At-Home Evaluation of Both Wearable and Touchless Digital Health Technologies for Measuring Nocturnal Scratching in Atopic Dermatitis: Analytical Validation Study

Avey S, Morris M, Sargsyan D, Lucas MV, O'Brisky A, Mosca K, Elias A, Fountoulakis N, Boukhechba M, Kok XH, Jain S, Oghbaie M, Manyakov NV, Wang M, Aguilar Z, Yieh L. J Med Internet Res 2025;27:e72216 doi: 10.2196/72216

Abstract

Background:

The most common symptom of atopic dermatitis (AD) is pruritus, which is often exacerbated at night and leads to nocturnal scratching and sleep disturbance. The quantification of nocturnal scratching provides an objective measure, which could be used as a clinical trial endpoint tracking this AD-related behavior. However, it is not clear how digital health technologies (DHTs) intended to measure scratching perform in the real-world environment of patient homes.

Objective:

In this study, we present the analytical validation of 2 DHTs: the GENEActiv wristband with Philips sleep and scratch algorithms (“Philips”) and the Emerald radio frequency touchless sensor (“Emerald”) to measure nocturnal scratching in adults with AD.

Methods:

Study design.

Thirty-one participants (15 with moderate AD, 11 with mild AD, and 5 healthy volunteers) were enrolled in the study. Nocturnal scratching was assessed by each DHT in the study participant’s home environment over a 4-week observation period. Infrared videos were recorded during sleep twice per week and manually annotated for the intended sleep window (total sleep opportunity [TSO]) and scratching events.

Comparative Efficacy of Montelukast–Levocetirizine Combination Therapy Versus Monotherapy in Allergic Rhinitis: A Systematic Review and Meta-analysis

Ji-Sun Kim, Gulnaz Stybayeva, Se Hwan Hwang; Int Arch Allergy Immunol 2025; https://doi.org/10.1159/000547410

Abstract

Introduction: Combination therapy with antihistamines and leukotriene receptor antagonists (LTRAs) is frequently used in allergic rhinitis (AR), particularly in patients with persistent or inadequately controlled symptoms. However, supporting evidence has been inconsistent. This meta-analysis assessed the efficacy of montelukast combined with levocetirizine in patients with allergic rhinitis by directly comparing the combination therapy with each monotherapy and evaluating individual symptom domains.

Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted, with database searches performed through March 2025. Outcomes included daytime and nighttime total symptom scores, individual nasal symptoms, rhinoconjunctivitis-related quality of life (RQLQ), and treatment-emergent adverse events (TEAEs). Pooled effects were calculated using standardized mean differences (SMDs) and odds ratios (ORs) with 95% confidence intervals (CIs).

Risk of anaphylaxis on commercial flights

Turner, Paul J. Current Opinion in Allergy and Clinical Immunology ():10.1097/ACI.0000000000001090, July 14, 2025. | DOI: 10.1097/ACI.0000000000001090

Abstract

Purpose of review 

Air travel has now returned to prepandemic levels, with over 10.5 billion passengers in 2024. Many of these passengers have food allergies, and there is a perception that allergic reactions are common during commercial flights.

Recent findings 

Estimated rates of food-induced allergic reactions
in people with known food allergy during
commercial flights 

A recent systematic review and meta-analysis reported an incidence of in-flight medical events due to allergic reactions of 0.7 (95% CI 0.4–1.1) events per million passengers. For those with food allergies, the incidence of allergic reactions is around 10–100 times lower than that reported for reactions ‘on the ground’ – equivalent to one reaction per 3600 food-allergic passengers in any 1-year period. Reassuringly, there is no evidence that this rate had increased over the past 30 years, despite significant increases in both the prevalence of food allergy and passenger numbers.

Summary 

Allergic reactions during commercial flights are uncommon

Advances in Shellfish Allergy Therapy: From Current Approaches to Future Strategies

Heidari, S., Ruethers, T., Karnaneedi, S. et al. Clinic Rev Allerg Immunol 68, 65 (2025). https://doi.org/10.1007/s12016-025-09077-8

Abstract

Shellfish allergy, triggered by immune reactions to crustacean and mollusk proteins upon consumption/inhalation, is one of the most severe and persistent food allergies, affecting approximately 1%–3% of the general population worldwide. Shellfish is among the “big nine” food allergens responsible for over 90% of food allergy cases worldwide. Its diagnosis poses major challenges due to regional species diversity and a lack of reliable diagnostic tools. Management strategies generally emphasize strict avoidance and provision of emergency adrenaline autoinjectors; however, these approaches are inconvenient and insufficient for both patients and healthcare providers. Given the rising prevalence of shellfish allergy, there is an urgent need for targeted therapies that focus on key allergens, particularly tropomyosin—a major pan-allergen.

