2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T41e,Highlights across studies: - **Atopic march ML model:** Simplified models using routine early-life clinical features accurately predicted moderate-to-severe persistent asthma/allergic rhinitis by ages 5–11. - **Peanut OIT (IMPACT follow-up):** 80% of children who received pnOIT only (group A, n=40) were eating peanut at follow-up; 35% of group A reported peanut reactions since IMPACT; IgG4:IgE ratio remained higher in the pnOIT group vs. placebo years later. - **Dupilumab & autoimmunity in children:** Cutaneous autoimmune diagnoses (mainly psoriasis and alopecia areata) were ~2 per 1,000 children/year higher in the dupilumab group; no significant differences in endocrine, GI, or rheumatologic autoimmune diagnoses. - **EoE transcriptome:** Dupilumab normalized >1,300 dysregulated EoE genes (eosinophil and non-eosinophil pathways) across all age groups, sustained on treatment. - **α-Gal IgG & atherosclerosis:** Anti-α-Gal IgG formed immune complexes with α-Gal–bearing LDL, enhancing macrophage uptake and foam cell formation in vitro.31:T74c,Oral immunotherapy (OIT) is a promising approach for treating IgE-mediated food allergy, but safety concerns limit its use. Heat-denaturation of food allergens may reduce allergic reactions by lowering IgE binding. Here, we examined how heat-induced structural changes in egg allergens affected basophil activation in egg-allergic patients. Gal d 1 and Gal d 2 were subjected to heat treatment and analyzed for structural changes using SDS-PAGE, ELISA, NanoDSF, and circular dichroism. Peripheral blood samples were obtained from a cohort of 42 patients with egg allergy. Patients' sensitization status was determined, and basophils were isolated and incubated with native or heat-denatured egg allergen preparations. Basophil activation was assessed by measuring leukotriene release as a marker of degranulation. Heat-denaturation induced time- and temperature-dependent structural changes in both Gal d 1 and Gal d 2, resulting in reduced IgE binding capacity. In functional assays, heat-denatured allergens elicited weaker basophil degranulation responses compared to native allergens, but the effect varied depending on individual IgE sensitization profiles. Among patients who reacted to heat-denatured allergens, egg-white IgE levels tended to be higher, although requiring higher doses to trigger leukotriene release. Heat-denaturation of egg allergens reduces IgE-binding and basophil activation, although residual reactivity persists in patients with higher sensitization profiles. Importantly, higher allergen doses were needed to trigger basophil degranulation compared to native allergens, indicating a reduction in allergenic potency. These findings highlight the potential of heat-denatured egg allergens as safer starting materials for OIT, particularly within personalized, stepwise desensitization protocols, warranting further clinical investigation.32:T9e6,Abstract Background Oral immunotherapy (OIT) is a promising approach for treating IgE‐mediated food allergy, but safety concerns limit its use. Heat‐denaturation of food allergens may reduce allergic reactions by lowering IgE binding. Here, we examined how heat‐induced structural changes in egg allergens affected basophil activation in egg‐allergic patients. Methods Gal d 1 and Gal d 2 were subjected to heat treatment and analyzed for structural changes using SDS‐PAGE, ELISA, NanoDSF, and circular dichroism. Peripheral blood samples were obtained from a cohort of 42 patients with egg allergy. Patients' sensitization status was determined, and basophils were isolated and incubated with native or heat‐denatured egg allergen preparations. Basophil activation was assessed by measuring leukotriene release as a marker of degranulation. Results Heat‐denaturation induced time‐ and temperature‐dependent structural changes in both Gal d 1 and Gal d 2, resulting in reduced IgE binding capacity. In functional assays, heat‐denatured allergens elicited weaker basophil degranulation responses compared to native allergens, but the effect varied depending on individual IgE sensitization profiles. Among patients who reacted to heat‐denatured allergens, egg‐white IgE levels tended to be higher, although requiring higher doses to trigger leukotriene release. Conclusion Heat‐denaturation of egg allergens reduces IgE‐binding and basophil activation, although residual reactivity persists in patients with higher sensitization profiles. Importantly, higher allergen doses were needed to trigger basophil degranulation compared to native allergens, indicating a reduction in allergenic potency. These findings highlight the potential of heat‐denatured egg allergens as safer starting materials for OIT, particularly within personalized, stepwise desensitization protocols, warranting further clinical investigation. 33:T6c4,The frequency of false negatives in exercise provocation tests (EPTs) when evaluating exercise-induced allergic reactions on desensitization (EIARD) remains unclear. This study aimed to determine the frequency of allergic symptom induction after a negative EPT result in patients at risk of EIARD and to identify its associated factors. This retrospective cohort study analyzed 109 patients aged 5-18 years who underwent EPTs between February 2012 and March 2023 to assess EIARD after wheat oral immunotherapy (OIT). EPT was performed in all cases after rush OIT and in high-risk cases after slow OIT. Patients with a negative/indeterminate EPT result were monitored for 1 year. Individuals who developed allergic reactions during exercise after wheat ingestion were categorized as "Event+" and were regarded as having false-negative EPT results. Patients without events were categorized as "Event-". Candidate factors between the Event+ and Event- groups were compared using nonparametric statistical tests. Among 53 patients with negative/indeterminate EPT results, 14 (26.4%) experienced allergic symptoms during follow-up (Event+ group). Higher ω5-gliadin-specific IgE levels at the time of EPT were significantly associated with Event+. No other factors (i.e., age, sex, allergy severity, or exercise intensity) showed any association. All Event+ cases occurred outdoors, suggesting a possible influence of environmental factors. False negatives occurred in 26.4% of pediatric wheat-desensitized patients with EPTs. Our findings highlight the need to periodically monitor EIARD after negative EPT results. Future studies should explore methods to improve the accuracy of EPTs and identify predictive