{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T22:49:28Z","timestamp":1787870968549,"version":"build-2784847793"},"reference-count":179,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Appropriateness of diagnostic test prescriptions represents a critical component of quality care in pediatric allergology, directly influencing diagnostic accuracy, therapeutic decisions, healthcare resource utilization, and patient outcomes. A multidisciplinary expert panel was convened to develop evidence-based clinical recommendations addressing the appropriate use of specialist consultations and diagnostic investigations in children with asthma, allergic rhinoconjunctivitis, and vernal keratoconjunctivitis (VKC). Methods: Clinical questions were formulated using the PICO framework and prioritized through structured expert consensus. Systematic literature reviews were conducted across major databases, and the certainty of evidence was assessed using the GRADE methodology. Results: Specialist evaluation emerged as a key determinant of improved diagnostic precision, optimization of treatment strategies, and reduction of inappropriate therapies. In asthma, spirometry, FeNO measurement, and allergy testing contributed to enhanced diagnostic accuracy and better control. In allergic rhinoconjunctivitis, allergological assessment supported diagnosis and the selection of immunotherapy, with demonstrated benefits on symptoms and quality of life. For VKC, multidisciplinary specialist involvement facilitated early diagnosis, personalized management, and prevention of complications. Conclusions: Although the overall certainty of evidence ranged from moderate to low, consistent clinical benefits supported consensus-based recommendations. Implementation of these recommendations may improve care quality, promote equitable access to diagnostic resources, and reduce unnecessary healthcare utilization.<\/jats:p>","DOI":"10.3390\/jcm15124848","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T03:09:17Z","timestamp":1782270557000},"page":"4848","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Evidence-Based Clinical Recommendations for the Appropriate Use of Diagnostic Tests in Pediatric Allergology: Focus on Asthma, Rhinoconjunctivitis, and Keratoconjunctivitis Vernal"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4601-7484","authenticated-orcid":false,"given":"Valentina","family":"Fainardi","sequence":"first","affiliation":[{"name":"Paediatric Clinic, Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6525-2159","authenticated-orcid":false,"given":"Matteo","family":"Ricc\u00f2","sequence":"additional","affiliation":[{"name":"Servizio di Prevenzione e Sicurezza Negli Ambienti di Lavoro (SPSAL), AUSL-IRCCS Reggio Emilia, 42122 Reggio Emilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachele","family":"Antignani","sequence":"additional","affiliation":[{"name":"Primary Care Pediatricians, Societ\u00e0 Italiana Medici Pediatri (SIMPE), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Bellodi","sequence":"additional","affiliation":[{"name":"Primary Care Pediatricians, Societ\u00e0 Italiana Medici Pediatri (SIMPE), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Borrelli","sequence":"additional","affiliation":[{"name":"Paediatric Clinic, Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommaso","family":"Carretta","sequence":"additional","affiliation":[{"name":"Paediatric Clinic, Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Calvani","sequence":"additional","affiliation":[{"name":"Societ\u00e0 Italiana di Allergologia e Immunologia Pediatrica (SIAIP), Italy"},{"name":"UOC Pediatria, Ospedale S. Camillo-Forlanini, 00152 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6774-6152","authenticated-orcid":false,"given":"Fabio","family":"Cardinale","sequence":"additional","affiliation":[{"name":"Societ\u00e0 Italiana di Allergologia e Immunologia Pediatrica (SIAIP), Italy"},{"name":"UOC Pediatria, Ospedale Pediatrico \u201cGiovanni XXIII\u201d, 70126 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Chiappini","sequence":"additional","affiliation":[{"name":"UOC Malattie Infettive, Ospedale Meyer, 50139 Firenze, Italy"},{"name":"Societ\u00e0 Italiana di Pediatria Preventiva e Sociale (SIPPS), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Angiola","family":"Crivellaro","sequence":"additional","affiliation":[{"name":"UOSD Allergologia Azienda Ospedale Universit\u00e0 di Padova, 35122 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7880-3450","authenticated-orcid":false,"given":"Massimiliano","family":"Esposito","sequence":"additional","affiliation":[{"name":"Societ\u00e0 Italiana di Medicina Legale e delle Assicurazioni (SIMLA), Italy"},{"name":"Faculty of Medicine and Surgery, \u201cKore\u201d University of Enna, 94100 Enna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Grandinetti","sequence":"additional","affiliation":[{"name":"Paediatric Clinic, Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1773-6482","authenticated-orcid":false,"given":"Amelia","family":"Licari","sequence":"additional","affiliation":[{"name":"Societ\u00e0 Italiana di Allergologia e Immunologia Pediatrica (SIAIP), Italy"},{"name":"UOC Clinica Pediatrica, IRCCS Policlinico San Matteo, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8369-5957","authenticated-orcid":false,"given":"Michele Miraglia Del","family":"Giudice","sequence":"additional","affiliation":[{"name":"Societ\u00e0 Italiana di Allergologia e Immunologia Pediatrica (SIAIP), Italy"},{"name":"Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Universit\u00e0 della Campania Luigi Vanvitelli, 80131 Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Marsella","sequence":"additional","affiliation":[{"name":"Societ\u00e0 Italiana Gestori del Rischio in Sanit\u00e0 (SIGeRiS), Italy"},{"name":"UOC di Pediatria Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati di Avellino, 83100 Avellino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Martelli","sequence":"additional","affiliation":[{"name":"Network delle Associazioni di Allergologia Pediatrica, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8552-0771","authenticated-orcid":false,"given":"Iria","family":"Neri","sequence":"additional","affiliation":[{"name":"Societ\u00e0 Italiana di Dermatologia Pediatrica (SIDeRP), Italy"},{"name":"UOC Clinica Dermatologica, IRCCS Azienda Ospedaliera Universitaria di Bologna, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4681-546X","authenticated-orcid":false,"given":"Rita","family":"Nocerino","sequence":"additional","affiliation":[{"name":"Societ\u00e0 Italiana di Pediatria Infermieristica (SIPINF), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0234-1373","authenticated-orcid":false,"given":"Diego","family":"Peroni","sequence":"additional","affiliation":[{"name":"Societ\u00e0 Italiana di Allergologia e Immunologia Pediatrica (SIAIP), Italy"},{"name":"Clinica Pediatrica, Universit\u00e0 di Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Piersantelli","sequence":"additional","affiliation":[{"name":"Societ\u00e0 Italiana delle Cure Primarie Pediatriche (SICuPP), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1571-5917","authenticated-orcid":false,"given":"Giuseppe","family":"Pingitore","sequence":"additional","affiliation":[{"name":"Societ\u00e0 Italiana di Malattie Respiratorie Infantili (SIMRI), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arianna","family":"Rossi","sequence":"additional","affiliation":[{"name":"Paediatric Clinic, Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Squazzini","sequence":"additional","affiliation":[{"name":"Primary