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        <title>Frontiers in Allergy | New and Recent Articles</title>
        <link>https://www.frontiersin.org/journals/allergy</link>
        <description>RSS Feed for Frontiers in Allergy | New and Recent Articles</description>
        <language>en-us</language>
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        <pubDate>2026-05-03T17:03:09.217+00:00</pubDate>
        <ttl>60</ttl>
        <item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/falgy.2026.1807883</guid>
        <link>https://www.frontiersin.org/articles/10.3389/falgy.2026.1807883</link>
        <title><![CDATA[Cultural sensitivity and patient-centered care regarding incense and candle smoke emissions]]></title>
        <pubdate>2026-05-01T00:00:00Z</pubdate>
        <category>Perspective</category>
        <author>Gomeo Lam</author><author>Cameron Nejat</author><author>Mary F. Lee-Wong</author>
        <description><![CDATA[Incense and candles are commonly utilized for relaxation, deodorization, aesthetics, and religious observance. Both are used ubiquitously and viewed innocuously. However, both modalities release a multitude of compounds, including carbon monoxide, benzene, acrolein, and polycyclic aromatic hydrocarbons, that carry documented risks for cardiovascular disease, pulmonary dysfunction, and cancer. Incense particulate matter generates 45 mg/g vs. 10 mg/g from cigarette smoke. The following two clinical cases illustrate this challenge: an 87-year-old woman with chronic obstructive pulmonary disease and asthma whose acute dyspnea was temporally associated with incense burning during ancestral worship and a 31-year-old atopic asthmatic woman whose symptoms were repeatedly triggered by meditative relaxation through lighting candles. For many patients worldwide, these practices are inseparable from cultural identity and religious devotion, rendering simple cessation counseling insufficient. This article explores the current evidence on health hazards from incense and candle smoke, synthesizes their cultural and religious significance across major traditions, and proposes a structured framework for clinician communication. Practical recommendations, including electronic alternatives, burn duration reduction, improved ventilation, and culturally sensitive phrasing, are presented to help clinicians navigate these conversations effectively. A summary table comparing health risks, cultural roles, and alternative options is provided as a practical clinical reference. Recognizing the cultural and religious significance of incense and candle use across diverse populations is a prerequisite for delivering care that is both clinically effective and respectful of patient values.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/falgy.2026.1819491</guid>
        <link>https://www.frontiersin.org/articles/10.3389/falgy.2026.1819491</link>
        <title><![CDATA[Emerging perspectives in respiratory allergic diseases: a review of future directions]]></title>
        <pubdate>2026-04-29T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Rafael Durán</author><author>Sergio E. Chiarella</author><author>Thanai Pongdee</author><author>Juyoung Choi</author><author>Martin Maillo</author><author>Cesar A. Galván</author>
        <description><![CDATA[BackgroundRespiratory allergic diseases are experiencing changes influenced by genetic factors, environmental shifts, and social and demographic elements. These evolving patterns, together with rapid advances in diagnosis and treatment, require a thorough review of emerging trends.ObjectiveTo examine future directions in managing respiratory allergic diseases, focusing on changing disease patterns, environmental factors, diagnostic innovations, and therapeutic advances toward precision medicine. A literature search was conducted in PubMed and Scopus databases covering 2015–2025. Studies addressing human populations with allergic rhinitis or asthma were included, emphasizing emerging patterns, environmental factors, diagnostic technologies, and therapeutic innovations, while reviews, conference proceedings, case reports, and studies without clinical relevance were excluded. Initial screening identified 52 studies, and 21 additional studies were identified through complementary searches, resulting in 73 studies in the final analysis.Summary of findingsClimate change is a key factor affecting disease patterns, with pollen seasons starting 10–40 days earlier and yearly emissions increasing by up to 200%. Regarding pathogenesis, early-life rhinovirus C infections with IgE sensitization significantly increase asthma risk (HR = 4.06), while severe asthma shows 40–84% eosinophilic patterns, depending on the assessment approach. On the diagnostic front, advances include multiplex platforms, proteomic biomarkers, and microRNAs. Therapeutically, innovations encompass biologics combined with allergen immunotherapy, nanobody-based therapeutics, and microbiota interventions.ConclusionsThese developments point toward personalized management of respiratory allergic diseases. However, challenges remain in research with underrepresented populations and accessibility. Moving forward, the key priority is integrating this diverse knowledge into practical strategies that advance precision medicine in respiratory allergic diseases.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/falgy.2026.1795685</guid>
