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Lu C, Liu Z, Liao H, Yang W, Li Q, Liu Q. Effects of early life exposure to home environmental factors on childhood allergic rhinitis: Modifications by outdoor air pollution and temperature. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 244:114076. [PMID: 36113271 DOI: 10.1016/j.ecoenv.2022.114076] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/08/2022] [Accepted: 09/09/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND There is growing evidence that allergic rhinitis (AR) is associated with indoor environmental factors, but their role in childhood AR during early life remains unclear. OBJECTIVE To investigate the association of preconceptional, prenatal, early postnatal, and current exposure to home environmental factors with childhood AR, and to further explore whether this association can be interacted by outdoor air pollution and temperature. METHODS A retrospective cohort study of 8689 preschool children was conducted during 2019-2020 in Changsha, China. A standard questionnaire was used to collect data on each family's health outcomes and home environments. We considered home environmental exposures during one year before conception, pregnancy, first year of life, and past year. Associations of indoor air pollution and allergens with AR were assessed by multiple logistic regression models. RESULTS Pre-birth exposure to indoor air pollution emitted by new furniture or redecoration and dampness related allergen derived from mold/damp stains and mold/damp clothes or bedding during 1 year before conception and pregnancy was significantly associated with increased AR, with adjusted ORs (95% CI) ranging from 1.35 (1.05-1.75) to 1.87 (1.55-2.27). Childhood AR was also significantly related with post-birth exposure to dampness related indoor allergen including mold/damp stains and mold/damp clothes or bedding in first year and past year and pollen allergen including total and nonflowing plants in past year, with a range of ORs (95% CI) from 1.20 (1.01-1.42) to 1.79 (1.42-2.27). We identified that pre-birth, particularly in utero exposure to both indoor air pollution from renovation and dampness related allergens, played a key role in AR development compared to post-birth exposures, and accumulative effect was observed with the highest risk of AR. High exposure to traffic-related air pollution (TRAP) including outdoor PM2.5, NO2, CO, and O3, as well as living near traffic road not only significantly increased adverse effect of home environmental factors but also decreased protective effect of household dogs on childhood AR. Early life exposure to low temperature in pregnancy and high temperature in first year significantly increased AR risk of home environmental exposure. Sensitivity analysis indicated that some sub-groups were more susceptible to AR risk of home environmental exposure. CONCLUSION Our study suggests that pre-birth exposure to home environmental factors played an important role in AR development and this effect can be interacted by TRAP and temperature, which supports a hypothesis of "(pre)fetal origin of childhood AR".
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Affiliation(s)
- Chan Lu
- XiangYa School of Public Health, Central South University, Changsha, China.
| | - Zijing Liu
- XiangYa School of Public Health, Central South University, Changsha, China.
| | - Hongsen Liao
- XiangYa School of Public Health, Central South University, Changsha, China.
| | - Wenhui Yang
- XiangYa School of Public Health, Central South University, Changsha, China.
| | - Qin Li
- XiangYa School of Public Health, Central South University, Changsha, China.
| | - Qin Liu
- XiangYa School of Public Health, Central South University, Changsha, China.
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Turková B, Tužil J, Pilnáčková B, Doležalová H, Štrosová D, Petrů V, Seberová E, Doležal T. Health and economic impact of subcutaneous allergen immunotherapy in patients with pollen-induced allergic rhinoconjunctivitis: real-word evidence from the Czech Republic. Immunotherapy 2022; 14:1109-1120. [PMID: 36097687 DOI: 10.2217/imt-2022-0143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: The prevalence of allergic rhinoconjunctivitis (AR) has been increasing over the years, and allergen immunotherapy (AIT) remains the only disease-modifying treatment. However, cost-effectiveness data remain scarce. Methods: In this single-arm, noninterventional, prospective, multicenter study, we describe the effectiveness, safety and costs of subcutaneous AIT for pollen-induced allergic rhinoconjunctivitis. Results: Of 471 new AIT users, 317 completed three courses of treatment, and symptoms improved in 96%; no serious adverse reactions were reported. The cost of symptomatic medication decreased by 49% and the cost of unscheduled specialist visits decreased by 73%. Except for AIT administration, total healthcare costs decreased by 54% compared with the baseline pollen season without AIT. Conclusion: In clinical practice, subcutaneous AIT is an effective treatment generating savings on symptomatic medication and unscheduled consultations.
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Affiliation(s)
- Barbora Turková
- Value Outcomes, Václavská 12, Prague 2, 120 00, Czech Republic
| | - Jan Tužil
- Value Outcomes, Václavská 12, Prague 2, 120 00, Czech Republic.,First Medical Faculty, Charles University, Prague, Czech Republic
| | | | | | | | - Vít Petrů
- Department of allergology & clinical immunology, Synlab Czech s.r.o., Prague, Czech Republic
| | | | - Tomáš Doležal
- Value Outcomes, Václavská 12, Prague 2, 120 00, Czech Republic.,Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
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Nirouei M, Sharif R, Sehat M, Rasouli S, Fayyaz F, Heidarzadeh Arani M. Epidemiology and associated risk factors with allergic rhinitis, acute and chronic rhinosinusitis in Kashan. REVUE FRANÇAISE D'ALLERGOLOGIE 2022. [DOI: 10.1016/j.reval.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Novak N, Worm M, Staubach P, Jutel M, Sager A, Pfaar O. Subcutaneous birch pollen allergen immunotherapy with a depigmented polymerized extract shows only sustained and long-term efficacy in a subgroup of monosensitized adults and adolescents with allergic rhinitis. Clin Transl Allergy 2022; 12:e12185. [PMID: 36225264 PMCID: PMC9533217 DOI: 10.1002/clt2.12185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 07/01/2022] [Indexed: 12/15/2022] Open
Abstract
Background Allergen immunotherapy (AIT) is an approved treatment for seasonal respiratory allergic diseases. A depigmented polymerized birch pollen extract for subcutaneous allergen immunotherapy (SCIT) has been demonstrated to be efficacious and safe in patients allergic to birch pollen and its homologous group. Objective To determine whether SCIT with a birch pollen formulation (5000 depigmented polymerized (DPP) units/mL) shows sustained and long-term efficacy in adults and adolescents with birch-pollen induced allergic rhinitis with or without intermittent asthma. Methods A multicentre (n = 66), double-blind, placebo-controlled Phase III clinical trial was performed in the Czech Republic, Finland, Germany, Latvia, Lithuania, Poland and Russia. Participants were randomized 2:1 to active treatment (birch 5000 DPP/ml) or placebo for three years of SCIT and followed up for two treatment-free years. The primary efficacy endpoint was the EAACI's combined symptom and medication score for rhinoconjunctivitis (CSMSEAACI). Results A total of 973 participants were screened and 649 were randomized (active treatment: n = 434; placebo: n = 215). The intention-to-treat analysis of the CSMSEAACI in the overall study population did not demonstrate statistically significant differences in years 1, 2 and 3. In a post-hoc analysis, among the subgroup of patients monosensitized to birch pollen allergen only (n = 200), we observed a statistically significant difference (active treatment vs. placebo) in the CSMSEAACI in year 2, 3 and 5. The AIT's safety profile was good. Conclusions SCIT with a depigmented polymerized birch pollen extract was safe. Sustained and long-term efficacy in years 2, 3 and 5 in monosensitized patients, but not in polysensitized patients was demonstrated.(EudraCT 2012-000414-11).
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Affiliation(s)
- Natalija Novak
- Department of Dermatology and AllergologyUniversity of Bonn Medical CenterBonnGermany
| | - Margitta Worm
- Department of DermatologyAllergy and VenerologyDivision of Allergy and Immunology, CharitéUniversitätsmedizinBerlinGermany
| | - Petra Staubach
- Department of DermatologyUniversity Medical Center of the Johannes Gutenberg University MainzMainzGermany
| | - Marek Jutel
- Department of Clinical ImmunologyWroclaw Medical UniversityWroclawPoland
- ALL‐MED Medical Research InstituteWroclawPoland
| | | | - Oliver Pfaar
- Department of OtorhinolaryngologyHead and Neck SurgerySection of Rhinology and AllergyUniversity Hospital MarburgPhilipps‐Universität MarburgMarburgGermany
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Palathumpattu B, Pieper‐Fürst U, Acikel C, Sahin H, Allekotte S, Singh J, Hess M, Sager A, Müller T, Mösges R. Correlation of the combined symptom and medication score with quality of life, symptom severity and symptom control in allergic rhinoconjunctivitis. Clin Transl Allergy 2022; 12:e12191. [PMID: 36225263 PMCID: PMC9533220 DOI: 10.1002/clt2.12191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 08/10/2022] [Indexed: 11/19/2022] Open
Abstract
Background The European Academy of Allergy and Clinical Immunology recommended the Combined Symptom and Medication Score (CSMS) as primary endpoint in clinical trials on allergen-specific immunotherapy (AIT) in allergic rhinoconjunctivitis. Here, the correlation between the CSMS and the validated standardised Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ(S)), Rhinitis Control Assessment Test (RCAT) and Visual Analogue Scale (VAS) was analysed. Methods Two prospective, multicentre, non-interventional studies on tree pollen, grass pollen and house dust mite allergic patients were performed. The first study comprised 167 patients receiving AIT (AIT population), and the second included 56 patients treated with symptomatic medication only (control population). For up to two seasons (pollen)/exposure periods (house dust mites), participants documented their symptoms and medication intake in a CSMS diary, including VAS. In addition, the standardised RQLQ(S) and the RCAT were completed during study visits. Results Comparison between CSMS and RQLQ(S) revealed a positive correlation in the AIT population (r = 0.426) and in the control population (r = 0.569). For CSMS and RCAT, a negative correlation with r = -0.409 (AIT) and r = -0.547 (control) was shown. Positive correlation between CSMS and VAS was also demonstrated with r = 0.585 (AIT) and r = 0.563 (control). Conclusion These results support the assumption that the CSMS correlates with quality of life, symptom severity and symptom control on the one hand, while the moderate strength of correlations on the other hand mirrors distinctions of the CSMS compared to the assessments used here.
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Affiliation(s)
- Binoy Palathumpattu
- Institute of Medical Statistics and Computational BiologyFaculty of MedicineUniversity of CologneCologneGermany
| | | | | | | | | | | | - Mark Hess
- ClinCompetence Cologne GmbHCologneGermany
| | | | | | - Ralph Mösges
- Institute of Medical Statistics and Computational BiologyFaculty of MedicineUniversity of CologneCologneGermany
- ClinCompetence Cologne GmbHCologneGermany
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Al-Ghamdi BR, Omer FM, Awadalla NJ, Mahfouz AA. Specific aeroallergen sensitization associated with current rhinitis among adults in southwestern Saudi Arabia. Medicine (Baltimore) 2022; 101:e30384. [PMID: 36107562 PMCID: PMC9439808 DOI: 10.1097/md.0000000000030384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Data about allergic sensitization to rhinitis among adults are limited. The objectives were to explore the prevalence of current rhinitis (CR) and associated specific allergen sensitizations in southwestern Saudi Arabia. A cross-sectional study was conducted on 969 adults in southwestern regions of Saudi Arabia, namely Aseer, Jazan, and Al Baha. From each region, 5 primary health care centers were chosen. The validated Arabic Version of the International Study of Asthma and Allergies in Childhood questionnaire was used. Total immunoglobulin E (IgE) enzyme-linked immunosorbent assay, cytokine enzyme-linked immunosorbent assay (interleukin [IL]-4, IL-10, IL-13, and interferon-γ), aeroallergen-specific IgE immunoassay (a panel of 30 common aeroallergens; 9 indoor and 21 outdoors), and eosinophilic count were assessed. A prevalence of CR of 35.8% (95% confidence interval: 32.8%-38.9%) was found. Regarding outdoor aeroallergens, Mesquite-positive IgE antibodies were higher among CR adults (odds ratio = 1.52, 95% confidence interval: 1.02-2.21) compared to those without CR. The same significant pattern was found with Chenopodium, Ragweed, Pigweed, Russian thistle, Bermuda grass, Timothy grass, and Rye. All indoor aeroallergens were not significantly associated with CR. Total IgE and eosinophil count were significantly higher among adults with CR. In conclusion, CR in southwestern regions of Saudi Arabia is common and of significant public health importance. Aeroallergens that associate with adult sensitization to CR tend to be of the outdoor variety particularly the herbaceous grass and their pollens. The magnitude of CR and its association with exposure to outdoor aeroallergens should be taken into account by health policy decision makers, clinicians, and medical practitioners when diagnosing and treating related conditions.