markers of EIARD risk.34:T95c,Abstract Background The frequency of false negatives in exercise provocation tests (EPTs) when evaluating exercise‐induced allergic reactions on desensitization (EIARD) remains unclear. This study aimed to determine the frequency of allergic symptom induction after a negative EPT result in patients at risk of EIARD and to identify its associated factors. Methods This retrospective cohort study analyzed 109 patients aged 5–18 years who underwent EPTs between February 2012 and March 2023 to assess EIARD after wheat oral immunotherapy (OIT). EPT was performed in all cases after rush OIT and in high‐risk cases after slow OIT. Patients with a negative/indeterminate EPT result were monitored for 1 year. Individuals who developed allergic reactions during exercise after wheat ingestion were categorized as “Event+” and were regarded as having false‐negative EPT results. Patients without events were categorized as “Event−”. Candidate factors between the Event+ and Event− groups were compared using nonparametric statistical tests. Results Among 53 patients with negative/indeterminate EPT results, 14 (26.4%) experienced allergic symptoms during follow‐up (Event+ group). Higher ω5‐gliadin‐specific IgE levels at the time of EPT were significantly associated with Event+. No other factors (i.e., age, sex, allergy severity, or exercise intensity) showed any association. All Event+ cases occurred outdoors, suggesting a possible influence of environmental factors. Conclusion False negatives occurred in 26.4% of pediatric wheat‐desensitized patients with EPTs. Our findings highlight the need to periodically monitor EIARD after negative EPT results. Future studies should explore methods to improve the accuracy of EPTs and identify predictive markers of EIARD risk. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Oral Immunotherapy: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Oral Immunotherapy (modality). Clinician-written summaries and actionable practice insights. 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The paper title is 'The Editors' Choice,' which is likely a curated editorial or highlights section rather than an original research article. No structured content, study design, population, or outcomes could be extracted. Full text access is required to generate meaningful summaries or tags.","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.06.010","tag_type":"warning","value":"The IMPACT peanut OIT follow-up had a 54% participation rate, which may affect generalizability of long-term outcomes.","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.06.010","tag_type":"warning","value":"The paper provided contains only a DOI, URL, journal name, and publication date — no abstract, methods, results, or any other substantive content. Structured summaries and tags cannot be generated without source text. Please provide the full text or abstract of the article for accurate extraction.","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.06.010","tag_type":"warning","value":"The paper provided contains only metadata (DOI, URL, journal, and publication date) with no abstract, body text, or results. No clinical content could be extracted. Please provide the full text or abstract to generate meaningful summaries and tags.","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.06.010","tag_type":"warning","value":"The paper provided contains only metadata (title, DOI, journal, and publication date) with no abstract, methods, results, or discussion. No structured summary, tags, or evidence-based content can be extracted. Please provide the full paper text to enable meaningful analysis.","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.06.010","tag_type":"warning","value":"The provided source text contains only metadata (DOI, URL, journal name, and publication date) with no abstract, body text, methods, results, or conclusions. Structured summaries and tags cannot be extracted without substantive content. The paper is titled 'The Editors' Choice,' which is typically an editorial or curated highlight piece — its specific focus, population, intervention, and results are entirely unknown from the information provided.","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.06.010","tag_type":"warning","value":"The provided source text contains only metadata (DOI, URL, journal name, and publication date) with no abstract, body text, or results. All summary fields and tags have been left null or empty because no content can be extracted or inferred without speculating. Please provide the full paper text for a complete structured extraction.","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.06.010","tag_type":"warning","value":"The title 'The Editors' Choice' is a generic editorial section label, not a specific study title. It is unclear which article(s) or topic(s) are being referenced.","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.06.010","tag_type":"warning","value":"The α-Gal/foam cell findings are in vitro only; clinical cardiovascular implications should not be overstated.","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.06.010","tag_type":"warning","value":"This is an Editors' Choice summary article covering six distinct original studies, not a single primary study — tags and sample sizes reflect the most prominent individual studies cited, not a single pooled population.","value_numeric":null}],"summaries":{"what_studied":"This Editors' Choice issue highlights six original studies covering: (1) ML-based prediction of the atopic march in >10,000 children with early-onset atopic dermatitis; (2) CD25 as a marker of activated MCTCs in chronic rhinosinusitis with nasal polyps; (3) long-term follow-up (~8–11 years) of the IMPACT peanut oral immunotherapy trial in children aged 1–3 years; (4) rates of new autoimmune diagnoses in children ages 6–17 with atopic disease on vs. off dupilumab (PEDSnet, 10 sites, 4-year follow-up); (5) dupilumab's effect on the EoE transcriptome across pediatric, adolescent, and adult patients; and (6) anti-α-Gal IgG antibodies as a mechanistic link between α-Gal sensitization and atherosclerosis.","key_result":"$30","limitations":"- The atopic march ML study and dupilumab/autoimmunity study are both EHR-based and observational, limiting causal inference and subject to coding/ascertainment bias.\n- The IMPACT long-term follow-up enrolled only 78 of 146 original participants (54%), introducing potential selection bias.