Care Pediatricians, Societ\u00e0 Italiana Medici Pediatri (SIMPE), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariangela","family":"Tosca","sequence":"additional","affiliation":[{"name":"Societ\u00e0 Italiana di Allergologia e Immunologia Pediatrica (SIAIP), Italy"},{"name":"Centro di Allergologia, IRCCS Giannina Gaslini, 16147 Genova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7710-6995","authenticated-orcid":false,"given":"Carlo","family":"Caffarelli","sequence":"additional","affiliation":[{"name":"Paediatric Clinic, Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy"},{"name":"Societ\u00e0 Italiana di Allergologia e Immunologia Pediatrica (SIAIP), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4103-2837","authenticated-orcid":false,"given":"Susanna","family":"Esposito","sequence":"additional","affiliation":[{"name":"Paediatric Clinic, Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy"},{"name":"Societ\u00e0 Italiana di Telemedicina (SIT), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Field, M.J., and Lohr, K.N. (1990). Clinical Practice Guidelines: Directions for a New Program, National Academy Press. [1st ed.].","DOI":"10.17226\/1626"},{"key":"ref_2","unstructured":"(2026, January 10). Global Initiative for Asthma Global Strategy for Asthma Management and Prevention (2025 Update). Available online: https:\/\/ginasthma.org\/2025-gina-strategy-report\/."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1111\/all.13317","article-title":"EAACI Guidelines on Allergen Immunotherapy: Allergic Rhinoconjunctivitis","volume":"73","author":"Roberts","year":"2018","journal-title":"Allergy Eur. J. Allergy Clin. Immunol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"5053","DOI":"10.1007\/s00431-024-05776-0","article-title":"Seeing Eye to Eye: A Modified Delphi Method-Based Multidisciplinary Expert Consensus on the Diagnosis and Treatment of Vernal Keratoconjunctivitis","volume":"183","author":"Ghiglioni","year":"2024","journal-title":"Eur. J. Pediatr."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"32S","DOI":"10.1177\/1203475419882654","article-title":"Approach to the Assessment and Management of Pediatric Patients with Atopic Dermatitis: A Consensus Document. Section IV: Consensus Statements on the Assessment and Management of Pediatric Atopic Dermatitis","volume":"23","author":"Lansang","year":"2019","journal-title":"J. Cutan. Med. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Moher, D., Liberati, A., Tetzlaff, J., Altman, D.G., Altman, D., Antes, G., Atkins, D., Barbour, V., Barrowman, N., and Berlin, J.A. (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med., 6.","DOI":"10.1371\/journal.pmed.1000097"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1186\/s13643-020-01542-z","article-title":"PRISMA-S: An Extension to the PRISMA Statement for Reporting Literature Searches in Systematic Reviews","volume":"10","author":"Rethlefsen","year":"2021","journal-title":"Syst. Rev."},{"key":"ref_8","unstructured":"Wells, G.A., Shea, B., O\u2019Connell, D., Peterson, J., Welch, V., Losos, M., and Tugwell, P. (2024, December 13). The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta-Analyses. Available online: http:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp."},{"key":"ref_9","unstructured":"Higgins, J., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M., and Welch, V. (2026, January 10). Cochrane Handbook for Systematic Reviews of Interventions (Version 6.5). Available online: https:\/\/training.cochrane.org\/handbook\/current."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1136\/emj.20.1.54","article-title":"Observational Research Methods. Research Design II: Cohort, Cross Sectional, and Case-Control Studies","volume":"20","author":"Mann","year":"2003","journal-title":"Emerg. Med. J."},{"key":"ref_11","unstructured":"National Toxicology Program (2019). Handbook for Conducting a Literature-Based Health Assessment Using OHAT Approach for Systematic Review and Evidence Integration."},{"key":"ref_12","unstructured":"(2026, January 10). NTP OHAT Risk of Bias Rating Tool for Human and Animal Studies, Available online: https:\/\/ntp.niehs.nih.gov\/sites\/default\/files\/ntp\/ohat\/pubs\/riskofbiastool_508.pdf."},{"key":"ref_13","unstructured":"R Development Core Team (2010). R a Language and Environment for Statistical Computing: Reference Index, R Foundation for Statistical Computing."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/j.jclinepi.2010.04.026","article-title":"GRADE Guidelines: 1. Introduction\u2014GRADE Evidence Profiles and Summary of Findings Tables","volume":"64","author":"Guyatt","year":"2011","journal-title":"J. Clin. Epidemiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1136\/bmj.39489.470347.AD","article-title":"GRADE: An Emerging Consensus on Rating Quality of Evidence and Strength of Recommendations","volume":"336","author":"Guyatt","year":"2008","journal-title":"BMJ"},{"key":"ref_16","unstructured":"Coclite, D., Napoletano, A., Fauci, A.J., Graziano, G., Ringraziano Holger, S., Sch\u00fcnemann, J., and Morgano, G.P. (2024). Manuale Metodologico per la Produzione di Linee Guida di Pratica Clinica (v. 2.0), Istituto Superiore di Sanit\u00e0."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1080\/17476348.2024.2314535","article-title":"Mild Asthma Is Not Mild: Risk Factors and Predictive Biomarkers for Severe Acute Exacerbations and Progression in Mild Asthma","volume":"17","author":"Wang","year":"2023","journal-title":"Expert Rev. Respir. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1901872","DOI":"10.1183\/13993003.01872-2019","article-title":"Overuse of Short-Acting \u03922-Agonists in Asthma Is Associated with Increased Risk of Exacerbation and Mortality: A Nationwide Cohort Study of the Global SABINA Programme","volume":"55","author":"Nwaru","year":"2020","journal-title":"Eur. Respir. J."},{"key":"ref_19","first-page":"1466","article-title":"Asthma and Respiratory Foundation NZ Child and Adolescent Asthma Guidelines: A Quick Reference Guide","volume":"130","author":"Asher","year":"2017","journal-title":"N. Z. Med. J."},{"key":"ref_20","unstructured":"AEPAP, ALAT, GRAP, SEAIC, SEFAC, SEFC, SEFH, SEICAP, SEMERGEN, and SEMES (2024). GU\u00cdA ESPA\u00d1OLA PARA EL MANEJO DEL ASMA (GEMA 5.4), Luz\u00e1n 5 Health Consulting, S.A."},{"key":"ref_21","first-page":"849","article-title":"Guideline for the Diagnosis and Treatment of Asthma: Guideline of the German Respiratory Society and the German Atemwegsliga in Cooperation with the Paediatric Respiratory Society and the Austrian Society of Pneumology","volume":"71","author":"Buhl","year":"2017","journal-title":"Pneumologie"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"00687-2022","DOI":"10.1183\/23120541.00687-2022","article-title":"Prevalence and Management of Severe Asthma in the Nordic Countries: Findings from the NORDSTAR Cohort","volume":"9","author":"Hansen","year":"2023","journal-title":"ERJ Open Res."},{"key":"ref_23","first-page":"15","article-title":"Canadian Thoracic Society Asthma Management Continuum\u20142010 Consensus Summary for Children Six Years of Age and over, and Adults","volume":"17","author":"Dell","year":"2010","journal-title":"Can. Respir. J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"200367","DOI":"10.1183\/16000617.0367-2020","article-title":"Management of Asthma Exacerbations in the Paediatric Population: A Systematic Review","volume":"30","author":"Manti","year":"2021","journal-title":"Eur. Respir. Rev."},{"key":"ref_25","unstructured":"(2024). Asthma: Diagnosis, Monitoring and Chronic Asthma Management (BTS, NICE, SIGN), National Institute for Health and Care Excellence (NICE)."