Search Results (360)

Background and Objective: Accurate medication allergy documentation is essential for patient safety. This study evaluated discrepancies and documentation quality between medication allergy records in the primary care information system (AP-Madrid) and the Hospital Clinical Information System (HCIS) at a tertiary care hospital. Methods: A retrospective cohort study included 223 patients with medication allergy records during 2022. Agreement between systems was assessed using Cohen’s kappa, and documentation quality was classified as adequate, moderate, or poor based on four predefined parameters. Results: Agreement between AP-Madrid and HCIS was poor (Cohen’s κ = −0.25). Of the 223 patients, medication allergy records were documented exclusively in HCIS for 94 patients, exclusively in AP-Madrid for 36 patients, and in both systems for 88 patients, while 5 patients had medication allergy information identified only in free-text clinical documentation. Documentation quality was predominantly poor in both HCIS (60.4%, n = 134) and AP-Madrid (61.9%, n = 138). Beta-lactam antibiotics and non-steroidal anti-inflammatory drugs (NSAIDs) were the most frequently implicated therapeutic groups. Two positive medication re-exposure events were identified. Conclusions: Substantial discrepancies and poor documentation quality were identified between primary care and hospital medication allergy records, highlighting limited interoperability between the two systems. Improving the completeness, consistency, and standardized exchange of medication allergy information across healthcare settings may enhance patient safety and continuity of care. Full article

House dust mites (HDMs) are major indoor allergens linked to asthma and atopic dermatitis, creating demand for safer, natural alternatives to synthetic acaricides and anti-allergy agents. This study aimed to investigate the dual bioactivity of curcuminoid extract from Curcuma longa to address HDM allergy through two distinct but complementary scopes: an environmental approach evaluating direct acaricidal efficacy to reduce allergen exposure and a cellular approach investigating the anti-inflammatory potential to mitigate the host’s underlying immune response. Curcuminoids were extracted using Soxhlet extraction with 70% ethanol and characterized via TLC, FTIR-ATR, and LC-MS. Acaricidal activity against HDMs was evaluated using extract-impregnated filter papers (0.1–10 mg/mL) over 24 h. Cytotoxicity and anti-inflammatory effects were assessed in HaCaT keratinocytes and RAW264.7 macrophages through cell viability, migration, phagocytic activity, nitric oxide (NO) inhibition, and gene expression assays. The curcuminoid extract demonstrated potent, dose-dependent acaricidal activity against HDM, achieving 100% mortality at 10 mg/mL within 24 h. A safe sub-cytotoxic concentration (≤0.001 µg/µL) preserved HaCaT cell migration and metabolic activity. In LPS-stimulated RAW264.7 cells, curcuminoids significantly reduced inflammatory NO production (p < 0.01) while enhancing phagocytic activity. Overall, these findings highlight curcuminoids as a sustainable natural strategy for reducing HDM exposure and mitigating allergic inflammation. Full article

Understanding how sensory preferences shape the acceptance of nutrient-dense foods is essential for improving prenatal nutrition. This exploratory study examined taste, smell, texture, appearance, and enjoyment factors influencing food acceptability among (n = 21) African American pregnant women, examining how determinants must be met for consumption. We administered surveys to identify preferred foods and analyzed the nutrient quantity of vitamin A, B vitamins, vitamin D, iodine, iron, calcium, magnesium, selenium, and omega-3 fatty acids in each food, given their influence on prenatal health. Nutrient-dense, anti-inflammatory foods were identified by ranking preferred foods by nutrients and selecting those that consistently ranked as top contributors. Focus groups further explored conditions that promote or hinder intake, and content analysis was conducted using NVivo. Preferred nutrient-dense, anti-inflammatory foods included cashews, peanuts, almonds, pistachios, black-eyed peas, pinto beans, salmon, carrots, red bell peppers, and spinach. Participants cited low acceptance due to allergies, undesirable textures (“dry” or “slimy”), unpleasant taste or appearance, a lack of cravings, preference for alternatives, unenjoyable preparation methods, and foods perceived as “display-only.” High acceptance was linked to appealing taste and texture, flexible preparation options, and perceived health benefits. These considerations suggest that taste, texture, appearance, and enjoyment are important considerations for prenatal food intake. Full article

