The prevalence of food allergy is increasing globally, becoming a significant public health issue that greatly impacts the quality of life for patients and their families. However, there is currently a problem with both underdiagnosis and overdiagnosis of food allergy. Therefore, accurate diagnosis of food allergy and personalized management based on accurate diagnosis are crucial. Over the past 10 years, there has been relevant research on food allergy diagnosis, particularly focusing on IgE-mediated food allergy diagnostic methods such as component resolved diagnosis and basophil activation test, since the launch of the European Academy of Allergy and Clinical Immunology(EAACI) Food Allergy Guidelines in 2014. In October 2023, EAACI published updated diagnostic guidelines for IgE-mediated food allergy. To help allergists and other medical professionals stay informed about the latest EAACI recommendations on the diagnosis of IgE-mediated food allergy, this guideline is now being interpreted.
食物过敏患病率在全球范围内呈逐年上升趋势，已成为重要的公共卫生问题之一，严重影响患者及家庭的生活质量。目前食物过敏诊断不足及诊断过度现象均存在。食物过敏的精准诊断及基于精准诊断进行个体化规范管理至关重要。自2014年欧洲变态反应和临床免疫学会（EAACI）发布食物过敏指南以来，近年来，食物过敏诊断，尤其是IgE介导食物过敏诊断方法，如过敏原组分诊断及嗜碱性粒细胞活化试验等相关研究陆续发表，EAACI于2023年10月更新发表IgE介导食物过敏诊断指南。为加强变态反应专科医师和相关专业医师理解最新EAACI关于IgE介导食物过敏诊断的建议和推荐，现将该指南进行详细解读。.

BACKGROUND: IgE-mediated food allergy (FA) is a global health concern with substantial individual and societal implications. While diverse intervention strategies have been researched, inconsistencies in reported outcomes limit evaluations of FA treatments. To streamline evaluations and promote consistent reporting, the Core Outcome Measures for Food Allergy (COMFA) initiative aimed to establish a Core Outcome Set (COS) for FA clinical trials and observational studies of interventions.
METHODS: The project involved a review of published clinical trials, trial protocols and qualitative literature. Outcomes found as a result of review were categorized and classified, informing a two-round online-modified Delphi process followed by hybrid consensus meeting to finalize the COS.
RESULTS: The literature review, taxonomy mapping and iterative discussions with diverse COMFA group yielded an initial list of 39 outcomes. The iterative online and in-person meetings reduced the list to 13 outcomes for voting in the formal Delphi process. One more outcome was added based on participant suggestions after the first Delphi round. A total of 778 participants from 52 countries participated, with 442 participating in both Delphi rounds. No outcome met a priori criteria for inclusion, and one was excluded as a result of the Delphi. Thirteen outcomes were brought to the hybrid consensus meeting as a result of Delphi and two outcomes, \'allergic symptoms\' and \'quality of life\' achieved consensus for inclusion as \'core\' outcomes.
CONCLUSIONS: In addition to the mandatory reporting of adverse events for FA clinical trials or observational studies of interventions, allergic symptoms and quality of life should be measured as core outcomes. Future work by COMFA will define how best to measure these core outcomes.

BACKGROUND: The International Society for Human and Animal Mycology (ISHAM) working group proposed recommendations for managing allergic bronchopulmonary aspergillosis (ABPA) a decade ago. There is a need to update these recommendations due to advances in diagnostics and therapeutics.
METHODS: An international expert group was convened to develop guidelines for managing ABPA (caused by Aspergillus spp.) and allergic bronchopulmonary mycosis (ABPM; caused by fungi other than Aspergillus spp.) in adults and children using a modified Delphi method (two online rounds and one in-person meeting). We defined consensus as ≥70% agreement or disagreement. The terms \"recommend\" and \"suggest\" are used when the consensus was ≥70% and <70%, respectively.
