1. Contact urticaria and related conditions: clinical reviewOlivier Aerts, David Pesqué, Melba Munoz, Riccardo Asero, Margarida Gonçalo, Thomas Rustemeyer, Mark Kačar, Ana M. Giménez-Arnau, 2025, review article Abstract: Contact urticaria (CoU) is an immediate contact reaction occurring within minutes to an hour after exposure to specific proteins or chemicals. CoU is categorised into non-immunologic (NI-CoU) and immunologic (I-CoU) types, with I-CoU potentially leading to anaphylaxis. Both forms of CoU can be associated with protein contact dermatitis and the CoU syndrome. Patients with I-CoU may also have other type I (immediate) allergic diseases, such as allergic conjunctivitis, rhinitis, asthma or food allergy. This review provides a detailed overview of CoU and related conditions, focusing on triggers, diagnostic methods and management strategies. NI-CoU is typically triggered by low molecular weight chemicals, while I-CoU involves IgE-mediated hypersensitivity to both high molecular weight proteins and low molecular weight chemicals. Early diagnosis is crucial, though CoU is often underrecognized. The diagnostic approach includes a thorough medical history, physical examination, evaluation of photographs, (non)invasive skin tests and in vitro assessments. Management strategies prioritise trigger avoidance and pharmacological treatments when avoidance is not fully possible. For I-CoU, second-generation H1-antihistamines are the first-line treatment. Severe cases of I-CoU may benefit from anti-IgE therapy (omalizumab). Patients at risk of anaphylaxis should carry an adrenaline auto-injector and wear a medical alert bracelet.
Keywords: inducible urticaria, occupational urticaria, protein contact dermatitis
Published in DiRROS: 09.07.2025; Views: 93; Downloads: 38
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2. Hymenoptera venom immunotherapy in dogs : safety and clinical efficacyAna Rostaher, Nina Maria Fischer, Alessio Vigani, Barbara Šteblaj, Franco Martini, Salina Brem, Claude Favrot, Mitja Košnik, 2023, original scientific article Abstract: Insect venom allergy is a potentially life-threatening allergic reaction following a bee, wasp, or ant sting. The only treatment to prevent further systemic sting reactions is venom immunotherapy (VIT), with an efficacy of up to 98% in humans. Prospective clinical data on VIT efficacy in dogs are currently lacking. In this investigation, 10 dogs with severe allergic reactions to either bee or wasp stings were treated with VIT. All dogs tolerated the therapy without adverse effects and the dogs which were re-stung tolerated the sting. This means that VIT is not only safe, but also efficacious in these patients. Furthermore, it was also shown that in addition to skin testing, two serum allergen-specific IgE tests were reliable to identify the underlying patients’ insect sensitization pattern.
Keywords: anaphylaxis, angioedema, dogs, Hymenoptera allergy, urticaria, venom immunotherapy
Published in DiRROS: 03.07.2025; Views: 157; Downloads: 62
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3. Adverse events in children and adolescents undergoing allergen immunotherapy for respiratory allergies : report from the Allergen Immunotherapy Adverse Events Registry (ADER), a European Academy of Allergy and Clinical Immunology taskforceJulijana Asllani, Dimitrios Mitsias, George Konstantinou, Mitja Košnik, Nikolaos G. Papadopoulos, 2023, original scientific article Keywords: allergies, immunotherapy, allergens, adverse events, children, adolescents, registries
Published in DiRROS: 02.07.2025; Views: 110; Downloads: 54
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4. ǂThe ǂAllergen Immunotherapy Adverse Events Registry : setup & methodology of a European Academy of Allergy and Clinical Immunology taskforce projectJulijana Asllani, Dimitrios Mitsias, George Konstantinou, Mitja Košnik, Moises Calderon, 2023, other scientific articles Keywords: allergies, immunotherapy, allergens, adverse events, registries
Published in DiRROS: 02.07.2025; Views: 101; Downloads: 57
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5. Patient-reported outcome measures in atopic dermatitis and chronic urticaria are underused in clinical practiceIvan Cherrez-Ojeda, Jean Bousquet, Ana M. Giménez-Arnau, Kiran V Godse, Dorota Krasowska, Joanna Bartosińska, Paulina Szczepanik-Kułak, Bartłomiej Wawrzycki, Pavel Kolkhir, Anastasiia Allenova, Mitja Košnik, 2024, original scientific article Abstract: Background
Patient-reported outcome measures (PROMs) are validated and standardized tools that complement physician evaluations and guide treatment decisions. They are crucial for monitoring atopic dermatitis (AD) and chronic urticaria (CU) in clinical practice, but there are unmet needs and knowledge gaps regarding their use in clinical practice.
