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Life
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Allergies and Allergic Diseases—Perspectives in Diagnosis and Management: 2nd Edition
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Allergies and Allergic Diseases—Perspectives in Diagnosis and Management: 2nd Edition

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: 30 October 2026 | Viewed by 7899

Special Issue Editor

Prof. Dr. Kinga Lis

E-Mail Website
Guest Editor
Department of Allergology, Clinical Immunology and Internal Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, ul. Ujejskiego 75, 85-168 Bydgoszcz, Poland
Interests: food additive; immunology; alergology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The diagnosis and management of allergic diseases constitute difficult tasks in many cases. Component-resolved diagnosis was a game-changing development, allowing the identification of patterns of sensitization. Furthermore, it enabled scholars to indirectly identify the proteins behind cross-sensitization. Double-blind placebo-controlled food challenges remain the gold-standard approach in the diagnosis of food allergies, whereas skin prick tests allow the diagnosis of pollen and house dust mite sensitization. Basophile activation tests are interesting tools, which allow in vitro challenges to be performed, eliminating the risk for patients. These methods all have benefits, but they remain insufficient in many cases.

We welcome research on different diagnostic tools for allergies and current trends in the management of allergic disorders. Other topics discussed in this Special Issue include allergens, allergen isoforms, new allergens, and ligand–allergen interactions.

Prof. Dr. Kinga Lis
Guest Editor

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Keywords

  • allergy
  • anaphylaxis
  • cross-allergies
  • IgE
  • exercise-induced anaphylaxis
  • component-resolved diagnosis

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Published Papers (5 papers)