RESULTS: We recommend screening for A. fumigatus sensitisation using fungus-specific IgE in all newly diagnosed asthmatic adults at tertiary care but only difficult-to-treat asthmatic children. We recommend diagnosing ABPA in those with predisposing conditions or compatible clinico-radiological presentation, with a mandatory demonstration of fungal sensitisation and serum total IgE ≥500 IU·mL-1 and two of the following: fungal-specific IgG, peripheral blood eosinophilia or suggestive imaging. ABPM is considered in those with an ABPA-like presentation but normal A. fumigatus-IgE. Additionally, diagnosing ABPM requires repeated growth of the causative fungus from sputum. We do not routinely recommend treating asymptomatic ABPA patients. We recommend oral prednisolone or itraconazole monotherapy for treating acute ABPA (newly diagnosed or exacerbation), with prednisolone and itraconazole combination only for treating recurrent ABPA exacerbations. We have devised an objective multidimensional criterion to assess treatment response.
CONCLUSIONS: We have framed consensus guidelines for diagnosing, classifying and treating ABPA/M for patient care and research.

牛奶蛋白过敏（CMPA）是一个重要的公共卫生问题，给患儿和家庭带来了重大的经济、营养和生活质量负担，影响儿童的早期健康，其临床表现缺乏特异症状及体征，严重程度不一，可累及皮肤、消化、呼吸等多个系统，易与新生儿坏死性小肠结肠炎（NEC）、败血、喂养不耐受等混淆。中华医学会儿科学分会新生儿学组和中华儿科杂志编辑委员会组织制订“新生儿牛奶蛋白过敏诊断与管理专家共识（2023）”，旨在对新生儿CMPA的临床特点、诊断与鉴别诊断、治疗与预防给予相应的推荐意见。.

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.

暂无摘要。

Fish is one of the \"big nine\" foods triggering allergic reactions. For this reason, fish allergens must be accurately specified on food labels. Fish allergy affects less than 1% of the world population, but a higher prevalence is observed in pediatric cohorts, up to 7%. Parvalbumin is the main fish allergen found in the muscles. In childhood, sensitization to fish allergens occurs most frequently through the ingestion of fish, rarely transcutaneously or by inhalation. Fish allergy symptoms usually appear within two hours of the allergen contact. The diagnosis begins with the collection of the history. If it is suggestive of fish allergy, prick tests or the measurement of serum-specific IgE should be performed to confirm the suspicion. The oral food challenge is the gold standard for the diagnosis. It is not recommended in case of a severe allergic reaction. It is important to make a differential diagnosis with anisakiasis or scombroid poisoning, which have overlapping clinical features but differ in pathogenesis. Traditionally, managing fish allergy involves avoiding the triggering species (sometimes all bony fish species) and requires an action plan for accidental exposures. The present review will analyze IgE- and non-IgE-mediated fish allergy in children from epidemiology, pathogenesis to clinical features. Moreover, clinical management will be addressed with a particular focus on potential nutritional deficiencies.

UNASSIGNED: Anaphylaxis is a potentially fatal hypersensitivity reaction but frequently underrecognized. Although its incidence rates vary according to geographical location, it seems clear that there has been a general increase in recent years, either because of greater recognition of this entity or because it is progressing proportionally to the presence of allergic diseases in the world. The development of anaphylaxis management guidelines adapted to local or regional needs seems of utmost importance. Furthermore, it is necessary to assess their implementation and their positive effect regarding diagnosing and treating anaphylaxis. In this review we explore the currently existing definitions of anaphylaxis and its epidemiology, the potential triggers of anaphylaxis and guideline recommendations in terms of diagnosis and management, proposing a novel anaphylaxis calculator and reviewing the current scoring methods for anaphylactic episodes.

BACKGROUND: Allergic skin diseases are common in horses worldwide. The most common causes are insect bites and environmental allergens.
OBJECTIVE: To review the current literature and provide consensus on pathogenesis, diagnosis, treatment and prevention.
METHODS: The authors reviewed the literature up to November 2022. Results were presented at North America Veterinary Dermatology Forum (2021) and European Veterinary Dermatology Congress (2021). The report was available to member organisations of the World Association for Veterinary Dermatology for feedback.
