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Introduction: Patients with severe asthma may present with different phenotypes. Severe eosinophilic asthma patients require frequent use of health care resources and have impaired health-related quality of life. Objective: We sought to determine the prevalence of an eosinophilic phenotype, defined as blood eosinophil counts >300 cells/mm3, for patients with severe asthma in Brazil. Methods: This was a cross-sectional, observational study of adult patients with severe asthma (high dose inhaled corticosteroid [GINA 2018] plus second controller) in routine clinical practice in Brazil. Allergic phenotype was defined as serum IgE>100 IU/mL plus clinical features of allergy. Results: A total of 385 patients were enrolled from 10 Brazilian centers. Most were female (78.4%) and white (57.4%), with a mean age of 53±13 years old. Prevalence of patients with eosinophilic phenotype was 40.0% [95% CI: 35.1–44.9%]. Those were mainly female (76.0%), white (62.3%), with mean age 50±14 years old. Eosinophilic patients presented lower BMI, with no other relevant clinical or demographics differences compared with non-eosinophilic phenotype patients. A high prevalence of allergic phenotype of 62.6% [95% CI: 57.8%-67.4%] was also identified. There was a high overlap between phenotypes as 79.9% [95% CI: 73.5–86.2%] of eosinophilic patients were also allergic. Conclusions: The prevalence of an eosinophilic phenotype for patients with severe asthma in Brazil is high, and these patients present with clinical and demographic characteristics similar to other worldwide populations. The overlap between allergic and eosinophilic phenotypes was common.

Tang, Mimi/0000-0002-3839-5293; Romano, Antonino/0000-0001-9742-9898; Zuberbier, Torsten/0000-0002-1466-8875; Thong, Bernard/0000-0002-6338-8482; EBO, Didier/0000-0003-0672-7529; Scala, Enrico/0000-0002-9391-9168; Monge Ortega, Olga Patricia/0000-0002-6195-417X WOS:000523267300003 PubMed: 32128023 Currently, testing for immunoglobulin E (IgE) sensitization is the cornerstone of diagnostic evaluation in suspected allergic conditions. This review provides a thorough and updated critical appraisal of the most frequently used diagnostic tests, both in vivo and in vitro. It discusses skin tests, challenges, and serological and cellular in vitro tests, and provides an overview of indications, advantages and disadvantages of each in conditions such as respiratory, food, venom, drug, and occupational allergy. Skin prick testing remains the first line approach in most instances; the added value of serum specific IgE to whole allergen extracts or components, as well as the role of basophil activation tests, is evaluated. Unproven, non-validated, diagnostic tests are also discussed. Throughout the review, the reader must bear in mind the relevance of differentiating between sensitization and allergy; the latter entails not only allergic sensitization, but also clinically relevant symptoms triggered by the culprit allergen. WAO Board of Directors The authors wish to thank the allergy societies from the membership of the World Allergy Organization who provided critical review of the draft and the WAO Board of Directors for supporting this work.

The publisher regrets we have been made aware of the below errors: 1) In Table 15, row NOVEOS chemiluminescent assay is written “utilizes 40 μL (0.04 ml) of sample per result”. The correct value would be “4 μL (0.004 ml)" of sample per result.2) In Table 16, is written “NOVEOS menu has 79 available allergens, consisting of 69 extracts and 10 molecular allergens”. It should say “NOVEOS menu continues to increase and it has 152 total allergens with 108 extracts and 44 components".3) In Table 15, row “Euroimmun”, column “Patient's serum”, is written “1000 ml”. The correct value would be “0.1 ml (-0.4 ml)”.The publisher would like to apologise for any inconvenience caused.

Background Allergen immunotherapy (IT) is widely used to treat patients with allergic diseases, proven effective and recommended by national and international guidelines. Its efficacy and safety depend on the correct indication, use of relevant allergens and good quality extracts, as well as prescription and supervision by a trained professional. Our aims were to evaluate the frequency of use of IT in Brazil and to investigate whether this practice meets recommendations of the Brazilian Association of Allergy and Immunology (ASBAI) and Brazilian Medical Association.