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Background: Chronic spontaneous urticaria (CSU) is a common, debilitating skin disorder characterized by recurring episodes of raised, itchy and sometimes painful wheals lasting longer than 6 weeks. CSU is mediated by mast cells which are absent from peripheral blood. However, lineage−CD34hiCD117int/hiFcεRI+ cells in blood have previously been shown to represent a mast cell precursor. Methods: We enumerated FcεRI−, FcεRI+ and FcεRIhi lineage−CD34+CD117+ cells using flow cytometry in blood of patients with CSU (n = 55), including 12 patients receiving omalizumab and 43 not receiving omalizumab (n = 43). Twenty‐two control samples were studied. Disease control and patient response to omalizumab was evaluated using the urticaria control test. We performed single‐cell RNA sequencing (scRNA‐Seq) on lineage−CD34hiCD117hi blood cells from a subset of patients with CSU (n = 8) and healthy controls (n = 4). Results: CSU patients had more lineage−CD34+CD117+FcεRI+ blood cells than controls. Lineage−CD34+CD117+FcεRI+ cells were significantly higher in patients with CSU who had an objective clinical response to omalizumab when compared to patients who had poor disease control 90 days after initiation of omalizumab. scRNA‐Seq revealed that lineage−CD34+CD117+FcεRI+ cells contained both lymphoid and myeloid progenitor lineages, with omalizumab responsive patients having proportionally more myeloid progenitors. The myeloid progenitor lineage contained small numbers of true mast cell precursors along with more immature FcεRI− and FcεRI+ myeloid progenitors. Conclusion: Increased blood CD34+CD117+FcεRI+ cells may reflect enhanced bone marrow egress in the setting of CSU. High expression of these cells strongly predicts better clinical responses to the anti‐IgE therapy, omalizumab. [ABSTRACT FROM AUTHOR]

Subcutaneous adipose tissue (SAT) is the deepest component of the three‐layered cutaneous integument. While mesenteric adipose tissue‐based immune processes have gained recognition in the context of the metabolic syndrome, SAT has been traditionally considered primarily for energy storage, with less attention to its immune functions. SAT harbors a reservoir of immune and stromal cells that significantly impact metabolic and immunologic processes not only in the skin, but even on a systemic level. These processes include wound healing, cutaneous and systemic infections, immunometabolic, and autoimmune diseases, inflammatory skin diseases, as well as neoplastic conditions. A better understanding of SAT immune functions in different processes, could open avenues for novel therapeutic interventions. Targeting SAT may not only address SAT‐specific diseases but also offer potential treatments for cutaneous or even systemic conditions. This review aims to provide a comprehensive overview on SAT's structure and functions, highlight recent advancements in understanding its role in both homeostatic and pathological conditions within and beyond the skin, and discuss the main questions for future research in the field. [ABSTRACT FROM AUTHOR]

This article examines the relationship between preoperative nasal mucus thymic stromal lymphopoietin (TSLP) and the impact on quality of life in chronic rhinosinusitis with nasal polyps (CRSwNP). The study reveals that CRSwNP patients have elevated TSLP levels in their nasal mucus, which is associated with a lower quality of life and treatment resistance. The findings suggest that measuring TSLP levels in nasal mucus could be a useful noninvasive method for predicting the severity and treatment response of CRSwNP. However, further research is needed to validate these findings and explore the role of TSLP in CRSwNP. The document also includes references to three scientific articles that provide additional insights into the topic of rhinosinusitis and nasal polyps. [Extracted from the article]

In rhinitis and asthma, several mHealth apps have been developed but only a few have been validated. However, these apps have a high potential for improving person‐centred care (PCC), especially in allergen immunotherapy (AIT). They can provide support in AIT initiation by selecting the appropriate patient and allergen shared decision‐making. They can also help in (i) the evaluation of (early) efficacy, (ii) early and late stopping rules and (iii) the evaluation of (carried‐over) efficacy after cessation of the treatment course. Future perspectives have been formulated in the first report of a joint task force (TF)—Allergic Rhinitis and Its Impact on Asthma (ARIA) and the European Academy of Allergy and Clinical Immunology (EAACI)—on digital biomarkers. The TF on AIT now aims to (i) outline the potential of the clinical applications of mHealth solutions, (ii) express their current limitations, (iii) make proposals regarding further developments for both clinical practice and scientific purpose and (iv) suggest which of the tools might best comply with the purpose of digitally‐enabled PCC in AIT. [ABSTRACT FROM AUTHOR]

Immunology and microbiology research has witnessed remarkable growth and innovation globally, playing a pivotal role in advancing our understanding of immune mechanisms, disease pathogenesis, and therapeutic interventions. This manuscript presents a comprehensive exploration of the key areas in immunology research, spanning from the utilisation of bacterial proteins as antibody reagents to the intricate realms of clinical immunology and disease management. The utilisation of bacterial immunoglobulin-binding proteins (IBPs), including protein A (SpA), protein G (SpG), and protein L (SpL), has revolutionised serological diagnostics, showing promise in early disease detection and precision medicine. Microbiological studies have shed light on antimicrobial resistance patterns, particularly the emergence of extended-spectrum beta-lactamases (ESBLs), guiding antimicrobial stewardship programmes and informing therapeutic strategies. Clinical immunology research has elucidated the molecular pathways underlying immune-mediated disorders, resulting in tailored management strategies for conditions such as severe combined immunodeficiency (SCID), neuropsychiatric systemic lupus erythematosus (NPSLE), etc. Additionally, significant efforts in vaccine development against tuberculosis and HIV are highlighted, underscoring the ongoing global pursuit of effective preventive measures against these infectious diseases. In summary, immunology and microbiology research have provided significant contributions to global healthcare, fostering collaboration, innovation, and improved patient outcomes. [ABSTRACT FROM AUTHOR]