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1002\/ppul.25780","article-title":"Pulmonary Specialist Involvement in Critical Asthma in the Pediatric Intensive Care Unit: A Retrospective Review","volume":"57","author":"Paskaradevan","year":"2022","journal-title":"Pediatr. Pulmonol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1136\/archdischild-2023-326635","article-title":"Effectiveness of Paediatric Asthma Hubs: A Clinical Pilot Study","volume":"110","author":"Hakizimana","year":"2025","journal-title":"Arch. Dis. Child."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.2147\/JAA.S334560","article-title":"Childhood Asthma\u2014The Effect of Asthma Specialist Intervention on Asthma Control: A Retrospective Review","volume":"14","author":"Rosman","year":"2021","journal-title":"J. Asthma Allergy"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"S125","DOI":"10.1016\/j.acap.2021.10.015","article-title":"Follow-Up After Asthma Emergency Department Visits and Its Relationship with Subsequent Asthma-Related Utilization","volume":"22","author":"Bardach","year":"2022","journal-title":"Acad. Pediatr."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/j.anai.2015.03.002","article-title":"Factors Associated with High Short-Acting \u03922-Agonist Use in Urban Children with Asthma","volume":"114","author":"Butz","year":"2015","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1016\/S1081-1206(10)62557-4","article-title":"Measurement of Children\u2019s Asthma Medication Adherence by Self Report, Mother Report, Canister Weight, and Doser CT","volume":"85","author":"Bender","year":"2000","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1089\/ped.2013.0265","article-title":"Training Pediatricians to Adhere to Asthma Guidelines","volume":"26","author":"Lee","year":"2013","journal-title":"Pediatr. Allergy Immunol. Pulmonol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1542\/peds.108.2.432","article-title":"Comparison of Quality of Care by Specialist and Generalist Physicians as Usual Source of Asthma Care for Children","volume":"108","author":"Diette","year":"2001","journal-title":"Pediatrics"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1374","DOI":"10.1164\/rccm.201407-1338OC","article-title":"Do Patients of Subspecialist Physicians Benefit from Written Asthma Action Plans?","volume":"191","author":"Sheares","year":"2015","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1513\/AnnalsATS.201408-376OC","article-title":"Allergen Sensitization Profiles in a Population-Based Cohort of Children Hospitalized for Asthma","volume":"12","author":"Beck","year":"2015","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"213","DOI":"10.3109\/02770903.2015.1075549","article-title":"Caregiver Education to Promote Appropriate Use of Preventive Asthma Medications: What Is Happening in Primary Care?","volume":"53","author":"Frey","year":"2016","journal-title":"J. Asthma"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1443","DOI":"10.1111\/j.1475-6773.2005.00410.x","article-title":"The Impact of Allergy and Pulmonary Specialist Care on Emergency Asthma Utilization in a Large Managed Care Organization","volume":"40","author":"Erickson","year":"2005","journal-title":"Health Serv. Res."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.acap.2012.10.009","article-title":"Preventive Asthma Care Delivery in the Primary Care Office: Missed Opportunities for Children with Persistent Asthma Symptoms","volume":"13","author":"Yee","year":"2013","journal-title":"Acad. Pediatr."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e017902","DOI":"10.1136\/bmjopen-2017-017902","article-title":"International Variations in Primary Care Physician Consultation Time: A Systematic Review of 67 Countries","volume":"7","author":"Irving","year":"2017","journal-title":"BMJ Open"},{"key":"ref_40","first-page":"CD008469","article-title":"Home-Based Educational Interventions for Children with Asthma","volume":"2025","author":"Hasan","year":"2025","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1186\/s43168-024-00336-4","article-title":"Evaluating Adherence and Inhaler Monitoring among Adolescent Asthmatic Patients: A Systematic Review and Meta-Analysis of Interventions","volume":"18","author":"Osama","year":"2024","journal-title":"Egypt. J. Bronchol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1164\/rccm.202011-4236ED","article-title":"National Asthma Education and Prevention Program 2020 Guideline Update: Where Do We Go from Here?","volume":"203","author":"Krishnan","year":"2021","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.2147\/JAA.S428623","article-title":"Prevalence of Poorly Controlled Asthma and Factors Associated with Specialist Referral in Those with Poorly Controlled Asthma in a Paediatric Asthma Population","volume":"16","author":"Kallis","year":"2023","journal-title":"J. Asthma Allergy"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1002\/ppul.25710","article-title":"Long-Term Predictors of Loss of Asthma Control in School-Aged Well-Controlled Children with Mild to Moderate Asthma: A 5-Year Follow-Up","volume":"57","author":"Hauerslev","year":"2022","journal-title":"Pediatr. Pulmonol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.aller.2019.12.001","article-title":"Exploratory Study of Language Paediatricians Use to Promote Adherence to Long-Term Controller Medication in Children with Asthma","volume":"48","author":"Koole","year":"2020","journal-title":"Allergol. Immunopathol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1002\/ppul.23138","article-title":"Long-Term Adherence to Daily Controller Medication in Children with Asthma: The Role of Outpatient Clinic Visits","volume":"50","author":"Keemink","year":"2015","journal-title":"Pediatr. Pulmonol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1016\/j.jaip.2019.10.032","article-title":"Real-World Assessment of Asthma Control and Severity in Children, Adolescents, and Adults with Asthma: Relationships to Care Settings and Comorbidities","volume":"8","author":"Nyenhuis","year":"2020","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1089\/ped.2018.0886","article-title":"Asthma Endotyping and Biomarkers in Childhood Asthma","volume":"31","author":"Licari","year":"2018","journal-title":"Pediatr. Allergy Immunol. Pulmonol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"94","DOI":"10.23736\/S0026-4806.21.07332-8","article-title":"Asthma Phenotypes and Endotypes in Childhood","volume":"113","author":"Fainardi","year":"2022","journal-title":"Minerva Med."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1097\/ACI.0000000000000970","article-title":"What\u2019s New in Pediatric Asthma and Rhinitis Phenotypes and Endotypes?","volume":"24","author":"Roberto","year":"2024","journal-title":"Curr. Opin. Allergy Clin. Immunol."},{"key":"ref_51","first-page":"e2020055","article-title":"An Approach to the Management of Children with Problematic Severe Asthma","volume":"91","author":"Fainardi","year":"2020","journal-title":"Acta Biomed."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1111\/apa.13059","article-title":"Getting the Basics Right Resolves Most Cases of Uncontrolled and Problematic Asthma","volume":"104","author":"Kreggemeijer","year":"2015","journal-title":"Acta Paediatr. Int. J. Paediatr."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1289\/ehp.02110939","article-title":"Home and Allergic Characteristics of Children with Asthma in Seven U.S. Urban Communities and Design of an Environmental Intervention: The Inner-City Asthma Study","volume":"110","author":"Crain","year":"2002","journal-title":"Environ. Health Perspect."