinumab (HR 1.4, 95% CI: 1.0–2.0, p = 0.039) compared to dupilumab.

Seasonal Proteomic Variations and Biomarkers in Seasonal Allergic Rhinitis: Insights from Olink Inflammation Profiling

Shen J, Zheng X, Yan M, Feng M, Ding C, Xie S, Xu H.  J Inflamm Res. 2025;18:6191-6202

https://doi.org/10.2147/JIR.S519126

Graphical Abstract

Purpose: Seasonal allergic rhinitis (SAR) is a prevalent inflammatory condition, yet its molecular mechanisms and reliable biomarkers remain incompletely understood. This study aimed to identify key inflammation-related proteins and pathways associated with SAR by investigating seasonal proteomic profile variations and their correlations with SAR symptoms.
Patients and Methods: Serum samples were collected from nineteen SAR patients during both allergy (in-season, IS) and non-allergy (out-of-season, OS) periods. Differentially expressed proteins (DEPs) were identified using the Olink Target 96 Inflammation panel, which were further analyzed through Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses.

Prenatal Ambient Air Pollution Associations With DNA Methylation in Asthma and Allergy Relevant Genes: Findings from ECHO

Meredith Palmore, Emma E Thompson, Fang Fang et al. Environmental Epigenetics, 2025;, dvaf013, https://doi.org/10.1093/eep/dvaf013

ABSTRACT

Background

Prenatal exposure to air pollution is an important risk factor for child health outcomes, including asthma. Identification of DNA methylation changes associated with air pollutant exposure can provide new intervention targets to improve children’s health.

Objectives

To test the association between prenatal air pollutant exposure and DNA methylation in developmental and asthma/allergy relevant biospecimens (placenta, buccal, cord blood, nasal mucosa, and lavage).

Methods

A subset of 2,294 biospecimens collected from 1,906 child participants enrolled in the Environmental Influences on Child Health Outcomes (ECHO) program with prenatal air pollutant and high-quality Illumina Asthma&Allergy DNA methylation array measures (n=37,197 probes) were included.

Rhinovirus as a driver of airway T cell dynamics in children with treatment-refractory recurrent wheeze

Bryant N, Muehling LM, Wavell K, Teague WG, Woodfolk JA.  JCI Insight. 2025 May 8;10(9):e189480. doi: 10.1172/jci.insight.189480.

Abstract

Graphical Abstract

Severe asthma in children is notoriously difficult to treat, and its immunopathogenesis is complex. In particular, the contribution of T cells and relationships to antiviral immunity remain enigmatic. Here, we coupled deep phenotyping with machine learning methods to elucidate the dynamics of T cells in the lower airways of children with treatment-refractory recurrent wheeze, and examine rhinovirus (RV) as a driver. Our strategy revealed a T cell landscape dominated by type 1 and type 17 CD8+ signatures. Interrogation of phenotypic relationships coupled with trajectory mapping identified T cell migratory and differentiation pathways spanning the blood and airways that culminated in tissue residency, and involved transitions between type 1 and type 17 tissue-resident types.

Prevalence of Intolerance to Amines and Salicylates in Individuals with Atopic Dermatitis: A Systematic Review and Meta-Analysis

Fischer, K.; Jones, M.; O’Neill, H.M.Nutrients 2025, 17, 1628. https://doi.org/10.3390/nu17101628

Abstract

Graphical abstract

Background/Objectives: Elimination diets targeting amines and salicylates have been used since the 1980s to diagnose pharmacological food intolerance in individuals with atopic dermatitis (eczema), yet supporting evidence regarding relevance is limited. To our knowledge, this systematic review with meta-analysis is the first to examine the prevalence and association between atopic dermatitis flares and amine intolerance (including histamine intolerance) and salicylate intolerance in individuals with atopic dermatitis. 

Methods: Following the PRISMA guidelines, searches of PubMed, Embase, CINAHL, and Cochrane were conducted. Included studies involved children and adults with atopic dermatitis who underwent dietary elimination and double-blind placebo-controlled challenges involving histamine, other amines, or salicylates.

Application and research progress of artificial intelligence in allergic diseases

Tan H, Zhou X, Wu H, Wang M, Zhou H, Qin Y, Zhang Y, Li Q, Luo J, Su H, Sun X. Int J Med Sci 2025; 22(9):2088-2102. doi:10.7150/ijms.105422. https://www.medsci.org/v22p2088.htm

Abstract

Artificial intelligence (AI), as a new technology that can assist or even replace some human functions, can collect and analyse large amounts of textual, visual and auditory data through techniques such as Reinforcement Learning, Machine Learning, Deep Learning and Natural Language Processing to establish complex, non-linear relationships and construct models. 

These can support doctors in disease prediction, diagnosis, treatment and management, and play a significant role in clinical risk prediction, improving the accuracy of disease diagnosis, assisting in the development of new drugs, and enabling precision treatment and personalised management. In recent years, AI has been used in the prediction, diagnosis, treatment and management of allergic diseases.

Rilzabrutinib in Antihistamine-Refractory Chronic Spontaneous Urticaria The RILECSU Phase 2 Randomized Clinical Trial

Giménez-Arnau A, Ferrucci S, Ben-Shoshan M, et al. JAMA Dermatol. Published online April 23, 2025. doi:10.1001/jamadermatol.2025.0733

Key Points

Question  What is the efficacy and risk profile of rilzabrutinib, an oral reversible covalent Bruton tyrosine kinase inhibitor, in adults with antihistamine-refractory chronic spontaneous urticaria (CSU)?

Findings  In this randomized clinical trial of 160 patients with moderate to severe CSU, rilzabrutinib, 1200 mg/d, significantly decreased patients’ weekly Urticaria Activity Score and its components (weekly Itch Severity Score and weekly Hives Severity Score) at week 12 and as early as week 1. No new risks were observed.

Meaning  Rilzabrutinib reduced itch and hives while maintaining a favorable risk-benefit profile, suggesting rilzabrutinib may be an efficacious treatment for patients with antihistamine-refractory moderate to severe CSU.

Abstract

Importance  Chronic spontaneous urticaria (CSU) is a skin disease driven mainly by the activation of cutaneous mast cells through various mechanisms.