Hypereosinophilic syndrome (HES) encompasses a heterogeneous and complex group of different subtypes within the wider group of hypereosinophilic disorders. Despite increasing research interest, several unmet needs in terms of disease identification, pathobiology, phenotyping, and personalized treatment remain to be addressed. Also, the prospective burden of non-malignant HES and, more in general, HE disorders is currently unknown. On a practical note, shortening the diagnostic delay and the time to an appropriate treatment approach probably represents the most urgent issue, even in light of the great impact of HES on the quality of life of affected patients. The present document represents the first action that the Italian Society of Allergy, Asthma, and Clinical Immunology (SIAAIC) has finalized within a wider project aiming to establish a collaborative national network on HES (InHES—Italian Network on HES) for patients and physicians. The first step of the project could not but focus on defining a common language as well as sharing with all of the medical community an update on the most recent advances in the field. In fact, the existing literature has been carefully reviewed in order to critically integrate the different views on the topic and derive practical recommendations on disease identification and treatment approaches. [ABSTRACT FROM AUTHOR]

Interleukin-17 (IL-17), a pivotal cytokine in immune regulation, has attracted significant attention in recent years due to its roles in various physiological and pathological processes. This review explores IL-17 in immunological context, emphasizing its structure, production, and signaling pathways. Specifically, we explore its involvement in inflammatory diseases and autoimmune diseases, with a notable focus on its emerging implications in cardiovascular system. Through an array of research insights, IL-17 displays multifaceted functions yet awaiting comprehensive discovery. Highlighting therapeutic avenues, we scrutinize the efficacy and clinical application of four marketed IL-17 mAbs along other targeted therapies, emphasizing their potential in immune-mediated disease management. Additionally, we discussed the novel IL-17D-CD93 axis, elucidating recent breakthroughs in their biological function and clinical implications, inviting prospects for transformative advancements in immunology and beyond. • Illuminating IL-17 : Discussing its structure, production mechanisms, and intricate signaling pathways. • IL-17 in immunological contexts: Its role in in inflammatory responses, autoimmune diseases, and cardiovascular diseases. • Anti-IL-17 therapiesL Assessing anti-IL-17 monoclonal antibodies for efficacy in managing immune-mediated diseases. • IL-17D's novel role and its receptor CD93: Discovering their transformative potentials in immunology and clinical practice. [ABSTRACT FROM AUTHOR]

Epidemiological studies have explored the relationship between allergic diseases and cancer risk or prognosis in AllergoOncology. Some studies suggest an inverse association, but uncertainties remain, including in IgE‐mediated diseases and glioma. Allergic disease stems from a Th2‐biased immune response to allergens in predisposed atopic individuals. Allergic disorders vary in phenotype, genotype and endotype, affecting their pathophysiology. Beyond clinical manifestation and commonly used clinical markers, there is ongoing research to identify novel biomarkers for allergy diagnosis, monitoring, severity assessment and treatment. Gliomas, the most common and diverse brain tumours, have in parallel undergone changes in classification over time, with specific molecular biomarkers defining glioma subtypes. Gliomas exhibit a complex tumour‐immune interphase and distinct immune microenvironment features. Immunotherapy and targeted therapy hold promise for primary brain tumour treatment, but require more specific and effective approaches. Animal studies indicate allergic airway inflammation may delay glioma progression. This collaborative European Academy of Allergy and Clinical Immunology (EAACI) and European Association of Neuro‐Oncology (EANO) Position Paper summarizes recent advances and emerging biomarkers for refined allergy and adult‐type diffuse glioma classification to inform future epidemiological and clinical studies. Future research is needed to enhance our understanding of immune–glioma interactions to ultimately improve patient prognosis and survival. [ABSTRACT FROM AUTHOR]

Summary: Peri‐operative anaphylaxis is a rare but potentially catastrophic event which must be considered whenever unexpected and significant cardiovascular or respiratory compromise occurs during anaesthesia. The Resuscitation Council UK algorithm for peri‐operative anaphylaxis highlights the importance of early intravenous adrenaline and fluid resuscitation and provides guidance on the treatment of refractory anaphylaxis and immediate follow‐up. This algorithm is endorsed by the Royal College of Anaesthetists, Association of Anaesthetists, British Society of Allergy and Clinical Immunology and Clinical Immunology Professional Network of the British Society for Immunology. This document was produced by the Perioperative Allergy Network steering committee in collaboration with the Resuscitation Council UK. [ABSTRACT FROM AUTHOR]

Introduction: The Coronavirus disease 2019 (COVID‑19) pandemic has been the biggest threat to humankind during the last 3 years. It has caused the loss of more than 6.9 million precious lives across the world. The only method by which the massacre could be stopped was by mass vaccination or mass immunization. The patients suffering from autoimmune rheumatic disorders (AIRDs) and treated with immunosuppressants were the high‑priority candidates for vaccination. However, the data regarding the efficacy of COVID‑19 vaccines in this group of patients are very less. Hence, this study was planned to study the immunogenicity of Covishield in patients with AIRDs attending the rheumatology OPD at DMCH, Ludhiana. Materials and Methods: It was a prospective cohort study and was planned by the Department of Biochemistry and Department of Clinical Immunology and Rheumatology at Dayanand Medical College and Hospital, Ludhiana. Fifty patients with AIRDs attending the DMCH rheumatology OPD and 52 age and sex‑matched healthy controls who had received two doses of Covishield vaccine were included in this study. Patients having any other immunosuppressive conditions like uncontrolled diabetes, hepatitis, malignancy or HIV were excluded. Patients who had suffered from previous laboratory‑confirmed COVID‑19 infection (by RT‑PCR) were also excluded. Blood samples were collected following all aseptic precautions from patients and controls on the 28th day after administration of a second dose of Covishield vaccine and total antibodies to the severe acute respiratory syndrome coronavirus 2 spike (S) protein receptor binding domain was measured using Elecsys Anti‑SARS‑CoV‑2 S kit from Roche. Results: It was observed that no significant difference was there in antibody titre between cases and controls (6213 ± 4418 vs. 8331 ± 7979, P = 0.1022). It was also observed that no statistically significant difference in antibody titre in cases without prednisolone and those taking treatment with prednisolone was found (P = 0.7058). A similar observation was found in terms of methotrexate also (P = 0.457). No significant difference in antibody titres was there when compared with controls (for prednisolone, P = 0.169, for methotrexate, P = 0.078). We found that only the patients receiving mycophenolate mofetil showed a statistically significant decrease in antibody titre in comparison to healthy controls (P = 0.03). Our study showed no statistically significant difference in antibody titres between patients suffering from different AIRDs. Conclusion: Our study supplements the fact that patients with AIRDs in India can receive Covishield as the primary vaccine against COVID‑19 without concerns regarding decreased immunogenicity or increased adverse effects. [ABSTRACT FROM AUTHOR]