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1164\/rccm.201609-1966OC","article-title":"Preventing Severe Asthma Exacerbations in Children a Randomized Trial of Mite-Impermeable Bedcovers","volume":"196","author":"Murray","year":"2017","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/s13601-017-0158-7","article-title":"Diagnosing Allergic Sensitizations in the Third Millennium: Why Clinicians Should Know Allergen Molecule Structures","volume":"7","author":"Alessandri","year":"2017","journal-title":"Clin. Transl. Allergy"},{"key":"ref_56","first-page":"CD011293","article-title":"Sublingual Immunotherapy for Asthma","volume":"2020","author":"Fortescue","year":"2020","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1177\/19458924231193528","article-title":"Efficacy of Sublingual Immunotherapy in Allergic Rhinitis Patients with Asthma: A Systematic Review and Meta-Analysis","volume":"37","author":"Ma","year":"2023","journal-title":"Am. J. Rhinol. Allergy"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/j.resinv.2025.01.003","article-title":"Guidance for Type 2 Inflammatory Biomarkers","volume":"63","author":"Matsunaga","year":"2025","journal-title":"Respir. Investig."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"107808","DOI":"10.1016\/j.rmed.2024.107808","article-title":"Real-World Phenotyping and Risk Assessment of Childhood Asthma Burden Using National Registries","volume":"234","author":"Alabdulkarim","year":"2024","journal-title":"Respir. Med."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1177\/1753465816680786","article-title":"Clinical Relevance of IgE-Mediated Sensitization against the Mould Alternaria Alternata in Children with Asthma","volume":"11","author":"Lehmann","year":"2017","journal-title":"Ther. Adv. Respir. Dis."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1016\/j.jaci.2015.01.016","article-title":"Pediatric Severe Asthma with Fungal Sensitization Is Mediated by Steroid-Resistant IL-33","volume":"136","author":"Castanhinha","year":"2015","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"2000132","DOI":"10.1183\/13993003.00132-2020","article-title":"Diagnosis of Asthma in Children: Findings from the Swiss Paediatric Airway Cohort","volume":"56","author":"Pedersen","year":"2020","journal-title":"Eur. Respir. J."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"409","DOI":"10.12659\/MSM.883925","article-title":"Sensitization Profile in Differential Diagnosis: Allergic Asthma vs. Chronic (Nonspecific) Cough Syndrome","volume":"19","author":"Drkulec","year":"2013","journal-title":"Med. Sci. Monit."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1034\/j.1398-9995.2002.1s3252.x","article-title":"Atopy and House Dust Mite Sensitization as Risk Factors for Asthma in Children","volume":"57","author":"Piacentini","year":"2002","journal-title":"Allergy Eur. J. Allergy Clin. Immunol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/S1081-1206(10)63160-2","article-title":"Asthma, Mite Sensitization, and Sleeping in Bunks","volume":"82","author":"Gaig","year":"1999","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"2004173","DOI":"10.1183\/13993003.04173-2020","article-title":"European Respiratory Society Clinical Practice Guidelines for the Diagnosis of Asthma in Children Aged","volume":"58","author":"Gaillard","year":"2021","journal-title":"Eur. Respir. J."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1002\/ppul.23541","article-title":"Misdiagnosis of Asthma in Schoolchildren","volume":"52","author":"Yang","year":"2017","journal-title":"Pediatr. Pulmonol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"e000334","DOI":"10.1136\/bmjpo-2018-000334","article-title":"Spirometry Monitoring in Asthmatic Children in Lombardy Region, Italy","volume":"2","author":"Casartelli","year":"2018","journal-title":"BMJ Paediatr. Open"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1111\/crj.13095","article-title":"Combining Spirometry and Fractional Exhaled Nitric Oxide Improves Diagnostic Accuracy for Childhood Asthma","volume":"14","author":"Eom","year":"2020","journal-title":"Clin. Respir. J."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"105880","DOI":"10.1016\/j.rmed.2020.105880","article-title":"Evaluating the FEV1\/FVC Ratio in the Lower Range of Normality as a Marker of Worse Clinical Outcomes in Asthmatic Subjects without Airway Obstruction: Lung Function and Asthma Outcomes","volume":"162","author":"Mingotti","year":"2020","journal-title":"Respir. Med."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"42","DOI":"10.13181\/mji.oa.247309","article-title":"Predictor of Recurrent Exacerbations in Pediatric Asthma","volume":"33","author":"Tran","year":"2024","journal-title":"Med. J. Indones."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"61","DOI":"10.2147\/JAA.S432648","article-title":"A Longitudinal Study of a Selected Pediatric Asthmatic Population with Normal and Abnormal Spirometry at Baseline: An Emphasis on Treatment Outcomes","volume":"17","author":"Yimlamai","year":"2024","journal-title":"J. Asthma Allergy"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"e001402","DOI":"10.1136\/bmjresp-2022-001402","article-title":"Does Routine Spirometry Impact on Clinical Decisions and Patient-Related Outcome Measures of Children Seen in Respiratory Clinics: An Open-Label Randomised Controlled Trial","volume":"10","author":"Boonjindasup","year":"2023","journal-title":"BMJ Open Respir. Res."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1901326","DOI":"10.1183\/13993003.01326-2019","article-title":"Diagnosis of Asthma in Children: The Contribution of a Detailed History and Test Results","volume":"54","author":"Pedersen","year":"2019","journal-title":"Eur. Respir. J."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"e14112","DOI":"10.1111\/pai.14112","article-title":"COBRAPed Cohort: Do Sensitization Patterns Differentiate Children with Severe Asthma from Those with a Milder Disease?","volume":"35","author":"Lejeune","year":"2024","journal-title":"Pediatr. Allergy Immunol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"1386","DOI":"10.1183\/09031936.99.13613919","article-title":"Exhaled Nitric Oxide and Sputum Eosinophil Markers of Inflammation in Asthmatic Children","volume":"13","author":"Piacentini","year":"1999","journal-title":"Eur. Respir. J."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"2101585","DOI":"10.1183\/13993003.01585-2021","article-title":"European Respiratory Society Guidelines for the Diagnosis of Asthma in Adults","volume":"60","author":"Louis","year":"2022","journal-title":"Eur. Respir. J."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"220236","DOI":"10.1183\/20734735.0236-2022","article-title":"Use of Exhaled Nitric Oxide in the Diagnosis and Monitoring of Childhood Asthma: Myth or Maxim?","volume":"19","author":"Fraser","year":"2023","journal-title":"Breathe"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.anai.2015.10.015","article-title":"Asthma Severity, Not Asthma Control, Is Worse in Atopic Compared with Nonatopic Adolescents with Asthma","volume":"116","author":"Arroyave","year":"2016","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"E809","DOI":"10.3399\/bjgp20X713033","article-title":"Spirometry and FeNO Testing for Asthma in Children in UK Primary Care: A Prospective Observational Cohort Study of Feasibility and Acceptability","volume":"70","author":"Lo","year":"2020","journal-title":"Br. J. Gen. Pract."