Purpose:There are limited studies on the intestinal microbiome in patients with wheat-dependent exercise-induced anaphylaxis (WDEIA), and changes in the gut microbiome in WDEIA patients after wheat-free diet have not been studied. Methods:This is a cross-sectional analysis. Fecal samples and clinical data were collected from 26 non-wheat-free patients with WDEIA, 11 wheat-free patients with WDEIA, and 24 healthy controls (HCs). The gut microbiota was evaluated through metagenomic sequencing. Results:The sequencing revealed differences in the gut microbiome between patients with WDEIA on a non-wheat-free diet and HCs; more specifically, the non-wheat-free group exhibited a downregulation of two families (Rikenellaceae and Odoribacteraceae), three genera (Alistipes, Odoribacter, and Catenibacterium), and four species (Bacteroides_stercoris, Alistipes_putredinis, Bacteroides_intestinalis, and Bacteroides_cellulosilyticus). A wheat-free diet is associated with intestinal flora more similar to the structure of healthy individuals. The species Bacteroides_stercoris was negatively correlated with T-IgE, and the genus Catenibacterium was negatively correlated with T-IgE, as well as wheat, gluten, or gliadin-specific IgE. The genus Catenibacterium was positively correlated with the healthy control-enriched "Apoptosis (ko04210)" pathway and negatively correlated with the non-wheat-free WDEIA group-enriched "Thyroid hormone signaling pathway (ko04919)" pathway. Conclusion:Patients with WDEIA exhibit a specific gut microbiota signature and function, which demonstrated the potential association between the gut microbiome and WDEIA development. WDEIA patients on a wheat-free diet exhibit a gut microbiome composition more similar to healthy individuals.

Background Remibrutinib has recently become available for the clinical management of chronic spontaneous urticaria (CSU) in China, yet relevant clinical experience remains limited, highlighting an urgent demand for population-specific real-world evidence. We therefore evaluated the early effectiveness, safety and clinical utilization of remibrutinib in a heterogeneous Chinese outpatient cohort. Methods This interim analysis was conducted based on an ongoing prospective, multicenter observational cohort enrolling 32 adult patients with CSU receiving treatment in routine outpatient settings. Eligibility criteria did not restrict prior treatment regimens, nor did it limit physician-managed background or rescue therapies for CSU. The safety set consisted of 29 patients who received at least one dose of remibrutinib, and the Week 4 efficacy set comprised 25 patients with evaluable 7-day Urticaria Activity Score (UAS7) data. Assessed outcomes included UAS7, Urticaria Control Test (UCT), Dermatology Life Quality Index (DLQI), 7-day Angioedema Activity Score (AAS7), Angioedema Control Test (AECT), treatment patterns and adverse events. All analyses were descriptive. Baseline UAS7 > 6 was defined as failure to achieve well-controlled disease. Results At remibrutinib initiation, 22 of 27 patients (81.5%) with available baseline UAS7 had not achieved well-controlled disease. Baseline exposure to H1-antihistamines, omalizumab, and systemic corticosteroids was documented in 21 of 29 (72.4%), 19 of 29 (65.5%), and 12 of 29 patients (41.4%), respectively; 20 of 29 (69.0%) had exposure to at least two baseline CSU treatment classes. Two patients (6.9%) initiated remibrutinib after H1-antihistamines as their only documented baseline CSU drug class, and both had baseline UAS7 > 6. At Week 4, mean UAS7 decreased from 19.4 (95% confidence interval [CI], 14.20-24.68) to 5.3 (95% CI, 2.70-7.86). Nineteen of 25 patients (76%) had UAS7 ≤ 6, and 9 of 25 (36%) had UAS7 = 0. Mean UCT increased from 6.36 to 11.56 (P < 0.001), and mean DLQI decreased from 8.56 to 3.24 (P = 0.012). Among four patients with paired angioedema assessments, AAS7 decreased from 44.5 at baseline to 0 at Week 4, while median AECT increased from 3.0 to 16.0. These findings were exploratory because paired observations were limited. Ten of 29 patients (34.5%) reported at least one adverse event (AE); no serious or severe AEs occurred. Petechiae were recorded in 4 of 29 patients (13.8%). Conclusions Across patients with diverse baseline treatment exposures, remibrutinib was associated with rapid improvements in disease activity, disease control, and quality of life by Week 4. However, longer-term follow-up is necessary to assess the durability of these improvements and further characterize the safety profile of remibrutinib. (Chinese Clinical Trial Registry number: ChiCTR2600127540.)