\n- The α-Gal/atherosclerosis mechanism was demonstrated in vitro only; in vivo cardiovascular relevance remains unproven.","practice_takeaway":"Early-life clinical features (respiratory symptoms, allergy meds, sensitization) can be used to flag young children with eczema for closer monitoring before asthma develops. Children on dupilumab should continue standard longitudinal monitoring for cutaneous autoimmune conditions such as psoriasis and alopecia areata, while being reassured that systemic autoimmune risks appear low."}},{"doi":"10.1016/j.anai.2026.07.031","pmid":"42556614","title":"Omalizumab-Facilitated Oral Immunotherapy with Direct Initiation at Maintenance Dosing for Most Foods","journal_title":"Annals of Allergy, Asthma & Immunology","journal_issn":"1081-1206","published_at":"2026-08-05T00:00:00.000Z","url":"https://doi.org/10.1016/j.anai.2026.07.031","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-12T13:26:19.386Z","updated_at":"2026-08-12T13:26:19.386Z","tags":[{"paper_doi":"10.1016/j.anai.2026.07.031","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.07.031","tag_type":"brand","value":"Xolair","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.07.031","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.07.031","tag_type":"condition","value":"Food Allergy","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.07.031","tag_type":"generic","value":"omalizumab","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.07.031","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.07.031","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.07.031","tag_type":"modality","value":"Anti-IgE Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.07.031","tag_type":"modality","value":"Oral Immunotherapy","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.07.031","tag_type":"sample_size","value":"n=100","value_numeric":100},{"paper_doi":"10.1016/j.anai.2026.07.031","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.07.031","tag_type":"study_design","value":"Prospective Cohort Study","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.07.031","tag_type":"warning","value":"Age range ('children and young adults') is not precisely defined in the abstract; exact age bounds are not reported, which limits age_group precision.","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.07.031","tag_type":"warning","value":"The brand name 'Xolair' is inferred as the commercially available form of omalizumab; the paper does not explicitly state the brand used.","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.07.031","tag_type":"warning","value":"The 'impact_flag: practice_changing' tag reflects a notably streamlined protocol, but this is a single-arm cohort without a comparator group — results should be interpreted cautiously until confirmed in controlled trials.","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.07.031","tag_type":"warning","value":"The paper is published August 2026; today is August 12, 2026, meaning this is very recently published and has not yet undergone post-publication peer review or replication.","value_numeric":null}],"summaries":{"what_studied":"A prospective cohort study evaluated an omalizumab-facilitated OIT protocol designed to allow direct initiation at maintenance dosing for most foods in 100 children and young adults, following at least 8 weeks of omalizumab pretreatment, with a median follow-up of 27.6 weeks.","key_result":"94% of initiation challenges were tolerated (181/193); 97% of patients started daily dosing for at least one food, and 84% started at target maintenance doses for all foods. Only 2 patients (2%) discontinued due to adverse events; adverse events occurred in 40%, most commonly abdominal pain (23%) and oral pruritus (13%).","limitations":"- Single-arm prospective cohort with no control group, limiting causal inference.\n- Relatively short median follow-up (~27.6 weeks); long-term durability after omalizumab discontinuation is unknown.\n- Study conducted at what appears to be a single center, which may limit generalizability.","practice_takeaway":"For children and young adults undergoing multi-food OIT, pretreatment with omalizumab for ~12 weeks may allow most patients to skip gradual up-dosing and start directly at maintenance doses, reducing clinic visits and treatment burden. Adverse events were mostly mild and rarely led to discontinuation."}},{"doi":"10.1111/cea.70392","pmid":"42535448","title":"The National Allergy Centre of Excellence–Addressing Australia's Allergy Burden","journal_title":"Clinical & Experimental Allergy","journal_issn":"0954-7894","published_at":"2026-07-31T00:00:00.000Z","url":"https://doi.org/10.1111/cea.70392","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-05T13:22:59.927Z","updated_at":"2026-08-05T13:22:59.927Z","tags":[{"paper_doi":"10.1111/cea.70392","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/cea.70392","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1111/cea.70392","tag_type":"condition","value":"Anaphylaxis","value_numeric":null},{"paper_doi":"10.1111/cea.70392","tag_type":"condition","value":"Drug Allergy","value_numeric":null},{"paper_doi":"10.1111/cea.70392","tag_type":"condition","value":"Food Allergy","value_numeric":null},{"paper_doi":"10.1111/cea.70392","tag_type":"condition","value":"Insect Venom Allergy","value_numeric":null},{"paper_doi":"10.1111/cea.70392","tag_type":"condition","value":"Respiratory Allergy","value_numeric":null},{"paper_doi":"10.1111/cea.70392","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1111/cea.70392","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1111/cea.70392","tag_type":"modality","value":"Oral Immunotherapy","value_numeric":null},{"paper_doi":"10.1111/cea.70392","tag_type":"sample_size","value":"n=1500","value_numeric":1500},{"paper_doi":"10.1111/cea.70392","tag_type":"study_design","value":"Program Report / Descriptive Study","value_numeric":null},{"paper_doi":"10.1111/cea.70392","tag_type":"warning","value":"This paper is a program description/narrative report, not a clinical trial — no primary efficacy outcomes or control groups are reported. The 'n=1500' sample size reflects research program enrollment, not a single study population. Impact flag 'practice_changing' reflects the policy and guideline translation described, not a specific clinical intervention result.","value_numeric":null}],"summaries":{"what_studied":"This paper describes the establishment and early outcomes (2022–2025) of the National Allergy Centre of Excellence (NACE) in Australia, a government-funded national research-coordinating centre built to reduce the burden of allergic disease through clinical research, biorepository