Advances in the management of allergic rhinitis: clinical relevance of the mometasone furoate-olopatadine association and the challenge of patient self-diagnosis and self-treatment

D'Amato M, D'Amato G. Drugs Context. 2026 May 25;15:2026-2-5. doi: 10.7573/dic.2026-2-5.

Abstract

Mechanism of Action

Allergic rhinitis is a highly prevalent inflammatory disease that significantly impairs sleep, daily functioning and quality of life, with symptoms increasingly amplified by environmental changes such as prolonged pollen seasons and urban pollution. Despite effective therapies, many patients remain poorly controlled due to delayed diagnosis, inappropriate self-selection of over-the-counter medications, limited adherence and incorrect intranasal technique. The fixed-dose intranasal combination of mometasone furoate and olopatadine addresses these gaps by uniting rapid antihistaminic, mast-cell stabilizing effects with potent, sustained anti-inflammatory activity.

Partisan and Geographic Variation in Emotional Responses to COVID-19 Vaccination on Social Media

Jaidka K, Wu Y, Rani A, et al.  JAMA Netw Open. 2026;9(6):e2615409. doi:10.1001/jamanetworkopen.2026.15409

Key Points

Question  How did collective emotional expressions on social media vary across US counties in response to the first COVID-19 vaccine administration?

Findings  In this cross-sectional study of over 18 million geotagged social media posts from 3065 counties, joy and anger expressions increased, while fear decreased after the first vaccine dose on December 14, 2020. Democratic-leaning counties and those with higher COVID-19 death tolls showed larger increases in joy.

Meaning  These findings suggest real-time social media monitoring can reveal heterogeneous emotional responses to public health milestones, informing targeted communication strategies.

Abstract

Importance  Public acceptance of the first COVID-19 vaccine administration was not uniform, yet the nature and county-level characteristics of heterogeneous emotional responses remain poorly characterized.

Oral immunotherapy for the treatment of pumpkin seed allergy: a real-world case series

Paradis, V., Kanou, M., Paradis, L. et al.  Allergy Asthma Clin Immunol (2026). https://doi.org/10.1186/s13223-026-01043-z

Abstract

Background

Pumpkin seed, a member of the Cucurbitaceae family, is increasingly consumed because of its high protein content and perceived health benefits. Along with its growing use, cases of pumpkin seed allergy are being reported. However, data on pumpkin seed allergy and oral immunotherapy (OIT) remain scarce.

Methods

We conducted a retrospective chart review at a tertiary pediatric center (Sainte-Justine University Hospital Center, Montreal, Canada) including all patients who initiated or completed pumpkin seed OIT since 2019. OIT protocols were individualized, with dose increases typically performed every four weeks. Target maintenance doses were at least 300 mg of pumpkin seed protein.

Results

Caracteristics of the population

Eleven patients (median age at OIT initiation: 6.5 years; range 1–12) underwent pumpkin seed OIT. Ten patients (91%) reached maintenance dosing within a median of 9.5 months (range 6–22) while one patient discontinued OIT due to persistent abdominal pain.

Safety of Dupilumab and Risk of Cutaneous T-Cell Lymphoma in Pediatric Patients With Atopic Dermatitis: A Data-Driven Guide to Counseling Patients and Families

M. G. Buethe, T. Sy, and L. F. Eichenfield. Pediatric Dermatology (2026): 1–7, https://doi.org/10.1111/pde.70285.

ABSTRACT

Features distinguishing CTCL from AD.

Recent publications reporting increased cutaneous T-cell lymphoma (CTCL) risk with dupilumab in atopic dermatitis (AD) have sparked debate, amplified by media coverage linking dupilumab to lymphoma. These concerns have reached pediatric populations, where we observe increasing parental hesitancy about initiating dupilumab for their children. This hesitancy is particularly acute given that dupilumab was only approved for infants aged 6 months and older in 2022—the first cohort now approaching 3–4 years of exposure.