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Research

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14 pages, 703 KB  
Article
Influence of Atopic Dermatitis on the Dermoscopic Phenotype of Positive Patch Test Reactions: A Prospective Comparative Study
by Anna Zaryczańska, Małgorzata Sokołowska-Wojdyło, Roman J. Nowicki and Magdalena Trzeciak
Life 2026, 16(4), 663; https://doi.org/10.3390/life16040663 - 14 Apr 2026
Viewed by 455
Abstract
Atopic dermatitis (AD) may alter the morphology of clinically positive allergic patch test reactions due to epidermal barrier dysfunction and a chronic inflammatory background, thereby complicating routine clinical interpretation. This prospective observational study aimed to evaluate the dermoscopic features of clinically positive allergic [...] Read more.
Atopic dermatitis (AD) may alter the morphology of clinically positive allergic patch test reactions due to epidermal barrier dysfunction and a chronic inflammatory background, thereby complicating routine clinical interpretation. This prospective observational study aimed to evaluate the dermoscopic features of clinically positive allergic patch test reactions and compare their phenotypic expression in patients with and without concomitant AD. Consecutive patients undergoing routine patch testing were screened, and clinically positive reactions (1+, 2+, or 3+ according to ICDRG criteria) were subjected to dermoscopic assessment at scheduled readings. A total of 160 participants were included. Patch test reactions in patients with AD exhibited a consistent dermoscopic pattern, characterized by an increased frequency of perifollicular erythema, yellowish areas, and pigment residuals, whereas homogeneous erythema demonstrated limited discriminatory value in both pediatric and adult populations. Yellowish areas were additionally associated with greater AD severity. These findings suggest that AD may modify the phenotypic expression of clinically positive allergic patch test reactions, particularly when evaluated using dermoscopy. This non-invasive diagnostic tool may provide adjunctive morphological support for patch test interpretation, especially in equivocal cases. Full article
(This article belongs to the Special Issue Allergies and Allergic Diseases—Perspectives in Diagnosis and Management: 2nd Edition)
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18 pages, 1609 KB  
Article
Airborne Ragweed (Ambrosia artemisiifolia) Allergen Exposure and Sensitization Pattern in Western Romania: A 5-Year Retrospective Cross-Sectional Observational Analysis of Sensitization Prevalence, Complemented by a Parallel Temporal Analysis of Aerobiological Data and Symptom-Driven Healthcare Presentation Patterns Study
by Valentin-Cristian Iovin, Carmen Neamtu, Roxana Buzan, Corina Porr, Alina-Daniela Totorean, Ana-Adina Iovin, Andreea-Adriana Neamtu, Diana Luisa Lighezan and Carmen Panaitescu
Life 2026, 16(3), 526; https://doi.org/10.3390/life16030526 - 22 Mar 2026
Viewed by 600
Abstract
Ragweed (Ambrosia artemisiifolia) represents a major and expanding source of aeroallergen exposure in Europe, with rising sensitization rates and substantial clinical impact. However, population-level data integrating airborne pollen exposure with detailed clinical sensitization patterns remain limited. We conducted a 5-year retrospective [...] Read more.
Ragweed (Ambrosia artemisiifolia) represents a major and expanding source of aeroallergen exposure in Europe, with rising sensitization rates and substantial clinical impact. However, population-level data integrating airborne pollen exposure with detailed clinical sensitization patterns remain limited. We conducted a 5-year retrospective cross-sectional observational analysis of sensitization prevalence, complemented by a parallel temporal analysis of aerobiological data and symptom-driven healthcare presentation patterns (2020–2024) in Timisoara, Romania, including all patients undergoing first-time sensitization evaluation at a tertiary referral hospital. Sensitization was assessed using standardized skin prick testing to common aeroallergens and other allergen categories, while airborne ragweed pollen concentrations were monitored through a peri-urban network of real-time bio-particle analyzers. Statistical analyses included descriptive statistics, multivariable logistic regression, χ2 tests for co-sensitization patterns, and comparative analyses of clinical manifestations across sensitization profiles. Among 4404 eligible patients, 50.7% were sensitized to at least one allergen. Ragweed sensitization was identified in 24.1% of patients, with a mean age of 31.1 years at diagnosis and no significant sex-related difference. Most ragweed-sensitized patients were polysensitized (71.5%), predominantly to other aeroallergens. Increasing age was independently associated with lower odds of polysensitization to other aeroallergens (adjusted OR = 0.97 per year, 95% CI: 0.96–0.98), while sex showed no independent association. Patients with ragweed sensitization alone and those cosensitized with aeroallergens exhibited similar prevalence of respiratory manifestations, whereas individuals with additional non-aeroallergen sensitization showed lower prevalence of rhinitis, conjunctivitis, and asthma but slightly higher rates of asthma exacerbations. Weekly diagnoses of ragweed sensitization demonstrated a pronounced seasonal peak between calendar weeks 33 and 38 (mid-August to late September), coinciding with peak airborne ragweed pollen concentrations. Ragweed sensitization therefore represents a substantial and seasonally driven healthcare burden in western Romania, characterized by frequent polysensitization, distinct clinical manifestation patterns across sensitization profiles, and close temporal alignment between airborne pollen exposure and clinical presentation. Integrating aerobiological monitoring with clinical surveillance may support targeted prevention strategies and improved patient management. Full article
(This article belongs to the Special Issue Allergies and Allergic Diseases—Perspectives in Diagnosis and Management: 2nd Edition)
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13 pages, 1016 KB  
Article