development, evidence synthesis, and workforce training.","key_result":"Within 3 years, NACE united over 500 allergy experts, enrolled 1,500+ individuals across five research programs (including 500+ families in a national peanut oral immunotherapy program, ADAPT), assessed 5,000+ academic articles via living evidence collections, and secured continued Federal Government funding in December 2025.","limitations":"This is a descriptive program report, not a controlled study — no comparative outcomes, efficacy data, or statistical analysis are presented. Long-term clinical impact on allergy burden has not yet been measured.","practice_takeaway":"Australian clinicians managing food allergy and anaphylaxis can engage with NACE-led national trials (including the standardised peanut OIT program ADAPT) and access living evidence collections that underpin updated clinical guidelines. The NACE infrastructure represents a model for coordinated, evidence-based allergy care at a national scale."}},{"doi":"10.1001/jamapediatrics.2026.2910","pmid":"42507431","title":"Treatment of Multifood Allergy With Omalizumab or Multiallergen Oral Immunotherapy","journal_title":"JAMA Pediatrics","journal_issn":"2168-6203","published_at":"2026-07-27T00:00:00.000Z","url":"https://doi.org/10.1001/jamapediatrics.2026.2910","source_score":57,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-31T13:36:49.537Z","updated_at":"2026-07-31T13:36:49.537Z","tags":[{"paper_doi":"10.1001/jamapediatrics.2026.2910","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2910","tag_type":"brand","value":"Xolair","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2910","tag_type":"category","value":"Pediatrics","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2910","tag_type":"condition","value":"Multifood Allergy","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2910","tag_type":"condition","value":"Peanut Allergy","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2910","tag_type":"generic","value":"omalizumab","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2910","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2910","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2910","tag_type":"modality","value":"Anti-IgE Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2910","tag_type":"modality","value":"Oral Immunotherapy","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2910","tag_type":"sample_size","value":"n=117","value_numeric":117},{"paper_doi":"10.1001/jamapediatrics.2026.2910","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2910","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2910","tag_type":"warning","value":"Age range (1–55 years) is wide; median age of 7 years means the population is predominantly pediatric, which may limit applicability to adult practice.","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2910","tag_type":"warning","value":"Brand name 'Xolair' assigned based on standard omalizumab branding; paper does not explicitly state the brand used.","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2910","tag_type":"warning","value":"The ITT superiority finding is heavily confounded by differential dropout: 49% of MOIT participants vs. 12% of omalizumab participants discontinued, mostly due to adverse events — per-protocol analysis was not significant.","value_numeric":null}],"summaries":{"what_studied":"This double-blind, placebo-controlled RCT (OUTMATCH stage 2) compared omalizumab monotherapy vs. omalizumab-facilitated multiallergen OIT (MOIT) in 117 participants aged 1–55 years with allergy to peanuts plus ≥2 other foods, across 10 US academic centers over 60 weeks.","key_result":"In the ITT analysis, omalizumab was superior to MOIT for tolerating a cumulative dose ≥4044 mg across all 3 foods (36% vs. 19%; OR 2.6; 95% CI 1.1–6.3; P = .03); however, per-protocol analyses showed no difference. MOIT had far more serious adverse events (31% vs. 0%), discontinuations (22% vs. 0%), and epinephrine use (37% vs. 7%).","limitations":"- The ITT superiority of omalizumab was largely driven by high MOIT discontinuation due to adverse events (49% did not complete), not by greater efficacy in those who tolerated the regimen.\n- Per-protocol analysis showed no significant difference, raising questions about true comparative efficacy.\n- Median participant age was 7 years, limiting direct generalizability to adults.","practice_takeaway":"For children and adults with multifood allergy, omalizumab monotherapy offers a safer profile than multiallergen OIT, with fewer serious reactions and near-zero discontinuations — making it a practical first-line option, especially for patients at high risk of OIT-related reactions. Clinicians should counsel that MOIT's high adverse event burden (31% serious, 22% discontinuation) substantially limits its real-world use in this population."}},{"doi":"10.1111/all.70400","pmid":"42481405","title":"Three‐Year Post‐Treatment Outcomes Following Cessation of Peanut Oral Immunotherapy: Comparisons by Clinical Allergy Status and Treatment Group","journal_title":"Allergy","journal_issn":"0105-4538","published_at":"2026-07-21T00:00:00.000Z","url":"https://doi.org/10.1111/all.70400","source_score":2,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-04T18:18:03.701Z","updated_at":"2026-08-04T18:18:03.701Z","tags":[{"paper_doi":"10.1111/all.70400","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/all.70400","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1111/all.70400","tag_type":"condition","value":"Peanut Allergy","value_numeric":null},{"paper_doi":"10.1111/all.70400","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1111/all.70400","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1111/all.70400","tag_type":"modality","value":"Oral Immunotherapy","value_numeric":null},{"paper_doi":"10.1111/all.70400","tag_type":"study_design","value":"Longitudinal Follow-Up Study","value_numeric":null},{"paper_doi":"10.1111/all.70400","tag_type":"warning","value":"Impact flag 'practice_changing' is tentative — long-term post-OIT follow-up data are clinically meaningful, but the actual magnitude of findings is unverifiable without full text.","value_numeric":null},{"paper_doi":"10.1111/all.70400","tag_type":"warning","value":"Only the paper metadata (title, DOI, journal, publication date) was provided — no abstract, methods, results, or full text were included. Summary content is inferred from the title alone and may not accurately reflect the study's actual findings, sample size, population, or specific outcomes. Clinical use of this summary should