Preventive Application of House Dust Mite-Sublingual Immunotherapy Induces Blocking Antibodies in Sensitized Preschool Children

V. Dwivedi, K. Schmidthaler, H. Demir, et al. Allergy (2026): 1–12, https://doi.org/10.1111/all.70387. 

ABSTRACT

Background

Sublingual allergen immunotherapy (SLIT) is an effective treatment for immunoglobulin (Ig)E-mediated allergies. Its success is associated with allergen-specific (s)IgG, which blocks IgE-mediated mechanisms. Preventive effects of SLIT in children before allergy-symptom onset remain largely unexplored.

Methods

Graphical Abstract: HDM-pSLIT induced IgG, IgG1, and IgG4 specific
to major HDM allergens in sensitized non-allergic preschool children
without increasing HDM-sIgE. It blunted the development of new
sensitizations and reduced HDM reactivity in skin and basophils.
HDM-pSLIT treated children displayed a blocking effect on
HDM-induced basophil activation.
HDM, house dust mite; Ig, immunoglobulin; pSLIT,
preventively administered sublingual immunotherapy.

A randomized trial was conducted between October 06, 2017 and December 15, 2022, which included house dust mite (HDM)-sensitized preschool children (aged 3–5 years) showing no allergy symptoms. They were randomized (2:2 blocks) to HDM-SLIT (300 index of reactivity/day, Staloral) or placebo solution for 2 years. Children receiving > 4 months of treatment were included in the analysis. Primary objective of the study was to compare the groups for change in major HDM allergen-Der p 1-sIgG levels from baseline to end of treatment (EOT).

Changes in the Use of Montelukast for Asthma After a US Food and Drug Administration Boxed Warning

Shanmugam H, Kesselheim AS, Liu ITT et al. JAMA Netw Open. 2026;9(5):e2614274. doi:10.1001/jamanetworkopen.2026.14274

Key Points

• Question  Did the use of montelukast to treat asthma change after an US Food and Drug Administration (FDA) boxed warning was announced in March 2020?
• Findings  In this cross-sectional study using national monthly cohorts of up to 614 637 patients with asthma from a national commercial claims dataset, the use of montelukast decreased after implementation of an FDA boxed warning.
• Meaning  These findings suggest that treatment patterns for patients with asthma changed after an FDA boxed warning.

Abstract

Importance  In March 2020, the US Food and Drug Administration (FDA) issued a boxed warning for montelukast amid reports of neuropsychiatric adverse effects.

A Multidisciplinary Approach to Checkpoint Inhibitor Adverse Reactions

Andrews C, Mukherjee E, Gibson A  et al. The Journal of Allergy and Clinical Immunology: In Practice, 14, 1058-1072

Abstract

Overlapping cellular and molecular mechanisms
of ICI efficacy and toxicities.

Immune checkpoint inhibitors are used in a wide range of cancers, offering durable responses for a substantial subset of patients. However, immune-related adverse events, the most clinically consequential checkpoint inhibitor–associated adverse reactions, pose a key challenge in practice, affecting virtually any organ system, resulting in treatment interruption, morbidity, or mortality. Patient education, early recognition, and effective management are essential to limit complications and maintain continuity of immunotherapy.

Impact of IL-4/IL-13 Blockade with Dupilumab on the Microbiome in Type 2 Inflammatory Diseases: A Systematic Review

Mari, PV., Carriera, L., Saviano, A. et al.  Curr Allergy Asthma Rep 26, 37 (2026). https://doi.org/10.1007/s11882-026-01281-6

Abstract

Purpose of Review

To systematically review current evidence on microbiota changes associated with dupilumab treatment across different anatomical sites in type 2 inflammatory diseases.

Recent Findings

Compartment-specific microbiome changes associated with dupilumab.
Dupilumab blocks IL-4Rα signaling, inhibiting IL-4 and IL-13 pathways
and promoting site-specific microbiome modulation.

Fifteen studies were included, comprising two randomized trials and thirteen observational studies, mostly in atopic dermatitis, with fewer data in chronic rhinosinusitis with nasal polyps and NSAID-exacerbated respiratory disease. The skin was the most frequently investigated site, followed by the sinonasal tract and gut.