Treatment of allergic rhinitis with allergen immunotherapy in children and adolescents - Adherence, rhinitis severity, and asthma onset

Hedman AM, Lundholm C, Konradsen JR et al. Pediatr Allergy Immunol. 2026 Apr;37(4):e70304. doi: 10.1111/pai.70304.

Abstract

Background

Sublingual immunotherapy (SLIT) has been used to reduce symptoms in allergic rhinitis and to prevent asthma onset. Many studies lack level of adherence and standardized endpoints based on international guidelines.

Objective

We aimed to study the long-term outcomes of allergic rhinitis severity and asthma onset by adherence of SLIT to grass and birch allergens in children and adolescents with allergic rhinitis.

Methods

In a population-based register study, we included all children 5–17 years, with initiation of SLIT between 1 July 2006 and 30 June 2022. Allergic rhinitis severity and asthma onset were based on diagnosis and treatment. Adherence was measured for one, two, and 3 years and divided into low, moderate, and high and compared to only one prescription (reference).

Lipid metabolic regulation of pathogenic type 2 immunity in the airway

Hiroyuki Yagyu, Masahiro Kiuchi, Kiyoshi Hirahara.  International Immunology, 2026;, dxag015, https://doi.org/10.1093/intimm/dxag015

Abstract

IL-33-mediated activation of innate and adaptive type 2 immune cells.

Immune memory is central to host protection against pathogens and contributes to the pathogenesis of chronic inflammatory diseases. Beyond canonical cytokines and antigenic stimuli, metabolic signals have emerged as pivotal regulators of T-cell activation, differentiation, and memory formation. However, the mechanisms by which metabolic and tissue-derived cues imprint pathogenic features on T cells remain poorly understood.

Aesthetic interventions in patients with allergic skin diseases: Risk assessment and evidence-based preventive risk management

 

Yiğit İK, Türsen Ü, Türsen B et al. Clin Dermatol. 2026 Mar 13:S0738-081X(26)00060-X. doi: 10.1016/j.clindermatol.2026.03.001. 

Abstract

The use of aesthetic dermatologic procedures in patients with underlying allergic and inflammatory skin diseases is on the rise, but specific safety considerations are often overlooked. Individuals with hypersensitivity to injectables, chronic inducible urticaria, allergic contact dermatitis, atopic dermatitis, or hereditary angioedema may face an increased risk of adverse reactions triggered by mechanical trauma, injected substances, or disruption of the skin barrier.

Adverse reactions to local anesthetics are predominantly non-IgE-mediated. Thus, preventive strategies should focus on selecting the appropriate agents and employing proper injection techniques rather than routine pharmacologic prophylaxis. Botulinum toxin, hyaluronic acid fillers, and hyaluronidase can rarely cause immediate or delayed hypersensitivity reactions. This highlights the need for individualized risk assessment and avoidance of reexposure in confirmed cases. For patients with chronic inducible urticaria, aesthetic procedures can act as physical triggers.

Frequency and severity of systemic reactions during beta-lactam skin testing in adults with immediate hypersensitivity allergy

Letón-Cabanillas, P., Noguerado-Mellado, B., Quijada-Morales, P. et al.  Allergy Asthma Clin Immunol (2026). https://doi.org/10.1186/s13223-026-01032-2

Abstract

Diagnostic workflow for beta-lactam immediate hypersensitivity skin 

testing

Hypersensitivity to beta-lactams (BL) is the most frequent drug allergy, and skin testing (ST) remains the first-line diagnostic tool. Although generally safe, systemic reactions (SR) during ST are a concern. We conducted a 7-year ambispective study (2018–2025) including 216 adults with confirmed immediate hypersensitivity reactions (HSR) to BL, established by positive skin tests (ST) or drug challenge tests (DCT). Among them, 138 (63.9%) had positive ST, predominantly intradermal tests (IDT; 93.5%). Five patients (3.6% of ST-positive; 2.3% of the entire cohort) developed SR during ST, all after IDT following negative skin prick tests (SPT).

Prediction of allergic disease trajectories from birth up to adolescence

Leskien M, Scheerer M, Thiering E e al. Pediatr Allergy Immunol. 2026 Apr;37(4):e70341. doi: 10.1111/pai.70341.