Background: We recently adopted a guideline for chronic cough in children in the Egyptian health system. Adapting clinical practice guidelines (CPGs) to the local healthcare setting is a valid alternative to de-novo development that can improve their uptake and implementation without demanding a substantial drain on resources. The objective of this study was to adapt evidence-based recommendations from global high-quality CPGs for children with a chronic cough to suit the Egyptian healthcare context. Methods: We followed the Adapted ADAPTE methodological framework for guideline adaptation. This process includes three phases: set-up, adaptation, and finalization. A guideline adaptation group (GAG) and an external review group including clinical content experts and methodologists conducted the process. Results: The GAG adapted 10 sections of recommendations from three original CPG(s) including (i) the American College of Chest Physicians (ACCP) 2006–2020, (ii) the European Respiratory Society (ERS) 2019, (iii) the Korean Academy of Asthma, Allergy and Clinical Immunology (KAAACI) 2018. A set of CPG implementation tools was added to enhance implementability including an algorithm, a slide presentation for clinical diagnosis, investigations and treatment of chronic cough, patient education, and online resources. Conclusion: The adapted CPG provides pediatricians and related healthcare workers with applicable evidence-based recommendations for chronic cough in children in Egypt. The project also highlighted the utility of Adapted ADAPTE and the invaluable collaboration between the clinical and methodological experts for the adaptation of pediatric national guidelines. [ABSTRACT FROM AUTHOR]

This article details the development of immunology as a scientific discipline based on basic research and clinical application in Turkey. Due to the valiant efforts of the Turkish Society of Immunology (TSI), immunology has become a fundamental discipline in its own right in Turkey. Immunology Laboratories were established at İstanbul Medical School, Cerrahpaşa Medical School, and Hacettepe Medical School in 1970. Since 1974, TSI has been the driving force organizing the '”National Immunology Congress” and joint meetings with international immunology and inborn errors of immunity (IEIs) centers. The immunological education program was established in some of Turkey’s most prominent medical schools during the 2000-2001 academic year. Following the establishment of the immunological programs, all facets of modern immunology and clinical medicine began to diverge. Subsequently, the Turkish National Society of Allergy and Clinical Immunology, and Clinical Immunology Society were established and initiated to organize congresses, educational meetings, courses, and webinars. With the assistance of international experts, Turkish clinical immunologists defined many gene defects in Turkish patients. As clinicians gained additional immunological experience, new techniques and practices that allowed for better diagnosis and treatment of a larger variety of different immunodeficiencies were developed. Beginning in 2011, the Ministry of Health started to regulate patient care by allowing pediatric/adult allergists and immunologists to provide patient care at the tertiary level. Screening tests for IEIs and intravenous or subcutaneous immunoglobulin replacement treatment are now being offered to all patients. Human stem cell therapy treatments are accessible for patients with T-cell deficiency, and available monoclonal therapies are provided to IEIs patients in Turkey [ABSTRACT FROM AUTHOR]

The article discusses the role of type 2 memory B cells in maintaining allergic memory. Allergy is an inappropriate immune response to harmless substances, often mediated by IgE antibodies. The study suggests that a subset of non-IgE B cells, specifically type 2-marked IgG memory B cells, may serve as a reservoir for allergic memory. These cells were found to be present in pediatric patients with peanut allergy and were associated with elevated peanut-specific IgE levels. The presence of type 2 memory B cells may explain the persistence of allergic sensitization and could be a potential target for allergy treatment. [Extracted from the article]

The article "Clinical and Experimental Immunology: Highlights of 2023" provides a summary of the research and achievements published in the journal throughout the year. It mentions the collaboration with the Federation of Clinical Immunology Societies (FOCIS) 2023 Annual Meeting and the compilation of research articles covering various fields of immunology. The article highlights specific studies on topics such as pembrolizumab-induced myasthenia gravis, lysophosphatidic acid treatment for neuropsychiatric systemic lupus erythematosus, and the impact of immunopeptide on pancreas homeostasis. It also mentions the introduction of new review series on unconventional T cells, inborn errors of immunity, and regulatory T cell enhancing approaches. The article concludes by expressing gratitude to the contributors and supporters of the journal. The document is a list of references to various articles on topics related to immunology, covering subjects such as leukocyte trafficking, unconventional T cells, innate lymphoid cells in transplantation, regulatory T-cell dysfunction, FOXP3+ regulators of immune responses, inborn errors of immunity, mutation types in immune disorders, regulatory T-cell enhancing approaches, and the role of B cells in granulomatosis with polyangiitis and COVID-19. [Extracted from the article]