Dust Mite-Specific IgE in Nasal Lavage Fluid During Natural Allergen Exposure and After Nasal Provocation Test in Subjects with Suspected Local Allergic Rhinitis
by Mohamad Mahdi Mortada, Alaa Sherri, Edyta Pietrowska, Marta Popławska, Maciej Chałubiński and Marcin Kurowski
Life 2025, 15(11), 1683; https://doi.org/10.3390/life15111683 - 29 Oct 2025
Cited by 2 | Viewed by 1362
Abstract
Introduction: Apart from the typical AR phenotype and its standard clinical manifestations—rhinorrhea, sneezing, nasal itching, and congestion—the so-called local allergic rhinitis (LAR) can be observed in a subset of subjects presenting rhinitis symptoms, a negative skin prick test (SPT), and serum-specific immunoglobulin E [...] Read more.
Introduction: Apart from the typical AR phenotype and its standard clinical manifestations—rhinorrhea, sneezing, nasal itching, and congestion—the so-called local allergic rhinitis (LAR) can be observed in a subset of subjects presenting rhinitis symptoms, a negative skin prick test (SPT), and serum-specific immunoglobulin E (sIgE) for the relevant allergens and confirmed with a positive nasal provocation test (NPT), which is the gold standard in LAR diagnosis. Our study aims to assess the clinical symptoms and local mucosal sIgE presence induced by NPT and natural exposure to HDM allergens in subjects with suspected LAR. Methods: In total, 25 suspected LAR subjects were included in the study. The total nasal symptom score (TNSS) and visual analog scale (VAS) were used for the subjective assessment. A nasal provocation test (NPT) was performed with house dust mite allergens. The nasal lavage technique was used for nasal secretion acquisition, in which the levels of sIgE were measured. Results: During the period of increased exposure vs. the off-exposure period, the TNSS and VAS were significantly higher (p = 0.0361 and p = 0.0031, respectively). Levels of IgE specific to Dermatophagoides pteronyssinus in nasal lavage were high (p = 0.0502). Similarly, high levels of sIgE to Dermatophagoides farinae were noted (p = 0.0164). Comparing pre-NPT and post-NPT results, LAR diagnosis was confirmed in 8 subjects. Only the VAS score was higher after a positive NPT. Both sIgE to Dermatophagoides pteronyssinus and Dermatophagoides farinae in nasal lavage were higher after a positive NPT; however, the change was not statistically significant. A higher fold change in the median relative value (sIgE/Total IgE) for both allergens was noted in the positive-NPT group compared to the negative-NPT group. Conclusions: Assessing the local nasal production of sIgE and other inflammatory mediators may contribute to expanding our knowledge of LAR pathogenesis. Further studies including a larger number of subjects are needed for a better understanding of the LAR entity in terms of diagnosis and treatment options. Full article
(This article belongs to the Special Issue Allergies and Allergic Diseases—Perspectives in Diagnosis and Management: 2nd Edition)
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13 pages, 721 KB  
Article
Systemic Allergic Reactions to Subcutaneous Allergen Immunotherapy—A Single-Center Experience
by Nataša Kusić, Aleksandra Plavšić, Vojislav Đurić, Jasna Bolpačić, Rajica Stošović, Milan Dimitrijević, Jelena Spirić-Milovančević, Irena Oštrić Pavlović, Antonije Veličković and Vesna Tomić-Spirić
Life 2025, 15(10), 1527; https://doi.org/10.3390/life15101527 - 28 Sep 2025
Viewed by 2781
Abstract
Background: Allergen immunotherapy (AIT) is generally considered a safe treatment modality, with systemic reactions (SRs) representing its most significant adverse events, despite their low incidence. This study aimed to evaluate the frequency and characteristics of SRs associated with subcutaneous allergen immunotherapy (SCIT) and [...] Read more.
Background: Allergen immunotherapy (AIT) is generally considered a safe treatment modality, with systemic reactions (SRs) representing its most significant adverse events, despite their low incidence. This study aimed to evaluate the frequency and characteristics of SRs associated with subcutaneous allergen immunotherapy (SCIT) and to identify potential risk factors. Methods: We conducted a retrospective analysis of 47,982 SCIT injections administered to 317 patients over 468 SCIT courses between January 2019 and January 2024. The study population consisted of 26 patients diagnosed with allergic rhinitis sensitized to pollen and/or house dust mites (HDMs), as well as individuals with venom allergies who experienced SRs to SCIT during the study period. Data collected included demographic characteristics, presence of asthma, allergen sensitivities, immunoglobulin E (IgE)-related immunologic biomarkers, and adverse reactions. SRs were classified according to the World Allergy Organization (WAO) SCIT SR Grading System. Results: A total of 26 SCIT-related SRs were documented in 26 patients (57.7% female; mean age 37.3 ± 10.04 years), corresponding to an incidence rate of 0.05% per injection, and 8.2% per patient. Asthma was present in 42.3% of patients. Prior adverse reactions to SCIT were noted in eight patients (30.8%). SRs occurred during the build-up phase in 61.5% of cases, compared with the maintenance phase. In 46.2% of patients, a single allergen was administered, while 53.8% received multiple allergens. Based on the WAO grading system, 30.8% of SRs were classified as grade 1, 42.3% as grade 2, 15.4% as grade 3, and 11.5% as grade 4. No fatalities were reported. The majority of SRs were early onset (88.5%), and epinephrine was administered in 76.9% of the cases. A higher serum specific IgE to total IgE (sIgE/tIgE) ratio was significantly associated with more severe SRs. Conversely, a history of prior allergic reactions to SCIT appeared to correlate with milder SRs. Conclusions: Our findings confirm that SRs to SCIT are rare, and severe reactions are infrequent. A higher serum sIgE/tIgE ratio can be risk factor for severe SRs. Nonetheless, a thorough risk–benefit assessment is essential prior to initiating SCIT, particularly in patients with identified risk factors. Full article
(This article belongs to the Special Issue Allergies and Allergic Diseases—Perspectives in Diagnosis and Management: 2nd Edition)
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Review