        <link>https://www.frontiersin.org/articles/10.3389/falgy.2026.1795685</link>
        <title><![CDATA[Sensitization to 19 allergen sources in 2,124 children in Kashi Prefecture, China: a single-center cross-sectional retrospective study]]></title>
        <pubdate>2026-04-29T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Riziwanguli Maitusong</author><author>Asimuguli Wubuli</author><author>Ayiguli Saimaier</author><author>Lifang Li</author><author>Gumina Kamili</author><author>Muyesaier Maimaiti</author><author>Rexiati Dawuti</author>
        <description><![CDATA[ObjectivesTo investigate the sensitization to common allergen sources among children in Kashi Prefecture and offer a scientific foundation for preventing allergic diseases in this demographic.MethodsThe study retrospectively collected the detection results of serum allergen-specific IgE antibodies from 2,124 children at the First People's Hospital of Kashi Prefecture from January 2022 to December 2024.ResultsThe overall sensitization rate detected by sIgE was 42.70%. Within the sensitization cases, inhalant allergens had a sensitization rate of 29.52%. The most frequent allergen sources included tree combinations (330 cases, 15.54%), cat fur (243, 11.44%), and Artemisia argyi (195, 9.18%). The sensitization rate for food allergens was 24.01%, with egg whites (229, 10.78%), milk (130, 6.12%), and peanuts (99, 4.66%) being the most frequent sources. Sensitization to tree combinations, Ambrosia artemisiifolia, cat fur, and peanuts was significantly higher in boys compared to girls. Tree combinations, Ambrosia artemisiifolia, Artemisia argyi, house dust, cat fur, mold combinations, and Humulus scandens exhibited an increasing trend in sensitization rate with age, whereas egg whites, milk, and beef exhibited decreasing trends with age. The sensitization rates for tree combinations, house dust, and mutton displayed significant seasonal variations.ConclusionsSensitization to common allergens was prevalent among children in Kashi, although only a small number exhibited allergic symptoms. The sensitization rates for common allergens varied significantly based on sex, age and season. These results suggest that sIgE detection of specific allergens can aid in identifying triggering factors, which is crucial for preventing allergic diseases.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/falgy.2026.1799085</guid>
        <link>https://www.frontiersin.org/articles/10.3389/falgy.2026.1799085</link>
        <title><![CDATA[The nasal-oral microbiome axis in allergic rhinitis: environmental triggers, microbial dysbiosis, and immune dysregulation]]></title>
        <pubdate>2026-04-28T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Yuan Li</author><author>Yue Sun</author><author>Lei Shi</author><author>Aiping Wang</author><author>Xue Gao</author><author>Hui Leng</author>
        <description><![CDATA[Allergic rhinitis (AR) is a common chronic inflammatory disease, which affects about 400 million people around the world. The role of the upper airway microbiota in the development of AR has recently emerged and seems to be an important player in its pathology, but there are still no detailed mechanistic models that incorporate exposure to the environment, dysbiosis of microbes or dysregulated immunity as a whole. In this review we summarize the state of the art about the microbiome nose-mouth connection in AR to understand how environmental stimuli change the microbiota composition as well as how an imbalance can induce allergy-related inflammation. This review follows a narrative approach. Literature was identified through systematic searches of PubMed, Web of Science, and Scopus databases (up to March 2025) using the following key terms and their combinations: “allergic rhinitis’, “nasal microbiome”, “oral microbiome”, “dysbiosis”, “epithelial barrier”, ’short-chain fatty acids’, “Th2 inflammation”, and “probiotics”. Inclusion criteria encompassed original research articles, systematic reviews, and meta-analyses published in English; conference abstracts, case reports, and purely non-human studies were excluded unless they provided mechanistic insights not available from human data. Environmental exposures substantially alter upper airway microbial communities. Air pollutants such as PM₂.