This article discusses a real-world study on the effectiveness and safety of upadacitinib, a selective JAK1 inhibitor, for the treatment of refractory pediatric atopic dermatitis (AD) in patients who did not respond to dupilumab. The study included 12 patients aged 6-14 who had failed conventional topical corticosteroid treatment and had a history of poor response to dupilumab. Significant improvements were observed in disease severity, itchiness, and quality of life after 16 weeks of upadacitinib treatment. Adverse events were generally mild, with the most common being acne. The study suggests that upadacitinib may be a promising therapeutic option for pediatric AD patients who do not respond to dupilumab. [Extracted from the article]

This article discusses a case of successful treatment of pemphigus foliaceus (PF), a rare autoimmune blistering dermatosis, with upadacitinib. The patient had been suffering from the disease for 8 years with recurrent severe relapses. Previous treatments with corticosteroids and immunosuppressive drugs had failed to control the disease. However, treatment with upadacitinib resulted in the resolution of skin lesions and a significant improvement in the patient's quality of life. The mechanisms by which upadacitinib exerts its effect in PF are still unknown, but it is believed to inhibit the proliferation and differentiation of T and B cells. Further studies are needed to determine the safety of upadacitinib in elderly adults with comorbidities. [Extracted from the article]

Introduction: Guidelines recommend treating asthma exacerbations (AAEs) with bronchodilators combined with inhaled and/or systemic corticosteroids. Indications for antibiotic prescriptions for AAEs are usually not incorporated although the literature shows antibiotics are frequently prescribed. Aim: To investigate the antibiotic prescription rates in AAEs and explore the possible determining factors of those practices. Methods: A digital survey was created to determine the antibiotic prescription rates in AAEs and the influencing factors for the prescription practices. The survey was distributed among European academy of allergy and clinical immunology (EAACI) members by mass emailing and through regional/national societies in the Netherlands, Italy, Greece, and Poland. Furthermore, we retrieved local antibiotic prescription rates. Results: In total, 252 participants completed the survey. Respondents stated that there is a lack of guidelines to prescribe antibiotics in AAEs. The median antibiotic prescription rate in this study was 19% [IQR: 0%–40%] and was significantly different between 4 professions: paediatrics 0% [IQR: 0%–37%], pulmonologists 25% [IQR: 10%–50%], general practitioners 25% [IQR: 0%–50%], and allergologists 17% [IQR: 0%–33%]) (p = 0.046). Additional diagnostic tests were performed in 71.4% of patients before prescription and the most common antibiotic classes prescribed were macrolides (46.0%) and penicillin (42.9%). Important clinical factors for health care providers to prescribe antibiotics were colorised/purulent sputum, abnormal lung sounds during auscultation, fever, and presence of comorbidities. Conclusion: In 19% of patients with AAEs, antibiotics were prescribed in various classes with a broad range among different subspecialities. This study stresses the urgency to compose evidence‐based guidelines to aim for more rational antibiotic prescriptions for AAE. [ABSTRACT FROM AUTHOR]

Background: The 2014 estimates of prevalence of food allergy (FA) in Europe published by the European Academy of Allergy and Clinical Immunology included only the eight so‐called big foods (cow's milk/egg/wheat/soy/peanut/tree nuts/fish/shellfish). Those estimates have recently been updated. Complementing this, we sought to identify and estimate the prevalence of allergy to other foods that have been reported during the last decade. Methods: Six databases were searched for studies published 2012–2021. Random‐effects meta‐analysis was performed to derive pooled prevalence of allergy to each food. Results: Twenty‐seven studies were included, containing a total of 66 FAs. Among the most frequently reported FAs, the lifetime and point prevalence range of self‐reported kiwi allergy was 0.1%–1.0% and 0.2%–8.1%, respectively, while the food challenge (FC)‐verified kiwi allergy point prevalence range was 0.01%–0.10%. The point prevalence range for self‐reported peach allergy was 0.2%–3.2%, while the range for FC‐verified peach allergy was 0.02%–0.05%. The lifetime and point prevalence range for self‐reported tomato allergy was 0.01%–1.8% and 0.2%–2.1%, respectively. Conclusion: Allergy to some foods traditionally not considered important are now emerging as relevant FAs. The focus on FA in Europe should not be limited to the so‐called eight big FA, but extended to other types of foods which need to be considered both for clinical purposes and population risk assessment. [ABSTRACT FROM AUTHOR]

In 2014, the European Academy of Allergy and Clinical Immunology (EAACI) published the first systematic review that summarized the prevalence of food allergy (FA) and food sensitization in Europe for studies published 2000–2012. However, only summary estimates for tree nut allergy (TNA) were feasible in that work. In the current update of that systematic review, we summarized the prevalence of tree nut allergy/sensitization to individual tree nuts. Six databases were searched for relevant papers published 2012–2021 and 17 eligible studies were added to the 15 studies already identified between 2000 and 2012, giving a total of 32 studies. Of the investigated tree nuts, meta‐analysis was possible for hazelnut, walnut, almond, and in few cases, for cashew, and Brazil nut. The lifetime self‐reported prevalence was 0.8% (95% CI 0.5–1.1) for hazelnut and 0.4% (0.2–0.9) for walnut. The point self‐reported prevalence was 4.0% (2.9–5.2) for hazelnut, 3.4% (2.0–4.9) for Brazil nut, 2.0% (1.1–2.9) for almond, and 1.8% (1.1–2.5) for walnut. Point prevalence of food challenge‐confirmed TNA was 0.04% (0.0–0.1) for hazelnut and 0.02% (0.01–0.1) for walnut. Due to paucity of data, we could not identify any meaningful and consistent differences across age groups and European regions. [ABSTRACT FROM AUTHOR]