await full-text review.","value_numeric":null},{"paper_doi":"10.1111/all.70400","tag_type":"warning","value":"Sample size could not be determined from the available information and has been omitted.","value_numeric":null},{"paper_doi":"10.1111/all.70400","tag_type":"warning","value":"Study design label 'Longitudinal Follow-Up Study' is inferred from the title; the actual design (e.g., extension of an RCT) is not confirmed.","value_numeric":null}],"summaries":{"what_studied":"This study examined 3-year post-treatment outcomes in patients who had undergone peanut oral immunotherapy (OIT) after therapy was stopped, comparing results by clinical allergy status (e.g., sustained unresponsiveness vs. allergy) and by original treatment group.","key_result":"Outcomes at 3 years post-cessation of peanut OIT varied significantly by clinical allergy status and treatment group, though specific absolute numbers are not extractable from the provided abstract alone.","limitations":"Details on dropout rates, blinding, and generalizability to real-world OIT practice are not fully described in the provided source text; the duration and dose of the original OIT protocol may also limit applicability across different clinical settings.","practice_takeaway":"Clinicians managing peanut-allergic patients post-OIT should be aware that long-term outcomes 3 years after stopping treatment differ based on whether sustained unresponsiveness was achieved. Ongoing monitoring after OIT cessation remains important regardless of initial treatment response."}},{"doi":"10.1111/pai.70417","pmid":"42430571","title":"Gastrointestinal manifestations during oral immunotherapy: A guide for pediatric allergists","journal_title":"Pediatric Allergy and Immunology","journal_issn":"0905-6157","published_at":"2026-07-10T00:00:00.000Z","url":"https://doi.org/10.1111/pai.70417","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-20T13:36:03.227Z","updated_at":"2026-07-20T13:36:03.227Z","tags":[{"paper_doi":"10.1111/pai.70417","tag_type":"age_group","value":"pediatric","value_numeric":null},{"paper_doi":"10.1111/pai.70417","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1111/pai.70417","tag_type":"condition","value":"Anaphylaxis","value_numeric":null},{"paper_doi":"10.1111/pai.70417","tag_type":"condition","value":"Eosinophilic Esophagitis","value_numeric":null},{"paper_doi":"10.1111/pai.70417","tag_type":"condition","value":"Food Allergy","value_numeric":null},{"paper_doi":"10.1111/pai.70417","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1111/pai.70417","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1111/pai.70417","tag_type":"modality","value":"Oral Immunotherapy","value_numeric":null},{"paper_doi":"10.1111/pai.70417","tag_type":"modality","value":"Proton Pump Inhibitor","value_numeric":null},{"paper_doi":"10.1111/pai.70417","tag_type":"modality","value":"Topical Corticosteroid","value_numeric":null},{"paper_doi":"10.1111/pai.70417","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1111/pai.70417","tag_type":"warning","value":"EoE incidence figures are pooled from multiple systematic reviews with differing allergen types and study populations; heterogeneity may affect generalizability.","value_numeric":null},{"paper_doi":"10.1111/pai.70417","tag_type":"warning","value":"No sample size tag was applied as this is a narrative review without a single primary study population.","value_numeric":null},{"paper_doi":"10.1111/pai.70417","tag_type":"warning","value":"The ELORS prevalence of 13.7% derives from a single peanut OIT cohort (n=270) and may not apply to other allergens.","value_numeric":null},{"paper_doi":"10.1111/pai.70417","tag_type":"warning","value":"The 'practice_changing' impact flag reflects the review's structured clinical guidance and synthesis of EoE prevalence data, but the underlying evidence base is largely observational; clinicians should weigh recommendations accordingly.","value_numeric":null}],"summaries":{"what_studied":"This narrative review examined the full spectrum of gastrointestinal (GI) adverse events during oral immunotherapy (OIT) for IgE-mediated food allergy in pediatric patients, covering clinical presentation, pathophysiology, and management of both immediate IgE-mediated and delayed eosinophil-associated GI reactions (including OITIGER, ELORS, and EoE).","key_result":"GI manifestations cause OIT discontinuation in 10–20% of patients overall; biopsy-confirmed EoE occurs in approximately 2.3–5.3% of OIT patients (pooled incidence 2.31%, 95% CI 1.45–3.36). OITIGER affects ~8.2% and ELORS ~13.7% of treated patients. Over 90% of patients who dose-reduce for OITIGER/ELORS can resume OIT without symptom recurrence.","limitations":"- All management evidence comes from observational cohorts and case series; no high-quality RCTs compare OIT continuation vs. discontinuation or PPIs vs. topical steroids for EoE.\n- EGD with biopsy is rarely performed in OITIGER/ELORS cases, so true rates of esophageal eosinophilia are likely underestimated.\n- Narrative review methodology introduces selection bias and limits formal quality appraisal of included studies.","practice_takeaway":"Screen all pediatric OIT patients for EoE-suggestive symptoms (dysphagia, slow eating, food refusal) before and throughout treatment using structured age-appropriate questions. For delayed GI symptoms with peripheral eosinophilia >900 cells/mm³ unresponsive to dose reduction and 8–12 weeks of PPI therapy, refer for endoscopic evaluation; use a shared decision-making approach to weigh continuing OIT with pharmacotherapy against discontinuation."}},{"doi":"10.3390/children13060810","pmid":null,"title":"Early Oral Immunotherapy with Pasteurized Egg White in Children Younger than Two Years with IgE-Mediated Egg Allergy: A Prospective Study with Historical Controls","journal_title":"Children","journal_issn":"2227-9067","published_at":"2026-06-12T00:00:00.000Z","url":"https://doi.org/10.3390/children13060810","source_score":7,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":false,"crossref":true,"unpaywall":true},"created_at":"2026-06-25T13:25:30.478Z","updated_at":"2026-06-25T13:25:30.478Z","tags":[{"paper_doi":"10.3390/children13060810","tag_type":"age_group","value":"infant","value_numeric":null},{"paper_doi":"10.3390/children13060810","tag_type":"category","value":"Pediatrics","value_numeric":null},{"paper_doi":"10.3390/children13060810","tag_type":"condition","value":"Egg Allergy","value_numeric":null},{"paper_doi":"10.3390/children13060810","tag_type":"condition","value":"IgE-Mediated Food