To investigate the clinical outcomes of patients with a history of iodinated contrast medium (ICM)-induced hypersensitivity reactions (HSR) undergoing re-exposure to ICM. Medical records of inpatients who received allergy consultations in Peking Union Medical College Hospital from January 1, 2019 to July 31, 2024 were retrospectively reviewed. Patients with prior ICM-related HSR who subsequently underwent ICM re-administration were enrolled. Of 997 patients referred for allergy consultation, 65 met inclusion criteria, including 47 males (72.3

To evaluate the effectiveness of outdoor field-based teaching in improving the ability of clinical medical postgraduates and visiting trainees to identify allergenic plants, and to provide evidence for optimizing standardized training curricula for allergy specialists. A single-group pre- and post-test design was employed. A two-hour outdoor practical teaching session was conducted at the National Botanical Garden for clinical medical postgraduates and visiting trainees from Peking Union Medical College Hospital. The course was jointly delivered by instructors in botany and allergy, using on-site explanations of representative plant species, analysis of key morphological features, real-time question-and-answer interactions, and guided discussions. Participants completed plant identification tests before and after the course, and a post-course questionnaire was administered to collect student feedback on learning experience and satisfaction. Sixteen students participated in the course. Post-course test scores 90.0 (80.0, 100.0) were significantly higher than pre-course scores 60.0 (42.5, 70.0), with a median improvement of 30 points (P < 0.001). The magnitude of score improvement was negatively correlated with baseline knowledge (ρ = -0.674, P = 0.004). After the course, plant identification accuracy exceeded 80

This nested matched case–control study, embedded in a prospective randomized controlled trial of Artemisia pollinosis prophylaxis, investigated available baseline nasal metabolomic and gut and nasal microbiomic profiles in a matched cohort of 64 patients with Artemisia pollen-induced rhinitis in relation to subsequent acute asthma exacerbation (AAE) during the pollen season. Participants were stratified into AAE (n = 32) and non-AAE (n = 32) groups and matched by prophylactic treatment, family allergy history, and Artemisia-specific IgE grade. Parallel profiling using 16S rRNA sequencing and untargeted metabolomics revealed group-associated microbial and metabolic signatures. The AAE group showed enrichment of several inflammation-associated taxa, whereas the non-AAE group retained multiple commensal-associated taxa. In the primary model containing baseline covariates only, fecal g__Mesorhizobium was associated with AAE status (q = 0.0002), although its environmental origin and the absence of sequenced negative controls preclude exclusion of contamination. Nasal g__Dolosigranulum met the exploratory q < 0.10 threshold (q = 0.068) and should not be regarded as a confirmatory finding. Metabolomic screening identified 128 features meeting the VIP, nominal p-value, and fold-change criteria after exclusion of 16 biologically implausible xenobiotic/drug annotations; none remained significant after Benjamini–Hochberg correction (q = 0.84186). These findings should therefore be considered exploratory, associative signatures that require independent validation.

Background:Alternaria alternata is a major fungal allergen, yet standardized skin prick test (SPT) extracts are lacking in China, hindering the use of this simple, first-line diagnostic tool. Objective:This study aimed to clinically evaluate a novel, domestically developed A. alternata extract for SPT and establish a diagnostic cutoff in a Chinese population. Patients and Methods:In this prospective, single-center study, 910 patients with allergic diseases were consecutively enrolled. All underwent SPT with the in-house A. alternata extract (Alt a 1: 25.7-34.8 µg/mL). Serum-specific IgE (sIgE) (ImmunoCAP™) served as the reference standard. Diagnostic accuracy was analyzed using receiver operating characteristic (ROC) curves. Safety was assessed by monitoring adverse events. Results:The per-protocol set included 610 subjects. The area under the ROC curve was 0.868 (95% CI: 0.839-0.897). The optimal diagnostic cutoff was a mean wheal diameter of 3.25 mm, yielding a sensitivity of 81.10% (95% CI: 76.76%-85.24%) and specificity of 79.32% (95% CI: 74.46%-84.18%). To achieve 95% specificity, the cutoff increased to 4.25 mm. No adverse events were reported among all 910 participants. Conclusion:The novel A. alternata SPT extract demonstrates high diagnostic accuracy for detecting Alternaria alternata sensitization and an excellent safety profile. The established cutoff of 3.25 mm provides a population-optimized threshold for identifying sensitized individuals in China. This study addresses a critical gap in allergen standardization and supports the use of SPT as a reliable first-line tool for assessing fungal sensitization in clinical practice. Trial Registration:ChiCTR ChiCTR1800014899. Registered 13 February 2018 (retrospectively registered).