The European Academy of Allergy and Clinical Immunology (EAACI) is updating the Guidelines on Food Allergy Diagnosis. We aimed to undertake a systematic review of the literature with meta‐analyses to assess the accuracy of diagnostic tests for IgE‐mediated food allergy. We searched three databases (Cochrane CENTRAL (Trials), MEDLINE (OVID) and Embase (OVID)) for diagnostic test accuracy studies published between 1 October 2012 and 30 June 2021 according to a previously published protocol (CRD42021259186). We independently screened abstracts, extracted data from full texts and assessed risk of bias with QUADRAS 2 tool in duplicate. Meta‐analyses were undertaken for food‐test combinations for which three or more studies were available. A total of 149 studies comprising 24,489 patients met the inclusion criteria and they were generally heterogeneous. 60.4% of studies were in children ≤12 years of age, 54.3% were undertaken in Europe, ≥95% were conducted in a specialized paediatric or allergy clinical setting and all included oral food challenge in at least a percentage of enrolled patients, in 21.5% double‐blind placebo‐controlled food challenges. Skin prick test (SPT) with fresh cow's milk and raw egg had high sensitivity (90% and 94%) for milk and cooked egg allergies. Specific IgE (sIgE) to individual components had high specificity: Ara h 2‐sIgE had 92%, Cor a 14‐sIgE 95%, Ana o 3‐sIgE 94%, casein‐sIgE 93%, ovomucoid‐sIgE 92/91% for the diagnosis of peanut, hazelnut, cashew, cow's milk and raw/cooked egg allergies, respectively. The basophil activation test (BAT) was highly specific for the diagnosis of peanut (90%) and sesame (93%) allergies. In conclusion, SPT and specific IgE to extracts had high sensitivity whereas specific IgE to components and BAT had high specificity to support the diagnosis of individual food allergies. [ABSTRACT FROM AUTHOR]

La réforme du 3e cycle des études médicales de 2017 a introduit le concept d'autonomie supervisée avec la création d'un nouveau statut de docteur junior (DJ). L'objectif de ce travail était d'interroger la première promotion de DJ de médecine interne et immunologie clinique (MIIC) concernant le déroulement et la mise en place de cette dernière année d'internat. Les DJ du diplôme d'études spécialisées de MIIC étaient invités à répondre à une enquête en ligne anonyme, sollicités par mail et via les réseaux sociaux. Le questionnaire a recueilli 36 réponses sur une cinquantaine de DJ estimés. La majorité des DJ consacrait plus de 70 % de leur temps en hospitalisation conventionnelle et moins de 20 % en hospitalisation programmée. La majorité aurait aimé faire davantage de consultation et d'avis. Le temps de travail hebdomadaire n'était pas respecté pour la majorité des DJ. Les temps de formation académiques et personnels n'étaient pas respectés pour 77,8 % d'entre eux. Au total, 75 % étaient satisfaits de l'autonomisation et 88,6 % estimaient que la transition avec le post-internat serait plus aisée grâce à la phase de consolidation. Un tiers rapportait que leur stage avait confirmé leur appréhension à exercer en tant qu'interniste voire que celle-ci pouvait remettre en question leur exercice futur. Cette enquête est un premier état des lieux concernant la mise en place de l'année de DJ dans le DES de MIIC. Un travail collectif autour de cette dernière année d'internat semble être indispensable pour garantir l'épanouissement personnel et professionnel des jeunes internistes. The 2017 reform of the 3rd cycle of medical studies introduced the concept of supervised autonomy with the creation of a new junior doctor (JD) status. The aim of this work was to interview the first class of JDs in internal medicine and clinical immunology (IMCI) regarding the progress and implementation of this final year of internship. The IMCI JDs were invited to complete an anonymous online survey, contacted by email and social networks. The questionnaire received 36 responses out of an estimated fifty JDs. The majority of JDs spent more than 70% of their time on conventional hospitalisation and less than 20% on scheduled hospitalisation. Most of them would have preferred to do more consultations and provide expert counsels. Weekly working hours were not respected for the majority of JDs. Personal education and academic formation were not respected for 77.8% of JDs. Overall, 75% were satisfied with their empowerment and 88.6% felt that the transition to post residency would be easier with the consolidation phase. A third reported that their residency had confirmed their apprehension about practising as an internist, and even that this apprehension might call into question their future practice. This survey is an initial assessment of the implementation of the JD year in the IMCI residency. A collective effort around this last year of internship seems to be essential to ensure the personal and professional development of young internists. [ABSTRACT FROM AUTHOR]

Immunology examination is an abstract boring medical professional course. According to the characteristics of this course, this paper uses mixed teaching and takes CBL as the basis to dig deeply into the ideological and political elements of this course. Starting from the cultivating a comprehensive development of people, from three aspects, namely the cultural foundation, independent development and society participation to consider, implementation of "knowledge" and "leading value" all-round education go hand in hand. To cultivate medical students who skilled in medicine, with correct outlook on life and values, so as to realize the fundamental task of cultivating morality and cultivating people. It provides an empirical basis for the teaching reform of "curriculum ideology and politics" of "clinical immunology examination technology". [ABSTRACT FROM AUTHOR]

The last two decades have witnessed a major revolution in the field of tumor immunology including clinical progress using various immunotherapy strategies. These advances have highlighted the potential for approaches that harness the power of the immune system to fight against cancer. While cancer immunotherapies have shown significant clinical successes, patient responses vary widely due to the complex and heterogeneous nature of tumors and immune responses, calling for reliable biomarkers and therapeutic strategies to maximize the benefits of immunotherapy. Especially, stratifying responding individuals from non‐responders during the early stages of treatment could help avoid long‐term damage and tailor personalized treatments. In efforts to develop non‐invasive means for accurately evaluating and predicting tumor response to immunotherapy, multiple affinity‐based agents targeting immune cell markers and checkpoint molecules have been developed and advanced to clinical trials. In addition, researchers have recently turned their attention to substrate and activity‐based imaging probes that can provide real‐time, functional assessment of immune response to treatment. Here, we highlight some of those recently designed probes that image functional proteases as biomarkers of cancer immunotherapy with a focus on their chemical design and detection modalities and discuss challenges and opportunities for the development of imaging tools utilized in cancer immunotherapy. [ABSTRACT FROM AUTHOR]