Pantothenic acid (PA; vitamin B5) is an essential component of many key metabolic processes. Vitamin B5 deficiency causes dysfunction in various systems and organs. Humans do not produce vitamin B5, so it must be constantly replenished through diet or supplementation. Pantothenic acid is synthesized by plants, fungi, and bacteria, so a well-balanced diet is a good source of pantothenic acid. Pantothenates have beneficial effects on the skin (regenerative, healing, and anti-inflammatory effects). They are readily absorbed through the skin, making them a common active ingredient in cosmetics and medications with soothing, healing, regenerative, moisturizing, and protective properties for damaged, sensitive, or atopic skin, including topical products labeled hypoallergenic or specifically intended for people with sensitive skin. Although PA is considered non-allergenic and safe, paradoxically, frequent exposure, especially to damaged skin, appears to lead to hypersensitivity to this substance. The pathogenetic mechanisms of pantothenate hypersensitivity have not been clearly defined. The main sensitization pathway is likely a delayed cellular mechanism (type IV, contact). However, other types of hypersensitivity, including immediate (type I) and mixed mechanisms, cannot be ruled out. PA allergy is considered rare and therefore difficult to diagnose. This is due to the unexpected sensitizing factor and the lack of standard diagnostic tests. Due to the likely contact nature of the allergy, patch testing (PT) with a cosmetic (drug) provided by the patient (“as is”) and PA (5% in petrolatum; 5% PET) appears to be the best approach. It is also suggested that PA (5% PET>) be included in the standard series of allergens (haptens) used in routine PT diagnostics. It appears that PA allergy is more common than currently believed, particularly in people with atopic skin and polysensitized individuals, who are the primary users of products containing pantothenate. It is possible that in these individuals, pantothenic acid may be more harmful than beneficial. Full article

Food allergy is an increasingly prevalent global health condition characterized by immune-mediated reactions to dietary antigens and a substantial clinical burden. Growing understanding of IgE-mediated mechanisms has highlighted the central role of type 2 inflammation, effector-cell activation, and impaired immune regulation. These advances have prompted the development of disease-modifying therapies beyond allergen avoidance. This narrative review summarizes recent advances in the therapeutic management of IgE-mediated food allergy. A structured PubMed search was performed to identify clinical trials, randomized studies, and meta-analyses published within the last five years. Both allergen-specific and non-allergen-specific interventions were evaluated. Current evidence supports oral immunotherapy as the most effective strategy for increasing reaction thresholds and inducing desensitization in peanut, milk, and egg allergies. However, safety concerns remain, and sustained unresponsiveness after treatment discontinuation is achieved inconsistently. Sublingual and epicutaneous immunotherapy show improved safety but lower efficacy. Modified allergen approaches, including baked milk and processed peanut products, may improve tolerability and facilitate immune modulation in selected patients. Biologic therapies, particularly anti-IgE agents, demonstrate efficacy both alone and when combined with immunotherapy. Emerging approaches include peptide vaccines, DNA immunization, microbiome-targeted interventions, and early dietary modulation. These strategies may improve durable immune tolerance through personalized, mechanism-based therapeutic approaches. Future progress will depend on optimizing safety, identifying predictive biomarkers, and integrating multimodal approaches to achieve durable immune tolerance. Full article

