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Environmental factors associated with allergic rhinitis symptoms in Japanese university students: A cross-sectional study. Auris Nasus Larynx 2018; 45:1006-1013. [PMID: 29475765 DOI: 10.1016/j.anl.2018.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 02/07/2018] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Numerous studies have reported that various environmental factors during early life are key determinants for developing allergic disease. Herein, we aimed to investigate the impact of environmental factors on allergic rhinitis. METHODS This cross-sectional study was conducted in a single university in Japan (from April to June, in 2015 and 2016). Students voluntarily answered online questionnaires regarding their allergic rhinitis symptoms and their exposure to various environmental factors during preschool-age. RESULTS Overall, 3075 students participated the questionnaire. After excluding those with incomplete datasets, 3016 students were eligible. Of these, 49% had allergic rhinitis symptoms. Female sex was associated with a lower risk of allergic rhinitis symptoms (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.68-0.99). Comorbidity of asthma or atopic dermatitis and a family history of allergy (asthma, atopic dermatitis, or allergic rhinitis) were associated with higher risks of allergic rhinitis symptoms. Regarding the number of household members, compared with subjects with <3 people, those with 5 (OR, 0.74; 95% CI, 0.57-0.97) and ≥6 people (OR, 0.66; 95% CI, 0.49-0.88) in their household showed lower incidences of allergic rhinitis symptoms. No other environmental factors, including birth order, number of siblings, living environment, passive smoking, furry pet ownership, housing, bedding, breastfeeding, dairy product intake, preschool setting, and starting age of preschool, was associated with the incidence of allergic rhinitis symptoms. CONCLUSION Sex, current asthma and atopic dermatitis symptoms, family history of allergies, and the number of people in the household at preschool-age were associated with the incidence of allergic rhinitis symptoms.
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Morgan BW, Siddharthan T, Grigsby MR, Pollard SL, Kalyesubula R, Wise RA, Kirenga B, Checkley W. Asthma and Allergic Disorders in Uganda: A Population-Based Study Across Urban and Rural Settings. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018; 6:1580-1587.e2. [PMID: 29361510 DOI: 10.1016/j.jaip.2017.11.032] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Revised: 11/02/2017] [Accepted: 11/20/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND Allergic diseases are increasing in sub-Saharan Africa, but few studies have characterized the burden among adults. OBJECTIVE We conducted a study to evaluate the prevalence and risk factors of allergic disorders in urban and rural Uganda. METHODS We present a cross-sectional analysis of enrollment data from a population-based cohort study of adults aged ≥35 years in urban and rural Uganda. Sociodemographic and both lifetime and 12-month respiratory symptoms data were collected and spirometry was conducted following standard guidelines. RESULTS In 1,308 adults (median age 43.8 years and 52.3% female), we found an age-adjusted prevalence of 6.8% for asthma (9.8% urban, 4.3% rural; P < .001), 11.9% for allergic rhinitis (16.4% urban, 7.8% rural; P < .001), and 8.2% for eczema (9.9% urban, 7.8% rural; P = .15). Urbanization was the primary driver of asthma, accounting for 61.4% of cases (95% confidence interval [CI] 22.0% to 83.4%), and was the strongest risk factor for any allergic illness (odds ratio [OR] = 1.87, 95% CI 1.39-2.51). Parental asthma was not associated with allergic illness. Asthma was associated with a lower forced expiratory volume in 1 second (FEV1) by 0.56 z scores (95% CI 0.33-0.80). We found a dose-response association between lower quintiles of the FEV1/forced vital capacity ratio and both hospitalization (OR = 1.77, 95% CI 1.21-2.59) and impairment in daily activities (1.65, 1.20-2.27). CONCLUSIONS Asthma and allergic rhinitis were twice as prevalent in urban settings. Asthma was associated with greater impairment and worse lung function outcomes. We identified a high prevalence of allergic disorders in Uganda, which can be expected to increase due to urbanization and resultant exposures throughout early development.
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Affiliation(s)
- Brooks W Morgan
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Md
| | - Trishul Siddharthan
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Md
| | - Matthew R Grigsby
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Md
| | - Suzanne L Pollard
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Md
| | - Robert Kalyesubula
- Department of Medicine and Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Robert A Wise
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Md
| | - Bruce Kirenga
- Department of Medicine and Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - William Checkley
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Md; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.