Although the prevalence of allergic diseases has been rising in China since the late twentieth century, comprehensive nationwide epidemiological data covering all age groups and multiple allergic conditions remain scarce. To investigate the epidemiological patterns of eight major allergic diseases in China, including their national and regional prevalence, demographic distribution, and comorbidity profiles, the National Epidemiology Study of Asthma and Allergies in China (NESAAC) was a nationwide cross-sectional survey conducted from September 2010 to December 2015. A multistage stratified cluster sampling method was employed across seven geographical regions, covering 882 communities and 587 villages in 16 cities. Data were collected via face-to-face interviews using standardized questionnaires. Prevalence was calculated for three categories: lifetime symptoms, current symptoms (past 12 months), and physician-diagnosed history. Among the 121,023 participants analyzed, the current symptom prevalence of each specific disease was: allergic rhinitis (4.2%), asthma (0.9%), eczema (0.7%), drug allergy (0.6%), food allergy (0.4%), urticaria (0.4%), contact dermatitis (0.3%), and anaphylactic shock (0.02%). Geographic variations were notable, with the highest prevalence consistently observed in North, East, and South China. Urban residents had significantly higher prevalence than rural residents across all conditions except anaphylactic shock. Age distribution revealed eczema and food allergy predominance in children under 6 years, whereas asthma and drug allergy prevalence increased with age. Most conditions were more prevalent among females than males. Allergic rhinitis was not only the most common condition but also demonstrated the strongest comorbidity, particularly with asthma. This first nationwide, all-age survey underscores marked epidemiological variations in allergic diseases across China.

Epidemic thunderstorm asthma (ETSA) has historically been characterised around grass pollen in temperate Australia and Europe, whereas reports from northern China suggest an Artemisia-associated and potentially recurrent pattern. This systematic review synthesises primary evidence on the epidemiology, allergen profile, clinical features and early-warning systems of ETSA, comparing the Chinese and grass-pollen experiences. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement, PubMed, Web of Science, the China National Knowledge Infrastructure (CNKI) and Wanfang were searched to 30 June 2026, and reference lists were screened. Two reviewers independently selected studies, extracted data and assessed risk of bias with the Newcastle-Ottawa Scale and the Murad tool; certainty was rated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Because of clinical and methodological heterogeneity, no meta-analysis was performed. Of 436 records identified and 333 screened after de-duplication, 54 primary studies were included (43 international and 11 Chinese, spanning Yulin, Hohhot, Chongqing, Lanzhou and Shenzhen). Three recurring observational patterns were identified. Chinese reports, especially from northern and north-western China, frequently described mugwort (Artemisia) sensitisation rather than ryegrass sensitisation; the proportion without a prior asthma diagnosis was high in both settings (approximately 40

Objective:Artemisia pollen is a major airborne allergen in northern China; however, the relative contributions of environmental pollen exposure and host susceptibility to allergic disease remain unclear in high-exposure regions. Methods:A population-based cross-sectional study was conducted in Yulin City, China, involving 12,345 participants recruited through multistage stratified cluster sampling. Serum Artemisia-specific IgE was measured in 3,130 participants. Disease status was classified into healthy, sensitized, allergic rhinitis, and acute asthma exacerbation groups. Regional pollen exposure was categorized into low, medium, and high levels based on monitoring data. Inverse probability weighting was applied to reduce selection bias. Multivariable logistic regression models were used to assess associations. Results:The IPW-adjusted prevalence of Artemisia sensitization, allergic rhinitis, and acute asthma exacerbations was 13.0%, 10.7%, and 1.9%, respectively. Regional pollen concentration was not significantly associated with sensitization or disease outcomes in adjusted models (all P > 0.05). In contrast, host-related factors, including family history of allergy and Artemisia-specific IgE levels, showed consistent associations across disease stages. Family history of allergy was strongly associated with sensitization (OR = 4.57, 95% CI: 3.01-6.95). Increasing Artemisia-specific IgE levels were associated with higher odds of progression from sensitization to clinical disease and from rhinitis to acute asthma exacerbation. Conclusion:In this high-exposure population, host susceptibility factors demonstrated stronger and more consistent statistical associations with Artemisia-related allergic disease than regional pollen concentration. These findings suggest that host heterogeneity may contribute importantly to disease variability in high-exposure environments; however, causal inference is limited by the cross-sectional design and exposure measurement constraints.