The current use of artificial light during the natural dark phase has acquired contaminant dimensions, known as “light pollution”. It is well known that exposure to dim light at night (dLAN) during the postnatal period severely impairs the immune system and related organs, but few reports have demonstrated the effects of dLAN during the fetal period. This study, therefore, examines whether exposure to dim light at night during two critical developmental windows (i.e., prenatal and postnatal periods) leads to long-lasting dysregulation of circadian, behavioral, and immune organization, as well as spleen immune responses, in early adulthood. To address this question, these outcomes were assessed using two defined sampling time points. To answer this question, we exposed two groups of C57BL/6J male mice to dim night light during the gestational and postnatal periods and compared them with control groups that were exposed to light–dark conditions (12 h each, LD). Parametric and non-parametric activity/rest values were analyzed with circular statistics. Compared to their controls, we found differences in alpha, onset, offset, M10, and L5 start time in dLAN groups. We also assessed the transcript levels of clock genes and inflammatory mediators in spleen tissue and found a dampening of daily variation in mRNA expression in both experimental groups. Finally, we used an ovalbumin (OVA) allergy challenge to test the B-cell response in the spleen and found a significantly higher cell recruitment to the spleen and more anti-OVA IgE. Together, these results clearly show that dLAN, at two ZT sampling points, affects peripheral molecular clocks and responses in the spleen, and that these effects are independent of the life stage at which exposure to dim light at night occurs. Full article

Food allergy (FA) and eosinophilic esophagitis (EoE) represent two of the most rapidly increasing allergen-driven conditions in pediatric medicine. Both diseases share key immunological features, including Th2 polarization and epithelial barrier dysfunction. Over the past two decades, compelling epidemiological and mechanistic evidence has established EoE as a late-manifesting component of the allergic march—the well-recognized sequential progression of atopic disease in childhood, which typically begins with atopic dermatitis, followed by IgE-mediated food allergy, allergic rhinitis, and asthma. Children with IgE-mediated food allergy carry a substantially elevated risk of developing EoE, and shared genetic susceptibility loci—including CAPN14, TSLP, and filaggrin (FLG)—underscore common pathogenic pathways. We conducted a narrative review of the literature by systematically searching PubMed/MEDLINE, EMBASE, and the Cochrane Library using the terms “eosinophilic esophagitis,” “food allergy,” “atopic march,” “IgE-mediated allergy,” and “pediatric” in combination; articles published from 2000 to March 2026 were considered, with priority given to systematic reviews, meta-analyses, randomized controlled trials, and guideline documents. This narrative review comprehensively examines the epidemiology, pathomechanisms, clinical presentation, diagnostic approach, and therapeutic landscape for pediatric FA and EoE, with particular emphasis on their immunological intersections and the evolving evidence positioning EoE within atopic disease trajectories. We highlight approval of dupilumab for children as young as 1 year with EoE—representing a paradigm shift toward biologic therapy for atopic multimorbidity—and discuss the pipeline of emerging agents including cendakimab, lirentelimab, and anti-IL-5 strategies. Identification of shared pathogenic mechanisms offers promising avenues for unified prevention, early diagnosis, and precision therapeutic approaches for children with multiple atopic diseases. Full article

The widespread use of proton pump inhibitors (PPIs) in clinical practice has increased the number of related hypersensitivity reactions (HSRs). The active ingredient is not always responsible for the reaction. In some cases, HSRs may be related to the excipients contained in the drug. The adverse reactions to anti-SARS-CoV-2 vaccines have drawn the scientific community’s attention to the potential roles of excipients such as polyethylene glycol (PEG) and polysorbate 80. We present a case of a patient with three anaphylactic reactions following the administration of the anti-SARS-CoV-2 vaccine and a history of HSR to omeprazole. Through an in-depth medical history and allergy testing, we found that the patient was sensitized to PEG contained in the vaccine and to the omeprazole formulation used. We also conducted a mini-review of the literature, reporting all cases of reactions to PPIs, both related to the active ingredient and to excipients. Adverse reactions to PPIs are rare but still increasing. To our knowledge, this is the first reported case of anaphylaxis to PPI-related PEG. Some excipients are widely used in commonly used products, including non-pharmaceuticals. Therefore, in patients with multiple episodes of anaphylaxis, it appears necessary to exclude a possible allergy to excipients. This could ensure a greater safety and a better quality of life. Full article