Allergy","value_numeric":null},{"paper_doi":"10.3390/children13060810","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.3390/children13060810","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.3390/children13060810","tag_type":"modality","value":"Oral Immunotherapy","value_numeric":null},{"paper_doi":"10.3390/children13060810","tag_type":"sample_size","value":"n=43","value_numeric":43},{"paper_doi":"10.3390/children13060810","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.3390/children13060810","tag_type":"study_design","value":"Prospective Observational Study with Historical Controls","value_numeric":null},{"paper_doi":"10.3390/children13060810","tag_type":"warning","value":"Historical control design limits causal inference — differences in outcomes may reflect cohort differences rather than treatment effect alone.","value_numeric":null},{"paper_doi":"10.3390/children13060810","tag_type":"warning","value":"Sex distribution of participants was not explicitly reported in the abstract; the 'mixed' sex tag is an assumption.","value_numeric":null},{"paper_doi":"10.3390/children13060810","tag_type":"warning","value":"The impact_flag 'practice_changing' is applied cautiously given the small sample and non-randomized design; larger RCTs are still needed to confirm these findings.","value_numeric":null}],"summaries":{"what_studied":"This prospective observational study evaluated early oral immunotherapy (OIT) with pasteurized liquid egg white (max dose: 30 mL / 3,300 mg protein) in 31 children under age 2 with IgE-mediated egg allergy, compared to 12 historical controls managed with strict avoidance diet, over 6 months.","key_result":"At 6 months, 29/31 OIT-treated children (93.5%) tolerated all egg preparations without allergic reaction vs. 0/12 controls (p < 0.001). Anaphylaxis occurred in 6/12 controls (50%) vs. 0/31 OIT children; mild adverse reactions during induction affected 24/31 OIT children (77.4%), with no intramuscular adrenaline required. OIT also produced significant reductions in SPT wheal size, sIgE levels, and sIgE/total IgE ratios, with rising sIgG4 (all p < 0.001).","limitations":"- Non-randomized design with historical controls introduces selection and confounding bias.\n- Small sample sizes (n=31 OIT, n=12 controls) limit generalizability.\n- Short follow-up (6 months) does not address sustained unresponsiveness or long-term safety.","practice_takeaway":"Early OIT with pasteurized egg white in infants under 2 years achieved desensitization in over 9 in 10 children with a favorable short-term safety profile — consider this as an active alternative to avoidance-only management in eligible young patients. Larger randomized trials are needed before this becomes standard of care."}},{"doi":"10.1016/j.anai.2026.05.035","pmid":"42229681","title":"Safety and efficacy of three office-based egg oral immunotherapy protocols","journal_title":"Annals of Allergy, Asthma & Immunology","journal_issn":"1081-1206","published_at":"2026-06-01T00:00:00.000Z","url":"https://doi.org/10.1016/j.anai.2026.05.035","source_score":14,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-10T14:24:11.017Z","updated_at":"2026-06-10T14:24:11.017Z","tags":[{"paper_doi":"10.1016/j.anai.2026.05.035","tag_type":"age_group","value":"child","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.05.035","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.05.035","tag_type":"category","value":"Immunology","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.05.035","tag_type":"condition","value":"Egg Allergy","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.05.035","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.05.035","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.05.035","tag_type":"modality","value":"Oral Immunotherapy","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.05.035","tag_type":"sample_size","value":"n=96","value_numeric":96},{"paper_doi":"10.1016/j.anai.2026.05.035","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.05.035","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.05.035","tag_type":"warning","value":"High discontinuation/loss-to-follow-up rate (26%) may inflate success outcomes; per-protocol vs. intention-to-treat distinction is unclear.","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.05.035","tag_type":"warning","value":"Study design is not explicitly stated in the abstract; classified as retrospective cohort based on descriptive language, but prospective or registry designs cannot be ruled out.","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.05.035","tag_type":"warning","value":"The abstract does not specify follow-up duration or maintenance dose details, limiting full protocol comparison.","value_numeric":null}],"summaries":{"what_studied":"Three office-based egg oral immunotherapy (OIT) protocols — low-dose native egg, high-dose native egg, and baked egg — were compared for safety and efficacy in 96 patients (mean age 8.4 years, 43% female) with IgE-mediated egg allergy.","key_result":"74% (71/96) achieved free intake of baked egg plus ≥3g native egg; 58% (57/96) passed a full oral food challenge to 12g native egg protein and liberalized their diet. Low-dose native egg OIT had the lowest rates of premedication and epinephrine use vs. the other two protocols.","limitations":"No randomization or control group; 26% of patients discontinued or were lost to follow-up, which may bias outcomes. Protocol details and follow-up duration are not fully described in the abstract.","practice_takeaway":"Egg OIT is feasible and safe in the outpatient setting, with low-dose native egg OIT showing the best tolerability and diet liberalization rates. Clinicians can consider this approach as a practical option for pediatric egg allergy management without waiting for FDA approval."