Future directions in shellfish allergy therapy.

As the primary target in current immunotherapy approaches, tropomyosin plays a central role in driving shellfish-induced immune responses.

Methotrexate and ciclosporin both reduce levels of circulating IL-4 and IL-13 expressing CD4+ memory T-cells in childhood atopic dermatitis

Anton Olsson, Kathryn Steel, Rachael Cooper, Ashley P Jones, Kaitlyn R Chan, Graham Ogg, Alan D Irvine, Carsten Flohr, Leonie S Taams, on behalf of the TREAT trial team, Clinical and Experimental Dermatology, 2025;, llaf301, https://doi.org/10.1093/ced/llaf301

Abstract

Atopic dermatitis (AD) is a chronic dermatosis characterised by type-2 inflammatory responses, skin barrier anomalies, and microbiome dysregulation. The variation of AD presentation necessitates a better understanding of the underlying disease mechanisms and the modulation of immune markers over a treatment course. Globally the most used systemic therapies for moderate-to-severe AD are methotrexate (MTX) and ciclosporin (CyA).

Gating strategy for identification and analysis of
cytokine-expressing CD4+ T 4 cells in peripheral blood
from TREAT participants.

The TReatment of severe Atopic Eczema in children Trial (TREAT) was a randomised controlled trial assessing the efficacy and safety of methotrexate and ciclosporin. Peripheral blood samples from n=18 TREAT participants were analysed in a longitudinal immunological study with a focus on cytokine-expressing CD4+ T-cells.

Inhaled Allergy Diagnostics and Treatment in a Polluted Environment

Mazur M, Czarnobilska E. Int J Mol Sci. 2025 Jun 21;26(13):5966. doi: 10.3390/ijms26135966. 

Abstract

Allergic diseases have been increasing in prevalence over the last years. In a polluted environment, this problem can worsen and become more complex. Long-term exposure to air pollution can lead to the aggravation of allergic rhinitis (AR) and even to the development of seasonal asthma. Climate changes can accelerate and extend the pollination season. Research indicates that air pollution may modify the properties of pollen, making it more aggressive. Asymptomatic allergic people disclose their allergies in a polluted environment.

Schematic Representation of Environmental Impacts
on Pollen and Allergy Burden

A polluted environment complicates the diagnosis of seasonal allergies. The treatment might be more challenging as standard allergy medications may not be enough to control symptoms. The causal treatment of allergic rhinitis is specific allergen immunotherapy (AIT), which may prove less effective in people living in a polluted environment. The problem may lie in the proper evaluation for AIT as well as the assessment of its effectiveness.

Endotypes in Immune Mediated Drug Reactions: Present and Future of Relevant Biomarkers. An EAACI Task Force Report

Mayorga, C., Fernandez-Santamaria, R., Çelik, G.E., Labella, M., Murdaca, G., Sokolowska, M., Naisbitt, D. and Sabato, V. Allergy. https://doi.org/10.1111/all.16576

ABSTRACT

Endotypes and biomarkers in immediate
drug hypersensitivity reactions (IDHRs).

Drug-induced immune reactions are an important burden for patients and health systems. They can be classified into immediate-drug hypersensitivity reactions (IDHRs) and delayed-DHRs (DDHRs) based on their phenotype. Drugs do not always behave as allergens and need to bind to proteins, forming adducts. Therefore, IDHRs can be classified as antigenic (IgE, and IgG mediated) and nonantigenic immune responses (complement activation-[CARPA], mas-related G-protein coupled receptor member X2 [MRGPRX2], cyclooxygenase [COX]-1 and cytokine release reactions [CRRs]).

Prevalence trends and risk factors for allergic rhinoconjunctivitis, asthma and eczema in the UK

Diwakar, L., Subramanian, A., Shah, D.K. et al. Allergy Asthma Clin Immunol 21, 31 (2025). https://doi.org/10.1186/s13223-025-00975-2

Abstract

Background

Allergic rhinoconjunctivitis (ARC), asthma and eczema carry a substantial morbidity. These conditions often co-exist within the same individual and their prevalence can differ based on age, ethnicity and gender.

Objectives

Using a UK primary care database, we estimated the trends in prevalence over the last decade for ARC, asthma and eczema and associated risk factors.

Methods

Longitudinal cohort analysis of the health improvement (THIN) database between 1st Jan 2010 and 1st Jan 2019. Logistic regression analysis was used to explore risk factors for diagnosis of these conditions.

Results

Trends in the prevalence of allergic rhinoconjunctivitis,
asthma and eczema among adults (2010–2019)

An average of 4.17 million records per year were analysed, 19.4% were children and 49.75% were male. There was an increase in prevalence of ARC, asthma and eczema amongst adults during the study period, whereas ARC and asthma prevalence amongst children has fallen.