Molecular allergy diagnosis enabling personalized medicine

Matricardi PM, van Hage M, Custovic A et al.  J Allergy Clin Immunol. 2025 Sep;156(3):485-502. doi: 10.1016/j.jaci.2025.01.014. 

Abstract

Allergic patients are characterized by complex and patient-specific IgE sensitization profiles to various allergens, which are accompanied by different phenotypes of allergic disease. Molecular allergy diagnosis establishes the patient’s IgE reactivity profile at a molecular allergen level and has moved allergology into the era of precision medicine. Molecular allergology started in the late 1980s with the isolation of the first allergen-encoding DNA sequences. 

Overview of MA’s many applications in diagnosis

Already in 2002, the first allergen microarrays were developed for the assessment of complex IgE sensitization patterns. Recombinant allergens are used for a precise definition of personal IgE reactivity profiles, identification of genuine IgE sensitization to allergen sources for refined prescription of allergen-specific immunotherapy and allergen avoidance diagnosis of co- versus cross-sensitization, epidemiologic studies, and prediction of symptoms, phenotypes, and development of allergic disease.

Identification of immune-related biomarkers associated with allergic rhinitis and development of a sample diagnostic model

Wang M, Wang S, Lin X, Lv X, Liu X, Zhang H. PLoS One. 2025 Sep 3;20(9):e0329549. doi: 10.1371/journal.pone.0329549. 

Abstract

This study was designed to identify immune-related biomarkers associated with allergic rhinitis (AR) and construct a robust a diagnostic model. Two datasets (GSE5010 and GSE50223) were downloaded from the NCBI GEO database, containing 38 and 84 blood CD4 + T cell samples, respectively. To eliminate batch effects, the surrogate variable analysis (sva) R package (version 3.38.0) was employed, enabling the integration of data for subsequent analysis. Immune cell infiltration profiles were assessed using the Gene Set Variation Analysis (GSVA) R package (version 1.36.3). A gene co-expression network was constructed via the Weighted Gene Co-Expression Network Analysis (WGCNA) algorithm to identify disease-related modules. Differentially expressed genes (DEGs) were identified using the linear models for microarray data (limma) R package (version 3.34.7), followed by functional enrichment analysis using DAVID. Protein-protein interaction (PPI) networks were constructed based on the STRING database to highlight key genes. A diagnostic model was subsequently developed utilizing the Least Absolute Shrinkage and Selection Operator (LASSO) regression algorithm and Support Vector Machine (SVM) method, with its discriminative capacity assessed via Receiver Operating Characteristic (ROC) curves. 

The expression of IL-3, LYN, RBB7, RCF4,
and TNFRSF1B in nasal mucosa of AR and
CTRL groups were detected by qPCR.

A total of twenty-eight immune cell types were analyzed, revealing significant differences in eight types between the AR and control groups. Through WGCNA, three disease-related modules comprising 4278 candidate genes were identified.

Control of Allergic Rhinitis and Asthma Test for Children (CARATkids): A systematic review and meta-analysis of its measurement properties

El Didi HS, Pereira AM, Jácome C et al. Pediatr Allergy Immunol. 2025 Sep;36(9):e70191. doi: 10.1111/pai.70191. 

Abstract

Control of Allergic Rhinitis and Asthma Test for Children (CARATkids) is the first patient-reported outcome measure (PROM) designed to assess both allergic rhinitis and asthma simultaneously in children aged 6 to 12 years. CARATkids has been validated in several languages and countries, highlighting the need for a review of its psychometric properties. This study aims to evaluate the measurement properties of CARATkids. This systematic review follows PRISMA and COSMIN guidelines. A systematic search was performed across three databases (Ovid/MEDLINE, Web of Science, and Scopus in October 2023, updated in June 2025). We included studies focused on the development, cultural adaptation, or validation of CARATkids, as well as studies comparing CARATkids with other PROMs. 

Main meta-analytical results on the properties of the
Control of Allergic Rhinitis and Asthma Test for Children (CARATkids).

We evaluated the quality of CARATkids development, the methodological quality of primary studies, the overall rating, and the certainty of evidence for each CARATkids measurement property and performed a meta-analysis of its measurement properties. Our search retrieved 193 results. We included nine studies. CARATkids displayed sufficient content validity.

Urticaria as a dermatologic manifestation of Giardia infection: a systematic review of clinical, diagnostic, and therapeutic features

Mahdavi, J., Ahmadifar, K. & Ghasemikhah, R. BMC Infect Dis 25, 1085 (2025). https://doi.org/10.1186/s12879-025-11484-3

Abstract

Background

Giardiasis is recognized as the most prevalent enteric protozoal infection worldwide. Although gastrointestinal symptoms are the most common manifestations of giardiasis, several studies have reported cases of urticaria associated with this infection. Urticaria is a common mast cell-dependent disorder characterized by wheals, angioedema, or both. The aim of this study was to conduct the first systematic review to comprehensively synthesize the clinical, diagnostic, and therapeutic features of urticaria as a dermatologic manifestation in patients with giardiasis.