Objective: Analyze feelings about allergen-specific immunotherapy on Twitter using the VADER model VADER (Valence Aware Dictionary and sEntiment Reasoner) model. Methods: tweets related to specific allergen immunotherapy were obtained through the Twitter Application Programming Interface (API). The keywords "allergy shot" were used between January 1, 2012, and December 31, 2022. The data was processed by removing URLs, usernames, hashtags, multiple spaces, and duplicate tweets. Subsequently, a sentiment analysis was performed using the VADER model. Results: A total of 34,711 tweets were retrieved, of which 1928 were eliminated. Of the remaining 32,783 tweets, 32.41% expressed a negative sentiment, 31.11% expressed a neutral sentiment, and 36.47% expressed a positive sentiment, with an average polarity of 0.02751 (neutral) over the 11-year period. Conclusions: The average polarity of tweets about allergen-specific immunotherapy is neutral over the 11 years analyzed. There was an annual increase in the average polarity over the years, with 2017, 2018, and 2022 having positive polarity averages. Additionally, the number of tweets decreased over time. [ABSTRACT FROM AUTHOR]

The prevalence and complexity of allergic diseases have increased in recent decades, leading to a significant burden for patients and their families. However, training in Allergy and Clinical Immunology (ACI) varies worldwide, with significant heterogeneity between countries. This variability may limit the number of healthcare professionals and researchers undergoing ACI training in the future. To address this, the European Academy of Allergy and Clinical Immunology (EAACI) has developed a mentorship program to support young professionals in enhancing their skills and network. The program has been successful and may serve as a model for other scientific organizations in the ACI field. [Extracted from the article]

This letter discusses the ongoing debate on the best way to apply quality control (QC) procedures for infectious serology tests. Some authors recommend a statistical approach, while others believe that less rigorous QC procedures can be used. The authors evaluated the Six Sigma approach for an Electro-chemiluminescence immunoassay (ECLIA) of toxoplasmosis serology. They found that the designed QC procedure based on low positive QC was more sensitive to systematic errors than the kit-QC for the Toxo IgM assay. The study demonstrates that a Six Sigma driven QC procedure can be developed for qualitative infectious serology tests if the assay is linear and well-designed and commutable QC materials are used. [Extracted from the article]

Four in five children with inborn errors of immunity globally remain undiagnosed. These figures are disproportionally high in low-income countries like Ethiopia. Apart from the inclusion of basic overviews of these disorders in to postgraduate pediatric curricula, little effort has been placed in to establishing clinical immunology training programs. This report summarizes the existing epidemiology of inborn errors of immunity in Ethiopia, unique presentations in Ethiopian children, challenges faced in diagnosing them, and efforts to improve their management. [ABSTRACT FROM AUTHOR]

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Endogenous retroviruses (ERVs) make up approximately 8% of the human genome and have important roles in human evolution, development, and diseases. Reactivating ERVs can enhance tumor immunogenicity and trigger immune responses against cancer cells. ERVs can also be used to develop mRNA delivery systems and tumor-specific expression vectors for clinical therapy. The reactivation of ERVs shows promise for clinical and immunological applications. [Extracted from the article]

This European Academy of Allergy and Clinical Immunology guideline provides recommendations for diagnosing IgE‐mediated food allergy and was developed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Food allergy diagnosis starts with an allergy‐focused clinical history followed by tests to determine IgE sensitization, such as serum allergen‐specific IgE (sIgE) and skin prick test (SPT), and the basophil activation test (BAT), if available. Evidence for IgE sensitization should be sought for any suspected foods. The diagnosis of allergy to some foods, such as peanut and cashew nut, is well supported by SPT and serum sIgE, whereas there are less data and the performance of these tests is poorer for other foods, such as wheat and soya. The measurement of sIgE to allergen components such as Ara h 2 from peanut, Cor a 14 from hazelnut and Ana o 3 from cashew can be useful to further support the diagnosis, especially in pollen‐sensitized individuals. BAT to peanut and sesame can be used additionally. The reference standard for food allergy diagnosis is the oral food challenge (OFC). OFC should be performed in equivocal cases. For practical reasons, open challenges are suitable in most cases. Reassessment of food allergic children with allergy tests and/or OFCs periodically over time will enable reintroduction of food into the diet in the case of spontaneous acquisition of oral tolerance. [ABSTRACT FROM AUTHOR]

Background: There is clear evidence that the prevalence of primary antibody deficiency (PAD) is higher in patients with recurrent and chronic rhinosinusitis (CRS) than in the general population. The purpose of this multi‐institutional and multidisciplinary evidence‐based review with recommendations (EBRR) is to thoroughly review the literature on rhinosinusitis with PAD, summarize the existing evidence, and provide recommendations on the evaluation and management of rhinosinusitis in patients with PAD. Methods: The PubMed, EMBASE, and Cochrane databases were systematically reviewed from inception through August 2022. Studies on the evaluation and management of rhinosinusitis in PAD patients were included. An iterative review process was utilized in accordance with EBRR guidelines. Levels of evidence and recommendations on the evaluation and management principles for PAD were generated. Results: A total of 42 studies were included in this evidence‐based review. These studies were evaluated on incidence of PAD in rhinosinusitis patients, incidence of rhinosinusitis in PAD patients, and on the different treatment modalities used and their outcome. The aggregate quality of evidence was varied across reviewed domains. Conclusion: Based on the currently available evidence, PAD can occur in up to 50% of patients with recalcitrant CRS. Despite the presence of multiple studies addressing rhinosinusitis and PAD, the level of evidence supporting different treatment options continues to be lacking. Optimal management requires a multidisciplinary approach through collaboration with clinical immunology. There is need for higher‐level studies that compare different treatments in patients with PAD and rhinosinusitis. [ABSTRACT FROM AUTHOR]