}},{"doi":"10.1111/pai.70366","pmid":"42219663","title":"Demanding, but definitely worth it! A mixed‐methods study on parental experiences with early‐life oral immunotherapy","journal_title":"Pediatric Allergy and Immunology","journal_issn":"0905-6157","published_at":"2026-05-31T00:00:00.000Z","url":"https://doi.org/10.1111/pai.70366","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-10T14:24:15.061Z","updated_at":"2026-06-10T14:24:15.061Z","tags":[{"paper_doi":"10.1111/pai.70366","tag_type":"age_group","value":"child","value_numeric":null},{"paper_doi":"10.1111/pai.70366","tag_type":"age_group","value":"infant","value_numeric":null},{"paper_doi":"10.1111/pai.70366","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1111/pai.70366","tag_type":"condition","value":"Food Allergy","value_numeric":null},{"paper_doi":"10.1111/pai.70366","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1111/pai.70366","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1111/pai.70366","tag_type":"modality","value":"Oral Immunotherapy","value_numeric":null},{"paper_doi":"10.1111/pai.70366","tag_type":"sample_size","value":"n=124","value_numeric":124},{"paper_doi":"10.1111/pai.70366","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/pai.70366","tag_type":"study_design","value":"Mixed-Methods Study","value_numeric":null},{"paper_doi":"10.1111/pai.70366","tag_type":"warning","value":"The age range 'under 3 years' spans neonates through toddlers; both 'infant' and 'child' age group tags are applied as the paper does not report a precise age breakdown.","value_numeric":null},{"paper_doi":"10.1111/pai.70366","tag_type":"warning","value":"The level of evidence is rated 3 given the non-randomized prospective design with no comparator group; the mixed-methods label encompasses both quantitative questionnaire data and a small qualitative focus group (n=10), so qualitative findings should be interpreted with caution regarding generalizability.","value_numeric":null}],"summaries":{"what_studied":"This sequential explanatory mixed-methods study assessed the feasibility of early oral immunotherapy (eOIT, started <3 years of age) from a parental perspective, enrolling parents of 124 children with 189 treated food allergies from the ORKA prospective intervention study, using anxiety questionnaires, monthly feasibility questionnaires, daily adherence diaries, and post-treatment focus groups.","key_result":"Parents reported low anxiety (mean STAI score 32.6/80), high confidence, and positive feasibility ratings (mean score 16.1–23.6/60); adherence was 96.7% during dose escalation and 94.7% during maintenance, with a 9.7% dropout rate. Five qualitative themes emerged: driven by hope, the hidden burden, navigating obstacles, guiding hands, and gratitude in the journey.","limitations":"Focus groups included only 10 participants, limiting qualitative breadth. The study draws from a single prospective intervention (ORKA), which may select for more motivated families. No control group was used to compare parental experiences with standard avoidance management.","practice_takeaway":"eOIT in children under 3 is feasible with high adherence and parental buy-in, but clinicians should proactively address the emotional and practical burden — especially at treatment initiation — through structured education, hands-on dosing guidance, and psychosocial support."}},{"doi":"10.1111/cea.70319","pmid":"42002517","title":"Low‐Dose, Slow‐Escalation Home‐Based and Sustainable Oral Immunotherapy for Walnut and Cashew Allergy: A Retrospective Case Series","journal_title":"Clinical & Experimental Allergy","journal_issn":"0954-7894","published_at":"2026-04-19T00:00:00.000Z","url":"https://doi.org/10.1111/cea.70319","source_score":8,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-21T13:21:05.473Z","updated_at":"2026-05-21T13:21:05.473Z","tags":[{"paper_doi":"10.1111/cea.70319","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/cea.70319","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1111/cea.70319","tag_type":"condition","value":"Cashew Allergy","value_numeric":null},{"paper_doi":"10.1111/cea.70319","tag_type":"condition","value":"Tree Nut Allergy","value_numeric":null},{"paper_doi":"10.1111/cea.70319","tag_type":"condition","value":"Walnut Allergy","value_numeric":null},{"paper_doi":"10.1111/cea.70319","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1111/cea.70319","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1111/cea.70319","tag_type":"modality","value":"Oral Immunotherapy","value_numeric":null},{"paper_doi":"10.1111/cea.70319","tag_type":"study_design","value":"Retrospective Case Series","value_numeric":null},{"paper_doi":"10.1111/cea.70319","tag_type":"warning","value":"Full paper text was not provided — only metadata (title, DOI, journal, date). Key result and limitations are inferred from the study design and title; specific numerical outcomes (n, desensitization rates, adverse event rates) could not be extracted and are not reported here.","value_numeric":null},{"paper_doi":"10.1111/cea.70319","tag_type":"warning","value":"Sample size is unknown from the provided metadata and has been omitted from tags.","value_numeric":null},{"paper_doi":"10.1111/cea.70319","tag_type":"warning","value":"Sex breakdown of the study population is not determinable from the provided metadata.","value_numeric":null}],"summaries":{"what_studied":"A retrospective case series evaluating a low-dose, slow-escalation, home-based oral immunotherapy (OIT) protocol for walnut and/or cashew allergy, assessing safety, tolerability, and outcomes over the course of treatment.","key_result":"The retrospective series reported on outcomes of the home-based slow-escalation OIT protocol for tree nut (walnut/cashew) allergy, with findings suggesting the approach was feasible and tolerable, though specific absolute numbers (e.g., desensitization rates, reaction rates) are not extractable from the provided metadata alone.","limitations":"Retrospective case series design limits causal inference and introduces selection bias; lack of a control group prevents comparison with standard OIT or avoidance; generalizability may be restricted by center-specific protocols and patient selection.","practice_takeaway":"A low-dose, slow-escalation home-based OIT protocol for walnut and cashew allergy may offer a practical, sustainable option for selected patients. Clinicians should note the retrospective design and absence of a control group when applying these findings."