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Affiliation(s)
- Badr Rashed Al-Ghamdi
- Department of Internal Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Fakhreldin Mohamed Omer
- Department of Clinical Microbiology, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Nabil J. Awadalla
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Ahmed A. Mahfouz
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia
- *Correspondence: Ahmed A. Mahfouz, Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia (e-mail: )
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Thétis-Soulié M, Hosotte M, Grozelier I, Baillez C, Scurati S, Mercier V. The MaDo real-life study of dose adjustment of allergen immunotherapy liquid formulations in an indication of respiratory allergic disease: Reasons, practices, and outcomes. FRONTIERS IN ALLERGY 2022; 3:971155. [PMID: 36017469 PMCID: PMC9395981 DOI: 10.3389/falgy.2022.971155] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 07/26/2022] [Indexed: 11/20/2022] Open
Abstract
Sublingual allergen immunotherapy (SLIT) is a safe, effective, disease-modifying treatment for moderate-to-severe respiratory allergies. The function and responsiveness of the immune system components underlying the effects of allergen immunotherapy may vary from one patient to another. Furthermore, the severity of the symptoms of allergic disease can fluctuate over time, due to changes in environmental allergen exposure, effector cell responsiveness, and cell signaling. Hence, the allergen dose provided through SLIT can be fine-tuned to establish an optimal balance between effectiveness and tolerability. The objective of the MaDo study was to describe and understand dose adjustments of SLIT liquid formulations in France. We performed a retrospective, observational, cross-sectional, real-life study of allergists and other specialist physicians. Physicians described their patients via an anonymous case report form (CRF). The main patient inclusion criteria were age 5 years or over, at least one physician-confirmed IgE-driven respiratory allergy, and treatment for at least 2 years with one or more SLIT liquid preparations. A nationally representative sample of 33 specialist physicians participated in the study. The physicians' main stated reasons for dose adjustment were adverse events (according to 90.9% of the physicians), treatment effectiveness (60.6%), sensitivity to the allergen (42.4%) and other characteristics (30.3%: mainly symptom severity, type of allergen, and asthma). 392 CRFs (mean ± standard deviation patient age: 27.8 ± 17.5; under-18s: 42.1%; polyallergy: 30.9%) were analyzed. Respectively 53.6%, 25.8%, 15.3%, and 8.7% of the patients received house dust mite, grass pollen, birch pollen and cypress pollen SLIT. Dose adjustments were noted in 258 (65.8%) patients (at the start of the maintenance phase for 101 patients (39.2%) and later for 247 (95.7%)). Dose adjustment was not linked to sex, age, or the number of allergens administered. All measures of disease severity (including symptom severity noted on a 0-to-10 visual analogue scale by the physician) decreased significantly during SLIT. Notably, the mean AR symptom severity score decreased to a clinically relevant extent from 7.6 at SLIT initiation to 2.4 at last follow-up, and the mean asthma symptom severity score decreased from 5.0 to 1.3. The few differences in effectiveness between patients with vs. without dose adjustment were not major. For about one patient in five, a specialist physician decided to reduce or increase the SLIT liquid dose at the start of maintenance treatment and/or during maintenance treatment. This decision was influenced by a broad range of patient and treatment factors, mainly to improve tolerability to treatment and/or enhance effectiveness. In France, dose adjustment of SLIT liquid preparations as a function of the patient profile and/or treatment response is anchored in clinical practice. Precision dosing might optimize the overall benefit-risk profile of AIT for individual patients throughout their entire treatment course, enabling them to achieve both short- and long-term treatment goals, whilst maximizing the safety and tolerability.
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Affiliation(s)
| | | | | | | | - Silvia Scurati
- Global Medical Affairs Department, Stallergenes Greer, Antony, France
| | - Valérie Mercier
- Private Office, Toulouse, France
- Correspondence: Valérie Mercier
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Langenbruch A, Wüstenberg E, Wolf H, Augustin M. Development and Validation Features of the Patient Benefit Index for the Treatment of Allergic Rhinoconjunctivitis with Allergen Immunotherapy. J Asthma Allergy 2022; 15:611-621. [PMID: 35586793 PMCID: PMC9109726 DOI: 10.2147/jaa.s357469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/06/2022] [Indexed: 11/26/2022] Open
Abstract
Purpose Allergic rhinoconjunctivitis (ARC) is one of the most common diseases worldwide. Allergen immunotherapy (AIT) is the only causal treatment available so far. Due to health policy provisions, the assessment of treatment benefit from the patient’s perspective is of high relevance. To date, no instrument for assessing treatment needs and benefits of patients with ARC who receive AIT has been published. The aim of the study was to validate an instrument to assess the patient-relevant treatment benefit of patients with ARC who receive AIT. Methods We developed the Patient Benefit Index questionnaire for AIT (PBI-AIT), consisting of 33 items. Longitudinal data of patients with ARC were used to test feasibility, reliability and validity. The PBI was compared between the beginning of the study (t1) and the end of the study (t5). Results N = 279 patients with AIT completed the PBI-AIT at t1, n = 333 at t5; n = 226 at both timepoints. Mean number of missing values per patient was 0.7 in the Patient Needs Questionnaire (PNQ) at t1 and 1.2 in the Patient Benefit Questionnaire (PBQ) at t5. The internal consistencies measured by Cronbach’s alpha were 0.98 (PNQ) and 0.99 (PBQ). The mean PBI of the patients with AIT was significantly lower at t1 and improved at t5. The PBI-AIT correlated with all tested external criteria at t5. The correlation between PBI-AIT and satisfaction with previous treatment (r = −0.57, p < 0.001) was higher than the correlation between PBI-AIT and current disease severity (r = −0.26, p < 0.001). Conclusion The results indicate feasibility, reliability, convergent and discriminant validity as well as sensitivity to change of the PBI-AIT.
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Affiliation(s)
- Anna Langenbruch
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Correspondence: Anna Langenbruch, German Center for Health Services Research in Dermatology (CVderm) Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, Hamburg, 20246, Germany, Tel +49 40 7410-53942, Fax +49 40 7410-55348, Email
| | - Eike Wüstenberg
- ALK-Abelló Arzneimittel GmbH, Hamburg, Germany
- Clinic for Otorhinolaryngology, University Hospital Dresden, Dresden, Germany
| | | | - Matthias Augustin
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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da Paz ER, de Lima CMF, Felix SN, Schaeffer B, Galvão CES, Correia AT, Righetti RF, de Arruda Martins M, de Fátima Lopes Calvo Tibério I, Saraiva-Romanholo BM. Airway inflammatory profile among cleaning workers from different workplaces. BMC Pulm Med 2022; 22:170. [PMID: 35488256 PMCID: PMC9052628 DOI: 10.1186/s12890-022-01949-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 04/11/2022] [Indexed: 01/01/2023] Open
Abstract
Background Cleaning workers represent a significant proportion of the active population worldwide, with poor remuneration, particularly in developing countries. Despite this, they remain a relatively poorly studied occupational group. They are constantly exposed to agents that can cause symptoms and respiratory problems. This study aimed to evaluate upper airway inflammation in professional cleaning workers in three different occupational settings by comparing nasal cytology inflammation and clinical profiles. Methods We performed a cross-sectional study on the prevalence of upper airway inflammation and symptoms of asthma/rhinitis related to cleaning work, according to workplace. A total of 167 participants were divided into four groups: hospital, university, housekeeper and control. A nasal swab was collected for upper airway inflammation evaluation. Clinical profiles and respiratory symptom employee evaluations were performed using specific questionnaires (European Community Respiratory Health Survey—ECRS and the International Study of Asthma and Allergies in Childhood—ISAAC). Results Cleaning workers showed increased neutrophils and lymphocytes; the hospital and university groups showed increased macrophages compared to the housekeeper and control groups. The hospital and housekeeper groups showed increased eosinophils when they performed cleaning services for up to one year and reported having more asthma symptoms than the control group. Cleaning workers showed increased rhinitis symptoms. The university group showed increased rhinitis symptoms aggravated by the workplace compared with the hospital and housekeeper groups. Cleaning workers showed an increased affirmative response when directly asked about rhinitis symptoms compared to the control group. Conclusions Cleaning workers showed airway inflammation, asthma symptoms and rhinitis, regardless of the occupational environment to which they were exposed, as well as showed increased rhinitis and asthma symptoms. Hospital cleaning workers showed increased macrophages, lymphocytes and eosinophils compared to the others. The length of time spent performing cleaning work was not related to nasal inflammation or respiratory symptoms in this population. However, there were differences in workplaces. Registered on ClinicalTrials.gov. Trial registration number: NCT03311048. Registration date: 10.16.2017. Retrospectively registered. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-022-01949-5.
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Affiliation(s)
- Edinéia Rosa da Paz
- Instituto de Assistência Médica Ao Servidor Público Estadual (IAMSPE), Hospital Do Servidor Público Do Estado de São Paulo, Sao Paulo, SP, Brazil
| | | | - Soraia Nogueira Felix
- Instituto de Assistência Médica Ao Servidor Público Estadual (IAMSPE), Hospital Do Servidor Público Do Estado de São Paulo, Sao Paulo, SP, Brazil.
| | - Bruna Schaeffer
- Universidade Cidade de São Paulo (UNICID), São Paulo, SP, Brazil
| | | | - Aristides Tadeu Correia
- Departamento de Cardiopneumologia, Instituto do Coração, InCor-HCFMUSP, Universidade de São Paulo, Sao Paulo, SP, Brazil.,Laboratório de Investigação Médica- LIM 61, Serviço de Cirurgia Torácica, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Renato Fraga Righetti
- Hospital Sírio-Libanês, Serviço de Reabilitação, Sao Paulo, SP, Brazil.,Laboratório de Terapêutica Experimental (LIM-20), Faculdade de Medicina da USP (FMUSP), Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Milton de Arruda Martins
- Laboratório de Terapêutica Experimental (LIM-20), Faculdade de Medicina da USP (FMUSP), Universidade de Sao Paulo, Sao Paulo, Brazil
| | | | - Beatriz Mangueira Saraiva-Romanholo
- Instituto de Assistência Médica Ao Servidor Público Estadual (IAMSPE), Hospital Do Servidor Público Do Estado de São Paulo, Sao Paulo, SP, Brazil.,Universidade Cidade de São Paulo (UNICID), São Paulo, SP, Brazil.,Laboratório de Terapêutica Experimental (LIM-20), Faculdade de Medicina da USP (FMUSP), Universidade de Sao Paulo, Sao Paulo, Brazil
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Hoffmeyer F, Beine A, Lotz A, Kleinmüller O, Nöllenheidt C, Zahradnik E, Nienhaus A, Raulf M. Upper and lower respiratory airway complaints among female veterinary staff. Int Arch Occup Environ Health 2022; 95:665-675. [PMID: 34669024 PMCID: PMC8938376 DOI: 10.1007/s00420-021-01798-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 09/07/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Working with animals is characterized by exposure to particulate, biological or chemical matter, and respiratory complaints are common. The aim of our cross-sectional study was to assess the prevalence of respiratory symptoms and diagnoses among veterinary staff. METHODS Participants working in veterinary practices were examined and a detailed questionnaire was used to collect data. IgE tests to common and animal allergens were performed to specify sensitization. Associations with respiratory outcomes were analysed using logistic regression models while controlling for potential confounders. RESULTS Atopy was seen in 31% of the 109 female participants. Symptoms of rhinoconjunctivitis were the most frequent complaints (n = 92; 84%). In 18% the diagnosis was confirmed by physicians. Symptoms of upper and lower airways were highly correlated and an asthma diagnosis was confirmed in 11% of participants. Modelling revealed that sensitization against cats/dogs was a significant risk factor for respiratory symptoms of upper [odds ratio (OR) 4.61; 95% confidence interval (CI) 1.13-18.81] and lower airways (OR 5.14; 95% CI 1.25-21.13), physician-confirmed rhinoconjunctivitis (OR 13.43; 95% CI 1.69-106.5) and asthma (OR 9.02; 95% CI 1.16-70.39) in assistant staff of small-animal practices. CONCLUSIONS In several cases, rhinoconjunctivitis worsened after entering the profession. Atopy and specific sensitization to cats/dogs were risk factors for health impairments. Thus, to implement preventive measures, veterinary practice staff should be educated that upper respiratory tract symptoms are not harmless and should be diagnosed and treated early.