The article discusses the cryopreservation of mouse thymus and its impact on immune reconstitution after transplantation. The study found that cryopreservation depleted thymocytes but preserved thymus function, and there were no differences in immune reconstitution between fresh and frozen/thawed transplants. This suggests that donor thymocyte depletion does not affect the outcome of thymus transplantation. Cryopreservation of thymus may have advantages such as increasing availability, decreasing delays in treatment, and enabling MHC-matching, which could improve immune reconstitution and reduce autoimmunity. [Extracted from the article]

This document is an editorial from the journal Biomedicines, paying tribute to the late Prof. Fernando Aiuti, a respected immunologist in Italy. Prof. Aiuti had a distinguished career at Sapienza, University of Rome, where he conducted research on primary and acquired immunodeficiencies. He also played a role in educating the public about immunology. The editorial includes contributions from researchers who worked with Prof. Aiuti, summarizing their studies on various topics such as the impact of COVID-19 on adults with primary antibody deficiencies, the effects of vaccines and monoclonal antibodies on patients with different medical conditions, proteomic analysis of deregulated IgE, gene therapy for primary immunodeficiencies, and immune activation in HIV-1 infection. The authors express their admiration for Prof. Aiuti's work and emphasize its ongoing significance. [Extracted from the article]

The exponential growth of precision diagnostic tools, including omic technologies, molecular diagnostics, sophisticated genetic and epigenetic editing, imaging and nano‐technologies and patient access to extensive health care, has resulted in vast amounts of unbiased data enabling in‐depth disease characterization. New disease endotypes have been identified for various allergic diseases and triggered the gradual transition from a disease description focused on symptoms to identifying biomarkers and intricate pathogenetic and metabolic pathways. Consequently, the current disease taxonomy has to be revised for better categorization. This European Academy of Allergy and Clinical Immunology Position Paper responds to this challenge and provides a modern nomenclature for allergic diseases, which respects the earlier classifications back to the early 20th century. Hypersensitivity reactions originally described by Gell and Coombs have been extended into nine different types comprising antibody‐ (I‐III), cell‐mediated (IVa‐c), tissue‐driven mechanisms (V‐VI) and direct response to chemicals (VII). Types I‐III are linked to classical and newly described clinical conditions. Type IVa‐c are specified and detailed according to the current understanding of T1, T2 and T3 responses. Types V‐VI involve epithelial barrier defects and metabolic‐induced immune dysregulation, while direct cellular and inflammatory responses to chemicals are covered in type VII. It is notable that several combinations of mixed types may appear in the clinical setting. The clinical relevance of the current approach for allergy practice will be conferred in another article that will follow this year, aiming at showing the relevance in clinical practice where various endotypes can overlap and evolve over the lifetime. [ABSTRACT FROM AUTHOR]

It is now 60 years since Ian Mackay and Macfarlane Burnet published their seminal text "The Autoimmune Diseases" in which they examined the full scope of human inflammatory pathology as a manifestation of the underlying structure and function of the immune system. Here I revisit this approach to ask to what extent has the promise of Mackay and Burnet's work been exploited in clinical medicine as currently practiced. In other words, is immunology doing well? Despite spectacular headline contributions of immunology in clinical medicine, I present evidence suggesting a performance ceiling in our capacity to answer the relatively straightforward questions that patients frequently ask about their own diseases and find that this ceiling exists across almost all of the 100 immune‐mediated inflammatory diseases examined. I propose that these questions are difficult, not so much because the immune system is overwhelmingly complex but rather that we have more to learn about the relatively simple agents and rules that may underpin self‐organizing complex interacting systems as revealed in studies from other disciplines. The way that the immune system has evolved to exploit the ancient machinery determining three independent cell fate timers as described in this Journal would be a great place to start to decode the self‐organizing principles that underpin the emergent pathology that we observe in the clinic. [ABSTRACT FROM AUTHOR]

This article, published in the Journal of Clinical Immunology, describes a case series of five Romanian patients with Deficiency of adenosine deaminase 2 (DADA2), an autoinflammatory disorder caused by mutations in the ADA2 gene. The patients presented with a range of symptoms including systemic inflammation, vasculitis, immune dysregulation, and hematologic dysfunction. The study identified novel variants in the ADA2 gene and confirmed reduced ADA2 activity in the patients. The authors emphasize the need for early detection of DADA2 to reduce morbidity and mortality, and highlight the heterogeneity of the disease and the importance of personalized treatment strategies. [Extracted from the article]

This letter, published in the Journal of Clinical Immunology, discusses the challenges in detecting and monitoring granulomatous disease in patients with common variable immune deficiency (CVID). The authors conducted a retrospective cohort study to identify biomarkers that could indicate granuloma progression in CVID. They found that the ratio of soluble interleukin-2 receptor (sIL-2R) to white blood cell (WBC) count was a more accurate and discriminative monitoring tool for detecting and monitoring granulomatous disease and progression in CVID compared to sIL-2R alone or other markers. The authors suggest that this ratio could be easily implemented in routine diagnostics. [Extracted from the article]

This document is a letter published in the Journal of Clinical Immunology. It discusses a case study of a male patient with Incontinentia Pigmenti and X-linked anhidrotic ectodermal dysplasia with immunodeficiency (IP-EDA-ID). The patient had a pathogenic variant in the NEMO/IKBKG gene, which caused split immunological reconstitution. The study examines the chronological changes in somatic mosaicism of T cells, B cells, and monocytes in the patient. The findings suggest that monitoring mosaicism can guide the appropriate treatment for NEMO deficiency. [Extracted from the article]