₅ and diesel exhaust particles (DEP) damage epithelial tight junction proteins via reactive oxygen species (ROS), increasing nasal permeability. DEP additionally functions as an immune adjuvant by promoting pro-Th2 immune polarization. Antibiotic treatment during early childhood may affect GI tract development by altering resident bacterial populations, being considered as a strong risk factor for developing AR. On the other hand, farm exposure and microbial diversity provide protection by enhancing regulatory T cell induction. AR patients exhibit characteristic nasal dysbiosis, including overgrowth of Staphylococcus aureus and Moraxella catarrhalis alongside depletion of protective commensals such as Dolosigranulum pigrum and Corynebacterium spp. This dysbiosis disrupts the epithelial barrier, triggering alarmin release (TSLP, IL-25, IL-33) and amplifying type 2 inflammation. The oral microbiota also contributes via the oral-nasal-pulmonary axis whereby periodontal pathogens are pro-inflammatory while commensals have immunomodulatory roles. Mechanistically, microbiome-derived metabolites—especially short chain fatty acids and tryptophan derivatives—regulate the immune system via G protein-coupled receptors, histone deacetylase inhibition, and aryl hydrocarbon receptor activation. Dysbiosis promotes Th2 polarization, Treg/Th17 imbalance, and the activation of ILC2s, whereas neuro-immune interactions via TRPV1/TRPA1 enhance neurogenic inflammation. Translation to clinical opportunity: Microbiome based diagnostic biomarker; Probiotic (nasal/oral); Prebiotics; postbiotics, and engineered bacteria. Multi-omics based precision medicine using ML to stratify patient and tailor intervention. In summary, this review offers an insight into the theory of the microbiome-immunology interplay in AR as well as new avenues to consider regarding treatment of this condition through the nasal-oral microbiota axis.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/falgy.2026.1757776</guid>
        <link>https://www.frontiersin.org/articles/10.3389/falgy.2026.1757776</link>
        <title><![CDATA[Diagnostics and monitoring in Hymenoptera venom allergy: current and future perspectives]]></title>
        <pubdate>2026-04-24T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Weronika Wilińska</author><author>Aleksandra Starosz</author><author>Kamil Grubczak</author>
        <description><![CDATA[Hymenoptera stings are a major trigger of IgE-mediated anaphylaxis, yet only a minority of exposed individuals develop systemic reactions, making accurate diagnosis essential but complex. This review synthesizes current evidence across clinical, serologic, cellular and molecular diagnostic modalities in Hymenoptera venom allergy. Clinical history and epidemiologic predictors—such as occupation, cumulative sting exposure, reaction latency, comorbidities and quality-of-life impairment, provide crucial context but lack sufficient predictive power when used alone. Skin prick and intradermal testing remain first-line tools due to high sensitivity, although interpretation is limited by interspecies cross-reactivity, extract variability and reduced reliability shortly after a sting. Serum IgE and component-resolved diagnostics improve species identification but are influenced by cross-reactive carbohydrate determinants and cannot reliably predict reaction severity or venom-immunotherapy outcomes. Basal and acute tryptase measurements contribute significantly to risk stratification and detection of clonal mast-cell disorders, though normal values do not exclude severe reactions. Functional assays, including basophil activation testing, histamine-release assays and emerging mast-cell activation platforms, provide dynamic confirmation of effector-cell reactivity in diagnostically challenging cases. Controlled sting challenge remains the reference method for confirming clinical reactivity or protection but is reserved for selected high-risk patients due to inherent procedural risks. Novel biomarkers such as osteopontin, KIT mutations, PGD2 metabolites, regulatory T-cell signatures and multi-omic molecular profiles offer promising avenues for future refinement. Overall, evidence supports a multimodal, individualized diagnostic strategy integrating clinical context with complementary laboratory and functional tests.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/falgy.2026.1666241</guid>
        <link>https://www.frontiersin.org/articles/10.3389/falgy.2026.1666241</link>
        <title><![CDATA[Actual use of PROMs in asthma and rhinitis recommended by guidelines in clinical settings: PROMUSE respiratory study]]></title>
        <pubdate>2026-04-24T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Ivan Cherrez-Ojeda</author><author>Jean Bousquet</author><author>Torsten Zuberbier</author><author>Juan C. Calderon</author><author>Pavel Kolkhir</author><author>Anastasiia Allenova</author><author>Andrey Allenov</author><author>Sergey Tkachenko</author><author>Florin Mihaltan</author><author>Ruxandra Ulmeanu</author><author>Mona Al-Ahmad</author><author>Mònica Rodriguez-González</author><author>Guillermo Wakida-Kusunoki</author><author>German D. Ramon</author><author>Maia Rukhadze</author><author>Désirée E. Larenas-Linnemann</author><author>Mitja Košnik</author><author>Juan Carlos Ivancevich</author><author>Luis Felipe Ensina</author><author>Nelson A. Rosario Filho</author><author>Violeta Kvedariene</author><author>Herberto Jose Chong-Neto</author><author>Ivan Tinoco</author><author>Anna Bedbrook</author><author>Gabriela Rodas-Valero</author><author>Marco Faytong-Haro</author><author>Marcus Maurer</author><author>Oliver Pfaar</author><author>Karla Robles-Velasco</author>