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Fröhlich M, Pinart M, Keller T, Reich A, Cabieses B, Hohmann C, Postma DS, Bousquet J, Antó JM, Keil T, Roll S. Is there a sex-shift in prevalence of allergic rhinitis and comorbid asthma from childhood to adulthood? A meta-analysis. Clin Transl Allergy 2017; 7:44. [PMID: 29225773 PMCID: PMC5715620 DOI: 10.1186/s13601-017-0176-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 10/31/2017] [Indexed: 01/08/2023] Open
Abstract
Background Allergic rhinitis and asthma as single entities affect more boys than girls in childhood but more females in adulthood. However, it is unclear if this prevalence sex-shift also occurs in allergic rhinitis and concurrent asthma. Thus, our aim was to compare sex-specific differences in the prevalence of coexisting allergic rhinitis and asthma in childhood, adolescence and adulthood. Methods Post-hoc analysis of systematic review with meta-analysis concerning sex-specific prevalence of allergic rhinitis. Using random-effects meta-analysis, we assessed male–female ratios for coexisting allergic rhinitis and asthma in children (0–10 years), adolescents (11–17) and adults (> 17). Electronic searches were performed using MEDLINE and EMBASE for the time period 2000–2014. We included population-based observational studies, reporting coexisting allergic rhinitis and asthma as outcome stratified by sex. We excluded non-original or non-population-based studies, studies with only male or female participants or selective patient collectives. Results From a total of 6539 citations, 10 studies with a total of 93,483 participants met the inclusion criteria. The male–female ratios (95% CI) for coexisting allergic rhinitis and asthma were 1.65 (1.52; 1.78) in children (N = 6 studies), 0.61 (0.51; 0.72) in adolescents (N = 2) and 1.03 (0.79; 1.35) in adults (N = 2). Male–female ratios for allergic rhinitis only were 1.25 (1.19; 1.32, N = 5) in children, 0.80 (0.71; 0.89, N = 2) in adolescents and 0.98 (0.74; 1.30, N = 2) in adults, respectively. Conclusions The prevalence of coexisting allergic rhinitis and asthma shows a clear male predominance in childhood and seems to switch to a female predominance in adolescents. This switch was less pronounced for allergic rhinitis only. Electronic supplementary material The online version of this article (10.1186/s13601-017-0176-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- M Fröhlich
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Clinic for Neonatology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - M Pinart
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Max-Delbrück-Centrum für Molekulare Medizin, Research Team Molecular Epidemiology, Berlin, Germany.,ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,IMIM (Hospital del Mar Research Institute), Barcelona, Spain.,Universitat Popmpeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - T Keller
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - A Reich
- Epidemiology, German Rheumatism Research Centre, Berlin, Germany
| | - B Cabieses
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - C Hohmann
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - D S Postma
- Department of Pulmonology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - J Bousquet
- University Hospital, Montpellier, France.,MACVIA-LR, Contre les Maladies Chroniques pour un Vieillissement Actifen Languedoc Roussillon, European Innovation Partnership on Active and Healthy Ageing Reference Site, and INSERM, VIMA: Ageing and Chronic Diseases, Epidemiological and Public Health Approaches, U1168, Paris, France.,UVSQ, UMR-S 1168, Université Versailles, St-Quentin-en-Yvelines, France
| | - J M Antó
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,IMIM (Hospital del Mar Research Institute), Barcelona, Spain.,Universitat Popmpeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - T Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Institute of Clinical Epidemiology and Biometry, University of Wuerzburg, Würzburg, Germany
| | - S Roll
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Wang ZX, Shi H. Single-allergen sublingual immunotherapy versus multi-allergen subcutaneous immunotherapy for children with allergic rhinitis. ACTA ACUST UNITED AC 2017; 37:407-411. [PMID: 28585143 DOI: 10.1007/s11596-017-1748-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 03/14/2017] [Indexed: 02/04/2023]
Abstract
It has always been controversial whether a single allergen performs better than multiple allergens in polysensitized patients during the allergen-specific immunotherapy. This study aimed to examine the clinical efficacy of single-allergen sublingual immunotherapy (SLIT) versus multi-allergen subcutaneous immunotherapy (SCIT) and to discover the change of the biomarker IL-4 after 1-year immunotherapy in polysensitized children aged 6-13 years with allergic rhinitis (AR) induced by house dust mites (HDMs). The AR polysensitized children (n=78) were randomly divided into two groups: SLIT group and SCIT group. Patients in the SLIT group sublingually received a single HDM extract and those in the SCIT group were subcutaneously given multiple-allergen extracts (HDM in combination with other clinically relevant allergen extracts). Before and 1 year after the allergen-specific immunotherapy (ASIT), the total nasal symptom scores (TNSS), total medication scores (TMS) and IL-4 levels in peripheral blood mononuclear cells (PBMCs) were compared respectively between the two groups. The results showed that the TNSS were greatly improved, and the TMS and IL-4 levels were significantly decreased after 1-year ASIT in both groups (SLIT group: P<0.001; SCIT group: P<0.001). There were no significant differences in any outcome measures between the two groups (for TNSS: P>0.05; for TMS: P>0.05; for IL-4 levels: P>0.05). It was concluded that the clinical efficacy of single-allergen SLIT is comparable with that of multi-allergen SCIT in 6-13-year-old children with HDM-induced AR.
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Affiliation(s)
- Zhong-Xi Wang
- Laboratory of Allergology, Institute of Immunology; Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Han Shi
- Department of Gerontology, Central Hospital of Taizhou, Taizhou, 380000, China
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