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1136\/thoraxjnl-2019-213068","article-title":"Lung Function and Asthma Control in School-Age Children Managed in UK Primary Care: A Cohort Study","volume":"75","author":"Lo","year":"2020","journal-title":"Thorax"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1080\/02770903.2022.2073549","article-title":"Association of Fractional Exhaled Nitric Oxide with Asthma Morbidity in Urban Minority Children","volume":"60","author":"Chen","year":"2023","journal-title":"J. Asthma"},{"key":"ref_83","first-page":"CD011439","article-title":"Exhaled Nitric Oxide Levels to Guide Treatment for Children with Asthma","volume":"2016","author":"Petsky","year":"2016","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"P584","DOI":"10.1016\/S2213-2600(21)00486-0","article-title":"The Lancet Respiratory Medicine Reducing Asthma Attacks in Children Using Exhaled Nitric Oxide as a Biomarker to Inform Treatment Strategy-a Randomised Trial","volume":"10","author":"Turner","year":"2022","journal-title":"Lancet Respir. Med."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"e617","DOI":"10.1097\/MJT.0000000000000423","article-title":"Correlation Between Fractional Exhaled Nitric Oxide Levels and Efficacy of Inhaled Corticosteroids in Children with Bronchial Asthma","volume":"25","author":"Gao","year":"2016","journal-title":"Am. J. Ther."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"66","DOI":"10.5414\/CP202570","article-title":"Elevated Fractional Exhaled Nitric Oxide (FeNO) Is a Clinical Indicator of Uncontrolled Asthma in Children Receiving Inhaled Corticosteroids","volume":"55","author":"Yin","year":"2017","journal-title":"Int. J. Clin. Pharmacol. Ther."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"3832","DOI":"10.12659\/MSM.913761","article-title":"Fractional Exhaled Nitric Oxide (FeNO) Combined with Pulmonary Function Parameters Shows Increased Sensitivity and Specificity for the Diagnosis of Cough Variant Asthma in Children","volume":"25","author":"Zhu","year":"2019","journal-title":"Med. Sci. Monit."},{"key":"ref_88","first-page":"479","article-title":"The Role of FENO in Comparison to Spirometry and ACT in Control of Children Asthma Symptoms","volume":"18","author":"Dabbaghzadeh","year":"2019","journal-title":"Iran. J. Allergy Asthma Immunol."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1111\/all.12523","article-title":"Disagreement between Skin Prick Test and Specific IgE in Young Children","volume":"70","author":"Schoos","year":"2015","journal-title":"Allergy Eur. J. Allergy Clin. Immunol."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.aller.2015.03.001","article-title":"Molecular-Based Diagnosis of Respiratory Allergic Diseases in Children from Curitiba, a City in Southern Brazil","volume":"44","author":"Araujo","year":"2016","journal-title":"Allergol. Immunopathol."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.1111\/cea.12781","article-title":"Pragmatic Randomized Controlled Trial of an Allergy Intervention for Children Aged 6\u201316 with Asthma and Rhinitis in General Practice","volume":"46","author":"Smith","year":"2016","journal-title":"Clin. Exp. Allergy"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"236","DOI":"10.4274\/BMB.galenos.2023.2023-07-066","article-title":"The Role of Hematological Parameters in the Diagnosis of Childhood Allergic Conjunctivitis","volume":"8","author":"Kandemir","year":"2023","journal-title":"Bagcilar Med. Bull."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"154","DOI":"10.23822\/EurAnnACI.1764-1489.327","article-title":"Local Allergic Rhinitis in Children: Identification and Characterization in a Specialty Outpatient Clinic","volume":"57","author":"Matsumoto","year":"2025","journal-title":"Eur. Ann. Allergy Clin. Immunol."},{"key":"ref_94","first-page":"354","article-title":"Skin Prick Test and Serum Specific IgE in Predicting Dust Mite-Induced Allergic Rhinitis Diagnosed from Nasal Provocation Test in Chronic Rhinitis Children","volume":"42","author":"Klangkalya","year":"2024","journal-title":"Asian Pac. J. Allergy Immunol."},{"key":"ref_95","first-page":"166","article-title":"A Descriptive Study of the Quality of Life in a Paediatric and Adolescent Population with Allergic Rhinitis at a Tertiary Hospital, Kigali, Rwanda","volume":"33","author":"Nyiranzeva","year":"2020","journal-title":"Curr. Allergy Clin. Immunol."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"101015","DOI":"10.1016\/j.waojou.2024.101015","article-title":"Allergen Immunotherapy in Italy: How, When, and Why\u2014A Real-World Study Conducted through a Patient Association","volume":"18","author":"Paoletti","year":"2025","journal-title":"World Allergy Organ. J."},{"key":"ref_97","doi-asserted-by":"crossref","unstructured":"Yang, J., and Lei, S. (2023). Efficacy and Safety of Sublingual versus Subcutaneous Immunotherapy in Children with Allergic Rhinitis: A Systematic Review and Meta-Analysis. Front. Immunol., 14.","DOI":"10.3389\/fimmu.2023.1274241"},{"key":"ref_98","first-page":"e40397","article-title":"The Clinical Significance of Pollen and Fungi Concentrations for Allergic Rhinitis: A Three-Year Study","volume":"15","author":"Katsimpris","year":"2023","journal-title":"Cureus"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1080\/1750743X.2024.2347828","article-title":"Satisfaction, Qol and Adherence of Patients Allergic to Dust Mites and\/or Pollens Undergoing Sublingual Immunotherapy","volume":"16","author":"Delgado","year":"2024","journal-title":"Immunotherapy"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"222","DOI":"10.23822\/EurAnnACI.1764-1489.104","article-title":"Quality of Life Improvement with Allergen Immunotherapy Treatment in Patients with Rhinoconjunctivitis in Real Life Conditions. Results of an Observational Prospective Study (\u00cdCARA)","volume":"51","author":"Laguna","year":"2019","journal-title":"Eur. Ann. Allergy Clin. Immunol."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/s13601-020-00315-0","article-title":"Impact on Quality of Life and Safety of Sublingual and Subcutaneous Immunotherapy in Children with Severe House Dust Mite and Pollen-Associated Allergic Rhinoconjunctivitis","volume":"10","author":"Proctor","year":"2020","journal-title":"Clin. Transl. Allergy"},{"key":"ref_102","first-page":"95","article-title":"The Influence of Sublingual Immunotherapy on Quality of Life in Children with Allergic Rhinitis","volume":"32","author":"Yang","year":"2018","journal-title":"Lin Chuang Er Bi Yan Hou TouJing Wai Ke Za Zhi"},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s13223-023-00756-9","article-title":"Treatment with Pollen Allergen Immunotherapy Improves Health-Related Quality of Life in Children and Adolescents: A Three-Year Follow-up-Study","volume":"19","author":"Brorsson","year":"2023","journal-title":"Allergy Asthma Clin. Immunol."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"101020","DOI":"10.1016\/j.waojou.2024.101020","article-title":"Efficacy and Safety of Sublingual Immunotherapy Using a Combination of Dermatophagoides pteronyssinus and Blomia tropicalis Extracts in Patients with Allergic Rhinitis: A Randomized, Double-Blind, Placebo-Controlled Trial","volume":"18","author":"Macedo","year":"2025","journal-title":"World Allergy Organ. J."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1177\/1945892418793470","article-title":"Salivary Immunoglobulin A, E, and G4 Levels Specific to Dermatophagoides pteronyssinus in Allergic Rhinitis Patients Treated with Subcutaneous Immunotherapy","volume":"32","author":"Liu","year":"2018","journal-title":"Am. J. Rhinol. Allergy"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/s13223-023-00781-8","article-title":"Long-Term Efficacy of HDM-SCIT in Pediatric and Adult Patients with Allergic Rhinitis","volume":"19","author":"Ren","year":"2023","journal-title":"Allergy Asthma Clin. Immunol."