From a one-time CRISPR therapy cutting HAE attacks by 87% to CSU biomarkers and emerging ILIT research, here are the 5 allergy stories worth catching up on from May 2026.
May 2026 was a busy month for
Whether you were heads-down at a conference or just working through a backlog, here are the 5 stories from May worth having on your radar.
The HAE treatment landscape is rapidly evolving, with updated international guidelines now recommending sebetralstat (Ekterly) as a first-line oral option for acute attacks in patients aged ≥ 12 years. Investigational therapy BW-20805, a small interfering RNA targeting prekallikrein, demonstrated 80 to 100% attack-free rates in phase 2 data. Most notably, the phase 3 HAELO trial of lonvoguran ziclumeran (lonvo-z), a one-time CRISPR/Cas9 gene editing therapy targeting the KLKB1 gene, showed an 87% reduction in monthly attack rate versus placebo. Intellia Therapeutics has begun a rolling BLA submission, with a potential US launch in 2027 pending FDA approval.
Food allergy management is shifting toward personalized, proactive strategies beyond strict avoidance. Christopher Brooks, MD, of The Ohio State University, highlighted the expanding role of omalizumab for multi-allergen patients and the importance of sequencing omalizumab with oral immunotherapy (OIT) based on individual patient goals and risk profiles.
Brooks emphasized that food challenges remain critically underused, noting that in some immunotherapy enrollment studies, roughly half of patients passed food challenges, indicating they were never truly allergic. He also stressed the need for better cross-specialty education around the limitations of blood testing and avoiding unnecessary dietary restrictions in patients without confirmed food allergy diagnoses.
Intralymphatic immunotherapy (ILIT), a delivery approach involving targeted lymph node injections already in use for environmental allergies, is in the earliest stages of investigation for food allergy treatment. Brooks discussed why ILIT has drawn research interest as a potentially shorter, more flexible alternative to conventional subcutaneous immunotherapy and oral immunotherapy.
Current research is focused primarily on establishing safety before efficacy can be assessed. Brooks noted that ILIT's appeal stems from its reduced scheduling burden compared to traditional allergy shots, which require weekly visits for up to 12 months before transitioning to monthly maintenance dosing.
A longitudinal study of 38 patients with house dust mite (HDM) allergy found that 18 months of SLIT produced biphasic changes in allergen-specific type 2 memory B cells—an early expansion at 4 months followed by reduction by 18 months—alongside sustained symptom improvement. Increased IgG4 and CD29 expression on Der p 1– and Der p 2–specific type 2 memory B cells correlated with lower symptom scores. Investigator Menno C. van Zelm, PhD, of Monash University, noted the late decline in these cells paralleled falling serum IgE levels and may be key to achieving durable, post-treatment unresponsiveness.
At the 2026 Eastern Allergy Conference (EAC) in Palm Beach, Florida, Jonathan Bernstein, MD, of the University of Cincinnati discussed biomarker-guided management of CSU, a heterogeneous disease with two primary endotypes: type I autoallergic and type IIb autoimmune. Bernstein highlighted total serum IgE, thyroid peroxidase (TPO) antibodies, and the CU Index as the most clinically informative biomarkers, noting composite scoring is more predictive of omalizumab response than individual markers alone. He cautioned that biomarker data for newer agents, including dupilumab and remibrutinib, remain limited and that longitudinal real-world studies are needed before biomarker-driven treatment selection becomes standard practice across community allergy settings.