CONCLUSIONS: Insect bite hypersensitivity (IBH) is the best characterised allergic skin disease. An immunoglobulin (Ig)E response against Culicoides salivary antigens is widely documented. Genetics and environmental factors play important roles. Tests with high sensitivity and specificity are lacking, and diagnosis of IBH is based on clinical signs, seasonality and response to insect control. Eosinophils, interleukin (IL)-5 and IL-31 are explored as therapeutic targets. Presently, the most effective treatment is insect avoidance. Existing evidence does not support allergen-specific immunotherapy (ASIT) using commercially available extracts of Culicoides. Hypersensitivity to environmental allergens (atopic dermatitis) is the next most common allergy. A role for IgE is supported by serological investigation, skin test studies and positive response to ASIT. Prospective, controlled, randomised studies are limited, and treatment relies largely on glucocorticoids, antihistamines and ASIT based on retrospective studies. Foods are known triggers for urticaria, yet their role in pruritic dermatitis is unknown. Recurrent urticaria is common in horses, yet our understanding is limited and focussed on IgE and T-helper 2 cell response. Prospective, controlled studies on treatments for urticaria are lacking. Glucocorticoids and antihistamines are primary reported treatments.
BACKGROUND: Les dermatoses allergiques sont courantes chez les chevaux dans le monde entier. Les causes les plus fréquentes sont les piqûres d\'insectes et les allergènes environnementaux.
OBJECTIVE: Examiner la littérature actuelle et établir un consensus sur la pathogénie, le diagnostic, le traitement et la prévention. MATÉRIELS ET MÉTHODES: Les auteurs ont passé en revue la littérature jusqu\'en novembre 2022. Les résultats ont été présentés au « North America Veterinary Dermatology Forum » (2021) et à l’« European Veterinary Dermatology Congress » (2021). Le rapport a été soumis organisations membres de l\'Association mondiale de dermatologie vétérinaire afin de recueillir leurs commentaires.
UNASSIGNED: L\'hypersensibilité aux piqûres d\'insectes (IBH) est l’affection cutanée allergique la mieux caractérisée. Une réponse médiée par les immunoglobulines (Ig)E contre les antigènes salivaires des Culicoides est largement documentée. Des facteurs génétique et les environnementaux jouent un rôle important. Des tests suffisamment sensible et spécifique font défaut, et le diagnostic de l\'IBH est fondé sur les signes cliniques, la saisonnalité et la réponse au contrôle des insectes. Les éosinophiles, l\'interleukine (IL)-5 et l\'IL-31 sont explorés comme cibles thérapeutiques. Actuellement, le traitement le plus efficace consiste en l’éviction parasitaire. Les données actuelles ne permettent pas de recommander l\'immunothérapie spécifique (ASIT) avec des extraits de culicoïdes disponibles dans le commerce. L\'hypersensibilité aux allergènes environnementaux (dermatite atopique) est le second type d’allergie le plus fréquent. Une implication des IgE est étayée par les tests sérologiques et cutanés et la réponse favorable à l\'ASIT. Les études prospectives, contrôlées et randomisées sont limitées et le traitement repose en grande partie sur les glucocorticoïdes, les antihistaminiques et l\'ASIT selon les données des études rétrospectives. Les aliments sont des déclencheurs connus de l\'urticaire, mais leur rôle dans les dermatites prurigineuses est inconnu. L\'urticaire récurrente est courante chez les chevaux, mais notre compréhension est limitée et axée sur la réponse des cellules IgE et T-helper 2. Des études prospectives contrôlées sur les traitements de l\'urticaire font défaut. Les glucocorticoïdes et les antihistaminiques sont les principaux traitements rapportés.
