{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T07:03:44Z","timestamp":1789542224997,"version":"build-2803163510"},"reference-count":27,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Allergy Immunology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hymenoptera venom allergy (HVA) is a potentially life\u2010threatening condition and the second most common cause of severe allergic reactions in children after food allergy. The risk of recurrence of systemic reaction is approximately 32% in untreated children; therefore, these patients need to undergo diagnostic tests and, if indicated, venom immunotherapy (VIT). However real\u2010life data on VIT in children remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted an observational study in a cohort of children and adolescents (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200940) with HVA and treated with VIT in an Italian tertiary allergy center between 1999 and 2023. Data included demographic features, index reaction, pre\u2010existing risk factors, timeline of VIT, adverse reactions to VIT, re\u2010sting outcomes and serological exams were analyzed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The cohort was predominantly male (87.5%). Adverse reactions to VIT were infrequent, occurred mainly as local reactions, and showed low rates per injection. Among patients who completed \u22653 or \u22655\u2009years of VIT, no severe systemic reactions were observed during treatment and epinephrine was never required. Re\u2010stings during VIT were common, occurring up to 75.0%, mainly during the maintenance phase. Reactions were mild and limited to cutaneous symptoms. Among patients re\u2010stung after completion of VIT (9\/27 patients, 33%), no systemic reactions were observed and no epinephrine was required. Venom\u2010specific IgE levels significantly decreased after completion of VIT (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.004).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The EAACI guidelines provide general recommendations for children, but many are based on limited pediatric evidence. This study provides additional data about the favorable safety profile and efficacy of VIT in children and adolescents with HVA.<\/jats:p>\n                    <jats:p>\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/pai70466-gra-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pai.70466","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T06:39:52Z","timestamp":1787035192000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Venom immunotherapy in children and adolescents: Efficacy and safety in an Italian tertiary allergy center"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7753-0614","authenticated-orcid":false,"given":"Valentina","family":"Gueli","sequence":"first","affiliation":[{"name":"Department of Medicine, School of Specialization in Allergy and Clinical Immunology University of Verona  Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5260-236X","authenticated-orcid":false,"given":"Francesca","family":"Norelli","sequence":"additional","affiliation":[{"name":"Azienda ULSS8 Berica Allergy Unit  Vicenza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Taus","sequence":"additional","affiliation":[{"name":"Department of Diagnostics and Public Health, Section of Medical Statistics University of Verona  Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2059-4470","authenticated-orcid":false,"given":"Giovanna","family":"Sfriso","sequence":"additional","affiliation":[{"name":"Department of Medicine, School of Specialization in Allergy and Clinical Immunology University of Verona  Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1690-6774","authenticated-orcid":false,"given":"Bianca","family":"Olivieri","sequence":"additional","affiliation":[{"name":"Allergy Unit and Asthma Center Verona University Hospital  Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8618-9032","authenticated-orcid":false,"given":"Francesca","family":"Nalin","sequence":"additional","affiliation":[{"name":"Allergy Unit San Bortolo Hospital  Vicenza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7548-3382","authenticated-orcid":false,"given":"Giorgia","family":"Marta","sequence":"additional","affiliation":[{"name":"Department of Medicine, School of Specialization in Allergy and Clinical Immunology University of Verona  Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Olivieri","sequence":"additional","affiliation":[{"name":"Allergy Unit and Asthma Center Verona University Hospital  Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9596-1268","authenticated-orcid":false,"given":"Patrizia","family":"Bonadonna","sequence":"additional","affiliation":[{"name":"Allergy Unit San Bortolo Hospital  Vicenza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2015.11.015"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aller.2020.04.003"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/cea.12144"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3038.2010.01054.x"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000338942"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-0546(09)71721-5"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000341666"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.13945"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12948-022-00170-3"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.5114\/ada.2022.123317"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2016.10.031"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2005.00963.x"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2222.2011.03788.x"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa022952"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0022-3476(95)70543-0"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.13262"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2023.1192081"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/pai.70195"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.3109\/02770906609106941"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.13657"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2014.08.018"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aller.2015.04.009"},{"issue":"4","key":"e_1_2_11_24_1","first-page":"260","article-title":"Serum tryptase level is a better predictor of systemic side effects than prostaglandin D2 metabolites during venom immunotherapy in children","volume":"21","author":"Cichocka\u2010Jarosz E","year":"2011","journal-title":"J Investig Allergol Clin Immunol"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2018.01.015"},{"issue":"2","key":"e_1_2_11_26_1","first-page":"148","article-title":"A modified ultrarush insect venom immunotherapy protocol for children","volume":"27","author":"Steiss JO","year":"2006","journal-title":"Allergy Asthma Proc"},{"issue":"1","key":"e_1_2_11_27_1","first-page":"40","article-title":"Safety of Ultrarush venom immunotherapy: comparison between children and adults","volume":"26","author":"Nittner\u2010Marszalska M","year":"2016","journal-title":"J Investig Allergol Clin Immunol"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2018.08.002"}],"container-title":["Pediatric Allergy and Immunology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pai.70466","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/pai.70466","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pai.70466","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T06:22:54Z","timestamp":1789539774000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pai.70466"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":27,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1111\/pai.70466"],"URL":"https:\/\/doi.org\/10.1111\/pai.70466","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.1111\/PAI.70466\/v1\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/PAI.70466\/v1\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/PAI.70466\/v1\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/PAI.70466\/v2\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/PAI.70466\/v2\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/PAI.70466\/v2\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/PAI.70466\/v2\/response1","asserted-by":"object"}]},"ISSN":["0905-6157","1399-3038"],"issn-type":[{"value":"0905-6157","type":"print"},{"value":"1399-3038","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"2025-08-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70466"}}