BackgroundHypoallergenic recombinant fold‐variants of major allergens have been suggested as safer and more effective AIT candidates. The Bet v 1‐fold variant BM41, with confirmed preclinical hypoallergenicity and increased immunogenicity, was proposed for the treatment of birch pollen allergy.MethodsWe performed a 6‐month randomized, double‐blind, placebo‐controlled first‐in‐human clinical trial with

BackgroundNasal microbiota composition of patients with diffuse type 2 chronic rhinosinusitis with nasal polyps (CRSwNP) is altered compared to healthy individuals. Dupilumab, an anti‐IL‐4Rα‐mAb, modulates type 2 inflammation, but the effect on microbiota composition in CRSwNP is unknown. The aim of this study was to investigate longitudinal effects of dupilumab on the nasal passage and gastrointestinal

The causative agents of respiratory allergies are bioaerosols, such as house dust mite feces, pollen grains, and fungal spores. Climate change and urbanization are considered to lead to an increase in the load of allergenic bioaerosols due to impacts on plant phenophases and allergenicity. Continuous and efficient monitoring of the atmospheric composition worldwide is essential, given the major changes

BackgroundChronic spontaneous urticaria (CSU) is characterized by mast cell (MC)‐mediated wheals and/or angioedema without identifiable triggers and is driven by MC activation. Barzolvolimab—a monoclonal anti‐KIT antibody—depletes MCs by inhibiting activation of KIT by stem cell factor. We evaluated multiple ascending doses in patients with CSU.MethodsPhase 1b double‐blind placebo‐controlled trial

BackgroundFew studies showed associations of childhood allergic diseases with epigenetic aging using traditional clocks trained mainly on adults. Tracking DNA methylation variation early in life has suggested poor performance of these clocks in children. Therefore, we aim to elucidate the association between allergic diseases and epigenetic age using a pediatric clock.MethodsWe used data from the German

BackgroundEosinophilic Esophagitis (EoE) is a chronic food allergy that causes esophageal inflammation and fibrosis and manifests with symptoms of reflux, chest pain, swallowing difficulty, and food impactions. Though the prevalence of EoE is increasing by ~15% each year, our understanding of EoE immunopathology is limited. A noted feature of EoE is the presence of food‐specific IgG4 antibodies in

BackgroundThere are conflicting data on a potential association between atopic dermatitis (AD) and cardiovascular diseases (CVD). The aim of this study was to further explore this connection and whether there are biomarkers indicating the risk for CVD in AD patients.MethodsWe included 677 AD patients and 79 nonatopic controls from an observational multicenter case–control study (ProRaD: Prospective

BackgroundPenicillins (PENs) are the most frequent drug‐allergic reactions trigger. However, diagnostic work‐up is complex and time‐consuming: it requires skin testing (ST) and drug‐provocation test (DPT), needing faster delabelling strategies. Although direct DPT without previous STs has shown to be safe, most of the studies are performed in children or in North American, Asian, or Oceanian adults

BackgroundDedicator of cytokinesis protein 8 (DOCK8) is a guanine nucleotide exchange factor highly expressed in, and critical for, the function of various innate and adaptive immune cells. DOCK8 deficiency leads to combined immunodeficiency characterized by susceptibility to infections, autoimmunity, and a severe Th2‐type immune response. While dysfunction in various T cell subsets has been implicated

BackgroundPost‐COVID Syndrome (PCS) is the term for a condition with persistent symptoms in a proportion of COVID‐19 patients after asymptomatic, mild, or severe disease courses. Numbers vary, but the current estimate is that after COVID‐19 approximately 10% develop PCS. The aim of our study was to evaluate the impact of SARS‐CoV‐2 infection on the gastrointestinal (GI) tract and associations with

IntroductionTezepelumab is an anti‐TSLP monoclonal antibody approved for the treatment of severe asthma. It has broad downstream anti‐T2 effects, offering the prospect of biological remission. Real‐world data on clinical remission rates with tezepelumab is lacking, and the relationship between clinical and biological remission is unclear. Finally, the effectiveness of tezepelumab in patients who have

Drug‐induced immune reactions are an important burden for patients and health systems. They can be classified into immediate‐drug hypersensitivity reactions (IDHRs) and delayed‐DHRs (DDHRs) based on their phenotype. Drugs do not always behave as allergens and need to bind to proteins, forming adducts. Therefore, IDHRs can be classified as antigenic (IgE, and IgG mediated) and nonantigenic immune responses

Exercise is an important treatment for people with asthma and should be considered alongside pharmacological therapy when developing personalised asthma management plans. Despite this, there remains limited guidance concerning the practicalities of asthma‐specific exercise prescription. This European Academy of Allergy and Clinical Immunology task force was therefore established to achieve three fundamental