        <description><![CDATA[RationaleGuidelines advise for the implementation of patient-reported outcomes (PROMs) to provide crucial insights into patients' perceptions of their disease burden, treatment needs, and quality of life. Despite their proven benefits in managing chronic respiratory diseases like asthma, allergic rhinitis (AR), and rhinosinusitis (RS), there is limited data on their adoption among physicians treating these conditions.ObjectivesOur objective is to identify the utilization patterns of PROMs, together with the reasons for their usage and the barriers to their adoption among practitioners managing patients with asthma, AR, and RS.MethodsThis was a cross-sectional observational study using a questionnaire encompassing all pertinent PROMs and disseminated to practitioners associated with the ARIA, UCARE, ADCARE, and ACARE networks. Individuals unfamiliar with PROMS or lacking prior experience with it were eliminated. Descriptive and analytical data were utilized, categorized by the frequency and type of PROMs applied. Stata 18.0 was utilized, with p < 0.05 indicating statistical significance.ResultsA total of 439 practitioners participated, with PROMs predominantly utilized by physicians certified for over 30 years and by respiratory specialists (16.67% and 12.46%, respectively; p < 0.05). Pulmonologists exhibited the greatest utilization of asthma PROMs at 86%, while allergists predominantly employed AR and RS PROMs at 38.42% and 33.33%, respectively (p < 0.001). ACT (66.74%), RCAT (27.79%), and SNOTT22 (15.26%) were the predominant PROMs utilized primarily for asthma (79.19%), AR (51.23%), and RS (57.26%), respectively (p < 0.001). The foremost purposes for their application were disease control monitoring (93.39%) and evaluation of performance of therapy approaches (90.2%). The most significant barrier identified was time constraint, rated at 75.40% (p > 0.05 across all groups).ConclusionsThe use of PROMs is suboptimal, primarily due to time limitations. It is imperative that methods be swiftly implemented to include these techniques into the therapeutic environment to attain enhanced outcomes.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/falgy.2026.1740307</guid>
        <link>https://www.frontiersin.org/articles/10.3389/falgy.2026.1740307</link>
        <title><![CDATA[The testosterone paradox in asthma]]></title>
        <pubdate>2026-04-23T00:00:00Z</pubdate>
        <category>Mini Review</category>
        <author>Ynuk Bossé</author>
        <description><![CDATA[Asthma and an excessive response to inhaled methacholine, commonly called hyperresponsiveness, are intimately linked. Therefore, factors increasing the methacholine response are expected to contribute to asthma as well. However, this is clearly not the case for testosterone, the predominant sex hormone in males. While testosterone increases the methacholine response, it is rather protective in asthma and experimental asthma. These incompatible observations are referred herein as the ‘testosterone paradox’, and the chase is now on to unravel its underlying mechanisms.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/falgy.2026.1786200</guid>
        <link>https://www.frontiersin.org/articles/10.3389/falgy.2026.1786200</link>
        <title><![CDATA[Nickel(II) sulphate–induced allergic contact dermatitis as experimental tool to investigate inflammatory pruritus in humans]]></title>
        <pubdate>2026-04-22T00:00:00Z</pubdate>
        <category>Brief Research Report</category>
        <author>Karoline Lukaschek</author><author>Kiran Kumar Bali</author><author>Konstantin Agelopoulos</author><author>Mustafa Kaplan</author><author>Sonja Ständer</author><author>Roman Rukwied</author><author>Elke Weisshaar</author>
        <description><![CDATA[Allergic contact dermatitis is a leading cause of occupational skin disease, with nickel(II) sulphate representing one of the most prevalent contact allergies worldwide. Clinically, nickel-induced dermatitis is characterised by pronounced inflammation and intense pruritus. The functional role of endogenous mediators, structural neuronal changes, and molecular mediators contributing to the generation of itch in allergic contact dermatitis still needs to be investigated. We present nickel(II) sulphate-induced contact dermatitis as a mechanistic model to investigate pruritus under controlled conditions in humans. Thereby, we can combine and correlate clinical characterisation of nickel(II) sulphate contact dermatitis with psycho-physical, structural, and molecular analyses to identify inflammatory pathways, mediator profiles, and gene regulatory pathways involved in pruritus generation. By enabling the systematic characterisation of itch mechanisms at molecular, structural, and functional, levels, this approach provides a translational scope to advance our understanding of pruritogenic pathways and for developing targeted therapeutic strategies in allergic contact dermatitis.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/falgy.2026.1846379</guid>
        <link>https://www.frontiersin.org/articles/10.3389/falgy.2026.1846379</link>
