The current issue of Annals of Allergy, Asthma & Immunology explores multiple disease states that affect our patients, including asthma, inborn errors of immunity, and food allergy.
Several research articles focus on asthma treatment. William A. Busse, MD, and colleagues examined the use of dupilumab in conjunction with medium-dose corticosteroids with long-acting beta-agonists compared to high-dose inhaled corticosteroids. They found improvement in FEV1 and a 70% reduction in exacerbations, suggesting an advantage of adding biologics before increasing to higher doses of corticosteroids. Arnaud Bourdin, MD, and colleagues conducted a large network meta-analysis and found similar exacerbation rates across four biologics, including dupilumab, omalizumab, benralizumab, and depemokimab. Their analysis shows little difference from one that found tezelpulumab and dupilumab were superior. Additional studies and possible direct randomized head-to-head comparisons are needed to answer these questions. The review by Morgane Gronnier, MD, and colleagues on the use of biomarkers to guide asthma care helps with treatment pathways and identification of personalized therapies for asthma. The review discusses the importance of monitoring biomarkers (FENO, eosinophilia) as a way to identify patients and response to therapy.
In a similar vein, Luz Fonacier, MD, and colleagues suggest a personalized approach to treatment in atopic dermatitis. Dr. Fonacier is one of the Distinguished Authors of 2026. Find out more about the Distinguished Authors in the accompanying editorial. Fonacier, et al, split atopic dermatitis into four phenotypes in their Figure 1 (IL31, mixed Th1/Th17, high IL-22 or barrier-dysfunction predominant) and propose treatment options for each. In Figure 2, they divide atopic dermatitis into six phenotypes (pediatric, head/neck, lichenified, pruritus, hand/foot, and older adults) and again propose optimal therapies for each. Read the article to find out what they recommend.
For those readers who are interested in food allergy, four articles should pique your interest. Shreaya Madireddy, BS, and colleagues discuss patients’ and their families’ perspectives on precautionary allergy labeling and future needs for better labeling. Luke Detlor, BS, and colleagues discuss racial differences in food allergy, finding that Black patients had higher specific IgE but no difference in skin test wheal and flare sizes. Black patients did pass food challenges at a higher rate than white patients, but they were less likely to undergo a food challenge. An editorial by Tarandeep Singh, DO, and Theresa A. Bingemann, MD, reviews these findings. For the treatment of food allergy, Timothy M. Buckey, MD, and colleagues review their findings on three different egg oral immunotherapy protocols, finding that low-dose OIT was superior to baked egg or high-dose in terms of safety outcomes.
For the clinical immunologist, a series of articles and editorials discuss testing for genetic inborn errors of immunity (IEI). Javier Chinen, MD, discusses genetic testing and improving pretest probability, while Aishwarya Navalpakam, MD, and colleagues discuss risk factors for abnormal T cell receptor excision circles (TREC), which include low APGAR, male gender and meconium-stained amniotic fluid. Natsumon Udomkittivorakul, MD, and colleagues attempt to optimize genetic testing for IEI’s by examining clinical factors.
As you read this issue of Annals, we hope you enjoy the start of the fall. As always, if you have comments, please consider sending correspondence to Annals (email: annals@ACAAI.org). We are always eager to hear how Annals has helped you improve the lives of patients.
Jonathan Spergel, MD, PHD, FACAAI
Deputy Editor