Background/Objectives: This report is an assessment of the characteristics associated with cardiovascular dysautonomia (CVD) in the context of long Coronavirus disease (COVID), which is currently inadequately characterized. Material and Methods: A retrospective cross-sectional study was performed involving 106 patients with long COVID, including 34 individuals diagnosed with CVD, among whom eight met the criteria for Postural Tachycardia Syndrome (PoTS). The variables assessed encompassed individual characteristics (e.g., age, sex, comorbidities), immunization parameters (e.g., vaccination/viral status, timing, frequency), cellular and humoral anti-Spike and anti-Nucleocapsid (Nuc) immune responses, inflammatory and allergic biomarkers, as well as an extensive panel of common autoantibodies comprising anti-nuclear antibodies, anti-central nervous system antibodies (cerebellum, brain), and anti-peripheral nervous system antibodies (gangliosides). Results: An age < 45 years, body mass index, hyperventilation syndrome as well as a higher cumulative number of antigenic contacts (vaccinations plus infections ≥ 3) and an elevated basophil count (≥0.06 G/L) were independently associated with CVD. There was no association between CVD and inflammatory markers or common autoantibodies. Patients with PoTS criteria had a strong anti-Spike cellular immune response and increased IgG anti-Nuc humoral immunity when compared with CVD and non-CVD long COVID counterparts. Conclusions: Compared to other long COVID patients, patients with long COVID-associated CVD have distinctive clinical and immunovirological features. Our results suggest the potential role of the immune response against Spike and of allergic pathways rather than humoral autoimmunity against common autoantibodies in long COVID CVD. Full article

This study aimed to investigate the anti-allergic potential of the ethyl acetate fraction (EtOAc) from Phyllanthus amarus using an ovalbumin (OVA)-induced allergic mouse model and in vitro RBL-2H3 mast cell assays. The EtOAc fraction was characterized by high total phenolic and flavonoid contents, reaching 261 ± 18 mg GAE/g EtOAc fraction and 86 ± 7 mg QE/g EtOAc fraction, respectively. It was found that EtOAc fraction significantly reduced histamine release up to 43.3% and suppressed reactive oxygen species (ROS) production from FcɛRI-mediated mast cell activation at a concentration treatment of 200 µg/mL. Furthermore, EtOAc fraction decreased interleukin-4 (IL-4) and tumor necrosis factor-alpha (TNF-α) release up to 94.2 pg/mL and 195.6 pg/mL, respectively. In the OVA-induced allergic mouse model, EtOAc fraction treatment markedly lowered sneezing frequency and serum IgE and histamine levels by approximately 50% at a dose treatment of 50 mg/kg. In addition, histopathological analysis revealed that the EtOAc fraction significantly alleviated inflammatory cell infiltration, particularly eosinophils, in lung tissue. Accordingly, the results highlight the potential of EtOAc fraction from P. amarus as a natural candidate for managing allergic diseases. Full article

Background/Objectives: Allergen immunotherapy (AIT) is the only disease-modifying treatment for grass pollen allergy. However, the proportion of patients interested in AIT who meet guideline-defined eligibility criteria remains unclear. This study aimed to characterise symptom burden, medication use, and AIT eligibility in adult patients with grass pollen allergy during the peak pollen season. Methods: In this multicentre, prospective, non-interventional epidemiological study, 479 adults with confirmed grass pollen allergy recorded daily nasal, ocular, and systemic symptoms, as well as anti-allergic medication use, via a validated electronic diary (CCC STUDY Diary) over a 30-day period in June/July 2025. A combined symptom–medication score (CSMS) was calculated daily, with a predefined threshold of ≥1.5 indicating clinically relevant symptom severity and potential eligibility for AIT. Both additive and weighted calculation approaches for the CSMS and the daily medication score (dMS) were evaluated to assess methodological robustness and reproducibility. Results: The mean additive CSMS was 2.14, indicating moderate symptom burden. Overall, 63.3% of participants exceeded the CSMS threshold of 1.5 and were considered eligible for AIT. Sensitivity analyses demonstrated excellent concordance between additive and weighted CSMS/dMS calculations (Spearman’s ρ >0.98; p < 0.001), and Bland–Altman analysis confirmed minimal bias (0.157) and narrow limits of agreement. Asthma was reported as a comorbidity in 36% of patients, generally associated with mild to moderate daily respiratory symptoms. Limitations included the self-reported nature of the data and a slightly reduced sample size; however, the results are representative of adult patients seeking care in specialised allergy centres in Germany. Conclusions: The CSMS also in its additive and therefore modernised form is a reliable, reproducible, and clinically meaningful tool for quantifying symptom severity and identifying patients suitable for AIT. Approximately two-thirds of adults interested in grass pollen AIT exhibited moderate to severe symptoms and were eligible for treatment according to current guideline recommendations. Full article