INTRODUCCIÓN: Las enfermedades alérgicas de la piel son comunes en los caballos en todo el mundo. Las causas más comunes son las picaduras de insectos y los alérgenos ambientales. OBJETIVOS: Revisar la literatura actual y brindar consenso sobre patogenia, diagnóstico, tratamiento y prevención. MATERIALES Y MÉTODOS: los autores revisaron la literatura hasta noviembre de 2022. Los resultados se presentaron en el Foro de Dermatología Veterinaria de América del Norte (2021) y el Congreso Europeo de Dermatología Veterinaria (2021). El informe estuvo disponible para las organizaciones miembros de la Asociación Mundial de Dermatología Veterinaria para recibir comentarios. CONCLUSIONES Y RELEVANCIA CLÍNICA: clínica- La hipersensibilidad a las picaduras de insectos (IBH) es la enfermedad alérgica de la piel mejor caracterizada. Una respuesta de inmunoglobulina (Ig)E contra antígenos salivales de Culicoides está ampliamente documentada. La genética y los factores ambientales juegan un papel importante. Faltan pruebas con alta sensibilidad y especificidad, y el diagnóstico de IBH se basa en los signos clínicos, la estacionalidad y la respuesta al control de insectos. Los eosinófilos, la interleucina (IL)-5 y la IL-31 se exploran como dianas terapéuticas. Actualmente, el tratamiento más efectivo es evitar los insectos. La evidencia existente no respalda la inmunoterapia específica de alérgenos (ASIT) con extractos de Culicoides disponibles comercialmente. La hipersensibilidad a los alérgenos ambientales (dermatitis atópica) es la siguiente alergia más común. El papel de la IgE está respaldado por la investigación serológica, los estudios de pruebas cutáneas y la respuesta positiva a ASIT. Los estudios prospectivos, controlados y al azarson limitados y el tratamiento se basa en gran medida en glucocorticoides, antihistamínicos y ASIT según estudios retrospectivos. Los alimentos son desencadenantes conocidos de la urticaria, pero se desconoce su papel en la dermatitis pruriginosa. La urticaria recurrente es común en los caballos, sin embargo, nuestra comprensión es limitada y se centra en la respuesta de las células IgE y T-helper 2. Faltan estudios prospectivos y controlados sobre tratamientos para la urticaria. Los glucocorticoides y los antihistamínicos son los principales tratamientos reportados. Actualmente, el tratamiento más efectivo es evitar los insectos. La evidencia existente no respalda la inmunoterapia específica de alérgenos (ASIT) con extractos de Culicoides disponibles comercialmente. La hipersensibilidad a los alérgenos ambientales (dermatitis atópica) es la siguiente alergia más común. El papel de la IgE está respaldado por la investigación serológica, los estudios de pruebas cutáneas y la respuesta positiva a ASIT. Los estudios prospectivos, controlados y al azar son limitados y el tratamiento se basa en gran medida en glucocorticoides, antihistamínicos y ASIT según estudios retrospectivos. Los alimentos son desencadenantes conocidos de la urticaria, pero se desconoce su papel en la dermatitis pruriginosa. La urticaria recurrente es común en los caballos, sin embargo, nuestra comprensión es limitada y se centra en la respuesta de las células IgE y T-helper 2. Faltan estudios prospectivos y controlados sobre tratamientos para la urticaria. Los glucocorticoides y los antihistamínicos son los principales tratamientos reportados.
UNASSIGNED: Allergische Hauterkrankungen kommen bei Pferden auf der ganzen Welt häufig vor. Die häufigsten Ursachen sind Insektenstiche und Umweltallergene.
UNASSIGNED: Das Ziel dieser Studie war die Durchführung einer Review der momentanen Literatur und Darstellung eines Konsenses in Bezug auf die Pathogenese, die Diagnose, die Therapie und die Vorbeugung.
UNASSIGNED: Die Autoren überprüften die Literatur bis in den November 2022. Die Ergebnisse wurden beim North American Veterinary Dermatology Forum (2021) und beim Europäischen Veterinärdermatologie Kongress (2021) präsentiert. Der Bericht wurde Mitgliedsorganisationen der World Association for Veterinary Dermatology für ein Feedback zur Verfügung gestellt.