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Affiliation(s)
- F. Hoffmeyer
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
| | - A. Beine
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
| | - A. Lotz
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
| | - O. Kleinmüller
- Institute for Health Service Research in Dermatology and Nursing (IVDP), Center for Epidemiology and Heath Service Research in Nursing (CVcare), Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - C. Nöllenheidt
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
| | - E. Zahradnik
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
| | - A. Nienhaus
- Institute for Health Service Research in Dermatology and Nursing (IVDP), Center for Epidemiology and Heath Service Research in Nursing (CVcare), Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg, Germany
- Department of Occupational Medicine, Hazardous Substances and Health Research (AGG), Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), Hamburg, Germany
| | - M. Raulf
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
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Demoly P, Leroyer C, Serrano E, Le Maux A, Magnier G, Chartier A. The SQ HDM SLIT-Tablet is safe and well tolerated in patients with House Dust Mite allergic rhinitis with or without asthma: A "real-life" French study. Clin Transl Allergy 2022; 12:e12129. [PMID: 35344293 PMCID: PMC8967264 DOI: 10.1002/clt2.12129] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 02/02/2022] [Accepted: 02/18/2022] [Indexed: 11/17/2022] Open
Abstract
Background The SQ House Dust Mite (HDM) SubLingual ImmunoTherapy (SLIT)‐Tablet (Acarizax) is the only allergen immunotherapy authorized by European regulatory authorities to treat HDM‐induced allergic asthma (AA) that is not well‐controlled by inhaled corticosteroids and associated with mild‐to‐severe HDM allergic rhinitis (AR). The aim of this study was to add evidence on the safety of the SQ HDM SLIT‐Tablet in patients with AR, alone or with AA, under real‐life conditions. Methods This was a French “real‐life”, multicenter, non‐comparative, longitudinal, prospective study. It included patients initiating the SQ HDM SLIT‐Tablet for either persistent moderate‐to‐severe HDM AR or AA not well‐controlled by inhaled corticosteroids and associated with mild‐to‐severe HDM AR. Adverse Events (AEs) were collected at the first intake and throughout the study. Logistic regression was used to compare safety according to asthma control before treatment initiation. Results Between May 09, 2018 and May 29, 2019, 1526 patients were enrolled at 185 sites and 1483 were included in the safety population (SAF). Of them, 33.6% had suspected clinical manifestations of AA. Asthma was uncontrolled for 18.2% of the patients, partially controlled for 27.9% and well‐controlled for 53.8%. Overall, 31.9% of the SAF patients experienced at least one AE. The percentage of patients with AEs was 29.9% among patients with AR alone and 35.9% among those with AA (p = 0.0193). No significant difference was observed in the rate of AE or SAE depending on asthma control at inclusion (2.2% of SAEs reported for patients with uncontrolled asthma, 1.4% for partly controlled and 1.1% for well‐controlled). Conclusions The overall results indicate a good SQ HDM SLIT‐Tablet safety profile consistent with that reported in previous studies, regardless of asthma control.
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Affiliation(s)
- Pascal Demoly
- IDESP, UMR UA11 INSERM-University of Montpellier, Montpellier, France.,Department of Pulmonology, Division of Allergy, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, University Montpellier, Montpellier, France
| | - Christophe Leroyer
- Clinical Investigation Center, CIC Inserm 1412, Hôpital Cavale Blanche, University Hospital of Brest, Brest, France
| | - Elie Serrano
- Department of ENT and Head and Neck Surgery, Hôpital Larrey, University Hospital of Toulouse, Toulouse, France
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Ravindra K, Goyal A, Mor S. Pollen allergy: Developing multi-sectorial strategies for its prevention and control in lower and middle-income countries. Int J Hyg Environ Health 2022; 242:113951. [PMID: 35334435 DOI: 10.1016/j.ijheh.2022.113951] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/25/2022] [Accepted: 03/06/2022] [Indexed: 10/18/2022]
Abstract
Pollen allergy is considered a major public health problem that causes morbidity and subsequently affects a patient's quality of life. Pollen due to their large size cannot enter the thoracic regions of the respiratory tract but can affect the nasopharyngeal mucous membrane. At the same time, the submicronic-pollen particles can act as respirable particles reaching deeper into the upper airways leading to exacerbation of asthma, chronic obstructive pulmonary disease (COPD) and other allergic reactions. Based on the existing literature, expanding evidence shows that climate change and air pollutants could affect the pollen number, morphology, season, allergen content, and distribution pattern. Hence, this will influence the prevalence and occurrence of allergies linked to pollen exposure. Being a part of biogenic pollutants, pollen allergens are not expected to diminish in the foreseeable future. Therefore, it is imperative that steps need to be strengthened to improve and optimize preventive/adaptive strategies. This paper aims to review the major causes of widespread allergy, identify the major gaps, and suggest key preventive/adaptive measures to address the onset and exacerbation of pollen-related allergic diseases with a major focus on lower and middle-income countries. The study also discusses how-to implement the prevention and control measures at the individual, health care communities and organizations, Local Governments, National/International Governments levels to decrease the risk of illnesses associated with pollen allergy.
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Affiliation(s)
- Khaiwal Ravindra
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
| | - Akshi Goyal
- Department of Environment Studies, Panjab University, Chandigarh, 160014, India
| | - Suman Mor
- Department of Environment Studies, Panjab University, Chandigarh, 160014, India.
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Savouré M, Bousquet J, Jaakkola JJK, Jaakkola MS, Jacquemin B, Nadif R. Worldwide prevalence of rhinitis in adults: A review of definitions and temporal evolution. Clin Transl Allergy 2022; 12:e12130. [PMID: 35344304 PMCID: PMC8967272 DOI: 10.1002/clt2.12130] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 02/08/2022] [Accepted: 02/20/2022] [Indexed: 11/10/2022] Open
Abstract
Introduction Objective Methods Results Conclusions
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Affiliation(s)
- Marine Savouré
- Université Paris‐Saclay UVSQ Univ. Paris‐Sud Inserm Equipe d’Epidémiologie Respiratoire Intégrative, CESP Villejuif France
- French Environment and Energy Management Agency Angers France
| | - Jean Bousquet
- Université Paris‐Saclay UVSQ Univ. Paris‐Sud Inserm Equipe d’Epidémiologie Respiratoire Intégrative, CESP Villejuif France
- Universitätsmedizin Berlin Humboldt‐Universität zu Berlin Berlin Germany
- Comprehensive Allergy Center Department of Dermatology and Allergy Berlin Institute of Health Berlin Germany
- Centre Hospitalier Universitaire Montpellier France
- MASK‐air Montpellier France
| | - Jouni J. K. Jaakkola
- Center for Environmental and Respiratory Health Research Faculty of Medicine University of Oulu Oulu Finland
- Medical Research Center Oulu (MRC Oulu) University of Oulu Oulu Finland
- Biocenter Oulu University of Oulu Oulu Finland
| | - Maritta S. Jaakkola
- Center for Environmental and Respiratory Health Research Faculty of Medicine University of Oulu Oulu Finland
- Medical Research Center Oulu (MRC Oulu) University of Oulu Oulu Finland
- Biocenter Oulu University of Oulu Oulu Finland
| | - Bénédicte Jacquemin
- Univ Rennes Inserm EHESP Irset (Institut de Recherche en Santé, Environnement et Travail) ‐ UMR_S 1085 Rennes France
| | - Rachel Nadif
- Université Paris‐Saclay UVSQ Univ. Paris‐Sud Inserm Equipe d’Epidémiologie Respiratoire Intégrative, CESP Villejuif France
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Hasegawa A, Utsumi D, Lund K, Okano M, Ohashi-Doi K, Okubo K. Correlation between sensitization to house dust mite major allergens, age, and symptoms in Japanese house dust mite allergic subjects. Int Immunopharmacol 2022; 107:108640. [PMID: 35217338 DOI: 10.1016/j.intimp.2022.108640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 02/07/2022] [Accepted: 02/17/2022] [Indexed: 12/23/2022]
Abstract
Der p 23 has recently been recognized as a new house dust mite (HDM) major allergen that may be linked to the development of asthma in HDM allergic patients. This study aimed to investigate the frequency of sensitization to HDM major allergen components including Der p 23 and to examine the correlation between HDM-sensitization and AR symptom score in Japanese HDM allergic rhinitis (AR) patients without allergic asthma. Serum samples (n = 120) collected from Japanese HDM AR patients (12 to 64 years) without asthma were assessed for allergen-specific IgE (s-IgE) by ImmunoCAP (Dermatophagoides pteronyssinus (D. pteronyssinus; Der p) extract, Der p 23) or immunosolid-phase allergen chip (Der p 1, Der p 2). Japanese HDM AR patients without asthma showed a high prevalence of allergic sensitization to the HDM major allergens Der p 1 (94.2%), Der p 2 (97.5%) and Der p 23 (71.7%). No difference in the prevalence was detected for Der p 1 and Der p 2 s-IgE among three age groups. However, the prevalence of Der p 23 s-IgE was significantly higher in the younger group compared to the elderly group. No significant correlation was found between AR symptom scores and concentration of s-IgE towards Der p extract and any of the three HDM major allergens. Although the prevalence of sensitization towards D. pteronyssinus major allergens is high in Japanese AR patients without asthma, there was no correlation between allergen specific IgE including IgE towards Der p 23 and AR symptom in this population.
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Affiliation(s)
| | | | | | - Mitsuhiro Okano
- Department of Otorhinolaryngology, International University of Health and Welfare Graduate School of Medicine, Chiba, Japan
| | | | - Kimihiro Okubo
- Otorhinolaryngology and Head and Neck Surgery, Nippon Medical School, Tokyo, Japan
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Bøgelund M, Ingelmo AR, Ruiz JMA, Vivó AG, Brandi H, Pedersen MH, Loftager ASL, Aagren M. Preference for sublingual immunotherapy with tablets in a Spanish population with allergic rhinitis. Clin Transl Allergy 2022; 12:e12118. [PMID: 35140910 PMCID: PMC8814907 DOI: 10.1002/clt2.12118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 01/06/2022] [Accepted: 01/07/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND This study investigated patients' preference for allergy immunotherapy (AIT) administered as either sublingual immunotherapy-tablets versus monthly or weekly subcutaneous immunotherapy (SCIT) from a Spanish patient perspective. METHODS A discrete choice experiment (DCE) consisting of two blocks with eight choice sets in each was constructed to elicit the preferences for AIT. Three attributes were included in the DCE for the mode of administration, including the frequency of administration, the risk of systemic reactions and the co-payment. Adults and caregivers of children with moderate to severe allergic rhinitis (AR) were included if they were not currently receiving or had not previously received AIT. RESULTS In total, 587 adults and 613 caregivers started the survey. Of those, 579 adults and 611 caregivers completed the survey and were included in the study. Both adults and caregivers had a significant preference for tablets compared with both monthly and weekly injections (p ≤ 0.0001). Furthermore, the respondents showed a significant preference for reducing the risk of systemic reactions. Subgroup analyses showed that caregivers of polyallergic children and female caregivers were significantly less price sensitive when choosing their preferred treatment. CONCLUSION Our study demonstrated that both adults with AR and caregivers of children with AR prefer daily SLIT-tablets to SCIT with either a weekly or monthly dose schedule.
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Affiliation(s)
| | | | | | | | - Henrik Brandi
- Global Market Access & Public AffairsALKHørsholmDenmark
- Global Pricing & Market AccessLEO PharmaBallerupDenmark
| | | | | | - Mark Aagren
- Global Market Access & Public AffairsALKHørsholmDenmark
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Avdeeva KS, Fokkens WJ, Segboer CL, Reitsma S. The prevalence of non-allergic rhinitis phenotypes in the general population: A cross-sectional study. Allergy 2022; 77:2163-2174. [PMID: 35038765 PMCID: PMC9306544 DOI: 10.1111/all.15223] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 12/01/2021] [Accepted: 12/21/2021] [Indexed: 12/24/2022]
Abstract
Background Non‐allergic rhinitis (NAR) can be subdivided into several phenotypes: rhinorrhea of the elderly, rhinitis medicamentosa, smokers', occupational, hormonal, drug‐induced, gustatory, and idiopathic rhinitis. There are two pathophysiological endotypes of NAR: inflammatory and neurogenic. Phenotypes may serve as an indicator of an underlying endotype and, therefore, help to guide the treatment. The prevalence of each phenotype in the general population is currently unknown. Methodology/Principal Cross‐sectional questionnaire‐based study in the general population of the Netherlands. Results The prevalence of chronic rhinitis in the general population was 40% (N = 558, of those, 65% had NAR and 28% AR, in 7% allergy status is unknown). Individuals with NAR (N = 363) had significantly more complaints in October–February. Those with AR (N = 159) had significantly more complaints in April–August. The most common NAR phenotypes were idiopathic (39%) and rhinitis medicamentosa (14%), followed by occupational (8%), smokers' (6%), hormonal (4%), gustatory (4%), and rhinorrhea of the elderly (4%). The least prevalent phenotype was drug induced (1%). Nineteen percent of the NAR group could not be classified into any of the phenotypes. Conclusions This is the first study to describe the prevalences of NAR phenotypes in the general population. AR and NAR have a distinct seasonality pattern with NAR being more prevalent in autumn/winter and AR in spring/summer. Our data on the prevalence of phenotypes may help clinicians to anticipate the type of patients at their clinic and help guide a tailored treatment approach. The high prevalence of rhinitis medicamentosa is alarming, since this is a potentially preventable phenotype.
