Current Insights Into Individualized Diagnosis and Treatment of Allergic Rhinitis Based on Phenotype and Endotype

Gu, Y., Shu, L.-L., Lu, T., Guan, D.-Y., Zheng, B.-W., Xiong, P.-H., Shen, Y. and Yang, Y.-C. (2025),  World Journal of Otorhinolaryngology - Head and Neck Surgery. https://doi.org/10.1002/wjo2.70035

ABSTRACT

Medications recommended based on endotype or phenotype

Allergic rhinitis (AR) is a chronic inflammatory disease of the nasal mucosa characterized by allergen sensitization and the involvement of multiple inflammatory mediators. Currently, the treatment of AR mainly includes symptomatic relief, anti-inflammatory therapy, and nerve desensitization.

Emollients to Prevent Pediatric Eczema: A Randomized Clinical Trial

Simpson EL, Michaels LC, Ramsey K, et al. JAMA Dermatol. Published online July 23, 2025. doi:10.1001/jamadermatol.2025.2357

Key Points

Question  Does daily emollient application from age 9 weeks to 24 months help to prevent atopic dermatitis (AD) in a population unselected for risk?

Findings  In this randomized, pragmatic, decentralized clinical trial of 1247 infant-parent dyads, those who were assigned to the daily moisturizer group had a lower cumulative incidence of AD compared with the standard of care group.

Meanings  The trial results suggest that applying emollient daily for infants may be a feasible way to reduce the incidence of AD.

Abstract

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 Emollients to Prevent Pediatric Eczema

Visual Abstract.

Importance  Atopic dermatitis (AD) imposes a global health burden for children and is a risk factor for developing food allergy and asthma. Few studies have evaluated emollient intervention for primary AD prevention in infants not selected for risk.

Neonatal BCG vaccination to prevent asthma: Results from the MIS BAIR randomized controlled trial

Pittet LF, Forbes EK, Donath S, et al. Pediatr Allergy Immunol. 2025; 36:e70110. doi:10.1111/pai.70110

Abstract

Background

Asthma has a significant impact worldwide, but prevention strategies remain limited. We aimed to evaluate the efficacy of neonatal BCG vaccination in preventing asthma by modulating early-life immunity.

Methods

The Melbourne Infant Study: BCG for Allergy and Infection Reduction (MIS BAIR) was a phase 3 multicentre randomized controlled trial in Victoria, Australia. Infants were randomly assigned to receive the BCG-Denmark vaccine or no intervention within 10 days of birth. The incidence of asthma at 5 years of age was estimated using the International Study of Asthma and Allergies in Childhood questions. ClinicalTrial.gov (NCT01906853).

Results

Difference in presence and severity of asthma between BCG and
control groups, assessed at 5 years of age. 

A total of 1272 infants were randomized. The adjusted incidence of asthma was 14.4% in the BCG group compared to 16.0% in the control group (adjusted risk difference [aRD] −1.7 percentage points; 95%CI −7.4, 3.9). Secondary outcomes, including severe asthma and use of preventer medication, showed similar trends, with an aRD of −3.9 (95%CI −7.7, 0.0), and −5.6 (95%CI −10.9, −0.4), respectively, favoring the BCG group.

Is there a role of genetics in acute and chronic urticaria—A systematic review and meta-analysis

Konstantinou GN, Podder I, Dhabal A.  Clin Transl Allergy. 2025;e70072. https://doi.org/10.1002/clt2.70072

Abstract

Background

Chronic urticaria (CU) is a heterogeneous skin disorder whose genetic drivers are incompletely defined

Objective

To systematically review and meta-analyse genetic and epigenetic factors that influence susceptibility and treatment response in acute and CU.

Methods

Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, PubMed, Scopus and Web of Science were searched from inception to 31 July 2024. Original human studies reporting genetic or epigenetic associations with any urticaria subtype were eligible. Random-effects meta-analyses were undertaken when at least three comparable datasets were available.

Results

Forest plot summarizing the association between HLA-B44 and chronic urticaria.

Sixty-one studies met the inclusion criteria. Associations were confirmed for HLA-B44 (pooled Odds Ratio 8.15, 95% Confidence Interval 1.61–41.29; I2 = 86%) and vitamin-D-receptor polymorphisms FokI, TaqI and BsmI, each conferring a 1.5- to 2.1-fold increased risk.

Impact of Nasal and Inhaled Corticosteroids on SARS-CoV-2 Infection Susceptibility

Rosas-Salazar, Christian et al. Journal of Allergy and Clinical Immunology, Volume 0, Issue 0

Abstract

Background

It is unknown whether nasal (NCS) or inhaled corticosteroid (ICS) use impacts the susceptibility to SARS-CoV-2 infection.

Objectives

To examine the associations of NCS and ICS use with the risk of SARS-CoV-2 infection among individuals with allergic rhinitis or asthma.

Methods

This is a prospective, multicenter, SARS-CoV-2 surveillance study of households with children. Nasal swabs were obtained from participants every two weeks with additional collections based on COVID-19-related symptoms. In our primary adjusted models, we examined the association of NCS or ICS use at study entry (in participants with allergic rhinitis or asthma, respectively) with the time to the first SARS-CoV-2 positive quantitative PCR testing using Cox proportional hazard regression.

Results

Effect modification of age on the association of
using topical airway corticosteroids (nasal [NCS]
and inhaled [ICS] corticosteroids) with the risk
of SARS-CoV-2 infection. 

There were 2,211 participants in 1,113 households included. The associations of NCS and ICS use with the risk of SARS-CoV-2 infection were modified by age (p for both interactions<0.05). NCS and ICS use were individually associated with higher risks of SARS-CoV-2 infection among adults (adjusted hazard ratio [aHR]=1.88, 95% CI=1.14-3.12, p=0.01, and aHR=2.15, 95% CI=1.003-4.63, p=0.049, respectively).

Drago®: An innovative mobile application to improve adherence and complience of house dust mite allergen immunotherapy

Luciana Kase Tanno , Pham Thao Van Luong, Éric Fromentin, Édouard Sève, Mickaël Poulequin , Hoai-Bich Trinh, Julien Cottet, Pascal Demoly. 

Journal of Allergy and Hypersensitivity Diseases Volume 6, April–June 2025, 100041

Highlights

• Allergen immunotherapy (AIT; allergen desensitization) is the only disease-modifying treatment for IgE allergies.

• Only 18 % patients complete the required 3-year treatment course.

• A novel app Drago® aims at tracking treatment adherence and burden of respiratory disease.

• The app empowers patients to self-monitor symptoms, share decisions with physicians and access education for AIT management.

• Drago® app in France boosts AIT use via education, tracking, and gamified adherence, modeling e-health in clinical care.

Abstract

Background

House dust mite (HDM) allergens constitute the most frequent cause of persistent allergic rhinitis and asthma. Allergen immunotherapy (AIT) is the only disease-modifying treatment for patients suffering from IgE-mediated allergic conditions. The Drago® application is a free application to optimize the use of AIT through education modules, timing track and implementation of adherence based on games and avatar evolution.

Methods

Graphical Abstract

Consecutive patients were offered to voluntarily use the application simultaneously to their AIT. We evaluated data related to patients’ adherence to HDM AIT over 3 years. Data generated were anonymized and stored following the French regulations. Compliance referred to the ratio of the number of doses taken by the patient to the duration of APP use by the patient, expressed as a percentage.

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).