UNASSIGNED: Die Insektenstich Hypersensibilität (IBH) ist die am besten beschriebene allergische Hauterkrankung. Eine Immunglobulin (Ig) E Antwort auf Culicoides Speichelallergene ist häufig beschrieben. Die Genetik und Umweltfaktoren spielen dabei eine wichtige Rolle. Es fehlen Tests mit hoher Sensibilität und Spezifität und die Diagnose von IBH basiert auf klinischen Zeichen, Saisonalität und Reaktion auf Insektenkontrolle. Eosinophile, Interleukin (IL)-5 und IL-31 werden als therapeutische Angriffspunkte untersucht. Zurzeit ist die Insektenvermeidung die am besten wirksame Therapie. Die bestehende Evidenz spricht nicht für eine Allergen-spezifische Immuntherapie (ASIT) mit kommerziell verfügbaren Culicoides Extrakten. Die Hypersensibilität auf Umweltallergene (Atopische Dermatitis) ist die zweithäufigste Allergie. Eine Rolle für IgE wird durch serologische Untersuchungen, Hautteststudien und positive Reaktionen auf ASIT gestärkt. Prospektive, kontrollierte, randomisierte Studien sind limitiert und die Behandlung stützt sich hauptsächlich auf Glukokortikoide, Antihistamine und ASIT basierend auf retrospektiven Studien. Futter stellen bekannte Auslöser für Urticaria dar, allerdings ist ihre Rolle bei der juckenden Dermatitis unbekannt. Wiederkehrende Urticaria treten bei Pferden häufig auf, unser Verständnis ist diesbezüglich aber limitiert und konzentriert sich auf Reaktionen von IgE und T2-Helferzellen. Prospektive kontrollierte Studien über die Behandlungen von Urticaria fehlen. Glukokortikoide und Antihistamine sind die am häufigsten beschriebenen Behandlungen.
背景: アレルギー性皮膚疾患は世界中の馬でよく見られる。主な原因は虫刺されや環境アレルゲンである。 目的: 本研究の目的は、 現在の文献をレビューし、病態、診断、治療、予防に関するコンセンサスを得ることであった。 材料と方法: 著者らは 2022 年 11 月までの文献をレビューした。結果は、North America Veterinary Dermatology Forum(2021年)およびEuropean Veterinary Dermatology Congress(2021年)で発表した。報告書は世界獣医皮膚科学会の会員団体に提供し、フィードバックを得た。 結論と臨床的関連性: 虫刺され過敏症(IBH)は、最も特徴的なアレルギー性皮膚疾患である。サシバエの唾液抗原に対する免疫グロブリン(Ig)E応答は広く報告されている。遺伝および環境因子が重要な役割を果たす。IBHの診断は、臨床症状、季節性、防虫への反応に基づいて行われる。好酸球、インターロイキン(IL)-5、IL-31が治療標的として探索されている。現在のところ、最も効果的な治療法は昆虫の忌避である。既存のエビデンスは、市販のサシバエ抽出物を用いたアレルゲン特異的免疫療法(ASIT)を支持しない。環境アレルゲンに対する過敏症(アトピー性皮膚炎)は、次に多いアレルギーである。IgEの役割は、血清学的調査、皮膚試験、およびASITに対する陽性反応によって裏付けられている。プロスペクティブな無作為化対照試験は限られており、治療は主にグルココルチコイド、抗ヒスタミン剤、レトロスペクティブな研究に基づくASITに頼っている。食品は蕁麻疹の誘因として知られているが、痒みのある皮膚炎におけるその役割は不明である。蕁麻疹の再発は馬によく見られるが、我々の理解は限られており、IgEとヘルパーT2細胞反応に焦点を当てている。蕁麻疹の治療法に関するプロスペクティブな対照試験は不足している。グルココルチコイドと抗ヒスタミン剤が主な治療法として報告されている.
背景: 过敏性皮肤病在世界各地的马中很常见。最常见的原因是昆虫叮咬和环境过敏原。 目的: 回顾现有达成共识的文献，就发病机制、诊断、治疗和预防。 材料和方法: 作者回顾了截至2022年11月的文献。研究结果在北美兽医皮肤病论坛(2021)和欧洲兽医皮肤病大会(2021)上公布。该报告可供世界兽医皮肤病学协会的成员组织反馈。 结论和临床相关性: 虫咬超敏反应(IBH)是最具特征的过敏性皮肤病。针对库蚊唾液抗原的免疫球蛋白(Ig)E反应已被广泛记录。遗传和环境因素起着重要作用。缺乏高灵敏度和特异性的测试，IBH的诊断是基于临床症状、季节性和对昆虫控制的反应。嗜酸性粒细胞、白细胞介素(IL)-5和IL-31被探索作为治疗靶点。目前，最有效的治疗方法是避开昆虫。现有证据不支持使用市售库蚊提取物的过敏原特异性免疫疗法(ASIT)。对环境过敏原过敏(特应性皮炎)是第二常见的过敏。血清学调查、皮肤试验研究和ASIT阳性反应支持了IgE的作用。前瞻性、对照、随机研究有限，治疗主要依赖于基于回顾性研究的糖皮质激素、抗组胺药和ASIT。食物是已知的荨麻疹诱因，但它们在瘙痒性皮炎中的作用尚不清楚。复发性荨麻疹在马中很常见，但我们的理解有限，主要集中在IgE和辅助T细胞2的反应上。缺乏关于荨麻疹治疗的前瞻性对照研究。糖皮质激素和抗组胺药是主要的治疗方法.