Methods

This review was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. PubMed/MEDLINE, Web of Science, Scopus, ScienceDirect, and Google Scholar were searched without language restrictions up to 2025 to identify articles reporting patients with urticaria and giardiasis.

Results

Number of cases from different countries

Thirteen papers describing a total of 23 patients (14 males and 9 females, aged 4 to 56 years) were included. The locations of urticarial lesions varied, involving the head, trunk, and extremities. The duration of urticaria ranged from 8 h to 8 months.

Prevention of Atopic Dermatitis in High-Risk Infants: A Review of the Role of Lipid-Based Barrier Repair Therapy

C.-W. J. Chan and M. O. Visscher,  Pediatric Dermatology (2025): 1–14, https://doi.org/10.1111/pde.70010.

ABSTRACT

Background/Objective

Growing evidence highlights the role of physiological lipids, namely ceramides, cholesterol, and free fatty acids, in maintaining skin barrier function and preventing atopic dermatitis (AD). Current evidence on the efficacy, safety, and clinical relevance of stratum corneum (SC) lipid-based therapies to prevent AD and increase skin barrier integrity in high-risk infants was reviewed and synthesized.

Methods

Searches with key words lipid-based therapy, atopic dermatitis, infant, and prevention were conducted to identify papers using PubMed, Embase, Cochrane Library, and Scopus databases from January 2000 to June 2024.

Results

SC lipid-based therapies were reported to replenish deficient SC lipids, thereby improving skin barrier function, a critical aspect of AD management.

Broad-spectrum synthetic carbohydrate receptors (SCRs) inhibit viral entry across multiple virus families

Ezzatpour S, Thakur K, Erzoah Ndede K et al.  Sci Adv. 2025 Aug 29;11(35):eady3554. doi: 10.1126/sciadv.ady3554. Epub 2025 Aug 27. 

Abstract

Viral pandemics continue to threaten global health and economic stability. Despite medical advances, the absence of broad-spectrum antivirals (BSAs) prevents rapid responses to emerging viral threats. This is largely due to the lack of universal drug targets across diverse viral families and high variability among viral proteins. In this study, we evaluated 57 synthetic carbohydrate receptors (SCRs) for antiviral activity in cellulo using pseudotyped virus particles (PVPs) from six high-risk viruses across three families: Paramyxoviridae, Filoviridae, and Coronaviridae. 

Binding of SCRs to N-glycan microarrays

Four SCRs inhibited all tested PVPs, and their efficacy was confirmed against live viruses including SARS-CoV-2, MERS-CoV, EBOV, MARV, NiV, and HeV.

Early-life allergic sensitization and respiratory infection—Two hits on lung function?

Wadhwa V, Dharmage SC, Wurzel D, et al. Pediatr Allergy Immunol. 2025; 36:e70115. doi:10.1111/pai.70115

Abstract

Background

Allergic sensitization and respiratory infections commonly occur in childhood. Interplay between them in asthma development is known as the ‘two-hit’ hypothesis. There has been no previous investigation of this hypothesis on adult lung function.

Objective

In a birth cohort at high risk for allergic diseases, we investigated interactions between these two factors and lung function outcomes into adulthood.

Methods

Allergic sensitization was assessed at age 24 months by skin prick testing to aero and food allergens. Respiratory infection was defined as cough, rattle or wheeze measured by frequent questionnaires up to age 24 months. Regression models were utilized to identify interactions between these exposures and associations with lung function at ages 12, 18 and 25 years.

Results

Association between respiratory infection (increasing number of
months) and allergic sensitization with change in lung function
z-scores (post-bronchodilator)—sensitization status at 2 years.

At age 25 years, those sensitized at age 2 years(n = 118) demonstrated reductions in pre-bronchodilator FEV1 of 0.06(95% CI: −0.12, 0.00, z-score units, p = .055) for each additional month of respiratory infections.

RSV Vaccine Effectiveness Against Hospitalization Among US Adults Aged 60 Years or Older During 2 Seasons

Surie D, Self WH, Yuengling KA, et al. . JAMA. Published online August 30, 2025. doi:10.1001/jama.2025.15896

Key Points

Question  What is the effectiveness of 1 dose of respiratory syncytial virus (RSV) vaccine against RSV-associated hospitalization among adults aged 60 years or older during 2 RSV seasons and by time since vaccination?

Findings  In this multicenter, test-negative, case-control study of 6958 adults with RSV, estimated RSV vaccine effectiveness against RSV-associated hospitalization during 2 seasons was 58%. Vaccine effectiveness was 69% when vaccination occurred in the same season before illness onset and 48% when vaccination occurred in the prior season; these estimates were not statistically significantly different.