        <title><![CDATA[Editorial: Allergen cross-reactivity - a challenge in daily practice]]></title>
        <pubdate>2026-04-21T00:00:00Z</pubdate>
        <category>Editorial</category>
        <author>Marcin Kurowski</author><author>Rosemarie DeKruyff</author><author>Daniela Briceno Noriega</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/falgy.2026.1781121</guid>
        <link>https://www.frontiersin.org/articles/10.3389/falgy.2026.1781121</link>
        <title><![CDATA[Recall urticaria caused by vedolizumab: case report and literature review]]></title>
        <pubdate>2026-04-21T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Mio Kozuma</author><author>Reiko Hara</author><author>Yumiko Sakuragi</author><author>Natsuko Saito-Sasaki</author><author>Yu Sawada</author>
        <description><![CDATA[Recall urticaria is a rare hypersensitivity phenomenon characterized by the reappearance of urticarial wheals strictly confined to previously exposed skin sites following systemic re-exposure to a trigger. Although reported with several drugs, its clinical features and underlying mechanisms remain poorly defined. A 25-year-old man with ulcerative colitis developed acute pruritic wheals localized exclusively to prior subcutaneous injection sites approximately 15 min after intravenous administration of vedolizumab. He had experienced repeated localized injection-site reactions during prior subcutaneous therapy. Histopathology revealed mild perivascular inflammation with eosinophils. The eruption resolved spontaneously within 24 h without systemic symptoms, and vedolizumab therapy was continued. This case represents the first report of vedolizumab-associated recall urticaria. A review of previously reported cases highlights strict site specificity as the defining feature, irrespective of the route or timing of re-exposure. Recall urticaria should be recognized as a site-specific hypersensitivity reaction distinct from systemic drug allergy.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/falgy.2026.1807126</guid>
        <link>https://www.frontiersin.org/articles/10.3389/falgy.2026.1807126</link>
        <title><![CDATA[A novel nasal-to-oral airflow pressure ratio as an objective indicator of nasal obstruction]]></title>
        <pubdate>2026-04-17T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Shiqi Wang</author><author>Baoshi Fan</author><author>Yuntian Bao</author><author>Yusong Dai</author><author>Minghui Wang</author><author>Xindi Yang</author><author>Wendong Liu</author><author>Caifeng Xia</author><author>Yu Song</author>
        <description><![CDATA[ObjectiveTo introduce and clinically validate, for the first time, a novel nasal-to-oral airflow pressure ratio as an objective metric for assessing nasal obstruction. This ratio is designed to capture compensatory breathing patterns and to improve correlation with subjective symptoms compared with existing assessment methods.MethodsA total of 108 patients with self-reported nasal obstruction and 26 healthy controls were enrolled. A custom-designed face mask equipped with pressure sensors recorded nasal airflow pressure during quiet breathing and oral airflow pressure during forced oral breathing. The nasal-to-oral airflow pressure ratio was calculated and correlated with visual analogue scale (VAS) scores for nasal obstruction using Spearman's correlation. Sex-specific subgroup analyses were performed.ResultsThe nasal-to-oral airflow pressure ratio was significantly lower in patients with nasal congestion than in controls (0.13 ± 0.10 vs 0.23 ± 0.12; p < 0.001). The ratio showed a strong negative correlation with VAS scores (ρ = −0.645; p < 0.001), outperforming traditional metrics for assessing nasal obstruction. Sex-specific analyses revealed consistent trends in both males and females, with a slightly stronger correlation in female patients.ConclusionThis study provides the first clinical validation of the nasal-to-oral airflow pressure ratio as a sensitive, practical, and objective indicator of nasal obstruction. By incorporating compensatory oral breathing dynamics, the ratio bridges the gap between subjective sensation and traditional objective measurements, offering a low-cost, easy-to-deploy tool for broad clinical use.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/falgy.2026.1842074</guid>
        <link>https://www.frontiersin.org/articles/10.3389/falgy.2026.1842074</link>
        <title><![CDATA[Editorial: Allergic diseases through precision medicine]]></title>
        <pubdate>2026-04-17T00:00:00Z</pubdate>
        <category>Editorial</category>
        <author>Patricia Agudelo-Romero</author><author>Enza D'Auria</author><author>Anthony Bosco</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/falgy.2026.1760856</guid>
        <link>https://www.frontiersin.org/articles/10.3389/falgy.2026.1760856</link>
        <title><![CDATA[Digital health in allergy care: current practices, evidence, and future prospects]]></title>
        <pubdate>2026-04-14T00:00:00Z</pubdate>
        <category>Mini Review</category>
        <author>Olga Lourenço</author><author>Adriano N. Raposo</author>