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1007\/s40261-016-0388-9","article-title":"Health-Related Quality of Life During Routine Treatment with the SQ-Standardised Grass Allergy Immunotherapy Tablet: A Non-Interventional Observational Study","volume":"36","author":"Horn","year":"2016","journal-title":"Clin. Drug Investig."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1034\/j.1398-9995.2000.00655.x","article-title":"Preseasonal Local Allergoid Immunotherapy to Grass Pollen in Children: A Double-Blind, Placebo-Controlled, Randomized Trial","volume":"55","author":"Caffarelli","year":"2000","journal-title":"Allergy Eur. J. Allergy Clin. Immunol."},{"key":"ref_109","first-page":"909","article-title":"Efficacy and Safety of Pediatric Sublingual Immunotherapy with Cedarcure\u00ae in Clinical Practice for Japanese Cedar Pollinosis in the First Follow-Up Season","volume":"69","author":"Yuta","year":"2020","journal-title":"Arerugi"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1186\/s13052-025-01947-3","article-title":"Quality of Life of the SQ House Dust Mite Sublingual Immunotherapy Tablet in Italian Adolescents with House Dust Mite-Induced Allergic Rhinitis","volume":"51","author":"Giovannini","year":"2025","journal-title":"Ital. J. Pediatr."},{"key":"ref_111","first-page":"101136","article-title":"Efficacy and Safety of SQ House Dust Mite Sublingual Immunotherapy-Tablet (12 SQ-HDM) in Children with Allergic Rhinitis\/Rhinoconjunctivitis with or without Asthma (MT-12): A Randomised, Double-Blind, Placebo-Controlled, Phase III Trial","volume":"48","author":"Schuster","year":"2025","journal-title":"Lancet Reg. Health\u2014Eur."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1002\/alr.21657","article-title":"The Effects of House Dust Mite Sublingual Immunotherapy in Patients with Allergic Rhinitis According to Duration","volume":"6","author":"Lin","year":"2016","journal-title":"Int. Forum Allergy Rhinol."},{"key":"ref_113","first-page":"1627","article-title":"Long-Term Efficacy of House Dust Mite Subcutaneous Immunotherapy in Allergic Rhinitis Patients","volume":"32","author":"Lou","year":"2018","journal-title":"Lin Chuang Er Bi Yan Hou TouJing Wai Ke Za Zhi"},{"key":"ref_114","first-page":"1354","article-title":"Efficacy of Sublingual Immunotherapy and Subcutaneous Immunotherapy in Children with Allergic Rhinitis","volume":"30","author":"Duan","year":"2016","journal-title":"Lin Chuang Er Bi Yan Hou TouJing Wai Ke Za Zhi"},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1017\/S0022215116000025","article-title":"Sublingual Immunotherapy in Patients with House Dust Mite Allergic Rhinitis: Prospective Study of Clinical Outcomes over a Two-Year Period","volume":"130","author":"Soh","year":"2016","journal-title":"J. Laryngol. Otol."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1111\/pai.12984","article-title":"Efficacy of House Dust Mite Sublingual Tablet in the Treatment of Allergic Rhinoconjunctivitis: A Randomized Trial in a Pediatric Population","volume":"30","author":"Okamoto","year":"2019","journal-title":"Pediatr. Allergy Immunol."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"1631","DOI":"10.1016\/j.jaci.2016.06.044","article-title":"Efficacy of House Dust Mite Sublingual Immunotherapy Tablet in North American Adolescents and Adults in a Randomized, Placebo-Controlled Trial","volume":"138","author":"Nolte","year":"2016","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"26","DOI":"10.15586\/aei.v49i4.94","article-title":"Evaluation of a Pre-Co-Seasonal and a Perennial Schedule of a Single Multiallergen Depigmented-Polymerized Subcutaneous Immunotherapy in Paediatric Patients","volume":"49","author":"Martinez","year":"2021","journal-title":"Allergol. Immunopathol."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/s13601-020-00331-0","article-title":"The Disease Burden in Patients with Respiratory Allergies Induced by House Dust Mites: A Year-Long Observational Survey in Three European Countries","volume":"10","author":"Demoly","year":"2020","journal-title":"Clin. Transl. Allergy"},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1159\/000515414","article-title":"Think Twice before Interpreting the Skin Prick Test as Age, Body Mass Index, and Atopy Affect Reaction Time and Size","volume":"182","author":"Beken","year":"2021","journal-title":"Int. Arch. Allergy Immunol."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1016\/j.anai.2022.11.014","article-title":"The Effect of Applied Force and Device Design on Skin Prick Test Performance","volume":"130","author":"Chiaranairungroj","year":"2023","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1016\/j.jaip.2022.10.033","article-title":"Extrapolating Evidence-Based Medicine of AIT Into Clinical Practice in the United States","volume":"11","author":"Calderon","year":"2023","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_123","doi-asserted-by":"crossref","unstructured":"Testera-Montes, A., Jurado, R., Salas, M., Eguiluz-Gracia, I., and Mayorga, C. (2021). Diagnostic Tools in Allergic Rhinitis. Front. Allergy, 2.","DOI":"10.3389\/falgy.2021.721851"},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1159\/000446776","article-title":"Disagreement between Skin Prick Tests and Specific IgE in Early Childhood","volume":"170","author":"Chauveau","year":"2016","journal-title":"Int. Arch. Allergy Immunol."},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"258","DOI":"10.23822\/EurAnnACI.1764-1489.135","article-title":"Comparison of the Performance of Skin Prick and Isac Tests in the Diagnosis of Allergy","volume":"52","author":"Scala","year":"2020","journal-title":"Eur. Ann. Allergy Clin. Immunol."},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1159\/000151243","article-title":"The Principle of Homologous Groups in Regulatory Affairs of Allergen Products\u2014A Proposal","volume":"148","author":"Lorenz","year":"2008","journal-title":"Int. Arch. Allergy Immunol."},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1016\/S1081-1206(10)61509-8","article-title":"Key Pollen Allergens in North America","volume":"91","author":"White","year":"2003","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/j.jaci.2010.09.034","article-title":"Allergen Immunotherapy: A Practice Parameter Third Update","volume":"127","author":"Cox","year":"2011","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"1166","DOI":"10.29271\/jcpsp.2020.11.1166","article-title":"Association of Severity of Allergic Conjunctivitis with Skin Prick Test","volume":"30","author":"Masrur","year":"2020","journal-title":"J. Coll. Physicians Surg. Pak."},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1111\/pai.12991","article-title":"Detection of Genuine Grass Pollen Sensitization in Children by Skin Testing with a Recombinant Grass Pollen Hybrid","volume":"30","author":"Douladiris","year":"2019","journal-title":"Pediatr. Allergy Immunol."},{"key":"ref_131","first-page":"128","article-title":"Skin Reactivity in Allergic Conjunctivitis","volume":"65","year":"2018","journal-title":"Rev. Alerg. Mex."},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/j.jpeds.2014.10.009","article-title":"Allergen Skin Prick Testing in Early Childhood: Reproducibility and Prediction of Allergic Symptoms into Early Adulthood","volume":"166","author":"Pesonen","year":"2015","journal-title":"J. Pediatr."