Severe asthma (SA) is a heterogeneous disease composed of various clinical phenotypes, and criteria for selecting the most appropriate biological agent rem

Introduction: Although separate immunogenic mechanisms are involved, IgE-type sensitization to wheat and celiac disease (CD) may coexist. We observationally assessed the importance of this relationship in daily practice using CD and wheat sensitization screenings. Methods: Celiac antibody (CA) screening and food prick tests (FPTs) were requested simultaneously from patients who presented to the Allergy Clinic between January 2022 and December 2023 and had any complaint accompanied by CD symptoms/findings (non-celiac group). Patients with positive CA (CA+) underwent endoscopy. As another group, FPT results were recorded for patients previously diagnosed with CD following a gluten-free diet (celiac group). Results: In total, 169 patients (124 non-celiac and 45 celiac) were included in the study. Wheat prick positivity (WP+) was observed in 1 patient with CD. Among 65 WP+ patients without a CD diagnosis, 14 (20.3%) tested positive for CA+, and histopathology detected CD in 4 of these cases. Among the 59 WP– patients, 4 (8.8%) had CA+. The CA+ status of those with WP+ was significantly higher than those with WP– (p = 0.023). Conclusion: The 4 patients unaware of their CD exhibited WP+, with a higher rate of CA+ observed in the WP+ group. The association between WP+ and CA+ suggests that an impaired intestinal barrier may lead to simultaneous T helper 1 and 2 type inflammatory responses. Although different types of sensitization to the same food would not typically be expected, growing evidence indicates that this phenomenon does occur. Further studies are necessary to confirm these findings and to explore the underlying causes.

Objective: Hereditary angioedema (HAE) is characterized by attacks of subcutaneous and mucosal edema. HAE usually affects the skin or mucosal tissues of the upper respiratory and gastrointestinal tract. Irritable bowel syndrome (IBS) is one of the diseases in which the abdominal symptoms of HAE may be confused. In this study, we aimed to clarify the role of IBS in clinical presentation and diagnostic delay in HAE. Material and Method: 50 patients with HAE followed in our clinic between January 2013 and April 2023 were included in this study, and hospital records were retrospectively reviewed. Patients with HAE were divided into two groups, those with and without IBS, and evaluated according to Rome IV criteria for diagnosing IBS. Results: The mean age of the study group was 40 ± 13 years, and 60% (n=30) were female. IBS was observed in 30% (n=15) of the patients, and 60% (n=9) had IBS before diagnosing HAE. The frequency of attacks and history of gastrointestinal tract medical/surgical history were more frequent in HAE patients with IBS (p

Background: This study analyzes the immune system parameters of intern doctors working actively during the COVID-19 pandemic. When an intern doctor failed to respond to the treatment during a severe COVID-19 condition, the immune system panel was examined and as a result, it revealed an underlying immunodeficiency. The death of the intern doctor caused several concerns among other intern doctors, and for this reason, their immune systems were also considered to be examined. This study aims to demonstrate that immunodeficiencies might be more common than is known among the general population. Methods: In this single-center study, the demographic characteristics and European Society for Immunodeficiencies (ESID) diagnostic criteria of 92 intern doctors have been examined retrospectively. For the study, immune system parameters (complete blood count, serum immunoglobulins and subgroup levels, specific vaccine responses, isohemagglutinin titers, lymphocyte subgroups, and class-switched memory B cell (cSMB) levels have been evaluated. Results: When the demographic characteristics have been analyzed it is seen that the median age is 23.6 (21-28) years, and 64 (70%) of the intern doctors are female. In immune system parameters, one or more are found to be low in 51.08% of the doctors. Among the immunoglobulin subgroups, low IgG4 has been the most common. Selective IgA deficiency has been detected in 2.17% and selective IgM deficiency has been detected in also 2.17% of them. Low B cells (CD19+) are detected in 10.9% and low levels of class-switched memory B cells are found in 35.7% of them. Conclusion: This study reveals that deficient immunological parameters, especially selective Ig A, selective IgM deficiency, and low IgG4, might be more frequent than known. Depending on the data, it can be concluded that immunodeficiency might be more common than it is known among the general population; however, low immunological parameters alone do not lead to immunodeficiency.

Aims: This study investigated whether baseline serum IgG4-to-IgG ratios are associated with the presence of autoimmune manifestations in patients diagnosed with common variable immunodeficiency (CVID). Methods: A retrospective cohort analysis was performed using clinical data from 85 patients with CVID evaluated between January 2013 and November 2023. The study included patients aged 18 years and over with a confirmed diagnosis of CVID. Patients with incomplete or insufficient clinical information were excluded. Serum IgG4-to-IgG ratios measured at initial assessment were compared between individuals with autoimmune manifestations and those without. Results: Of the 85 patients, 36 (42.4%) had at least one autoimmune condition. Autoimmune cytopenias constituted the most frequent autoimmune presentation (17.6%). The median IgG4-to-IgG ratio in CVID with autoimmune disease was 0.018 (interquartile range, 0.014–0.043), which was significantly lower than that observed in the group without autoimmunity (p=0.03). Building on this finding, ROC analysis identified a threshold IgG4-to-IgG ratio of 0.04 for differentiating autoimmune from non autoimmune cases (AUC 0.709; 95% CI 0.60–0.82; p=0.002; sensitivity 72%; specificity 60%). Finally, logistic regression analysis demonstrated that a reduced IgG4-to-IgG ratio was significantly associated with the development of autoimmune disease (odds ratio, 1.682; 95% confidence interval, 1.129–2.489; p=0.037). Conclusion: Lower baseline IgG4-to-IgG ratios were associated with autoimmune manifestations in CVID. This parameter may serve as a practical adjunctive biomarker for the early identification and monitoring of autoimmune complications in this heterogeneous disorder.

Objectives: To comprehensively analyze the scientific literature (2005–2025) on biologic agents for Type 2 inflammatory diseases, including Severe Asthma (SA), Atopic Dermatitis (AD), and chronic rhinosinusitis with nasal polyps (CRSwNP). This study aimed to identify publication trends, thematic clusters, collaboration networks, and the field's intellectual foundation. Methods: A bibliometric analysis was performed using data from the Web of Science (WoS) Core Collection (retrieved October 27, 2025). VOSviewer software was used to analyze co-occurrence networks (based on Author Keywords) and map collaborations. Results: A total of 7,339 publications were analyzed. A significant acceleration in publishing occurred after 2017. The most productive countries were the USA (n=2,346), Italy (n=1,149), and the UK (n=936). Thematic analysis identified three distinct clusters: AD, SA, and CRSwNP. The intellectual foundation of the field is built upon highly cited phase 3 clinical trials (e.g., mepolizumab, dupilumab, benralizumab) published in top-tier journals (NEJM, The Lancet). Conclusions: The research landscape for Type 2 biologics has grown rapidly since 2017, driven by clinical validation in landmark trials. The field's focus is evolving from demonstrating clinical efficacy toward mechanism-based personalized medicine and biomarker identification.