        <description><![CDATA[This mini-review summarizes the current applications of digital tools in allergy care, including telemedicine platforms, mobile health technologies, and AI-based decision support systems. It critically examines available evidence, benefits, and challenges for clinical practice and outlines future directions for integrating digital health into personalized allergy management. Mobile apps and wearable sensors enable real-time tracking of symptoms, medication use, and environmental triggers, providing actionable data that supports proactive disease management. Continuous data streams enhance clinicians’ ability to adjust treatment promptly and personalize care. AI-driven tools offer emerging opportunities for predictive modeling and decision support, while telemedicine expands access and convenience. Together, these innovations may support more patient-centered, equitable, and data-informed care.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/falgy.2026.1789143</guid>
        <link>https://www.frontiersin.org/articles/10.3389/falgy.2026.1789143</link>
        <title><![CDATA[The AhR–TLR4 axis in non-IgE-mediated Cow's milk allergy: a systematic review with integrated multi-omics corroboration]]></title>
        <pubdate>2026-04-14T00:00:00Z</pubdate>
        <category>Systematic Review</category>
        <author>Wei Kong</author><author>Bin Wu</author><author>Ying Huang</author><author>Haiying Liu</author><author>Congfu Huang</author>
        <description><![CDATA[Background & aimsNon-IgE-mediated cow's milk allergy (non-IgE-CMPA) is the most prevalent form of CMPA in infancy; however, its pathogenesis is still poorly understood, which impedes the development of targeted nutritional strategies. Recent evidence suggests a connection between gut dysbiosis and immune dysregulation. Therefore, this systematic review, incorporating multi-omics corroboration, sought to clarify a pathogenic axis driven by dysbiosis and involving the aryl hydrocarbon receptor (AhR) and Toll-like receptor 4 (TLR4). Furthermore, the review aimed to evaluate related predictive biomarkers and potential therapeutic approaches.MethodsWe synthesized evidence from 39 studies of infants (0–3 years) with physician-confirmed non-IgE-CMPA, following PRISMA guidelines. To visually corroborate key mechanistic pathways at cellular resolution, we performed an integrative analysis of publicly available single-cell RNA sequencing datasets from pediatric intestinal biopsies.ResultsNon-IgE-mediated CMPA exhibits a distinct gut dysbiosis signature, characterized by decreased Bifidobacterium and increased Enterobacteriacea. This dysbiosis is associated with reduced microbial AhR ligands and TLR4 pathway in intestinal epithelial cells. A B/E ratio <0.5 at 3 months of age predicted persistent allergy (HR = 1.9, AUC = 0.82). scRNA-seq data confirmed IEC-specific upregulation of TLR4 co-receptors (CD14, LY96), activation of the NLRP3 inflammasome, and reduced expression of intestinal barrier integrity markers. Synbiotic intervention (LGG + HMOs) was associated with a 67% resolution of symptoms.ConclusionEarly-life gut dysbiosis may disrupt AhR–TLR4 crosstalk, leading to NLRP3-mediated inflammation and barrier dysfunction in non-IgE-mediated CMPA. Bradford Hill criteria suggest a causal relationship for this pathway. Furthermore, the B/E ratio holds promise for early risk stratification, and synbiotics represent a potential mechanism-guided nutritional strategy for restoring microbial-immune homeostasis.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/view/CRD42025104533, PROSPERO CRD420251045333.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/falgy.2026.1783914</guid>
        <link>https://www.frontiersin.org/articles/10.3389/falgy.2026.1783914</link>
        <title><![CDATA[Hereditary α-tryptasemia; a review of mechanisms linking α-tryptase gene dosage to intestinal homeostasis and immunopathology]]></title>
        <pubdate>2026-04-14T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Ilaria M. Simeone</author><author>Michelle Galeas-Pena</author><author>Katelyn White</author><author>Brandy Sullivan</author><author>Alexandra Morelli</author><author>Jocelyn A. Silvester</author><author>Liza Konnikova</author><author>Amelie Therrien</author><author>Sarah C. Glover</author>
        <description><![CDATA[Hereditary α-tryptasemia (HαT) is a genetic trait characterized by increased TPSAB1 copy number. Identified in 2015, the HαT trait impacts approximately 4%–6% of individuals of European ancestry and manifests with core clinical features in one-third of individuals who test positive for the genetic trait. HαT represents a natural human model of α-tryptase overexpression which can be leveraged to better and more comprehensively understand tryptase and mast cell (MC) biology at the tissue level. In this review, we synthesize emerging evidence demonstrating that HαT is a clinically significant modifier of disease in the gastrointestinal (GI) tract. We summarize findings demonstrating that HαT impacts small intestinal immunopathology even in the absence of overt GI pathology. In celiac disease, coexisting HαT is associated with