Objecctive
We investigated the global real-world use of AD and CU PROMs in allergology and dermatology clinics as well as their associated local and regional networks.
Methods
Across 72 specialized allergy and dermatology centers and their local and regional networks, 2,534 physicians in 73 countries completed a 53-item questionnaire on the use of PROMs for AD and CU.
Results
Of 2,534 physicians, 1,308 were aware of PROMs. Of these, 14% and 15% used PROMs for AD and CU, respectively. Half of physicians who use PROMs do so only rarely or sometimes. Use of AD and CU PROM is associated with being female, younger, and a dermatologist. The Patient-Oriented Scoring Atopic Dermatitis Index and Urticaria Activity Score were the most common PROMs for AD and CU, respectively. Monitoring disease control and activity are the main drivers of the use of PROMs. Time constraints were the primary obstacle to using PROMs, followed by the impression that patients dislike PROMs. Users of AD and CU PROM would like training in selecting the proper PROM.
Conclusions
Although PROMs offer several benefits, their use in routine practice is suboptimal, and physicians perceive barriers to their use. It is essential to attain higher levels of PROM implementation in accordance with national and international standards.
Keywords: allergy, atopic dermatitis, chronic urticaria, dermatology, patient reported outcome measures
Published in DiRROS: 02.07.2025; Views: 119; Downloads: 53
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6. Risk factors for severe sting reactions and side effects during venom immunotherapyGunter Sturm, Eva Schadelbauer, Giorgia Marta, Patrizia Bonadonna, Mitja Košnik, 2025, review article Abstract: Understanding the risk factors leading to severe systemic sting reactions (SSRs) is crucial for initiating venom immunotherapy (VIT) and for educating affected individuals and their families. Some of these risk factors are well established, some are no longer considered risk factors, and some remain controversial. Well-established risk factors for severe SSRs include clonal mast cell disease, high baseline serum tryptase, and advanced age. The absence of skin symptoms and the rapid onset of symptoms are indicators of severe SSRs. Recent publications indicate that antihypertensive treatment and stings in the head and neck area are not risk factors for severe SSRs. VIT is the only available treatment that can potentially prevent further anaphylactic reactions. Although rare and generally manageable, individuals undergoing VIT may experience systemic adverse events (sAEs). More sAEs are expected in patients undergoing bee VIT compared with vespid VIT. The role of elevated baseline serum tryptase as a risk factor for sAEs remains debated, but if it is a factor, the risk is increased by only about 1.5-fold. Rapid updosing protocols, depending on the specific regimen, can also be associated with more sAEs. Severe initial SSRs, antihypertensive medication, high skin test reactivity, and high specific IgE levels are not risk factors for sAEs.