BackgroundEosinophils easily accumulate in the intra‐epithelial layer and subepithelial regions in eosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP). While several factors influence the migration of eosinophils from peripheral blood to extravascular tissues, the triggers and role of eosinophils near the epithelial layer in CRSwNP remain unclear.MethodsWe examined interactions between

BackgroundInborn errors of immunity (IEI) are genetic disorders characterized by recurrent and/or severe infections, autoimmunity, autoinflammation, allergies, and cancer. Despite frequent drug exposures due to recurrent infections and comorbidities, the prevalence and characteristics of drug hypersensitivity reactions (DHR) in pediatric patients with IEI remain understudied.MethodsThis multicenter

BackgroundIgE‐mediated fish allergy has long been considered an umbrella term due to the high cross‐reactivity of parvalbumin, the major fish allergen. Yet, clinical tolerance to certain fish highlights allergenicity differences. In this study, we sought to construct a fish allergenicity ladder and identify fish parvalbumin epitopes to improve the diagnosis of fish allergy.MethodsReported clinical

BackgroundPeanut oral immunotherapy (OIT) has shown effectiveness in achieving desensitization of children; however, evidence in adults is lacking.MethodsThis phase II trial evaluated peanut OIT in peanut‐allergic adults using real‐world peanut products. A Simon's minimax two‐stage design, incorporating a stop:go for futility, was employed. A separate untreated control group was also recruited for

BackgroundRegulatory T cells (Tregs) are living drugs with feasibility, tolerability, and therapeutic benefits. Although Tregs are linked to asthma prognosis through inflammation regulation, no therapeutic agents specifically designed to manage asthma by upregulating Tregs have been developed to date.MethodsWe screened a library of 250 natural products using a cytometric bead array. Among the selected

BackgroundHereditary angioedema (HAE) is a rare disease characterized by unpredictable, frequently severe swelling that negatively impacts patients' quality of life (QoL). In the phase III OASIS‐HAE study (NCT05139810), donidalorsen reduced HAE attack rate, increased disease control, and improved QoL. Here, we report further analysis of donidalorsen's impact on QoL and other patient‐reported outcomes

IgE‐mediated allergies play a significant role in respiratory diseases. Given the similar mucosal epithelium of the upper and lower respiratory tracts and their shared (patho)physiological immune responses, the “unified airways” concept views these tracts as a single system. Recently, this model has been extended to include the middle ear, with studies confirming that the Eustachian tube and middle

BackgroundSymptom monitoring can improve adherence to daily medication. However, controlled clinical trials on multi‐modular allergy apps and their various functions have been difficult to implement. The objective of this study was to assess the clinical benefit of an allergy app with varying numbers of functions in reducing symptoms and improving quality of (QoL) life in grass pollen allergic individuals

BackgroundMonkeypox virus (mpox) outbreak since 2022 has already constituted a public health emergency of international concern. A comprehensive study on epidemiological features, symptoms and signs, complications, sequelae, and clinical outcomes has been lacking. Accordingly, we performed a large‐scale multicenter study to comprehensively summarize the clinical, epidemiological, behavioral, laboratory

BackgroundIn Type I hypersensitivity, IgE is the antibody that contributes to the onset of anaphylaxis through the activation of effector cells, causing the release of allergic mediators. Blocking IgE activity with anti‐IgE autoantibodies induced by active immunization could potentially offer an efficient and cost‐effective method to treat allergic disorders. We recently developed an effective and

BackgroundMolecular forms of allergen‐specific immunotherapy (AIT) for cat allergy are needed. Fel d 1, Fel d 4, and Fel d 7 are the most important cat allergens.MethodsIgE epitopes of Fel d 4 and Fel d 7 were mapped by blocking allergic patients' IgE binding with allergen peptide‐specific antisera. Five recombinant fusion proteins (PreS‐Cat 1‐PreS‐Cat 5) each containing hepatitis B virus (HBV)‐derived

Immediate drug hypersensitivity reactions (IDHRs) pose significant diagnostic challenges, often requiring potentially hazardous drug challenge testing (DCT). Flow cytometry‐based cellular tests including the basophil activation test (BAT), the mast cell activation test (MAT) and the T cell activation test (TAT) offer promising alternatives to reduce DCT reliance. While these tests are still in development

We performed an in‐depth appraisal of indirect head‐to‐head comparisons of biologics approved for asthma, including anti‐IL5/5Rα (mepolizumab, benralizumab), anti‐IL4Rα (dupilumab), anti‐TSLP (tezepelumab) and anti‐IgE (omalizumab), which was neither a systematic review nor a meta‐analysis. A crude evaluation of 95% CI's for rate ratios which excluded unity revealed greater overall reductions in annualised