increased duodenal MCs and persistent GI symptoms (diarrhea, bloating, abdominal pain) despite a gluten-free diet. We also review emerging data indicating that HαT may act as a disease modifier in inflammatory bowel disease (IBD); increased α-tryptase gene dosage is associated with intestinal MC activation and increased expression of MRGPRX2. These changes may amplify MC–mediated inflammatory pathways within the intestinal mucosa and contribute to the complexity of immune signaling traditionally attributed to T-cell–driven inflammation in IBD. Taken together, emerging modern cellular and molecular biology evidence suggests that the natural overexpression of α-tryptase in HαT alters MC behavior and GI intestinal immunopathology, thereby modifying disease outcomes across a spectrum of GI illnesses.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/falgy.2026.1772380</guid>
        <link>https://www.frontiersin.org/articles/10.3389/falgy.2026.1772380</link>
        <title><![CDATA[Asthma and corticosteroids “odi et amo”: how to deal with it?]]></title>
        <pubdate>2026-04-13T00:00:00Z</pubdate>
        <category>Mini Review</category>
        <author>Luca Borsari</author><author>Laura Carbonieri</author><author>Luca M. Verdini</author><author>Valentina Ruggieri</author><author>Bianca Beghe’</author>
        <description><![CDATA[Asthma is a chronic, heterogeneous respiratory disease that affects more than 300 million individuals worldwide and is responsible for substantial morbidity, mortality and healthcare burden. Chronic airway inflammation plays a central role in symptom expression, disease progression, and response to therapy. Corticosteroids, both inhaled and systemic, are the cornerstone of asthma treatment. However, it is well known that the use and abuse of systemic corticosteroids is almost invariably associated to the development of significant acute and chronic adverse events. Epidemiological data report that despite the availability of new target therapy, e.g., biologics, in real practice systemic steroids are still overused, and in this review, we highlight strategies 1) to identify and screen patients at risk of developing corticosteroids adverse events and 2) to reduce them.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/falgy.2026.1806555</guid>
        <link>https://www.frontiersin.org/articles/10.3389/falgy.2026.1806555</link>
        <title><![CDATA[The relationship between allergic rhinitis and sleep disorders and mental health]]></title>
        <pubdate>2026-04-10T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Xiaoning Feng</author><author>Zhaowei Gu</author><author>Yunxiu Wang</author>
        <description><![CDATA[Allergic Rhinitis (AR) is a highly prevalent IgE-mediated chronic inflammatory disease of the nasal mucosa worldwide. Its incidence is continuously increasing and has become one of the important chronic diseases affecting public health. Recent studies have gradually revealed that AR not only presents with local symptoms such as nasal congestion, runny nose, sneezing, and nasal itching, but is also closely related to a wide range of physical and mental health problems, especially mental and psychological disorders (such as anxiety and depression) and decreased sleep quality. There is a complex two-way or even circular interaction between these three factors. This article systematically reviews the epidemiological characteristics and pathophysiological mechanisms of AR, and focuses on exploring the association pathways and potential mechanisms between AR and mental health as well as sleep disorders, including neuroimmune regulation (such as inflammatory mediators, HPA axis function), psychological and behavioral factors, and social function impairment. Based on this, the article further summarizes the assessment tools and multimodal intervention strategies for mental and psychological problems and sleep disorders in AR patients, covering drug treatment, psychotherapy, sleep hygiene education, and comprehensive health management, etc. This article integrates current evidence and provides a theoretical framework for a comprehensive understanding of the multi-dimensional impact of AR, and offers references for comprehensive assessment and individualized intervention in clinical practice.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/falgy.2026.1817101</guid>
        <link>https://www.frontiersin.org/articles/10.3389/falgy.2026.1817101</link>
        <title><![CDATA[Emerging molecular and environmental biomarkers of shrimp allergy in African Americans in the US]]></title>
        <pubdate>2026-04-10T00:00:00Z</pubdate>
        <category>Mini Review</category>
        <author>Tanmoy Mondal</author><author>Dalyngs Duvelsaint</author><author>Kingston Griffin</author><author>McKenzie Williams</author><author>Oluwaseyitodun Johnson</author><author>Zara Campbell</author><author>Carla M. Davis</author>