Background Prophylactic treatment for pollinosis is advantageous for managing nasal symptoms in patients with seasonal allergic rhinitis. Inadequate control of rhinitis symptoms increases the risk of acute asthma attacks. Nevertheless, there is limited research on the use of nasal glucocorticoids and antihistamines for the preventive treatment of pollinosis.Objective This study aimed to assess the efficacy of prophylactic treatment for nasal symptoms and acute asthma attacks by enrolling patients with Artemisia pollinosis to use a combined device of azelastine hydrochloride and fluticasone nasal spray prior to the pollen season.Methods The study was registered at Chictr.org.cn (ChiCTR2300073758). A total of 120 patients with Artemisia pollinosis were randomly assigned to either a prophylactic treatment group or a control group at a 1:1 ratio. In the prophylactic treatment group, the nasal spray was initiated approximately two weeks before the onset of the pollen season.Results During both the pollen season and the concurrent medication period, the prophylactic treatment group presented significantly lower total nasal symptom scores (TNSS) (means of 5.97 and 5.94) than the control group (means of 7.86 and 7.80) (P = 0.015 and 0.016). Although the prophylactic treatment group had a lower asthma attack rate than the control group, the difference was not statistically significant (P = 0.284).Conclusions Prophylactic treatment with azelastine hydrochloride and fluticasone propionate nasal sprays can alleviate nasal symptoms and may reduce acute asthma attacks during the pollen season.Clinical Trial Registration [Chictr.org.cn], identifier (ChiCTR2300073758).

BACKGROUND:This study aimed to analyze the risk signals of iodinated and gadolinium-based contrast media associated with anaphylaxis. RESEARCH DESIGN AND METHODS:Data from the United States Food and Drug Administration Adverse Event Reporting System (FAERS) were retrospectively reviewed from January 2004 to September 2022. Disproportionality and Bayesian analyses were used in data mining to screen for suspected anaphylaxis using contrast media. RESULTS:A total of 1240 reports of anaphylaxis associated with contrast media were identified (464 men, 37.4%). The average age of anaphylaxis associated with iodinated contrast media (ICM) and gadolinium-based contrast media (GBCM) was 56.8 ± 17.2 and 50.9 ± 18.0 years old, respectively (p < .001). Among ICM, iopamidol showed the highest reporting odds ratio (ROR) (29.0), and amidotrizoate showed the lowest ROR (7.4). Among low-osmolality ICM, iopamidol had the highest ROR (29.0), and iopromide had the lowest ROR (8.8). Among the macrocyclic agents, gadoteridol had the highest ROR (37.3), while gadoterate meglumine had the lowest (10.4). Among the linear agents, gadobenate dimeglumine had the highest ROR (28.8), and gadodiamide had the lowest (1.4). The mortality rate in ICM was significantly higher than that in GBCM (p < 0.001). CONCLUSIONS:This study provides clinicians and pharmacists evidence for risk signals of anaphylactic reactions among contrast agents.

Hymenopteran insect stings are a risk factor that cannot be ignored for the people allergic to hymenopteran venoms.In China,the current diagnostic tools cannot provide accurate information to identify sensitized insects,thus affecting clinical diagnosis and treatment.Honeybee is a common hymenopteran insect.Due to its wide distribution,large number,and complex venom composition,researchers have carried out recombination schemes for the main allergens of honeybee venom,laying a theoretical foundation for the detection of allergens.The development of diagnostic technologies for allergen components can accurately detect bee venom allergens,providing a new set of clinical diagnosis and treatment schemes for the population allergic to bee venom.

1背景 出生后接触宠物与过敏性疾病风险之间的关系仍然存在争议[1-2],本文介绍一项出生队列研究,该研究表明,出生后早期接触狗可以减少未来哮喘和对吸入性变应原致敏的风险,接触猫有增加致敏的风险.

