Background Fungal sensitization is increasingly recognized as a clinically relevant contributor to allergic diseases. However, in China, the available evidence remains highly fragmented, with substantial variability across regions and study designs. Objective To provide a comprehensive and critical synthesis of the epidemiological patterns, dominant allergenic fungal species, diagnostic approaches, and key research gaps in fungal sensitization across China. Methods We systematically reviewed 105 studies spanning 27 provincial-level administrative regions and encompassing tens of thousands of patients with allergic conditions. Study characteristics, sensitization rates, fungal species distribution, and diagnostic methodologies were extracted and comparatively analyzed. Results Reported fungal sensitization rates showed striking heterogeneity, ranging from <2% to >75%, largely influenced by geographic location, climatic conditions, study populations, and testing strategies. Higher sensitization was consistently observed in warm and humid regions, particularly during spring and summer. The most frequently reported allergenic fungi included Aspergillus fumigatus, Alternaria, and Penicillium. Notably, nearly half of studies relied on mixed mould extracts, substantially limiting species-level resolution. Current diagnostic practices are dominated by skin prick testing and serum-specific IgE assays; however, allergen panels remain narrow and lack standardization across centers. The majority of studies were single-center, clinic-based, and cross-sectional, with a near absence of nationwide prospective data. Conclusion The existing evidence is insufficient to delineate a robust and internally consistent national profile of fungal sensitization in China. Addressing this gap will require coordinated multicenter prospective studies, expansion of allergen panels, adoption of component-resolved diagnostics, and integration of environmental exposure data. Such efforts are essential to advance both epidemiological understanding and precision management of fungal allergy.
Background Significant progress has been made in the clinical awareness and management of Hereditary angioedema (HAE) in China in recent years. This study aims to comprehensively evaluate the current status of HAE in China through a multicenter cross-sectional questionnaire survey. Methods This study employed an online questionnaire survey targeting major public hospitals in China that manage confirmed HAE cases. The questionnaire covered 3 dimensions: number of cases, analysis of diagnostic pathways, and therapy accessibility. Results Twenty valid questionnaires were collected across 18 regions in China, including the mainland and the Hong Kong Special Administrative Region (SAR). The study aggregated 1097 confirmed HAE cases, with HAE with C1 inhibitor (C1–INH) dysfunction (HAE-C1-INH) Type 1, HAE-C1-INH- Type 2HAE-C1-INH-1HAE-C1-INH-2, and HAE with normal C1-INHaccounting for 94.8%, 4.2%, and 1.0% of cases, respectively. The number of confirmed cases was significantly lower than estimates based on international prevalence rates, indicating substantial underdiagnosis in China. Among the participating hospitals, only 5 could perform clinical C1–INH antigen level testing. C1–INH functional testing is not approved for clinical use in mainland China and is only routinely available in Hong Kong SAR. In the participating hospitals, 75% have icatibant, and 80% have lanadelumab, which are covered by the National Reimbursement. Additionally, several clinical trials are undergoing, including C1–INH replacement, BW-20805, PHVS416/PHVS719, garadacimab, STAR-0215, and ADX-324. Conclusions The number of confirmed HAE patients in China remains markedly lower than estimates derived from international prevalence rates, suggesting substantial underdiagnosis. Standardized C1–INH antigen level and functional assays are not widely available nationwide. Although accessibility of first-line therapies has improved and multiple clinical trials are ongoing, the repertoire of marketed therapeutic agents in China remains limited.
Background In regions with prolonged and intense exposure to olive pollen, sensitization to minor allergens such as Ole e 7 and Ole e 9 and their specific IgE levels tend to increase. This has raised concerns regarding a potentially higher risk of adverse reactions during allergen immunotherapy. Objective To assess subcutaneous immunotherapy (SCIT) safety and the clinical outcomes observed after 1 year of treatment in routine clinical practice in patients with olive pollen–induced allergic respiratory disease, according to their molecular sensitization profiles. Methods This retrospective observational study included patients with rhinitis and/or asthma caused by olive pollen sensitization who received SCIT with a depigmented, polymerized olive pollen extract. Olive allergen sensitization profiles were determined using component-resolved diagnosis, and their association with disease severity, treatment tolerance, and clinical response was assessed. Results A total of 196 patients were included in the analysis. Rhinitis was present in 97% of patients and asthma in 94%, predominantly of moderate persistent severity. Sensitization to Ole e 1 was observed in 96% of patients, whereas 73% and 68% were sensitized to Ole e 7 and Ole e 9, respectively; 58% were sensitized to all 3 components. Six late local reactions and 1 grade 3 systemic reaction (EAACI classification) were reported. Clinical improvement according to the predefined clinical response criteria was observed in 76% of patients, along with a reduction in rescue medication use and a decrease in the number of patients requiring emergency department visits, from 60 at baseline to none after 1 year of follow-up. No association was observed between molecular sensitization profiles and SCIT tolerability or clinical response. Conclusion SCIT with a depigmented polymerized olive pollen extract was well tolerated and was associated with favorable one-year clinical outcomes in a population with high environmental exposure to olive pollen, irrespective of sensitization to minor olive allergens.
