Summary Eczema was not consistently associated with reduced lung function across observational studies. Selected studies identified associations between eczema and longitudinal lung function outcomes in specific populations.
ABSTRACT Background The role of cofactors contributing to anaphylaxis severity remains unclear. Methods We analysed data from the European Anaphylaxis Registry (2007–2024) to determine the impact of suspected cofactors on reaction severity. Adjusted odds ratios (aOR) were calculated for the number of organ systems affected, but also two severity classification systems (Ring/Messmer and Brown). Results At least one suspected cofactor was reported in 8310 cases (49%) out of 16,915. Cofactors were less frequently suspected among younger patients (< 18 years: 26% and ≥ 18 years: 59%). Medication was the most common suspected cofactor in adults (41%), followed by exercise (27%), which was in parallel the most frequent suspected cofactor in children (19%). Emotional burden (children 3%/adults 8%), alcohol (0.4%/8%), sleep deprivation (0.5%/2%) and menstruation (2%/4%) were less commonly reported. We observed a trend between reaction severity and an increasing number of suspected cofactors. Among suspected cofactors, we observed consistent effects on anaphylaxis reaction severity for acute infections among children and alcohol consumption among adults in food‐induced reactions. Moreover, we identified an association between the presence of a suspected cofactor(s) and an increased time interval between exposure and onset of symptoms across all age groups in food‐induced anaphylaxis. Conclusions Our data suggest an age‐dependent role of suspected cofactors in anaphylaxis severity. Clinicians should explore the presence of cofactors in patients who experienced anaphylaxis, in particular in those with prolonged time intervals between exposure and reaction onset.
Summary MAT correlated with cat‐specific IgE but was not interchangeable and may identify cat‐induced asthma‐like symptoms. MAT correlated with objective airway responses in a combined two‐centre inhaled cat allergen challenge cohort.
ABSTRACT Background Peanut allergy remains a clinical challenge, with limited treatment options such as omalizumab (Xolair) and allergen immunotherapy (AIT). However, these are constrained by eligibility and safety concerns. AIT induces protective allergen‐neutralizing IgG4 in most, but not all patients. Allergen‐neutralizing IgG4 competes with allergen‐specific IgE, inhibits FcεRI‐mediated mast cell activation, and inhibits IgE‐facilitated antigen presentation via CD23. Recent findings suggest that combining omalizumab with AIT enhances safety and reduces side effects. We hypothesize that controlled allergen exposure combined with peanut‐specific IgG4 mAbs (MY‐4‐mAbs) prevents IgE binding to peanut allergens, reduces CD23‐mediated allergen presentation and Th2 responses, and skews immunity towards protective allergen‐specific IgG while limiting allergen‐specific IgE induction. Methods PBMCs from peanut‐allergic donors were exposed to Ara h 2 with or without MY‐4‐mAbs. Th2 cytokines, Foxp3+ Tregs, and IgE‐facilitated allergen binding (FAB) to B cells were assessed. In vivo, peanut‐sensitized C3H/HeJ mice underwent oral‐AIT with peanut extract with or without MY‐4‐mAbs and were monitored for anaphylaxis during and after oral‐AIT. Additionally, peanut‐specific IgG and IgE levels were measured before and after oral‐AIT. Results Ex vivo, MY‐4‐mAbs with Ara h 2 suppressed Th2 cytokines, enhanced IL‐10 secretion, and inhibited FAB. MY‐4‐mAbs redirected allergen binding to myeloid antigen‐presenting cells and promoted tolerance‐associated responses. In vivo, the combination maintained peanut‐specific IgG induced during oral‐AIT, prevented increases in IgE, and reduced mast cell activation. Conclusions Allergen‐specific IgG4 mAbs with controlled allergen exposure may improve the safety and efficacy of peanut AIT while promoting tolerance‐associated immune responses, which might allow disease modification towards allergen tolerance.
Summary We observed no differences in skin testing for FQ or vancomycin by dermatographism status. We observed a higher‐than‐expected rate of dermatographism among this drug‐allergic cohort.
