A New Drug Target in Allergic Diseases: Bruton Tyrosine Kinase

Labrador-Horrillo M, Cenni B, Ferrer Puga M.  J Investig Allergol Clin Immunol. 2026 Jun 15;36(3):170-184. doi: 10.18176/jiaci.1183. 

Abstract

BTK signaling transduction pathways and inhibitor binding sites 

Though first recognized as a signaling molecule in B cells, Bruton tyrosine kinase (BTK) has been shown to play a crucial role in signal transduction in innate and adaptive immune cells. BTK is an attractive therapeutic target, given its diverse role in immune regulation. Development of the first-generation BTK inhibitor (BTKi), ibrutinib, revolutionized the treatment of B-cell malignancies. Since its approval, newer-generation BTKis with improved pharmacological properties have been developed, with higher selectivity for BTK and fewer off-target effects than ibrutinib. BTK is essential for IgE-driven allergic responses and may influence IgE antibody production by B cells.

Declining venom immunotherapy: patient characteristics and clinical outcomes

Ueberschaar, S., Trautmann, A. & Stoevesandt, J. Allergy Asthma Clin Immunol 22, 38 (2026). https://doi.org/10.1186/s13223-026-01046-w

Abstract

Background

A largely unknown proportion of Hymenoptera venom-allergic patients do not undergo venom immunotherapy (VIT) despite positive allergy testing and counselling. We aimed to identify factors associated with the refusal of VIT, and evaluate the natural course of venom allergy in untreated individuals.

Methods

Out of 1163 candidates for VIT, 271 (23.3%) declined or postponed treatment for at least 12 months. Complete data from 166 of these patients, who were interviewed and counselled during routine follow-up, were available for retrospective evaluation.

Results

Individualised counselling and recommendation of VIT,
taking into account anaphylaxis severity, risk factors/exposure,
and the patient’s needs, fears, and expectations

Patients declining VIT were significantly more likely to be female (P = 0.012) and had a lower grade of index sting-induced anaphylaxis (P < 0.001) compared to those who accepted treatment.

Novelties in the pragmatic management of anaphylaxis in pediatric age

Marseglia, G.L., Tosca, M.A., Miraglia del Giudice, M. et al.  Eur J Pediatr 185, 480 (2026). https://doi.org/10.1007/s00431-026-07147-3

Intranasal adrenaline in pediatric self-management: promise and limits. 

What is Known:

• Intramuscular adrenaline is the first-line treatment for anaphylaxis and should not be delayed.

• Food is the leading trigger in children, while drugs, venom, and cofactors become more relevant with age.

What is New:

• Intranasal adrenaline is a promising needle-free option, but pediatric evidence remains limited.

• Omalizumab and oral immunotherapy may reduce risk but do not replace emergency preparedness.

Abstract

Anaphylaxis is a time-critical, potentially fatal systemic hypersensitivity reaction. This narrative review summarizes recent advances in the diagnosis and management of anaphylaxis in children and adolescents, with emphasis on new diagnostic frameworks, improved self-management strategies, intranasal adrenaline, and disease-modifying therapies.

Predicting sublingual immunotherapy efficacy in allergic rhinitis

Wang, J., Zhu, X. & Ding, Z.  BMC Pulm Med (2026). https://doi.org/10.1186/s12890-026-04394-w

Abstract

Background

Sublingual immunotherapy (SLIT) efficacy for allergic rhinitis (AR) varies considerably, with 30%–40% of patients showing poor response. A reliable tool integrating multidimensional factors for individualized efficacy prediction remains lacking. This study aimed to construct an optimal prediction model incorporating clinical characteristics, environmental exposure factors, and immune-inflammatory indicators to predict SLIT efficacy in AR patients, and further establish a nomogram as an auxiliary interpretable tool for intuitive clinical application.

Materials and methods

A total of 346 AR patients receiving SLIT were included and randomly allocated to training (n = 242) and validation (n = 104) cohorts at a 7:3 ratio. Baseline data included demographics, clinical features, symptom scores, environmental exposures, and immune-inflammatory indicators. Univariate and multivariate logistic regression analyses were performed to screen independent predictive factors. Three models, including random forest, support vector machine, and conventional logistic regression, were developed for performance comparison. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC), calibration curves, and decision curve analysis (DCA). On the basis of independent predictors, a nomogram was constructed for visual interpretation. Shapley Additive Explanations (SHAP) analysis was further applied to interpret feature importance of the optimal model.

Results

Multivariate logistic regression confirmed these same seven variables as independent predictors of SLIT clinical efficacy in AR: disease duration, baseline symptom score, baseline medication score, air conditioning usage time, specific immunoglobulin E/total immunoglobulin E (sIgE/tIgE) ratio, interleukin (IL)-4, and IL-10 (all P < 0.05).

Predictors of psychosocial burden in parents of children with food allergy

Kubala S, Young F, Callier V et al. Annals of Allergy, Asthma & Immunology, 2026; 0

Abstract

Background

The psychosocial burden of food allergy (FA) impacts the entire family, particularly the affected child and their parents.

Objective

To evaluate psychosocial parental burden (PB) in families of children with FA, identify factors associated with PB, and assess its relationship with child-reported and parent-proxy food allergy quality of life (FAQOL).

Methods

A total of 114 children aged 2 to 17 years with IgE–mediated FA and their parents (mothers = 86.5%) completed validated age-specific FAQOL and PB questionnaires. Associations between demographic and clinical variables and scores were analyzed.

Results

Strict allergen avoidance and trace reactions relate to PB.

Greater PB was associated with more frequent and/or severe reactions, reactions to trace allergen exposures, multiple FAs, wheat or unbaked milk or egg allergy, and/or a history of oral food challenge (regardless of outcome).

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.