Abstract

Background

Allergic diseases often develop jointly during early childhood. Potential disease trajectories and relevant early-life factors have been described, yet existing prediction approaches mostly focus on single allergic diseases cross-sectionally. Models addressing allergic multimorbidity and disease trajectories are lacking. We aim to predict allergic disease trajectories from birth up to adolescence using early-life factors.

Methods

Preceding research using data from 4646 adolescents of the German birth cohorts GINIplus and LISA identified seven allergic disease trajectories up to the age of 15 years. A set of predictors comprising parental and perinatal factors, early allergic or respiratory symptoms, lifestyle and environmental factors was used with an XGBoost machine learning approach to perform multiclass classification. In a subsample (N = 2109), polygenic risk scores (PRS) for asthma, allergic rhinitis, atopic dermatitis, and any allergy were added to the predictor set.

Results

Sankey Plot illustrating the distributions of observed and predicted
trajectories and their overlaps.

Our approach revealed moderate classification success (multiclass area under the curve (AUC) = 0.69). A macro-averaged sensitivity of 0.26 and specificity of 0.89 were obtained. The most important predictors were early-life skin rash, respiratory symptoms, and air pollution.

Loss of symbiotic gut bacteria in children at diagnosis of food protein–induced enterocolitis syndrome

Winberg A, Simonyté Sjödin K, Öhlund M, West CE. J Allergy Clin Immunol. 2026 Mar 11:S0091-6749(26)00184-3. doi: 10.1016/j.jaci.2026.02.043.

Abstract
Background

Gut microbial composition has been proposed to influence disease onset in children with food protein–induced enterocolitis syndrome (FPIES).

Objective
We sought to investigate differences in gut microbiota profiles in children with newly diagnosed FPIES and healthy control subjects.

Methods
Fecal samples were collected at FPIES diagnosis from 56 children stratified into 3 age groups: mean (SD) age 4.6 (0.5) months, 6.5 (0.6) months, and 11.7 (7.8) months. Gut microbiota profiles were analyzed using 16S ribosomal RNA gene amplicon sequencing and compared between children with FPIES and 43 age-matched control subjects.

Graphical Abstract

Results
Age was the strongest determinant of gut microbiota composition, followed by FPIES status. β-diversity differed significantly between children with FPIES and control subjects (P < .01), primarily driven by shifts in Bacteroidota, Proteobacteria, Actinobacteriota, and Verrucomicrobiota.

Hypersensitivity to Excipients in Drugs: An EAACI Position Paper

L. H.Garvey, K.Brockow, A.Barbaud, et al.  Allergy (2026): 1–26, https://doi.org/10.1111/all.70324.

ABSTRACT

Characteristics of immediate drug hypersensitivity

reactions (DHR) caused by excipients.

Drugs contain active pharmaceutical ingredients and excipients, compounds which enhance the pharmacokinetics, stability and palatability of the pharmaceutical formulation. While most drug hypersensitivity reactions (DHR) are caused by active ingredients, excipients may also be involved. Excipient-related DHR are easily overlooked and may lead to repeated anaphylaxis in patients exposed to pharmaceutical formulations containing different active ingredients.

Risk Factors for the Development of Food Allergy in Infants and Children: A Systematic Review and Meta-Analysis

Islam N, Chu AWL, Sheriff F, et al. JAMA Pediatr. Published online February 09, 2026. doi:10.1001/jamapediatrics.2025.6105

Key Points

Question  What are the risk factors associated with the development of food allergy in children?

Findings  This systematic review and meta-analysis of 2.8 million participants in 190 studies identified the following largest and most certain risk factors associated with the development of food allergies in children: prior allergic conditions (atopic march/diathesis), atopic dermatitis, increased skin transepidermal water loss, filaggrin gene sequence variations, delayed solid food introduction, infant and intrapartum antibiotic exposure, male sex, being first born, family history of allergy, parental migration, self-identification as Black, and cesarean delivery.

Meaning  This systematic review and meta-analysis clarifies the major and minor risk factors associated with developing early-onset food allergy to inform optimal prevention clinical practice, policy, and research.

Abstract

Importance  The incidence and risk (predictive) factors for early life food allergy development remain uncertain.