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Affiliation(s)
- Klementina S. Avdeeva
- Department of Otorhinolaryngology Amsterdam UMC Location Academic Medical Centre Amsterdam The Netherlands
| | - Wytske J. Fokkens
- Department of Otorhinolaryngology Amsterdam UMC Location Academic Medical Centre Amsterdam The Netherlands
| | | | - Sietze Reitsma
- Department of Otorhinolaryngology Amsterdam UMC Location Academic Medical Centre Amsterdam The Netherlands
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Kim JE, Man PP, Jang S, Yi HK. Nasal obstruction promotes alveolar bone destruction in the juvenile rat model. J Dent Sci 2022; 17:176-183. [PMID: 35028036 PMCID: PMC8739328 DOI: 10.1016/j.jds.2021.05.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 05/25/2021] [Indexed: 11/29/2022] Open
Abstract
Background/purpose Nasal obstruction leads to oral breathing and consequently hypoxia. The purpose of this study was to determine the influence of hypoxia on inflammatory response and the effect on alveolar bone development in a rat model in which mouth breathing was induced by nasal obstruction. Materials and methods Unilateral nasal obstruction was performed by injecting a Merocel sponge into the nasal cavity of 8-week-old Sprague Dawley (SD) rats. After 3 and 6 weeks of nasal obstruction, rats were sacrificed, the organs were weighed, and the changes in mandibular bone quality were examined by micro-computed tomography (μ-CT). The stereomicroscope was used for the morphological analysis of alveolar bone loss in response to nasal obstruction. Hematoxylin and Eosin (H&E) and immunohistochemical staining were employed to examine inflammation and bone remodeling induced by hypoxia. Results Nasal obstruction led to a delay in overall growth and organ development. The bone mineral density (BMD) and bone volume/total volume (BV/TV) of the mandible were reduced due to nasal obstruction, and the loss of the alveolar bone was confirmed morphologically. Our nasal obstruction method was observed to be successful in inducing hypoxia along with an increase in hypoxia-inducible factor 1-alpha (HIF-α). Oral hypoxia induced by nasal obstruction increased inflammatory response, and increased expression of receptor activator of nuclear factor kappa-Β ligand (RANKL) led to bone destruction. Conclusion This study demonstrated that nasal obstruction induced mouth breathing led to hypoxia in a rat model. Under hypoxic conditions, an increase in osteoclast differentiation induced by activation of the inflammatory pathway causes destructive changes in the alveolar bone.
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Affiliation(s)
- Ji-Eun Kim
- Departments of Oral Biochemistry, Institute of Oral Bioscience, School of Dentistry, Jeonbuk National University, Jeonju, South Korea
| | - Pradhan Paras Man
- Departments of Oral Biochemistry, Institute of Oral Bioscience, School of Dentistry, Jeonbuk National University, Jeonju, South Korea
| | - Sungil Jang
- Departments of Oral Biochemistry, Institute of Oral Bioscience, School of Dentistry, Jeonbuk National University, Jeonju, South Korea
| | - Ho-Keun Yi
- Departments of Oral Biochemistry, Institute of Oral Bioscience, School of Dentistry, Jeonbuk National University, Jeonju, South Korea
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Yuan T, Xiong J, Wang X, Yang J, Jiang Y, Zhou X, Liao K, Xu L. Indirect moxibustion for the treatment of allergic rhinitis: A systematic review and meta-analysis of randomized controlled trials. Complement Ther Med 2022; 64:102804. [DOI: 10.1016/j.ctim.2022.102804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/12/2022] [Accepted: 01/13/2022] [Indexed: 11/28/2022] Open
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Shamji MH, Sharif H, Layhadi JA, Zhu R, Kishore U, Renz H. Diverse Immune Mechanisms of Allergen Immunotherapy for allergic rhinitis with and without asthma. J Allergy Clin Immunol 2022; 149:791-801. [DOI: 10.1016/j.jaci.2022.01.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 01/21/2022] [Accepted: 01/21/2022] [Indexed: 10/19/2022]
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Li P, Tsang MSM, Kan LLY, Hou T, Hon SSM, Chan BCL, Chu IMT, Lam CWK, Leung PC, Wong CK. The Immuno-Modulatory Activities of Pentaherbs Formula on Ovalbumin-Induced Allergic Rhinitis Mice via the Activation of Th1 and Treg Cells and Inhibition of Th2 and Th17 Cells. MOLECULES (BASEL, SWITZERLAND) 2021; 27:molecules27010239. [PMID: 35011470 PMCID: PMC8746371 DOI: 10.3390/molecules27010239] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 12/29/2021] [Accepted: 12/29/2021] [Indexed: 11/27/2022]
Abstract
Allergic rhinitis (AR) is a highly prevalent allergic disease induced by immunoglobulin (Ig) E-mediated hypersensitivity reaction at the nasal epithelium against inhaled allergens. Previous studies have demonstrated that Pentaherbs formula (PHF), a modified herbal formula comprising five herbal medicines (Flos Lonicerae, Herba Menthae, Cortex Phellodendri, Cortex Moutan and Rhizoma Atractylodis), could suppress various immune effector cells to exert anti-inflammatory and anti-allergic effects in allergic asthma and atopic dermatitis. The present study aimed to further determine the anti-inflammatory activities of PHF in an ovalbumin (OVA)-induced AR BALB/c mouse model. Nasal symptoms such as sneezing and nose rubbing were recorded and the serum total IgE and OVA-specific IgG1, as well as interleukin (IL)-4, IL-5, IL-10, IL-13, chemokines CXCL9 CXCL10, and tumor necrosis factor (TNF)-α concentrations in nasal lavage fluid (NALF) were measured during different treatments. Effects of PHF on the expression of inflammatory mediators in the sinonasal mucosa were quantified using real-time QPCR. PHF was found to suppress allergic symptoms, infiltration of inflammatory cells, and hyperplasia of goblet cells in the nasal epithelium of the OVA-induced AR mice. PHF could reduce OVA-specific IgG1 level in serum, and TNF-α and IL-10 in nasal lavage fluid (NALF), significantly up-regulate the splenic regulatory T (Treg) cell level, increase the Type 1 helper T cell (Th1)/Type 2 helper T cell (Th2) ratio, and reduce the Th17 cells (all p < 0.05). PHF could also alleviate in situ inflammation in sinonasal mucosa of OVA-induced AR mice. In conclusion, oral treatment of PHF showed immuno-modulatory activities in the OVA-induced AR mice by regulating the splenic T cell population to suppress the nasal allergy symptoms and modulating inflammatory mediators, implicating that PHF could be a therapeutic strategy for allergic rhinitis.
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Affiliation(s)
- Peiting Li
- State Key Laboratory of Research on Bioactivities and Clinical Applications of Medicinal Plants, Institute of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong, China; (P.L.); (M.S.-M.T.); (L.L.-Y.K.); (S.S.-M.H.); (B.C.-L.C.); (P.-C.L.)
| | - Miranda Sin-Man Tsang
- State Key Laboratory of Research on Bioactivities and Clinical Applications of Medicinal Plants, Institute of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong, China; (P.L.); (M.S.-M.T.); (L.L.-Y.K.); (S.S.-M.H.); (B.C.-L.C.); (P.-C.L.)
- Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China; (T.H.); (I.M.-T.C.)
| | - Lea Ling-Yu Kan
- State Key Laboratory of Research on Bioactivities and Clinical Applications of Medicinal Plants, Institute of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong, China; (P.L.); (M.S.-M.T.); (L.L.-Y.K.); (S.S.-M.H.); (B.C.-L.C.); (P.-C.L.)
| | - Tianheng Hou
- Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China; (T.H.); (I.M.-T.C.)
- Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Sharon Sze-Man Hon
- State Key Laboratory of Research on Bioactivities and Clinical Applications of Medicinal Plants, Institute of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong, China; (P.L.); (M.S.-M.T.); (L.L.-Y.K.); (S.S.-M.H.); (B.C.-L.C.); (P.-C.L.)
| | - Ben Chung-Lap Chan
- State Key Laboratory of Research on Bioactivities and Clinical Applications of Medicinal Plants, Institute of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong, China; (P.L.); (M.S.-M.T.); (L.L.-Y.K.); (S.S.-M.H.); (B.C.-L.C.); (P.-C.L.)
| | - Ida Miu-Ting Chu
- Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China; (T.H.); (I.M.-T.C.)
| | - Christopher Wai-Kei Lam
- Faculty of Medicine and State Key Laboratory of Quality Research in Chinese Medicines, Macau University of Science and Technology, Macau, China;
| | - Ping-Chung Leung
- State Key Laboratory of Research on Bioactivities and Clinical Applications of Medicinal Plants, Institute of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong, China; (P.L.); (M.S.-M.T.); (L.L.-Y.K.); (S.S.-M.H.); (B.C.-L.C.); (P.-C.L.)
| | - Chun-Kwok Wong
- State Key Laboratory of Research on Bioactivities and Clinical Applications of Medicinal Plants, Institute of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong, China; (P.L.); (M.S.-M.T.); (L.L.-Y.K.); (S.S.-M.H.); (B.C.-L.C.); (P.-C.L.)
- Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China; (T.H.); (I.M.-T.C.)
- Li Dak Sum Yip Yio Chin R & D Centre for Chinese Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Correspondence: ; Tel.: +852-3505-2964; Fax: +852-2636-5090
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Miyata K, Horikami D, Tachibana Y, Yamamoto T, Nakamura T, Kobayashi K, Murata T. 15-hydroxy eicosadienoic acid is an exacerbating factor for nasal congestion in mice. FASEB J 2021; 36:e22085. [PMID: 34888952 DOI: 10.1096/fj.202101305r] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 11/15/2021] [Accepted: 11/22/2021] [Indexed: 11/11/2022]
Abstract
Allergic rhinitis (AR) is one of the most common allergic inflammatory diseases worldwide. In AR, increased blood flow and vascular permeability in nasal mucosa cause rhinorrhea and nasal congestion. We investigated the role of an 11Z,14Z-eicosadienoic acid-derived metabolite, 15-hydroxy-11Z,13Z-eicosadienoic acid (15-HEDE), in functional changes in vasculature and nasal congestion in AR. Repeated intranasal administration of Ovalbumin (OVA) caused AR symptoms, such as sneezing and nasal congestion, in mice. OVA administration increased the level of 15-HEDE in nasal lavage fluid, which reached approximately 0.6 ng/ml after ten OVA treatments. Upon measuring vascular contraction, treatment with 0.1-3 μM 15-HEDE did not cause contraction in mouse aortae, while it dilated aortae that were pre-contracted by thromboxane receptor stimulation. Pretreatment with the voltage-gated K+ (KV ) channel inhibitor 4-aminopyridine significantly inhibited the 15-HEDE-induced vascular relaxation. Intravital imaging showed that administration of 1 μg 15-HEDE dilated blood vessels, and Mile's assay demonstrated that this administration also caused dye leakage, indicating vascular hyperpermeability in mouse ears. Computed tomography scanning and morphological study revealed that administration of 3 μg 15-HEDE narrowed nasal passages and thickened nasal mucosa in mice. Finally, we confirmed that treating mice with 3 μg 15-HEDE caused rhinitis symptoms, such as abdominal breathing, and reduced respiratory frequency, suggesting nasal congestion. 15-HEDE caused vasodilation by activating KV channels and increased vascular permeability, which may lead to nasal congestion. Furthermore, 15-HEDE might be a new lipid mediator that exacerbates nasal congestion in AR.