UNASSIGNED: Dermatopatias alérgicas são comuns em equinos em todo o mundo. As principais causas são picadas de insetos e alérgenos ambientais.
OBJECTIVE: Revisar a literatura atual e produzir um consenso sobre patogênese, diagnóstico, tratamento e prevenção. MATERIAIS E MÉTODOS: Os autores revisaram a literatura até novembro de 2022. Os resultados foram apresentados no North America Veterinary Dermatology Forum (2021) e no European Veterinary Dermatology Congress (2021). O relatório estava disponível para as organizações membro da World Association for Veterinary Dermatology para que dessem seu feedback. CONCLUSÕES E RELEVÂNCIA CLÍNICA: Hipersensibilidade a picada de insentos (IBH) é a dermatopatia alérgica melhor caracterizada. Resposta mediada por imunoglobulina (Ig)E contra antígenos salivares de Culicoides é amplamente documentada. Genética e fatores ambientais possuem participação importante. São poucos os testes com alta sensibilidade e especificidade, e o diagnóstico de IBH é baseado em sinais clínicos, sazonalidade e resposta ao controle de insetos. Eosinófilos, interleucina (IL)-5 e IL-31 estão sendo exploradas como alvos terapêuticos. Atualmente, o tratamento mais eficaz é evitar o contato com os insetos. As evidências existentes não corroboram com a utilização de imunoterapia alérgeno-específica (ASIT) utilizando extratos comerciais de Culicoides. Hipersensibilidade a alérgenos ambientais (dermatite atópica) é a segunda alergopatia mais comum. Investigação sorológica, testes cutâneos e resposta positiva à ASIT confirmam a participação de IgE. Estudos prospectivos placebo-controle randomisados são limitados e o tratamento é feito com glicocorticoides, antihistamínicos e ASIT baseado em estudos retrospectivos. Alimentos são gatilhos conhecidos para urticária, mas a sua participação em dermatopatias pruriginosas é desconhecida. Urticária recorrente é comum em equinos, apesar de o nosso conhecimento ser ainda limitado e focado em IgE e respostas de células T-helper 2. Faltam estudos prospectivos e controlados sobre tratamentos para urticária. Glicocorticoides e antihistamínicos são os principais tratamentos relatados.

In the 5 years that have passed since the publication of the 2018 International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (ICAR-Allergic Rhinitis 2018), the literature has expanded substantially. The ICAR-Allergic Rhinitis 2023 update presents 144 individual topics on allergic rhinitis (AR), expanded by over 40 topics from the 2018 document. Originally presented topics from 2018 have also been reviewed and updated. The executive summary highlights key evidence-based findings and recommendation from the full document.
ICAR-Allergic Rhinitis 2023 employed established evidence-based review with recommendation (EBRR) methodology to individually evaluate each topic. Stepwise iterative peer review and consensus was performed for each topic. The final document was then collated and includes the results of this work.
ICAR-Allergic Rhinitis 2023 includes 10 major content areas and 144 individual topics related to AR. For a substantial proportion of topics included, an aggregate grade of evidence is presented, which is determined by collating the levels of evidence for each available study identified in the literature. For topics in which a diagnostic or therapeutic intervention is considered, a recommendation summary is presented, which considers the aggregate grade of evidence, benefit, harm, and cost.
The ICAR-Allergic Rhinitis 2023 update provides a comprehensive evaluation of AR and the currently available evidence. It is this evidence that contributes to our current knowledge base and recommendations for patient evaluation and treatment.