},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"9286","DOI":"10.1038\/s41598-017-10111-9","article-title":"Sensitization Patterns and Minimum Screening Panels for Aeroallergens in Self-Reported Allergic Rhinitis in China","volume":"7","author":"Lou","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_134","first-page":"193","article-title":"Intradermal Skin Testing in Allergic Rhinitis and Asthma with Negative Skin Prick Tests","volume":"16","author":"Erel","year":"2017","journal-title":"Iran. J. Allergy Asthma Immunol."},{"key":"ref_135","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/s13223-016-0126-0","article-title":"Diagnostic Accuracy of Skin-Prick Testing for Allergic Rhinitis: A Systematic Review and Meta-Analysis","volume":"12","author":"Nevis","year":"2016","journal-title":"Allergy Asthma Clin. Immunol."},{"key":"ref_136","first-page":"1","article-title":"Citation Health Quality Ontario. Skin Testing for Allergic Rhinitis: A Health Technology Assessment","volume":"16","author":"Sikich","year":"2016","journal-title":"Ont. Health Technol. Assess. Ser."},{"key":"ref_137","doi-asserted-by":"crossref","first-page":"125","DOI":"10.4274\/jpr.galenos.2023.91069","article-title":"Optimal Skin Prick Test Panel for Detecting Respiratory Allergens in Children: A Retrospective Study","volume":"10","author":"Eski","year":"2023","journal-title":"J. Pediatr. Res."},{"key":"ref_138","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1097\/ICO.0000000000000496","article-title":"Correlations Between Allergen-Specific IgE Serum Levels in Patients with Ocular Allergy","volume":"34","author":"Cabral","year":"2015","journal-title":"Cornea"},{"key":"ref_139","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1111\/cea.13785","article-title":"Validation Study of a New Chemiluminescent Singleplex IgE Assay in a Set of Italian Allergic Rhinitis Patients","volume":"51","author":"Potapova","year":"2021","journal-title":"Clin. Exp. Allergy"},{"key":"ref_140","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1111\/cea.13264","article-title":"A New Molecular Multiplex IgE Assay for the Diagnosis of Pollen Allergy in Mediterranean Countries: A Validation Study","volume":"49","author":"Arasi","year":"2019","journal-title":"Clin. Exp. Allergy"},{"key":"ref_141","doi-asserted-by":"crossref","unstructured":"Han, J.Y., Lee, H., Chung, J.L., Kim, Y.J., Kim, J.Y., and Tchah, H. (2021). Multiple Allergen Simultaneous Test-Immunoblot Assay for Immunoglobulin e Detection in Patients with Isolated Allergic Conjunctivitis. J. Clin. Med., 10.","DOI":"10.3390\/jcm10050960"},{"key":"ref_142","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1111\/all.13338","article-title":"Diagnostic Relevance of IgE Sensitization Profiles to Eight Recombinant Phleum Pratense Molecules","volume":"73","author":"Cipriani","year":"2018","journal-title":"Allergy Eur. J. Allergy Clin. Immunol."},{"key":"ref_143","doi-asserted-by":"crossref","first-page":"100975","DOI":"10.1016\/j.waojou.2024.100975","article-title":"Inverse Association between the Molecular Spreading of IgE to Grass Pollen and the IgE Response to Dermatophagoides pteronyssinus among Children with Seasonal Allergic Rhinitis","volume":"17","author":"Brindisi","year":"2024","journal-title":"World Allergy Organ. J."},{"key":"ref_144","doi-asserted-by":"crossref","first-page":"617","DOI":"10.5114\/ada.2023.130314","article-title":"The Importance of Specific IgE Antibodies in the Epidemiology of Allergic Rhinitis and Asthma (ECAP Survey): Part Five. The Relationship between the Concentration of Specific IgE Antibodies in Serum and Types of Rhinitis","volume":"40","author":"Lipiec","year":"2023","journal-title":"Postep. Dermatol. Alergol."},{"key":"ref_145","doi-asserted-by":"crossref","first-page":"1507","DOI":"10.1111\/j.1398-9995.2009.02089.x","article-title":"GA2LEN Skin Test Study II: Clinical Relevance of Inhalant Allergen Sensitizations in Europe","volume":"64","author":"Burbach","year":"2009","journal-title":"Allergy Eur. J. Allergy Clin. Immunol."},{"key":"ref_146","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1111\/pai.13454","article-title":"New Concepts in Pediatric Rhinitis","volume":"32","author":"Papadopoulos","year":"2021","journal-title":"Pediatr. Allergy Immunol."},{"key":"ref_147","doi-asserted-by":"crossref","first-page":"1657","DOI":"10.1111\/all.13200","article-title":"Non-Allergic Rhinitis: Position Paper of the European Academy of Allergy and Clinical Immunology","volume":"72","author":"Hellings","year":"2017","journal-title":"Allergy Eur. J. Allergy Clin. Immunol."},{"key":"ref_148","doi-asserted-by":"crossref","first-page":"200","DOI":"10.5662\/wjm.v6.i4.200","article-title":"Non-Allergic Rhinitis in Children: Epidemiological Aspects, Pathological Features, Diagnostic Methodology and Clinical Management","volume":"6","author":"Poddighe","year":"2016","journal-title":"World J. Methodol."},{"key":"ref_149","first-page":"174","article-title":"Local Allergic Rhinitis in Pediatric Patients: Is IgE Dosage in Nasal Lavage Fluid a Useful Diagnostic Method in Children?","volume":"6","author":"Colavita","year":"2017","journal-title":"Int. J. Mol. Cell. Med."},{"key":"ref_150","doi-asserted-by":"crossref","first-page":"3039","DOI":"10.1111\/all.14582","article-title":"Biomarkers for Diagnosis and Prediction of Therapy Responses in Allergic Diseases and Asthma","volume":"75","author":"Breiteneder","year":"2020","journal-title":"Allergy Eur. J. Allergy Clin. Immunol."},{"key":"ref_151","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1111\/pai.13036","article-title":"Early Molecular Biomarkers Predicting the Evolution of Allergic Rhinitis and Its Comorbidities: A Longitudinal Multicenter Study of a Patient Cohort","volume":"30","author":"Cipriani","year":"2019","journal-title":"Pediatr. Allergy Immunol."},{"key":"ref_152","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1111\/pai.12681","article-title":"Asthma and Allergic Rhinitis in Childhood: What\u2019s New","volume":"27","author":"Mastrorilli","year":"2016","journal-title":"Pediatr. Allergy Immunol."},{"key":"ref_153","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1111\/all.12888","article-title":"Endotypes of Pollen-Food Syndrome in Children with Seasonal Allergic Rhinoconjunctivitis: A Molecular Classification","volume":"71","author":"Mastrorilli","year":"2016","journal-title":"Allergy Eur. J. Allergy Clin. Immunol."},{"key":"ref_154","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1111\/pai.12866","article-title":"Molecular Sensitization Patterns and Influence of Molecular Diagnosis in Immunotherapy Prescription in Children Sensitized to Both Grass and Olive Pollen","volume":"29","author":"Corzo","year":"2018","journal-title":"Pediatr. Allergy Immunol."},{"key":"ref_155","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1016\/j.aller.2018.03.002","article-title":"How Molecular Diagnosis May Modify Immunotherapy Prescription in Multi-Sensitized Pollen-Allergic Children","volume":"46","year":"2018","journal-title":"Allergol. Immunopathol."},{"key":"ref_156","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.aller.2016.04.005","article-title":"Comparison of Two Diagnostic Techniques, Skin-Prick Test and Component Resolved Diagnosis in the Follow-up of a Cohort of Paediatric Patients with Pollinosis. Multicentre Pilot Study in a Highly Exposed Allergenic Area","volume":"45","author":"Trujillo","year":"2017","journal-title":"Allergol. Immunopathol."