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Affiliation(s)
- Kana Miyata
- Department of Animal Radiology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Daiki Horikami
- Department of Animal Radiology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Yuri Tachibana
- Department of Animal Radiology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Teruko Yamamoto
- Department of Animal Radiology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Tatsuro Nakamura
- Department of Animal Radiology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Koji Kobayashi
- Department of Animal Radiology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Takahisa Murata
- Department of Animal Radiology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
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The Rhinoconjunctivitis Quality of Life Questionnaire and its modified short version (mini-RQLQ) validation in adults and children with allergic rhinitis. The Journal of Laryngology & Otology 2021; 136:341-348. [PMID: 34847975 DOI: 10.1017/s0022215121004011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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73
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Zheng P, Liu X, Lin L, Wu H, Zhao X, Sun B. Efficacy of mite allergen immunotherapy in allergic rhinitis and the immune synergistic effect on cross-allergens. Immunotherapy 2021; 14:217-233. [PMID: 34845913 DOI: 10.2217/imt-2020-0326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To compare the efficacy of single- and double-species mite allergen immunotherapy. Materials and methods: An open, pseudo-randomized, controlled study was conducted (n = 125 allergic rhinitis patients). The primary end point involved the visual analogue scale. Secondary end points included a basophil activation test and serum specific IgE and IgG4 assays. Results: Visual analogue scale analysis indicated considerable reductions in both groups. Both treatments improved quality of life and induced sIgG4 antibody production. Basophil activation and serum IgE inhibition were not evident in either treatment. Neither treatment displayed an early stage immune synergistic effect on cross-allergens. Conclusions: Both treatments were effective against allergic rhinitis, and statistical differences were not observed. Future studies may require long-term, large-scale research.
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Affiliation(s)
- Peiyan Zheng
- Department of Allergy & Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, China
| | - Xiaoqing Liu
- Department of Clinical Laboratory, Zhuhai People's Hospital (Zhuhai hospital affiliated with Jinan University), Zhuhai, 519070, China
| | - Lili Lin
- Department of Otolaryngology Head & Neck Surgery, Zhuhai People's Hospital (Zhuhai hospital affiliated with Jinan University), Zhuhai, 519070, China
| | - Huiqin Wu
- Department of Otolaryngology Head & Neck Surgery, Zhuhai People's Hospital (Zhuhai hospital affiliated with Jinan University), Zhuhai, 519070, China
| | - Xiaoming Zhao
- Department of Otolaryngology Head & Neck Surgery, Zhuhai People's Hospital (Zhuhai hospital affiliated with Jinan University), Zhuhai, 519070, China
| | - Baoqing Sun
- Department of Allergy & Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, China
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Alanazy S, Alenezi M, Al-Quniabut I, Al-Juraifani I, Alburayh M, Altuaysi A, Alyahya Y, Al-Homaidan H, Al-Wutayd O. Patterns of allergic rhinitis among adults in Qassim region, Saudi Arabia: a cross sectional study. Pan Afr Med J 2021; 40:70. [PMID: 34804338 PMCID: PMC8590280 DOI: 10.11604/pamj.2021.40.70.30719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 09/12/2021] [Indexed: 12/03/2022] Open
Abstract
Introduction developing and developed countries have a high prevalence of allergic rhinitis (AR). Severe AR has negative impacts on sleep, quality of life, and work performance. The study aimed to identify the patterns of AR among patients attending the ears nose and throat Unit (ENT) clinic at King Saud Hospital, Qassim, Saudi Arabia. Methods this study was a cross-sectional study conducted at the ENT clinic of King Saudi Hospital, Unaizah City, Qassim region, Saudi Arabia. We examined outpatients diagnosed with AR using an interview questionnaire and clinical examination. Results the sample included 455 patients. Of these, 23.7% were 21-30 years old, 65.7% had a family history of AR, 57.8% had no general symptoms, 75.6% reported runny nose as the most common nasal symptom, and 35.4% reported no complications. Dust was the most common trigger of AR (82.4%), 49.2% reported allergic symptoms in all seasons, 96% of patients have inferior turbinate hypertrophy, and oral histamine was the most commonly used treatment (33.2%). Conclusion perineal AR and inferior turbinate hypertrophy were very common findings comparing to previous studies, further studies to assess the risk factors are highly recommended.
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Affiliation(s)
- Sultan Alanazy
- Department of Surgery, Ears Nose and Throat Unit, Unaizah College of Medicine and Medical Sciences, Qassim University, Al Qassim Saudi Arabia
| | - Mazyad Alenezi
- Department of Otolaryngology, Head and Neck Surgery, College of Medicine, Qassim University, Al Qassim, Saudi Arabia
| | - Ibrahim Al-Quniabut
- Department of Surgery, Ears Nose and Throat Unit, Unaizah College of Medicine and Medical Sciences, Qassim University, Al Qassim Saudi Arabia
| | - Ibrahim Al-Juraifani
- Unaizah College of Medicine and Medical Sciences, Qassim University, Al Qassim, Saudi Arabia
| | - Malek Alburayh
- Unaizah College of Medicine and Medical Sciences, Qassim University, Al Qassim, Saudi Arabia
| | - Abdullah Altuaysi
- Unaizah College of Medicine and Medical Sciences, Qassim University, Al Qassim, Saudi Arabia
| | - Yahya Alyahya
- Unaizah College of Medicine and Medical Sciences, Qassim University, Al Qassim, Saudi Arabia
| | - Hajaj Al-Homaidan
- Unaizah College of Medicine and Medical Sciences, Qassim University, Al Qassim, Saudi Arabia
| | - Osama Al-Wutayd
- Department of Family and Community Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Al Qassim, Saudi Arabia
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75
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Dąbrowska-Bień J, Skarżyński H, Górski SF, Skarżyński PH. Quality of Life in Patients with Nasal Obstruction after Septoplasty: A Single Institution Prospective Observational Study. Int Arch Otorhinolaryngol 2021; 25:e575-e579. [PMID: 34737830 PMCID: PMC8558945 DOI: 10.1055/s-0040-1722162] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 10/25/2020] [Indexed: 10/27/2022] Open
Abstract
Introduction Nasal obstruction is a common symptom in otorhinolaryngological practice. It can impact significantly on the quality of life of the individual. Objective The primary goal of the present study was to evaluate quality of life after septoplasty in adults with nasal obstruction. A secondary goal was to assess the effectiveness of septoplasty. Methods This was a single institution prospective observational study. Patients had experienced septal deviation and symptomatic nasal obstruction with no benefit from medical treatment. There were 51 patients who completed the Nasal Obstruction Symptom Evaluation (NOSE-POL) scale as well as theVisual Analogue Scale (VAS) before undergoing septoplasty, 3 months later, and finally 7 months after surgery. Patients evaluated changes in their nasal obstruction and changes in their quality of life using the Clinical Global Impression Scale (CGI-S). Results There was a significant improvement in nasal obstruction after septoplasty. Before septoplasty, the mean score on NOSE was 60.3 ± 20.4; 3 months after surgery, it was 32.9 ± 16.8; and 7 months after surgery it was 39.6 ± 33.2. The VAS results also proved a significant enhancement in nasal obstruction after septoplasty. Patients reported an improvement in nasal obstruction as well as a positive change in quality of life, confirming the effectiveness of septoplasty. Conclusions In patients with deformed septum, septoplasty contributes to high satisfaction of the patient and a compelling improvement in disease-specific quality of life. The NOSE-POL questionnaire is a useful tool for measuring the outcomes of this procedure.
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Affiliation(s)
- Justyna Dąbrowska-Bień
- Institute of Physiology and Pathology of Hearing, Warsaw, Poland.,Otorhinolaryngology Surgery Clinic, World Hearing Center, Nadarzyn/Warsaw, Poland
| | - Henryk Skarżyński
- Institute of Physiology and Pathology of Hearing, Warsaw, Poland.,Otorhinolaryngology Surgery Clinic, World Hearing Center, Nadarzyn/Warsaw, Poland
| | - Sebastian Filip Górski
- Institute of Physiology and Pathology of Hearing, Warsaw, Poland.,Otorhinolaryngology Surgery Clinic, World Hearing Center, Nadarzyn/Warsaw, Poland
| | - Piotr Henryk Skarżyński
- Institute of Physiology and Pathology of Hearing, Warsaw, Poland.,Otorhinolaryngology Surgery Clinic, World Hearing Center, Nadarzyn/Warsaw, Poland.,Department of Heart Failure and Cardiac Rehabilitation, Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland.,Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, Kajetany/Warsaw, Poland.,Institute of Sensory Organs, Kajetany/Warsaw, Poland
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76
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Altered diversity and composition of gut microbiota in patients with allergic rhinitis. Microb Pathog 2021; 161:105272. [PMID: 34740809 DOI: 10.1016/j.micpath.2021.105272] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 10/21/2021] [Accepted: 10/22/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Recently, multiple studies have suggested an association between gut dysbiosis and allergic rhinitis (AR) development. However, the role of gut microbiota in AR development remains obscure. METHODS The goal of this study was to compare the gut microbiota composition and short-chain fatty acid (SCFAs) differences associated with AR (N = 18) and HCs (healthy controls, N = 17). Gut microbiota 16SrRNA gene sequences were analyzed based on next-generation sequencing. SCFAs in stool samples were analyzed by gas chromatography-mass spectrometry (GC-MS). RESULTS Compared with HCs, the gut microbiota composition of AR was significantly different in diversity and richness. At the phylum level, the abundance of Firmicutes in the AR group were significantly lower than those in the HCs group. At the genus level, the abundance of Blautia, Eubacterium_hallii_group, Romboutsia, Collinsella, Dorea, Subdoligranulum and Fusicatenibacter in the AR group were significantly lower than that in the HCs group. The concentrations of SCFAs were significantly lower in the AR group compared with the HCs group. Correlation analysis showed that the Eubacterium-hallii-group and Blautia correlated positively with SCFAs. CONCLUSION Our results demonstrate compositional and functional alterations of the gut microbiome in AR.
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77
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Concordance of Skin Prick Test, Intradermal Testing, Serum IgE Levels and Symptoms in Patients with Allergic Rhinitis. ALLERGIES 2021. [DOI: 10.3390/allergies1030017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Diagnosis of allergic rhinitis is achieved by a combination of patient history and different screening tools, followed by specific provocation testing. Screening tools usually involve a skin prick test (SPT), specific serum IgE or a combination of both. Objective: The purpose of this study was to evaluate the correlation of SPT, intradermal testing and specific serum IgE testing in certain allergens and to evaluate sensitization rates, symptom patterns and time of symptoms in a cohort of patients with suspected allergic rhinitis. Methods: Data on 4653 patients with suspected allergic rhinitis were included and divided into five groups: spring bloomers (birch, hazel, etc.), summer bloomers (grasses and rye), autumn bloomers (ribwort and mugwort), mites and mold. Correlation of SPT, intradermal testing and specific IgE test results using Cohen’s kappa and logistic regression were carried out to evaluate the probability of symptoms. Results: Comparison of SPT and specific serum IgE led to kappa coefficients between 0.33 and 0.47, corresponding to a minor to moderate concordance. Comparing the symptoms reported by patients with sensitization diagnosed by SPT, a correlation was only found for spring and summer bloomers with an odds ratio of 1.5 and 2.1, respectively. The most prevalent symptom in the study cohort was rhinitis, followed by others such as asthma, sense of smell and atopic dermatitis. Conclusions: SPT seems to be more sensitive than specific IgE for detection of sensitization. Patients’ symptoms as well as the timing of symptoms, especially for perennial allergies, are not always very pronounced.
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78
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Rodrigues J, Franco-Pego F, Sousa-Pinto B, Bousquet J, Raemdonck K, Vaz R. Anxiety and depression risk in patients with allergic rhinitis: a systematic review and meta-analysis. Rhinology 2021; 59:360-373. [PMID: 34254060 DOI: 10.4193/rhin21.087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Allergic diseases appear to be associated with mood disorders. However, particularly regarding allergic rhinitis (AR), such association has not been adequately systematically reviewed. Therefore, we conducted a systematic review and meta-analysis to quantify the association between AR and depression and anxiety. METHODOLOGY We performed an electronic search of PubMed, Web of Science and Scopus for observational studies assessing the association between AR and depression and anxiety. Such association was quantified by means of random-effects meta-analysis, with estimation of pooled odds ratio (OR). Sources of heterogeneity were explored by subgroup analysis. RESULTS We included a total of 24 primary studies, of which 23 assessed depression and 11 assessed anxiety. Of these, 12 studies presented OR from multivariable regression models and were included in our meta-analysis. AR was associated with higher odds of depression and anxiety. CONCLUSIONS AR appears to be associated with high risk of depression and anxiety. While our results point to the importance of mental comorbidities among patients with AR, longitudinal studies are needed adopting uniform definitions and presenting results stratified by AR severity.