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17 pages, 1441 KB  
Review
Clinical and Etiopathological Perspective of Vitamin B1 Hypersensitivity and an Example of a Desensitization Protocol
by Kinga Lis
Life 2026, 16(1), 50; https://doi.org/10.3390/life16010050 - 28 Dec 2025
Cited by 1 | Viewed by 1782
Abstract
Vitamin B1 (thiamine) is a water-soluble B vitamin. As a cofactor of many enzymes, it is essential for the proper functioning of many body systems and organs, including metabolic and energy metabolism. In extreme cases, vitamin B1 deficiency causes neurodegenerative disorders, including beri-beri, [...] Read more.
Vitamin B1 (thiamine) is a water-soluble B vitamin. As a cofactor of many enzymes, it is essential for the proper functioning of many body systems and organs, including metabolic and energy metabolism. In extreme cases, vitamin B1 deficiency causes neurodegenerative disorders, including beri-beri, or cognitive impairment resulting from encephalopathy. B1 avitaminosis may result from increased demand, dietary errors, malabsorption, or excessive loss. Thiamine supplementation is used in cases of vitamin B1 deficiency or for preventative measures in situations of increased demand. Vitamin B1 can be administered enterally or parenterally (intravenously, intramuscularly, subcutaneously). The route and dose depend on the individual patient’s clinical situation. Hypersensitivity to vitamin B1 is rare and appears to be primarily associated with rapid intravenous infusion of large doses of thiamine hydrochloride over a short period (intravenous bolus). Hypersensitivity to thiamine administered by routes other than intravenous or intramuscular injection appears to be an incidental phenomenon. Thiamine should also be considered as an occupational allergen. The mechanism of thiamine hypersensitivity has not been clearly elucidated. However, considering the clinical nature and dynamics of the reaction, the most likely reaction seems to be an immediate type of hypersensitivity reaction (immunoglobulin E (IgE)-dependent), in which thiamine (but not its metabolites) acts as a hapten. Diagnosing hypersensitivity to vitamin B1 is difficult due to the lack of validated tests for additional testing. In individuals requiring thiamine supplementation who have experienced hypersensitivity to intramuscular or intravenous administration of this vitamin, switching to oral administration may be considered (provided this does not reduce treatment efficacy). This form of supplementation is usually well tolerated by individuals allergic to parenteral thiamine. However, if enteral supplementation does not guarantee the maintenance of therapeutic potential, thiamine desensitization may be considered, which seems to be an effective therapeutic method in such a clinical situation. Full article
(This article belongs to the Special Issue Allergies and Allergic Diseases—Perspectives in Diagnosis and Management: 2nd Edition)
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