},{"key":"ref_157","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/j.jaci.2016.03.025","article-title":"The Impact of a Clinical Decision Support System on Allergen Prescription in Children and Adults with Seasonal Rhinitis","volume":"138","author":"Arasi","year":"2016","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_158","doi-asserted-by":"crossref","first-page":"e12246","DOI":"10.1002\/clt2.12246","article-title":"INMUNOCAT Study: The Impact of Molecular Diagnosis on Immunotherapy Prescription in Pollen Polysensitized Patients from Catalonia","volume":"13","author":"Tena","year":"2023","journal-title":"Clin. Transl. Allergy"},{"key":"ref_159","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.aller.2018.05.008","article-title":"Molecular Diagnostics Improves Diagnosis and Treatment of Respiratory Allergy and Food Allergy with Economic Optimization and Cost Saving","volume":"47","author":"Peveri","year":"2019","journal-title":"Allergol. Immunopathol."},{"key":"ref_160","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1111\/cea.13867","article-title":"@IT2020: An Innovative Algorithm for Allergen Immunotherapy Prescription in Seasonal Allergic Rhinitis","volume":"51","author":"Arasi","year":"2021","journal-title":"Clin. Exp. Allergy"},{"key":"ref_161","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/s13601-018-0193-z","article-title":"7th International Symposium on Molecular Allergology (ISMA 2017)","volume":"8","year":"2018","journal-title":"Clin. Transl. Allergy"},{"key":"ref_162","doi-asserted-by":"crossref","unstructured":"Knyziak-M\u0119drzycka, I., Majsiak, E., and Cukrowska, B. (2023). Allergic March in Children: The Significance of Precision Allergy Molecular Diagnosis (PAMD@) in Predicting Atopy Development and Planning Allergen-Specific Immunotherapy. Nutrients, 15.","DOI":"10.3390\/nu15040978"},{"key":"ref_163","doi-asserted-by":"crossref","first-page":"e14056","DOI":"10.1111\/pai.14056","article-title":"Component-Resolved Diagnosis in Childhood and Prediction of Asthma in Early Adolescence: A Birth Cohort Study","volume":"34","author":"Farraia","year":"2023","journal-title":"Pediatr. Allergy Immunol."},{"key":"ref_164","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.jtos.2024.12.007","article-title":"Epidemiological Insights into Childhood Vernal Keratoconjunctivitis in India: Unravelling Clinical Presentation and Environmental Influences\u2014The EPIC VKC Study\u2014Fourth Report of the ICMR EYE SEE Study Group","volume":"36","author":"Gupta","year":"2025","journal-title":"Ocul. Surf."},{"key":"ref_165","first-page":"e2021517","article-title":"Vernal Keratoconjunctivitis: State of Art and Update on Treatment","volume":"92","author":"Brindisi","year":"2021","journal-title":"Acta Biomed."},{"key":"ref_166","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1111\/aos.15212","article-title":"Prevalence of Allergic Sensitization with Vernal Keratoconjunctivitis: A Systematic Review with Meta-Analyses","volume":"101","author":"Rasmussen","year":"2023","journal-title":"Acta Ophthalmol."},{"key":"ref_167","doi-asserted-by":"crossref","unstructured":"Capobianco, M., Zeppieri, M., Gagliano, G., Visalli, F., D\u2019Esposito, F., Foti, R., Cannizzaro, L., Tognetto, D., and Gagliano, C. (2025). Ocular Manifestations in Children with Vernal Keratoconjunctivitis. Children, 12.","DOI":"10.3390\/children12050609"},{"key":"ref_168","doi-asserted-by":"crossref","first-page":"1816","DOI":"10.4103\/ijo.IJO_2128_22","article-title":"An Observational Study on the Presence of Perilimbal Conjunctival Pigmentation in Vernal Keratoconjunctivitis","volume":"71","author":"Dubbaka","year":"2023","journal-title":"Indian J. Ophthalmol."},{"key":"ref_169","doi-asserted-by":"crossref","first-page":"636","DOI":"10.21037\/tp-20-216","article-title":"Distribution of Serum Specific IgE in Children with Allergic Conjunctivitis and Analysis of Its Concomitant Allergic Diseases","volume":"9","author":"Wang","year":"2020","journal-title":"Transl. Pediatr."},{"key":"ref_170","doi-asserted-by":"crossref","first-page":"16","DOI":"10.2500\/aap.2017.38.4003","article-title":"Diagnosis and Management of Allergic Conjunctivitis in Pediatric Patients","volume":"38","author":"Berger","year":"2017","journal-title":"Allergy Asthma Proc."},{"key":"ref_171","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1111\/pai.13520","article-title":"Health-Related Quality of Life in Children at the Diagnosis of Vernal Keratoconjunctivitis","volume":"32","author":"Artesani","year":"2021","journal-title":"Pediatr. Allergy Immunol."},{"key":"ref_172","doi-asserted-by":"crossref","first-page":"2058738419833468","DOI":"10.1177\/2058738419833468","article-title":"Vitamin d Serum Levels in Children with Vernal Keratoconjunctivitis and Disease Control","volume":"33","author":"Ghiglioni","year":"2019","journal-title":"Int. J. Immunopathol. Pharmacol."},{"key":"ref_173","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1097\/ACI.0000000000000915","article-title":"Diagnostic Criteria of Chronic Conjunctivitis: Atopic Keratoconjunctivitis and Vernal Keratoconjunctivitis","volume":"23","author":"Leonardi","year":"2023","journal-title":"Curr. Opin. Allergy Clin. Immunol."},{"key":"ref_174","doi-asserted-by":"crossref","first-page":"2828","DOI":"10.1177\/11206721211022153","article-title":"Vernal Keratoconjunctivitis: An Update","volume":"31","author":"Ghiglioni","year":"2021","journal-title":"Eur. J. Ophthalmol."},{"key":"ref_175","doi-asserted-by":"crossref","unstructured":"Bara\u0144ski, K., and Zejda, J.E. (2022). Screening Accuracy of FeNO Measurement for Childhood Asthma in a Community Setting. Children, 9.","DOI":"10.3390\/children9060858"},{"key":"ref_176","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1038\/s41533-018-0072-z","article-title":"Adherence and Quality of Life in Adults and Children during 3-Years of SLIT Treatment with Grazax-a Real Life Study","volume":"28","author":"Kiotseridis","year":"2018","journal-title":"npj Prim. Care Respir. Med."},{"key":"ref_177","first-page":"125","article-title":"Comparison of Specific Immunoglobulin E with the Skin Prick Test in the Diagnosis of House Dust Mites and Cockroach Sensitization in Patients with Asthma and\/or Allergic Rhinitis","volume":"50","author":"Alimuddin","year":"2018","journal-title":"Acta Medica Indones."},{"key":"ref_178","doi-asserted-by":"crossref","unstructured":"Expert Panel Working Group of the National Heart, Lung, and Blood Institute (NHLBI) administered and coordi-nated National Asthma Education and Prevention Program Coordinating Committee (NAEPPCC), Cloutier, M.M., Baptist, A.P., Blake, K.V., Brooks, E.G., Bryant-Stephens, T., DiMango, E., Dixon, A.E., Elward, K.S., and Hartert, T. (2020). 2020 Focused Updates to the Asthma Management Guidelines: A Report from the National Asthma Education and Pre-vention Program Coordinating Committee Expert Panel Working Group. J. Allergy Clin. Immunol., 146, 1217\u20131270. Erratum in J. Allergy Clin. Immunol. 2021, 147, 1528\u20131530. https:\/\/doi.org\/10.1016\/j.jaci.2021.02.010.","DOI":"10.1016\/j.jaci.2020.10.003"},{"key":"ref_179","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1183\/09031936.00202013","article-title":"International ERS\/ATS Guidelines on Definition, Evaluation and Treatment of Severe Asthma","volume":"43","author":"Chung","year":"2014","journal-title":"Eur. Respir. J."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/12\/4848\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T01:27:13Z","timestamp":1782437233000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/12\/4848"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,22]]},"references-count":179,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["jcm15124848"],"URL":"https:\/\/doi.org\/10.3390\/jcm15124848","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,22]]}}}