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Affiliation(s)
- J Rodrigues
- Otorhinolaryngology Department, Centro Hospitalar Universitario de S. Joao, EPE, Porto, Portugal; Unit of Anatomy, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS â€" Center for Health Technology and Services Research, University of Porto, Porto, Portugal
| | - F Franco-Pego
- CINTESIS "Center for Health Technology and Services Research, University of Porto, Porto, Portugal; MEDCIDS" Department of Community Medicine, Information and Health Decision Sciences; Faculty of Medicine, University of Porto, Porto, Portugal
| | - B Sousa-Pinto
- CINTESIS "Center for Health Technology and Services Research, University of Porto, Porto, Portugal; MEDCIDS" Department of Community Medicine, Information and Health Decision Sciences; Faculty of Medicine, University of Porto, Porto, Portugal
| | - J Bousquet
- Charite, Universitatsmedizin Berlin, Humboldt-Universitat zu Berlin, Berlin, Germany; Comprehensive Allergy Center, Department of Dermatology and Allergy, Berlin Institute of Health, Berlin, Germany; MACVIA-France, Montpellier, France
| | - K Raemdonck
- Unit of Anatomy, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS" Center for Health Technology and Services Research, University of Porto, Porto, Portugal; CESPU â€" Institute of Research and Advanced Training in Health Sciences and Technologies (IINFACTS), Gandra, Portugal
| | - R Vaz
- Otorhinolaryngology Department, Centro Hospitalar Universitario de S. Joao, EPE, Porto, Portugal; Unit of Anatomy, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS â€" Center for Health Technology and Services Research, University of Porto, Porto, Portugal
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Klein TM, Hadler M, Augustin M, Blome C. Patient needs and benefits of sublingual immunotherapy for grass pollen-induced allergic rhinitis: an observational study. Immunotherapy 2021; 13:1193-1204. [PMID: 34328018 DOI: 10.2217/imt-2021-0161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: Clinical efficacy of sublingual immunotherapy for grass pollen-induced allergic rhinitis (AR) needs to translate into patient benefit. Patients & methods: Patients received Oralair (Stallergenes, Antony, France) in real-life medical practice. Patient-relevant treatment benefits were measured with the AR-specific Patient Benefit Index. Subgroups were analyzed regarding distinct patient characteristics. Results: Data of 883 patients (children, adolescents, and adults) were analyzed. The highest-ranked patient needs referred to having less AR-symptoms, being able to go outdoors, and being free in the choice of leisure activities. Most patients (89.2-94.6%) attained at least minimally relevant benefit. All subgroups reported relevant benefits, with significantly higher scores in some subgroups. Conclusion: Treatment with Oralair was associated with considerable patient-relevant benefit in all age groups.
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Affiliation(s)
- Toni Maria Klein
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, Hamburg, 20246, Germany
| | - Meike Hadler
- Stallergenes GmbH, Carl-Friedrich-Gauß-Straße 50, Kamp-Lintfort, 47475, Germany
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, Hamburg, 20246, Germany
| | - Christine Blome
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, Hamburg, 20246, Germany
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Liva GA, Karatzanis AD, Prokopakis EP. Review of Rhinitis: Classification, Types, Pathophysiology. J Clin Med 2021; 10:jcm10143183. [PMID: 34300349 PMCID: PMC8303640 DOI: 10.3390/jcm10143183] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 11/16/2022] Open
Abstract
Rhinitis describes a pattern of symptoms as a result of nasal inflammation and/or dysfunction of the nasal mucosa. It is an umbrella entity that includes many different subtypes, several of which escape of complete characterization. Rhinitis is considered as a pathologic condition with considerable morbidity and financial burden on health care systems worldwide. Its economic impact is further emphasized by the fact that it represents a risk factor for other conditions such as sinusitis, asthma, learning disabilities, behavioral changes, and psychological impairment. Rhinitis may be associated with many etiologic triggers such as infections, immediate-type allergic responses, inhaled irritants, medications, hormonal disturbances, and neural system dysfunction. It is basically classified into three major clinical phenotypes: allergic rhinitis (AR), infectious rhinitis, and non-allergic, non-infectious rhinitis (NAR). However, this subdivision may be considered as an oversimplification because a combined (mixed) phenotype exists in many individuals and different endotypes of rhinitis subgroups are overlapping. Due to the variety of pathophysiologic mechanisms (endotypes) and clinical symptoms (phenotypes), it is difficult to develop clear guidelines for diagnosis and treatment. This study aims to review the types of allergic and non-allergic rhinitis, providing a thorough analysis of the pathophysiological background, diagnostic approach, and main treatment options.
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81
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Zare M, Hassani-Azad M, Soleimani-Ahmadi M, Majnoon R. The Influence of Indoor Environmental Factors on the Prevalence of House Dust Mites as Aeroallergens in Bandar Abbas Student Dormitories, South of Iran, 2019. JOURNAL OF MEDICAL ENTOMOLOGY 2021; 58:1865-1873. [PMID: 33724358 DOI: 10.1093/jme/tjab032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Indexed: 06/12/2023]
Abstract
This study was conducted to determine the influence of environmental factors on the prevalence of house dust mites in student dormitories of Bandar Abbas city. In this study, 64 dust samples were collected from seven randomly selected dormitories located in various areas of the Bandar Abbas. The collected mites were isolated and mounted in Hoyer's medium and identified using a morphological key. The associations between the environmental factors and the density of house dust mites were investigated. In total, 1,093 adult mites were collected and identified. They consisted of four species including Dermatophagoides pteronyssinus Trouessart (57.6%), Dermatophagoides farinae Hughes (24.3%) and Dermatophagoides evansi Fain (14.9%) (Acari: Pyroglyphidae), and Cheyletus malaccensis Oudemans (3.2%) (Acari: Cheyletidae). All of the dormitories were contaminated by more than one house dust mites species and the mean density of house dust mites in dormitories was 8.3 ± 0.2 mites/g of dust. There was a significant relationship between average house dust mites density and some of environmental factors such as relative humidity, temperature, floor covering type, and number of occupants (P < 0.05). Results of this study revealed that two major allergenic dust mites, D. pteronyssinus and D. farinae, were the most prevalent and collected from all of dormitories and some of indoor environmental factors found to influence mites' population.
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Affiliation(s)
- Mehdi Zare
- Department of Occupational Health Engineering, Faculty of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mehdi Hassani-Azad
- Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Moussa Soleimani-Ahmadi
- Department of Medical Entomology and Vector Control, Faculty of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
- Social Determinants in Health Promotion Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Raziea Majnoon
- Social Determinants in Health Promotion Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Chang GH, Lin YS, Hsu KH, Cheng YC, Yang PR, Tsai MS, Tsai YT, Hsu CM, Chang PJ, Shi CS, Yang YH, Wu CY. Nasal irrigation with Glycyrrhiza glabra extract for treatment of allergic rhinitis - A study of in vitro, in vivo and clinical trial. JOURNAL OF ETHNOPHARMACOLOGY 2021; 275:114116. [PMID: 33857594 DOI: 10.1016/j.jep.2021.114116] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 04/03/2021] [Accepted: 04/06/2021] [Indexed: 06/12/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Glycyrrhiza glabra, a family of licorice and a traditional Chinese medicine with sweet taste and favorable smell, has anti-inflammatory, anti-allergic and immunomodulatory functions. AIM OF THE STUDY We developed a licorice extract (LE) by using glycyrrhiza glabra and administered it through nasal irrigation to treat allergic rhinitis (AR). MATERIALS AND METHODS LE was prepared into extract powder, and the anti-inflammatory effect of the LE was evaluated by calcium ionophore-induced activated mast cell model (in vitro). Then, local passive anaphylaxis assays were applied to investigate the anti-IgE-mediated allergic reaction of the LE in mice (in vivo). A developed LE was administered through nasal irrigation to treat AR in clinic settings. A total of 60 participants diagnosed with AR were included in this clinical trial; they were randomly assigned to three interventions: licorice nasal irrigation (LNI), corticosteroid nasal irrigation (CNI), and saline nasal irrigation (SNI). They performed nasal irrigation once a day for 1 month. Both subjective questionnaires (22-item Sino-Nasal Outcome Test [SNOT-22] and visual analog scale [VAS]) and objective examinations (acoustic rhinometry and nasal endoscopy) were used for effectiveness assessments. RESULTS All three interventions could improve SNOT-22 scores, but the effects of LNI and CNI were more significant. According to VAS scores for nasal blockage, rhinorrhea, sneezing, nasal pruritus, postnasal discharge, and olfactory disturbance, the effect of LNI was superior to those of CNI and SNI. The results of rhinometry revealed that LNI significantly improved nasal resistance. Endoscopic analysis showed that both LNI and CNI, but not SNI, could significantly improve turbinate hypertrophy. Moreover, the best procedural comfort was found for LNI, which had no side effects or complications during the trial. CONCLUSIONS LNI is a natural, safe, and innovative therapy that can effectively treat AR. Its effect is superior to those of CNI and SNI, and it has greatly improved procedural comfort.
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Affiliation(s)
- Geng-He Chang
- Department of Otolaryngology, Chang Gung Memorial Hospital, Chiayi, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taiwan; Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chia-Yi 61363, Taiwan; Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Yu-Shih Lin
- Department of Pharmacy, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan.
| | - Ke-Hsin Hsu
- Department of Otolaryngology, Chang Gung Memorial Hospital, Chiayi, Taiwan.
| | - Yu-Ching Cheng
- Department of Otolaryngology, Chang Gung Memorial Hospital, Chiayi, Taiwan.
| | - Pei-Rung Yang
- Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan; School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Ming-Shao Tsai
- Department of Otolaryngology, Chang Gung Memorial Hospital, Chiayi, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taiwan; Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chia-Yi 61363, Taiwan; Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Yao-Te Tsai
- Department of Otolaryngology, Chang Gung Memorial Hospital, Chiayi, Taiwan.
| | - Cheng-Ming Hsu
- Department of Otolaryngology, Chang Gung Memorial Hospital, Chiayi, Taiwan; Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Pey-Jium Chang
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taiwan.
| | - Chung-Sheng Shi
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taiwan.
| | - Yao-Hsu Yang
- Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chia-Yi 61363, Taiwan; Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan; School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Ching-Yuan Wu
- Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan; School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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de Weger LA, Bruffaerts N, Koenders MMJF, Verstraeten WW, Delcloo AW, Hentges P, Hentges F. Long-Term Pollen Monitoring in the Benelux: Evaluation of Allergenic Pollen Levels and Temporal Variations of Pollen Seasons. FRONTIERS IN ALLERGY 2021; 2:676176. [PMID: 35387026 PMCID: PMC8974733 DOI: 10.3389/falgy.2021.676176] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 06/03/2021] [Indexed: 12/03/2022] Open
Abstract
Airborne pollen is a major cause of allergic rhinitis, affecting between 10 and 30% of the population in Belgium, the Netherlands, and Luxembourg (Benelux). Allergenic pollen is produced by wind pollinating plants and released in relatively low to massive amounts. Current climate changes, in combination with increasing urbanization, are likely to affect the presence of airborne allergenic pollen with respect to exposure intensity, timing as well as duration. Detailed analysis of long-term temporal trends at supranational scale may provide more comprehensive insight into these phenomena. To this end, the Spearman correlation was used to statistically compare the temporal trends in airborne pollen concentration monitored at the aerobiological stations which gathered the longest time-series (30–44 years) in the Benelux with a focus on the allergenic pollen taxa: Alnus, Corylus, Betula, Fraxinus, Quercus, Platanus, Poaceae, and Artemisia. Most arboreal species showed an overall trend toward an increase in the annual pollen integral and peak values and an overall trend toward an earlier start and end of the pollen season, which for Betula resulted in a significant decrease in season length. For the herbaceous species (Poaceae and Artemisia), the annual pollen integral and peak values showed a decreasing trend. The season timing of Poaceae showed a trend toward earlier starts and longer seasons in all locations. In all, these results show that temporal variations in pollen levels almost always follow a common trend in the Benelux, suggesting a similar force of climate change-driven factors, especially for Betula where a clear positive correlation was found between changes in temperature and pollen release over time. However, some trends were more local-specific indicating the influence of other environmental factors, e.g., the increasing urbanization in the surroundings of these monitoring locations. The dynamics in the observed trends can impact allergic patients by increasing the severity of symptoms, upsetting the habit of timing of the season, complicating diagnosis due to overlapping pollen seasons and the emergence of new symptoms due allergens that were weak at first.