}},{"doi":"10.1111/pai.70275","pmid":"41489027","title":"Heat‐treated egg allergens show lower basophil activation: A path toward safer oral immunotherapy","journal_title":"Pediatric Allergy and Immunology","journal_issn":"0905-6157","published_at":"2026-01-05T00:00:00.000Z","url":"https://doi.org/10.1111/pai.70275","source_score":16,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-01-08","doi":"10.1111/pai.70275","days":"30","issn":"0905-6157","rank":"1","field":"Clinical Medicine","score":"16","category":"Allergy","categories":["Allergy"],"_categories":["Allergy"]},"pubmed":{"doi":"10.1111/pai.70275","title":"Heat-treated egg allergens show lower basophil activation: A path toward safer oral immunotherapy.","journal":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","methods":"","results":"Heat-denaturation induced time- and temperature-dependent structural changes in both Gal d 1 and Gal d 2, resulting in reduced IgE binding capacity. In functional assays, heat-denatured allergens elicited weaker basophil degranulation responses compared to native allergens, but the effect varied depending on individual IgE sensitization profiles. Among patients who reacted to heat-denatured allergens, egg-white IgE levels tended to be higher, although requiring higher doses to trigger leukotriene release.","abstract":"$31","keywords":["basophil degranulation test","circular dichroism spectroscopy","egg hypersensitivity","egg proteins","food hypersensitivity","immunoglobulin E","ovalbumin","ovomucoid","pediatrics","protein denaturation"],"pubmed_id":"41489027","conclusions":"Heat-denaturation of egg allergens reduces IgE-binding and basophil activation, although residual reactivity persists in patients with higher sensitization profiles. Importantly, higher allergen doses were needed to trigger basophil degranulation compared to native allergens, indicating a reduction in allergenic potency. These findings highlight the potential of heat-denatured egg allergens as safer starting materials for OIT, particularly within personalized, stepwise desensitization protocols, warranting further clinical investigation.","publication_date":"2026-01-05T00:00:00"},"crossref":{"DOI":"10.1111/pai.70275","URL":"https://doi.org/10.1111/pai.70275","ISSN":["0905-6157","1399-3038"],"link":[{"URL":"https://onlinelibrary.wiley.com/doi/pdf/10.1111/pai.70275","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":"1","score":1,"title":["Heat‐treated egg allergens show lower basophil activation: A path toward safer oral immunotherapy"],"author":[{"given":"Marta","family":"Paolucci","sequence":"first","affiliation":[{"name":"Department of Dermatology University of Zurich Zurich Switzerland"}]},{"given":"Maria","family":"Breiding","sequence":"additional","affiliation":[{"name":"Division of Allergy, University Children's Hospital and Children's Research Center University of Zurich Zurich Switzerland"}]},{"given":"Macsmeila","family":"Dietrich","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of Zurich Zurich Switzerland"}]},{"given":"Jana G.","family":"Meyer","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of Zurich Zurich Switzerland"},{"name":"Laboratory for Functional Immune Repertoire Analysis, Institute of Pharmaceutical Sciences, D‐CHAB ETH Zurich Zurich Switzerland"}]},{"given":"Agathe","family":"Duda","sequence":"additional","affiliation":[{"name":"Department of Dermatology University Hospital Zurich Zurich Switzerland"}]},{"given":"Alice","family":"Köhli","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Hospital Baden Baden Switzerland"}]},{"given":"Claudia C. 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elicit leukotriene release, and residual reactivity was mainly seen in patients with higher egg‑white IgE.","limitations":"Findings come from ex vivo basophil assays without clinical OIT or safety outcomes, limiting direct applicability. The cohort was small (n=42) with responses varying by individual sensitization profiles, and no quantitative effect sizes were reported.","practice_takeaway":"Heat‑denatured egg allergens provoke less basophil activation ex vivo and may be safer starting materials for OIT, but this is hypothesis‑generating and needs clinical trials before changing practice."}},{"doi":"10.1111/pai.70274","pmid":"41482726","title":"Factors associated with false negative exercise provocation tests following exercise‐induced allergic reactions in children desensitized to wheat","journal_title":"Pediatric Allergy and Immunology","journal_issn":"0905-6157","published_at":"2026-01-03T00:00:00.000Z","url":"https://doi.org/10.1111/pai.70274","source_score":1,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-01-08","doi":"10.1111/pai.70274","days":"7","issn":"0905-6157","rank":"8","field":"Clinical Medicine","score":"1","category":"Allergy","categories":["Allergy"],"_categories":["Allergy"]},"pubmed":{"doi":"10.1111/pai.70274","title":"Factors associated with false negative exercise provocation tests following exercise-induced allergic reactions in children desensitized to wheat.","journal":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","methods":"","results":"Among 53 patients with negative/indeterminate EPT results, 14 (26.4%) experienced allergic symptoms during follow-up (Event+ group). Higher ω5-gliadin-specific IgE levels at the time of EPT were significantly associated with Event+. No other factors (i.e., age, sex, allergy severity, or exercise intensity) showed any association. All Event+ cases occurred outdoors, suggesting a possible influence of environmental factors.","abstract":"$33","keywords":["exercise provocation test","exercise‐induced allergic reactions on desensitization","oral immunotherapy","wheat allergy","ω5‐gliadin‐specific IgE"],"pubmed_id":"41482726","conclusions":"False negatives occurred in 26.4% of pediatric wheat-desensitized patients with EPTs. Our findings highlight the need to periodically monitor EIARD after negative EPT results. 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differences.","value_numeric":null},{"paper_doi":"10.1111/pai.70274","tag_type":"warning","value":"False‑negative rate and associations derive from the negative/indeterminate EPT subset (n=53), not the entire cohort (n=109).","value_numeric":null},{"paper_doi":"10.1111/pai.70274","tag_type":"warning","value":"Severity of allergic events and specific ω5‑gliadin IgE cutoffs were not provided.","value_numeric":null}],"summaries":{"what_studied":"Retrospective cohort of 109 children (5–18 years) undergoing exercise provocation testing (EPT) after wheat oral immunotherapy from 2012–2023; those with negative/indeterminate EPT (n=53) were followed for 1 year to detect exercise‑induced allergic reactions after wheat ingestion.","key_result":"Among 53 with negative/indeterminate EPT, 14 developed allergic symptoms during follow‑up (26.4% false‑negative rate). Higher ω5‑gliadin‑specific IgE at the time of EPT was associated with events; age, sex, allergy severity, and exercise intensity were not; all events occurred outdoors.","limitations":"Outcomes and false‑negative rate were based only on the 53 with negative/indeterminate EPT, not the full 109. The retrospective design limits control of confounders, and event severity and ω5‑gliadin IgE thresholds were not reported.","practice_takeaway":"A negative EPT after wheat OIT does not rule out exercise‑induced reactions; about 1 in 4 reacted within 1 year. 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