Jacareubin (2), nujiangexanthone A, and α-mangostin display the highest anti-allergic effects among the active xantones through still not well-known mechanisms. This study investigates the SAR of jacareubin, its precursor xanthone V (1) and their peracetylated (1a and 2a), permethylated (1b and 2b) derivatives and their anti-allergic and anti-inflammatory effects. To characterize the inhibitory effect of jacareubin, 2a and 2b on the anaphylactic reaction, we first utilized in vitro models of bone marrow derived mast cells (BMMCs), determining their capacity of inhibiting the IgE/Antigen-induced degranulation, myeloperoxidase (MPO), and xanthine oxidase (XO) activation. Also, we utilized in vivo models of passive cutaneous anaphylaxis (PCA) and TPA-induced ear edema. In vitro tests showed that the compound 2b was more effective than jacareubin in the inhibition of BMMCs degranulation. Besides, in vivo models of PCA revealed that the fourth cyclized ring of jacareubin is the critical structural element for anti-allergic efficacy, as compound 1 was less effective. Additionally, hydroxyl groups were found to be essential for inhibiting MPO. Jacareubin was the only tested xanthone that directly inhibited XO, a result supported by molecular docking. Overall, jacareubin represents a promising multi-target scaffold that could be used for developing new treatments for inflammatory and allergic diseases. Full article

The utilization of immunomodulatory nanomaterials, i.e., leveraging their unique properties to enhance immune responses, represents a transformative approach for the treatment of various diseases. Recent advancements in nanotechnology have enabled the design of nanomaterials capable of delivering immunomodulatory agents in a targeted manner, such as cytokines, antibodies, and nucleic acids, to specific cells or tissues involved in immune regulation. These nanomaterials, including nanoparticles, liposomes, nanogels, nanoemulsions, dendrimers, MXenes and extracellular vesicles, have been increasingly tailored to modulate immune responses with precision and efficacy. This targeted approach not only enhances therapeutic outcomes but also reduces off-target effects, minimizing systemic toxicity. In this review, an overview of immunomodulatory nanomaterials and their biomedical applications are highlighted. Herein, we have discussed different types of nanomaterials and their design strategies, interactions with different immune system components (macrophages, dendritic cells (DCs), neutrophils, T lymphocytes (CD4⁺ helper T-cells, CD8⁺ cytotoxic T-cells, regulatory T-cells/Tregs, and memory T-cells), and B lymphocytes), and immunomodulation mechanisms. Furthermore, nanomaterial-based immunomodulation strategies to enhance cancer immunotherapy, wound healing, and bone regeneration and the treatment of infectious diseases, autoimmune diseases, and allergy and are discussed in detail. In addition to therapeutic applications, selected nanomaterial platforms demonstrate significant potential in pharmaceutical formulations by improving drug stability, controlled release, and bioavailability, as well as in cosmetology through skin-targeted delivery, anti-inflammatory activity, immune protection, and enhanced tissue regeneration. Finally, clinical trial updates, challenges and future prospects are outlined. Key findings indicate that lipid-based, polymeric, inorganic nanoparticles and dendrimers provide complementary advantages for immunomodulation, including efficient delivery, controlled release, multifunctionality, and precise immune targeting. Despite safety, regulatory, and scalability challenges, these systems show strong potential for advancing precision and personalized medicine. Taken together, these innovations hold great promise for personalized medicine approaches, wherein nanomaterials can be tailored to individual patient profiles for more effective and precise disease treatment and prevention strategies. This review focuses primarily on the mechanistic interactions between immunomodulatory nanomaterials and immune cells, including macrophages, dendritic cells, neutrophils, T lymphocytes, and B lymphocytes, rather than providing an exhaustive treatment of physicochemical optimization parameters such as particle size or surface modification chemistry, which fall outside the defined scope of this work. Full article