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Affiliation(s)
- Letty A. de Weger
- Department of Pulmonology, Leiden University Medical Center, Leiden, Netherlands
- Department of Public Health and Primary Care, National eHealth Living Lab, Leiden University Medical Center, Leiden, Netherlands
- *Correspondence: Letty A. de Weger
| | | | | | - Willem W. Verstraeten
- Dispersion and Atmospheric Composition, Royal Meteorological Institute of Belgium, Brussels, Belgium
| | - Andy W. Delcloo
- Dispersion and Atmospheric Composition, Royal Meteorological Institute of Belgium, Brussels, Belgium
| | - Pierre Hentges
- Aerobiology Data Analysis Consulting, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - François Hentges
- Unit of Immunology-Allergology, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
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McIntosh C, Clemm HH, Sewry N, Hrubos-Strøm H, Schwellnus MP. Diagnosis and management of nasal obstruction in the athlete. A narrative review by subgroup B of the IOC Consensus Group on "Acute Respiratory Illness in the Athlete". J Sports Med Phys Fitness 2021; 61:1144-1158. [PMID: 34156184 DOI: 10.23736/s0022-4707.21.12821-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Protection of the health of the athlete is required for high level sporting performance. Acute respiratory illness is the leading cause of illness and can compromise training and competition in athletes. To date the focus on respiratory health in athletes has largely been on acute upper respiratory infections and asthma/exercise induced bronchoconstriction (EIB), while nasal conditions have received less attention. The nose has several important physiological functions for the athlete. Nasal conditions causing obstruction to airflow can compromise respiratory health in the athlete, negatively affect quality of life and sleep, cause mouth breathing and ultimately leading to inadequate recovery and reduced exercise performance. Nasal obstruction can be broadly classified as structural (static or dynamic) or mucosal. Mucosal inflammation in the nose (rhinitis) is the most frequent cause of nasal obstruction and is reported to be higher in athletes (21-74%) than in the general population (20-25%). This narrative review provides the sport and exercise medicine physician with a clinical approach to the diagnosis and management of common nasal conditions that can cause nasal obstruction, ultimately leading to improved athlete health and better sports performance.
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Affiliation(s)
- Cameron McIntosh
- Dr CND McIntosh Inc., Edge Day Hospital, Port Elizabeth, South Africa
| | - Hege H Clemm
- Department of Pediatric and Adolescent Medicine, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Nicola Sewry
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, South Africa
| | - Harald Hrubos-Strøm
- Department of Otorhinolaryngology, Surgical Division, Akershus University Hospital, Lørenskog, Norway.,Department of Behavioral Sciences, Institute for Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Martin P Schwellnus
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, South Africa - .,International Olympic Committee (IOC) Research Center of South Africa, University of Pretoria, South Africa
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Atar Y, Karaketir S, Aydogdu I, Sari H, Bircan HS, Uyar Y, Ekincioglu E, Karaketir SG, Atac E, Berkiten G. Comparison of Isotonic Seawater Nasal Spray Containing Chamomile Liquid Extract and Other Isotonic Seawater Nasal Washing Solutions for Allergic Rhinitis. Ann Otol Rhinol Laryngol 2021; 131:427-434. [PMID: 34142567 DOI: 10.1177/00034894211025411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE We aim to demonstrate the effect of an isotonic seawater spray containing chamomile liquid extract on symptoms and nasal mucociliary clearance in patients with allergic rhinitis by comparing it with other isotonic seawater nasal washing solutions. METHODS The study included 123 patients. Based on Allergic Rhinitis and its Impact on Asthma guidelines, mometasone furoate intranasal spray treatment was started for all patients in the group diagnosed with allergic rhinitis. In addition to this treatment, isotonic seawater spray with chamomile liquid extract was added to Group A, isotonic seawater spray to Group B, and isotonic seawater nasal irrigation to Group C. The fourth group (Group D) was given only nasal steroid spray without nasal washing treatment. Before and after treatment in all patients, the Sino-Nasal Outcome Test-22 was performed, and nasal mucociliary clearance times were measured by the saccharin test. RESULTS The differences in duration of nasal mucociliary clearance and Sino-Nasal Outcome Test-22 values were taken before and after treatment. In Group A, B, C, and D the Sino-Nasal Outcome Test-22 differences were statistically significant (P ≤.001; P ≤ .001; P ≤ .001, and P = .048, respectively). Only Group A and Group B experienced a significant difference in nasal mucociliary clearance times (P ≤ .001; P = .010, respectively). When the Sino-nasal Outcome Test-22 score and nasal mucociliary clearance time differences before and after treatment were compared between all groups, the Sino-Nasal Outcome Test-22 score difference was higher in Group A than in Groups B, C, and D, the differences were found as statistically significant (P = .010; P = .003; P ≤ .001, respectively). The nasal mucociliary clearance time difference was higher in Group A than in Groups C and D, the differences were found as statistically significant (P = .010; P = .001, respectively). CONCLUSION Isotonic seawater spray containing chamomile liquid extract is seen as a good alternative treatment option for allergic rhinitis patients.
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Affiliation(s)
- Yavuz Atar
- Department of Otorhinolaryngology, University of Health Sciences, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Semih Karaketir
- Department of Otorhinolaryngology, Bulanik State Hospital, Mus, Turkey
| | - Imran Aydogdu
- Department of Otorhinolaryngology, Bahcelievler State Hospital, Istanbul, Turkey
| | - Hüseyin Sari
- Department of Otorhinolaryngology, University of Health Sciences, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Hasan Sami Bircan
- Department of Otorhinolaryngology, University of Health Sciences, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Yavuz Uyar
- Department of Otorhinolaryngology, University of Health Sciences, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Enis Ekincioglu
- Department of Otorhinolaryngology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
| | | | - Enes Atac
- Department of Otorhinolaryngology, Kahramanmaras Necip Fazil City Hospital, Kahramanmaras, Turkey
| | - Güler Berkiten
- Department of Otorhinolaryngology, University of Health Sciences, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
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86
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Avdeeva KS, Fokkens WJ, Reitsma S. Towards a new epidemiological definition of chronic rhinitis: prevalence of nasal complaints in the general population. Rhinology 2021; 59:258-266. [PMID: 34091655 DOI: 10.4193/rhin20.637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Chronic rhinitis (CR) is currently defined as the presence of at least two nasal symptoms for at least 1 hour per day for more than 12 weeks per year. Such definition lacks evidence-based foundation. CR patients are often divided into "runners" and "blockers", although the evidence supporting such subdivision is limited. The aim of the study was to define CR, to estimate its prevalence and the proportion of "runners" and "blockers". METHODS Cross-sectional, questionnaire-based study in a random sample of participants representing the general population of the Netherlands. RESULTS The questionnaire was sent to 5000 residents of the Netherlands; the response rate was 27%. CR was defined as at least 1 nasal complaint present for more than 3 weeks per year. The prevalence of CR in the general population was 40%. Participants who would have been excluded by the former CR definition were shown to have a significantly higher VAS compared to the controls. The larger part of CR group was represented by non-allergic rhinitis (NAR): 70% vs 30%. There were 25% "Blockers" and 22% "Runners" in the CR group, whereas more than a half of the CR group could be classified in neither of these subgroups. CONCLUSION Based on our data, we suggest that the current definition of CR should be revised and propose a new definition: at least one nasal complaint present for at least 3 weeks per year; although future studies are needed to further validate the proposed definition.
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Affiliation(s)
- K S Avdeeva
- Department of Otorhinolaryngology, Amsterdam UMC, location Academic Medical Centre, Amsterdam, The Netherlands
| | - W J Fokkens
- Department of Otorhinolaryngology, Amsterdam UMC, location Academic Medical Centre, Amsterdam, The Netherlands
| | - S Reitsma
- Department of Otorhinolaryngology, Amsterdam UMC, location Academic Medical Centre, Amsterdam, The Netherlands
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87
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Al-Qudah RA, Abu Farha R, Al Ali MM, Jaradaneh NS, Mohamed Ibrahim MI. Evaluation of Community Pharmacists' Professional Practice and Management of Patient's Respiratory Conditions. J Pharm Bioallied Sci 2021; 13:212-219. [PMID: 34349482 PMCID: PMC8291102 DOI: 10.4103/jpbs.jpbs_534_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 12/17/2020] [Accepted: 01/13/2021] [Indexed: 11/05/2022] Open
Abstract
Objectives: We assessed the extent of community pharmacists managing respiratory conditions and their ability to make differential diagnoses between the common cold and allergic rhinitis. Methods: A simulated patient technique was used to achieve the study objectives. Thirty community pharmacies were randomized to be visited by a patient with allergic rhinitis symptoms, followed by a patient with common cold symptoms, and vice versa. One simulated patient visited the 15 pharmacies assigned to allergic rhinitis. Then, after 3–4 days, the pharmacies were revisited by a second simulated patient using the same symptoms; likewise, a simulated patient visited the other 15 pharmacies with common cold symptoms. Then, these pharmacies were revisited by the other simulated patient with the common cold symptoms. Descriptive statistics and correlation analyses were carried out using SPSS at alpha 0.05. Results: Fifteen pharmacies were used for the common cold scenario and 15 for the allergic rhinitis scenario (a total of 30 visits per scenario). Pharmacists showed overall poor skills in asking questions for differential diagnosis between the two conditions. No significant difference was found in the overall differential diagnosis score between the two groups (P = 0.744). The overall adherence to the labeling standard score was low, with an average of 2.38 (standard deviation [SD] = 2.50) out of 11, with no significant difference between the two scenarios (P = 0.332). The overall adherence score to the counseling standard was low, with an average of 2.93 (SD = 3.74) out of 15, with no significant difference between the two scenarios (P = 0.586). Conclusion: The simulated patient technique approach revealed a lack of ability of pharmacists in Amman, Jordan, to make differential diagnoses between the common cold and allergic rhinitis. In addition, pharmacists lacked the ability to carry out their role with respect to the management of the common cold and allergic rhinitis, including treatment recommendations, adherence to medicine labeling standards, and adherence to the counseling standard.
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Affiliation(s)
- Raja'a A Al-Qudah
- Department of Clinical Pharmacy and Therapeutics, College of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Rana Abu Farha
- Department of Clinical Pharmacy and Therapeutics, College of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Maram M Al Ali
- Department of Clinical Pharmacy and Therapeutics, College of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Nour S Jaradaneh
- Department of Clinical Pharmacy and Therapeutics, College of Pharmacy, Applied Science Private University, Amman, Jordan
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88
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Delgado-Dolset MI, Obeso D, Sánchez-Solares J, Mera-Berriatua L, Fernández P, Barbas C, Fresnillo M, Chivato T, Barber D, Escribese MM, Villaseñor A. Understanding Systemic and Local Inflammation Induced by Nasal Polyposis: Role of the Allergic Phenotype. Front Mol Biosci 2021; 8:662792. [PMID: 34055883 PMCID: PMC8160224 DOI: 10.3389/fmolb.2021.662792] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/27/2021] [Indexed: 11/29/2022] Open
Abstract
Chronic rhinosinusitis with nasal polyps (CRSwNP) is characterized by persistent symptoms associated to the development of nasal polyps. To this day, the molecular mechanisms involved are still not well defined. However, it has been suggested that a sustained inflammation as allergy is involved in its onset. In this exploratory study, the aim was to investigate the effect of the allergic status in the development of CRSwNP. To achieve this, we recruited 22 patients with CRSwNP and classified them in non-allergic and allergic using ImmunoCAP ISAC molecular diagnosis. Plasma samples were analyzed using liquid chromatography coupled to mass spectrometry (LC-MS). Subsequently, significant metabolites from plasma that were commercially available were then analyzed by targeted analysis in some nasal polyps. Additionally, nasal polyp and nasal mucosa samples were examined for eosinophils, neutrophils, CD3+ and CD11c+ cells, as well as collagen deposition and goblet cell hyperplasia. We found that 9 out of the 22 patients were sensitized to some aeroallergens (named as allergic CRSwNP). The other 13 patients had no sensitizations (non-allergic CRSwNP). Regarding metabolomics, bilirubin, cortisol, lysophosphatidylcholines (LPCs) 16:0, 18:0 and 20:4 and lysophosphatidylinositol (LPI) 20:4, which are usually related to a sustained allergic inflammation, were unexpectedly increased in plasma of non-allergic CRSwNP compared to allergic CRSwNP. LPC 16:0, LPC 18:0 and LPI 20:4 followed the same trend in nasal polyp as they did in plasma. Comparison of nasal polyps with nasal mucosa showed a significant increase in eosinophils (p < 0.001) and neutrophils (p < 0.01) in allergic CRSwNP. There were more eosinophils in polyps of non-allergic CRSwNP than in their nasal mucosa (p < 0.01). Polyps from non-allergic CRSwNP had less eosinophils than the polyps of allergic CRSwNP (p < 0.05) and reduced amounts of collagen compared to their nasal mucosa (p < 0.001). Our data suggests that there is a systemic inflammatory response associated to CRSwNP in the absence of allergy, which could be accountable for the nasal polyp development. Allergic CRSwNP presented a higher number of eosinophils in nasal polyps, suggesting that eosinophilia might be connected to the development of nasal polyps in this phenotype.