Background: Wheat-induced anaphylaxis (WIA) is a serious and potentially life-threatening wheat allergy, more common in adults than in children. Little is known about the differences in clinical profiles in WIA among patients of various ages in China.Methods: We analyzed data retrospectively from an allergy department in a tertiary hospital that included 248 patients (208 adults and 40 children and adolescents) with a history of WIA.Results: We found that alcohol was more frequent in patients aged >50 years [older adults] (19.0%, 4/21) than in those aged 12-17 years [adolescents] (0%, 0/33; p = 0.019). The frequency of NSAID use in older adults (42.9%, 9/21) was significantly higher than that in adolescents (0%, 0/ 33; p < 0.001), and patients aged 18-49 years [young adults] (2.8%, 5/178; p < 0.001). During WIA, cardiovascular symptoms in children were less frequent than those in other age groups (children, 28.6%; adolescents, 87.9%; young adults, 93.0%; older adults, 95.2%; p < 0.001). The consciousness loss rate in adults (both age groups; p < 0.001) and the hypotension rate in older adults (p = 0.006) were higher than those in other age groups. Compared with adults (young and older adults), children had a higher rate of allergic comorbidities (p = 0.004, 0.001, respectively) and a higher rate of other food allergies (p < 0.001, <0.001, respectively). Compared with the mild-to-moderate anaphylaxis group, the severe anaphylaxis group had a higher onset age (p = 0.001), higher cofactor prevalence (p = 0.004), lower allergic comorbidity rate (p = 0.014), and higher positive rate of specific IgE to omega-5 gliadin (u-5 gliadin) (p = 0.023).Conclusion: Clinical profiles of patients with WIA are different among various onset age/severity groups. An improved understanding of WIA symptoms in various age/severity groups could help accelerate diagnosis, suggest preventive measures, and contribute to improved patient care.

2023 年8 月7 日至13 日是第八个 "中国过敏防治周" , 今年的主题是 "关注气候、环境和生活方式变化, 预防过敏". 8 月 4 日, 2023 年中国过敏防治周启动会在北京协和医院学术会堂启动. 中国医师协会变态反应医师分会会长尹佳、中华医学会变态反应学分会主任委员程雷、中华预防医学会过敏病预防与控制专业委员会名誉主委刘光辉、中国研究型医院学会过敏医学专业委员会主任委员孙劲旅等出席会议 (图1).

1背景 出生后接触宠物与过敏性疾病风险之间的关系仍然存在争议[1-2],本文介绍一项出生队列研究,该研究表明,出生后第1年接触猫与到18岁时对猫变应原致敏的风险降低有关.

北京协和过敏培训云学院启动会于 2023 年 8月4 日在北京协和医院学术会堂顺利召开, 标志着过敏性疾病专科医师培训及教育领域迈出了重要的一步. 云学院由北京协和医学院培训中心与北京协和医院联合国内顶尖过敏专家共同发起, 旨在加快过敏性疾病诊疗标准化建设, 提升基层医生的诊疗水平, 普及专科知识, 共享行业发展 (图1).

Background: Allergic rhinitis (AR) is a common allergic airway disorder that is often poorly managed. There is an urgent need to enhance medication adherence in order to improve treat-ment outcomes in patients with AR. The efficacy of wearable smart watches in improving medi-cation adherence is currently unclear. Objectives: This study aimed to evaluate the efficacy of a novel smart watch in improving medication adherence and symptom control in patients with AR. The reliability of self-reported medication use was also investigated.Methods: This randomized, open-label, parallel controlled, pilot study enrolled adult patients with AR caused by cypress pollen. Patients were randomized in a 1:2 ratio to an intervention group and control group. Smart watches were only distributed to patients in the intervention group. During the cypress pollen season, all patients were required to take oral antihistamines daily and use nasal corticosteroids and antihistamine eye drops as needed. Daily AR symptom scores and medication usage were recorded in both groups. The smart watch was able to identify medication -taking behaviors of patients via artificial intelligence (AI) and relay this information to physicians, who sent short message service reminders to patients who forgot to take oral antihistamines for more than 2 days.Results: During the pollen season, the adherence rate to oral antihistamines in the intervention group (n = 17) was significantly higher than that in the control group (n = 38) (63.3% +/- 28.5% versus 43.2% +/- 30.2%, P = 0.02). The daily symptom score of the intervention group was lower than that of the control group (2.4 +/- 1.1 versus 3.9 +/- 1.0, P < 0.001). There was no significant difference in the on-demand medication score between the 2 groups (1.3 +/- 0.4 versus 1.5 +/- 0.5, P = 0.13). The consistency rate between self-reported nasal corticosteroid usage and the gold standard (ie, human observation of medication usage in the videos recorded by the smart watch) was 20.0% (0%, 53.7%), and the consistency rate between self-reported antihistamine eye drop usage and the gold standard was 24.3% (2.1%, 67.1%).Conclusions: This pilot study showed that the application of smart watches in patients with AR was associated with improved medication adherence and symptom control. Furthermore, the reliability of self-reported medication usage was limited.