Rapid and noninvasive detection of macrophage polarization can facilitate the acquisition of crucial information for pre- and post-evaluation in cancer immunotherapy, unraveling tumor immune escape mechanisms and discovering drugs. Herein, we demonstrate an approach to identify macrophage polarization using the metasurface-based terahertz biosensor of quasi-bound state in the continuum. Non-polarized macrophages (M0) are driven into a pro-inflammatory phenotype (M1) or an anti-inflammatory phenotype (M2) in response to lipopolysaccharide or interleukin-4 stimulation. It is found that the M1 macrophages result in a slight resonance frequency blueshift, while the M2 results in an obvious resonance frequency blueshift as well as a broader resonance linewidth. The permittivity change reveals the aforementioned frequency change. Flow cytometry and gene expression measurements reveal distinct differences of phenotypes between M1 and M2 polarizations, consistent with the results of terahertz biosensing. Our results manifest a cost-effective approach for detecting macrophage polarization status and their functional activations, which holds significant implications for clinical and cellular immunology research. [ABSTRACT FROM AUTHOR]

Background: Urticarial vasculitis (UV) should be differentiated from chronic spontaneous urticaria (CSU) in patients initially presenting with recurrent wheals, although criteria for differential diagnosis remain ill‐defined. Objectives: To set the goals, define criteria and unmet needs in UV diagnosis and differential diagnosis with CSU, and explore the possibility of coexistence of both diseases. Methods: Thirteen experts experienced in UV research participated in a Delphi survey of European Academy of Allergy and Clinical Immunology taskforce. This Delphi survey involved three rounds of anonymous responses to n = 32 questions with the aim to aggregate the experts' opinions and to achieve consensus. Urticaria specialists (n = 130, most from Urticaria Centers of Reference and Excellence) evaluated the consensus statements and recommendations in the fourth and final round. Results: The panel agreed that essential criteria to guide a skin biopsy in patients with recurrent wheals should include at least one of the following features: wheal duration >24 h, bruising/postinflammatory hyperpigmentation, and systemic symptoms. Leukocytoclasia and fibrin deposits were identified as a minimum set of UV histological criteria. As agreed by the panel members, CSU and normocomplementemic UV (NUV) may coexist in some patients. Conclusions: The use of established criteria for the diagnosis and differential diagnosis of UV in patients with recurrent wheals can help guide the diagnostic approach and prompt earlier treatment. Further studies should investigate whether CSU and NUV are different entities or part of a disease spectrum. [ABSTRACT FROM AUTHOR]

BackgroundInborn errors of immunity (IEI) are a group of genetic disorders that impair the immune system, with over 400 genes described so far, and hundreds more to be discovered. To facilitate the search for new genes, we need a way to prioritize among all the genes in the genome those most likely to play an important role in immunity.ResultsHere we identify a new list of genes by linking known IEI genes to new ones by using open-source databases of protein-protein interactions, post-translational modifications, and transcriptional regulation. We analyze this new set of 2,530 IEI-related genes for their tolerance of genetic variation and by their expression levels in various immune cell types.ConclusionsBy merging genes derived from protein interactions of known IEI genes with transcriptional data, we offer a new list of candidate genes that may play a role in as-yet undiscovered IEIs.

This article discusses the role of real-life data (RLD) in the development and implementation of health guidelines. The European Academy of Allergy and Clinical Immunology (EAACI) and the Respiratory Effectiveness Group (REG) are committed to using RLD to reflect the real-life experiences of patients. The article highlights the importance of non-randomized studies of interventions (NRSI) as a source of evidence that mimics real-life situations. The REG Manifesto on the importance of real-life research and the Real Life Evidence Assessment Tool (RELEVANT) are also mentioned. The article concludes by mentioning the upcoming workshop in Rome to further discuss these topics. [Extracted from the article]

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Abstract Background Common Variable Immunodeficiency (CVID) is a primary immunodeficiency syndrome resulting in recurrent infections, autoimmunity, and granulomatous manifestations. Methods and materials This retrospective study was conducted on an Iranian national registry of immunodeficient patients from 2010 to 2021. The frequency of first presentations of CVID and its association with sex, age of onset, and family history of CVID was evaluated. Results A total of 383 patients entered the study, 164 of whom were female, and the rest were male. The mean age of the patients was 25.3 ± 14.5 years. The most frequent first presentations of CVID were pneumonia (36.8%) and diarrhea (19.1%). Patient sex, age of onset, and family history did not make significant differences in first presentations of this disease. Conclusion pneumonia is the most common first presentation of CVID. Family history of CVID, the age of symptom onset, and sex made no differences in the first presentations of CVID.

Immunotherapy, notably immune checkpoint inhibitors, has recently inserted itself into the standard clinical dogma of bladder urothelial carcinoma, particularly as systemic therapy has seen minimal progress in the past 20 years. Since the initial approval of secondline immunotherapy in platinum refractory patients, new strategies have been evaluated to improve patient’s prognosis. We summarize in this review updated data regarding immunotherapeutic agents in bladder urothelial carcinoma. [ABSTRACT FROM AUTHOR]

Angioedema is the most common adult allergy presentation at two Cape Town emergency centres. Our tertiary hospital ACARE centre consults 2-3 new referrals a week, with a high burden of angioedema without urticaria. Many practitioners feel comfortable with the work-up of possible mast-cell-mediated angioedema, which occurs together with urticaria. However, the diagnostic work-up, the availability of certain specialised testing - for example, functional C1-INH testing - and the increasing use of treatment trials is less familiar. In this article we present two cases of recurrent angioedema without urticaria which highlight the differences between bradykinin-mediated and mast-cell phenotypes and the way this has an impact on diagnosis and management. We also present an integrated algorithm that is employed at our South African ACARE centre. [ABSTRACT FROM AUTHOR]