Background and Objectives: Systemic mastocytosis (SM) is a clonal mast cell disorder characterized by abnormal mast cell accumulation and activation in multiple organs, leading to mediator-related symptoms, including anaphylaxis. Drug hypersensitivity reactions (DHRs) are a major clinical challenge in SM, but their frequency and characteristics remain undefined. This study aimed to evaluate the frequency of drug allergy, identify high-risk drug groups, investigate reaction characteristics, and examine the relationship between drug reactions, baseline serum tryptase levels, and SM subtypes in patients with SM. Materials and Methods: We retrospectively analyzed 34 patients diagnosed with SM between 2009 and 2024 at Ege University Faculty of Medicine. Clinical features, SM subtypes, baseline serum tryptase levels, and DHR characteristics were recorded. Reactions to antibiotics, nonsteroidal anti-inflammatory drugs (NSAIDs), paracetamol, anesthetics, radiocontrast media (RCM), and COVID-19 vaccines were graded using the Ring and Messmer anaphylaxis classification. Results: Among 34 patients, the mean age was 48.6 ± 13.3 years, 53% were male, and 10 (29.4%) had DHRs. The most common culprit drugs were NSAIDs (17.6%) and β-lactam antibiotics (14.7%). Anaphylaxis was the predominant reaction, frequently associated with hypotension. In 5 patients (14.7%), drug-induced anaphylaxis was the initial and only manifestation of SM. No hypersensitivity reactions occurred to quinolones, general anesthetics, or COVID-19 vaccines. Median baseline tryptase was 50.25 µg/L (min–max: 8.59–200.00) overall, and 41.85 µg/L (min–max: 19.00–200.00) among those with DHRs. Conclusions: Patients with SM are at increased risk of severe DHRs, particularly to NSAIDs and beta-lactam antibiotics. In some patients, drug allergy may be the first and only manifestation of SM. Measurement of baseline serum tryptase is essential in patients with drug-induced anaphylaxis. A comprehensive allergy assessment, including tolerance testing and individualized counseling, is crucial to ensure safe pharmacological management. Full article

Trained immunity confers protection against subsequent unrelated infections through metabolic and epigenetic reprogramming. Unlike adaptive immunity, trained innate immunity provides broad, non-specific protection against diverse heterologous pathogens. In addition to potentiating inflammatory responses upon secondary challenge, trained innate immune cells can also acquire anti-inflammatory and tolerogenic phenotypes, a property with important implications for chronic inflammatory diseases such as allergic disorders. Trained immunity-based vaccines (TIbVs) have emerged as promising immunomodulatory strategies capable of attenuating allergic inflammation by inducing immune tolerance. Similarly, allergen-specific immunotherapy (AIT) promotes long-term tolerance to allergens through metabolic and epigenetic reprogramming of innate immune cells. AIT drives the differentiation of monocytes into tolerogenic dendritic cells, thereby reshaping downstream adaptive immune responses. This review summarizes the current understanding of trained immunity and its role in protection against the same and heterologous infections. We discuss the molecular mechanisms underlying trained immunity, with an emphasis on metabolic and epigenetic reprogramming. Furthermore, we highlight the therapeutic potential of TIbVs and AIT as next-generation vaccines for allergic diseases. A deeper understanding of AIT-induced immune tolerance, the identification of predictive biomarkers, and the optimization of delivery platforms—such as lipid nanoparticle-based systems—will be critical for improving the safety and efficacy of future anti-allergy vaccines. Full article