Keywords: immunology, anaphylaxis, Hymenoptera venom allergy, risk factors, severe systemic sting reactions, side effects, venom immunotherapy
Published in DiRROS: 02.07.2025; Views: 126; Downloads: 74
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7. Usage prevalence of angioedema patient-reported outcome measures : results from the UCARE and ACARE PROMUSE studyIvan Cherrez-Ojeda, Jean Bousquet, Ana M. Giménez-Arnau, Kiran V Godse, Dorota Krasowska, Joanna Bartosińska, Paulina Szczepanik-Kułak, Bartłomiej Wawrzycki, Pavel Kolkhir, Anastasiia Allenova, Mitja Košnik, 2024, other scientific articles Keywords: allergy, angioedema, measures, results of tests, patient reported outcome measures
Published in DiRROS: 02.07.2025; Views: 105; Downloads: 64
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8. Combination of experimental and bioinformatic approaches for identification of immunologically relevant protein–peptide InteractionsJerneja Debeljak, Peter Korošec, Julij Šelb, Matija Rijavec, Mitja Košnik, Mojca Lunder, 2023, original scientific article Abstract: Protein–peptide interactions are an essential player in cellular processes and, thus, of great interest as potential therapeutic agents. However, identifying the protein’s interacting surface has been shown to be a challenging task. Here, we present a methodology for protein–peptide interaction identification, implementing phage panning, next-generation sequencing and bioinformatic analysis. One of the uses of this methodology is identification of allergen epitopes, especially suitable for globular inhaled and venom allergens, where their binding capability is determined by the allergen’s conformation, meaning their interaction cannot be properly studied when denatured. A Ph.D. commercial system based on the M13 phage vector was used for the panning process. Utilization of various bioinformatic tools, such as PuLSE, SAROTUP, MEME, Hammock and Pepitope, allowed us to evaluate a large amount of obtained data. Using the described methodology, we identified three peptide clusters representing potential epitopes on the major wasp venom allergen Ves v 5.
Keywords: phage panning, next-generation sequencing, bioinformatic analysis, allergen Ves v 5, epitopes
Published in DiRROS: 02.07.2025; Views: 98; Downloads: 130
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9. Remission of chronic urticaria in patients treated with omalizumabKlara Cvenkel, Mojca Bizjak, Julij Šelb, Mitja Košnik, 2024, original scientific article Abstract: Introduction: This study examined the remission probability and duration in chronic spontaneous urticaria (CSU) patients resistant to second-generation H1-antihistamines (sgAHs) undergoing omalizumab treatment.
Methods: This is a retrospective observational study of 176 adult CSU patients exhibiting a significant pruritus component (≥ 8) of the weekly urticaria activity score (UAS7) despite four daily sgAH tablets and starting omalizumab treatment with 300 mg every 4 weeks. After excluding 13 nonresponders, we analyzed 163 omalizumab responders (mean age 51.8 years, 74.4% female). The intervals between applications were increased. Discontinuation was considered for patients that remained asymptomatic on a gradually reduced dosage (to 150 mg every 12 weeks) without sgAHs.
Results: Omalizumab discontinuation was possible in 25.8% (42/163). The duration of omalizumab treatment before remission ranged from 7 to 6 months. Twenty-one patients (50.0%) maintained complete remission until the end of the observation period (September 2021) for 8 to 68 months. Of the relapsed patients, 71.4% (15/21) effectively controlled CSU with sgAHs. Six patients (28.6%; 6/21) required omalizumab reintroduction after 6 to 40 months of remission, responding favorably.
Conclusions: The study shows that a quarter of severe CSU patients achieve long-term remission. In addition, sgAHs effectively
manage symptoms in a majority of relapsed cases, and those requiring omalizumab reintroduction respond favorably.
Keywords: urticaria, antihistamines, omalizumab, urticaria, remission, urticaria relapse
Published in DiRROS: 16.06.2025; Views: 142; Downloads: 76
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10. Cold-induced anaphylaxis : new insights into clinical and genetic characteristicsMojca Bizjak, Peter Korošec, Mitja Košnik, Julij Šelb, Urška Bidovec, Manca Svetina, Samo Zver, Dejan Dinevski, Matija Rijavec, 2025, original scientific article Abstract: The pathogenesis of cold urticaria (ColdU) and cold-induced anaphylaxis (ColdA) remains poorly understood, and ColdA is underrepresented in anaphylaxis literature. Laboratory features to guide management are largely unknown. This study evaluated basal serum tryptase (BST) and total immunoglobulin E (IgE) levels in ColdU and ColdA, their associations with clinical features, and the utility of testing for the KIT p.D816V variant in blood leukocytes and hereditary a-tryptasemia (HaT).
Keywords: anaphylaxis, cold urticaria, hereditary α-tryptasemia, KIT p.D816V, mast cell, total IgE, tryptase
Published in DiRROS: 21.05.2025; Views: 290; Downloads: 122
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