        <description><![CDATA[Shrimp allergy (SA), a major cause of food-induced anaphylaxis, represents a disproportionate and under-characterized burden among African American (AA) populations in the United States. Unlike many childhood food allergies, SA is often persistent and commonly presents in adolescence or adulthood, suggesting a role for cumulative environmental exposures in disrupting oral tolerance. A key diagnostic challenge in AA communities is the high prevalence of IgE sensitization to shrimp tropomyosin (Pen a 1), which shares strong structural homology with cockroach and house dust mite tropomyosins, leading to frequent cross-reactive but clinically irrelevant sensitization in urban settings. This review critically examines molecular and environmental biomarkers of SA with a focus on AA populations. We assess the limitations of extract-based IgE testing and component-resolved diagnostics, highlighting how single-component assays may overestimate true clinical allergy. We emphasize the added value of functional assays, particularly the basophil activation test, in distinguishing sensitization from challenge-confirmed allergies. Mechanistically, we discuss how chronic exposure to indoor arthropod allergens, air pollution, and socioenvironmental stressors may drive epithelial barrier dysfunction, IL-33 release, and amplification of type 2 immune pathways, lowering reaction thresholds and influencing disease persistence. We identify key gaps, including limited oral food challenge–confirmed data and underrepresentation of AA cohorts. Finally, we propose equity-centered, integrative research frameworks combining molecular diagnostics, functional assays, environmental assessment, and multi-omics to improve diagnostic precision and advance clinical equity in SA care.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/falgy.2026.1840104</guid>
        <link>https://www.frontiersin.org/articles/10.3389/falgy.2026.1840104</link>
        <title><![CDATA[Editorial: Biologics for airway diseases: from bench to bedside]]></title>
        <pubdate>2026-04-10T00:00:00Z</pubdate>
        <category>Editorial</category>
        <author>Andreas M. Matthaiou</author><author>Nikoleta Bizymi</author><author>Dina Visca</author><author>Lena Uller</author><author>Nikolaos G. Papadopoulos</author><author>Alexander G. Mathioudakis</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/falgy.2026.1816013</guid>
        <link>https://www.frontiersin.org/articles/10.3389/falgy.2026.1816013</link>
        <title><![CDATA[Two combinations of house dust mite allergens show similar performance than extracts for asthma diagnosis]]></title>
        <pubdate>2026-04-10T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Victoria Marrugo</author><author>Josefina Zakzuk</author><author>Randy Reina</author><author>Karen Donado</author><author>Ronald Regino</author><author>Isabel Gil</author><author>Caterine Meza</author><author>Dilia Mercado</author><author>Enrique Fernández-Caldas</author><author>Leonardo Puerta</author><author>Nathalie Acevedo</author><author>Luis Caraballo</author>
        <description><![CDATA[IntroductionMolecular allergy diagnostics for house dust mite (HDM) sensitization includes both allergenic molecules and extracts, but extracts have batch-to-batch variability, incomplete allergen representation and cross-reactivity, which confound results and reduces test accuracy. However, although using extract-free arrays could solve these problems, there is no study that formally supports this change. Therefore, the aim of this study was to compare the diagnostic performance and clinical relevance of measuring specific IgE to Dermatophagoides pteronyssinus and Blomia tropicalis extracts vs. two allergen combinations, Blo t 2/Blo t 5/Blo t 21 and Der p 1/Der p 2/Der p 23.MethodsIn 201 adults with asthma and matched controls, diagnostic performance of specific IgE towards molecular allergen combinations and extracts were compared using receiver operator characteristics analysis, with physician-diagnosed asthma as reference standard. Associations between specific IgE (extracts and combinations) and type 2 inflammation biomarkers (fractional exhaled nitric oxide and blood eosinophils) were also evaluated.ResultsSpecific IgE frequencies and levels were higher in patients. Allergen combinations and extracts showed equivalent performance. The area under the curve of the combination Blo t 2/Blo t 5/Blo t 21 was similar to that of the B. tropicalis extract: 0.783 and 0.808 respectively (p = 0.42). Likewise, the area under the curve of the combination Der p 1/Der p 2/Der p 23 was 0.793 and that of extract was 0.788 (p = 0.8). Notably, IgE response to D. pteronyssinus allergens was more specific than the extract and significantly associated with fractional exhaled nitric oxide and blood eosinophils.ConclusionOur findings provide, for the first time, direct evidence that specific allergen combinations have similar diagnostic performance to HDM extracts in molecular diagnostics, improving test accuracy and supporting a shift toward standardized, molecular-resolved diagnostic strategies. In addition, we found that allergen combinations, and not HDM extracts, are strongly associated with type 2 inflammation biomarkers, supporting their use for personalized asthma management.]]></description>
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