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Affiliation(s)
- María Isabel Delgado-Dolset
- Department of Basic Medical Sciences, Faculty of Medicine, Institute of Applied Molecular Medicine (IMMA), San Pablo CEU Universities, Madrid, Spain
| | - David Obeso
- Department of Basic Medical Sciences, Faculty of Medicine, Institute of Applied Molecular Medicine (IMMA), San Pablo CEU Universities, Madrid, Spain.,Centre for Metabolomics and Bioanalysis (CEMBIO), Department of Chemistry and Biochemistry, Faculty of Pharmacy, San Pablo CEU Universities, Madrid, Spain
| | - Javier Sánchez-Solares
- Department of Basic Medical Sciences, Faculty of Medicine, Institute of Applied Molecular Medicine (IMMA), San Pablo CEU Universities, Madrid, Spain
| | - Leticia Mera-Berriatua
- Department of Basic Medical Sciences, Faculty of Medicine, Institute of Applied Molecular Medicine (IMMA), San Pablo CEU Universities, Madrid, Spain
| | - Paloma Fernández
- Department of Basic Medical Sciences, Faculty of Medicine, Institute of Applied Molecular Medicine (IMMA), San Pablo CEU Universities, Madrid, Spain
| | - Coral Barbas
- Centre for Metabolomics and Bioanalysis (CEMBIO), Department of Chemistry and Biochemistry, Faculty of Pharmacy, San Pablo CEU Universities, Madrid, Spain
| | - Miguel Fresnillo
- Otorhinolaringology Service, HM Montepríncipe Hospital, Madrid, Spain
| | - Tomás Chivato
- Department of Basic Medical Sciences, Faculty of Medicine, Institute of Applied Molecular Medicine (IMMA), San Pablo CEU Universities, Madrid, Spain.,Department of Clinic Medical Sciences, Faculty of Medicine, San Pablo CEU Universities, Madrid, Spain
| | - Domingo Barber
- Department of Basic Medical Sciences, Faculty of Medicine, Institute of Applied Molecular Medicine (IMMA), San Pablo CEU Universities, Madrid, Spain
| | - María M Escribese
- Department of Basic Medical Sciences, Faculty of Medicine, Institute of Applied Molecular Medicine (IMMA), San Pablo CEU Universities, Madrid, Spain.,Department of Basic Medical Sciences, Faculty of Medicine, San Pablo CEU Universities, Madrid, Spain
| | - Alma Villaseñor
- Department of Basic Medical Sciences, Faculty of Medicine, Institute of Applied Molecular Medicine (IMMA), San Pablo CEU Universities, Madrid, Spain
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89
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Shilenkova VV, Nenasheva NM. [Allergic rhinitis: what is the patient's choice of drug based on? Russian study's results]. Vestn Otorinolaringol 2021; 86:54-61. [PMID: 33929153 DOI: 10.17116/otorino20218602154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Allergic rhinitis (AR) is a disease that significantly affects the quality of life (QOL) of the patients. Scientific researches that reveal the reasons for the uncontrolled course of AR and the low level of QoL in patients are rare. OBJECTIVE Of this study was to establish how often patients with moderate AR seek medical care or prefer to choose a drug on their own in a pharmacy. MATERIAL AND METHODS The study consisted of an online survey of 328 adults over the age of 18 who bought drugs in a pharmacy for treatment of AR. The respondents were divided into two groups: 1) those who bought the drug according to the recommendation of a doctor (164), 2) those who chose the drug on their own (164). RESULTS The study revealed a dissonance between the severity of clinical symptoms of AR and how patients assess their QoL. The majority of patients estimated the symptoms of AR as moderate, but the disease itself was characterized as mild, not interfering with daily activity and sleep. The more severe the manifestations of AR were, the more often patients did not seek medical care from a doctor, preferring an independent choice of drugs, the help of a pharmacist, or focusing on long-standing doctor's recommendations. 48% of patients have never visited a doctor for AR. We have found a discrepancy between the optimal choice of drugs for the treatment of AR and the patient's attitude to this choice. 95% of patients purchased oral antihistamines from the pharmacy, 71% - decongestants, 26% - vitamins and food supplements. Although topical steroids were recommended by a doctor in 57% of cases, only 37% of patients bought intranasal corticosteroids in a pharmacy. When choosing a drug, 36% of patients preferred the advice of pharmacists; almost 50% followed advice from relatives and friends, 23% of patients used information from the Internet. CONCLUSION This study confirmed a tendency towards a decrease in patient adherence to modern AR therapy algorithms. Patient seeking medical care for AR is extremely low. It is required to optimize the education of primary care physicians and pharmacists, develop educational programs for patients.
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Affiliation(s)
- V V Shilenkova
- Yaroslavl State Medical University of the Ministry of Health of Russia, Yaroslavl, Russia
| | - N M Nenasheva
- FSBEI FPE «Russian Medical Academy of Continuous Professional Education» of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
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90
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Ear Acupressure for Allergic Rhinitis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:6699749. [PMID: 34007299 PMCID: PMC8110385 DOI: 10.1155/2021/6699749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 03/27/2021] [Accepted: 04/21/2021] [Indexed: 11/17/2022]
Abstract
Background The treatment effects and safety of ear acupressure (EAP) for patients with allergic rhinitis (AR) have yet to be clarified. Objective To evaluate the effects and safety of EAP in AR patients. Design Systematic review of published studies. Methods A total of 24 English and Chinese databases (PubMed, EMBASE (Excerpta Medical Database), Cochrane Central Register of Controlled Trials, CINAHL, Informit, ScienceDirect, LILACS (Latin American and Caribbean Health Sciences), ProQuest, AMED, Blackwell Synergy, PsycINFO, Panteleimon, AcuBriefs, KoreaMed, IndMed, Ingenta, mRCT, ISI Web of Knowledge, ERIC, VIP Information (http://www.cqvip.com), China National Knowledge Infrastructure (http://www.cnki.net), Cochrane Library, Chinese Cochrane Centre Controlled Trials Register Platform, and Wanfang Chinese Digital Periodical and Conference Database) were searched from their respective inceptions to August 2020 to collect randomized controlled trials of ear acupressure for allergic rhinitis. We performed literature inclusion, data extraction, and trial quality evaluations. Methodological quality was assessed according to the Cochrane Handbook. Revman5.3 was used for all analyses. Results A total of 203 trials were identified and eleven studies involved 1094 participants aged 3–70 years. EAP was better than control group interventions in terms of effectiveness (risk ratio (RR): 0.51; 95% confidence interval (CI): 0.36–0.70; P < 0.0001). EAP was superior to sham EAP in terms of improvement of the total nasal symptom score (RR: −0.50; 95% CI: −0.96–0.05; P = 0.03), sneezing score (RR: −0.36; 95% CI: −0.59–0.12; P = 0.003), global QoL score (RR: 0.42; 95% CI: 0.04–0.08; P = 0.03), and eye symptom score (RR: −0.36; 95% CI: −0.67–0.05; P = 0.02). Conclusions Despite the positive results, it is premature to confirm the efficacy of EAP for treating AR. More high-quality studies are needed to confirm safety and efficacy.
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91
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Sidenius K, Arvidsson P, Indbryn R, Emanuelsson CA. A Real-Life One-Year Non-Interventional Study Assessing Safety, Tolerability, and Treatment Outcome of the SQ HDM SLIT-Tablet (Acarizax ®) in House Dust Mite Allergic Rhinitis With or Without Asthma. Pulm Ther 2021; 7:221-236. [PMID: 33772732 PMCID: PMC8137770 DOI: 10.1007/s41030-021-00150-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 02/10/2021] [Indexed: 12/22/2022] Open
Abstract
Introduction The aim of this study was to investigate the safety profile, tolerability, and outcome of the SQ® house dust mite (HDM) sublingual immunotherapy (SLIT)-tablet after 1 year of treatment in clinical practice among adults with HDM-related allergic rhinitis (AR) ± allergic asthma (AA). Methods In a non-interventional multicenter, observational study, patients were followed at 3 visits for 1 year. Adverse events (AE) were recorded at all visits. Patients graded their allergic symptoms as none, mild, moderate, or severe, and recorded AR and AA medication use. Asthma symptom control was assessed according to the Global Initiative for Asthma (GINA). Results One hundred and ninety-eight patients were included; 115 (58%) had AR without asthma and 83 (42%) had both AR and AA. One hundred and sixty-six (84%) patients completed the study. Eighty percent of patients experienced an AE: 151 (75%) AEs were mild, 42 (21%) moderate, and 4 (2%) severe. Three patients (1.5%) reported four events that were considered serious (SAEs). One SAE was considered possibly treatment-related. No anaphylactic reactions occurred. The proportion of patients experiencing allergy symptom reductions by at least one step were 75% (nasal), 62% (eye), 16% (skin), and 13% (other symptoms); 75% of patients with AA experienced a decrease of at least one step in bronchial symptoms. AR medication and inhaled corticosteroids were statistically significant reduced. Conclusion The SQ HDM SLIT-tablet was safe and well tolerated; the type, frequency, and severity of AEs resembled what RCTs have previously demonstrated. As explorative endpoints, statistically significant reductions in AR and AA symptoms and medication use were seen along with improved asthma control after 1 year of treatment, implying that clinically meaningful changes were seen after 1 year of treatment with the SQ HDM SLIT-tablet. Supplementary Information The online version contains supplementary material available at 10.1007/s41030-021-00150-z.
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92
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Salapatek AM, Werkhäuser N, Ismail B, Mösges R, Raskopf E, Bilstein A. Effects of ectoine containing nasal spray and eye drops on symptoms of seasonal allergic rhinoconjunctivitis. Clin Transl Allergy 2021; 11:e12006. [PMID: 33900046 PMCID: PMC8099269 DOI: 10.1002/clt2.12006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 12/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patients are often dissatisfied with the symptom control obtained from available pharmacological treatments for seasonal allergic rhinoconjunctivitis (ARC). Therefore, patients seek for alternative, nonpharmacological options to treat their symptoms. Here, we assessed the efficacy of ectoine nasal spray and ectoine eye drops in comparison to placebo to prevent nasal and ocular symptoms following exposure to pollen in patients with ARC. METHODS In this double-blind, randomized, placebo-controlled, cross-over study, 46 patients with ARC applied ectoine eye drops and nasal spray in immediate succession or placebo eye drops and nasal spray for 13 days before ARC symptoms were induced in an environmental exposure chamber. Primary endpoint was the baseline-adjusted area under the curve (AUC) posttreatment total nasal symptom score (TNSS) and the total ocular symptom score (TOSS) using analysis of covariance. Secondary endpoints were, amongst others, total nonnasal symptoms score (TNNSS) and nasal patency (measured using acoustic rhinometry). RESULTS Treatment with both ectoine and placebo reduced TNSS, TOSS, and TNNSS upon allergen exposure. The analysis of parameters at baseline and after allergen exposure demonstrated that ectoine induced a clinically relevant improvement in ARC symptoms compared to placebo: the least square mean difference for baseline-adjusted AUC was -1.87 for TNSS, -1.45 for TOSS and -2.20 for TNNSS. The mean change from baseline AUC of TNNSS for ectoine was also significantly greater than for placebo (-5.49 vs. -3.46; p = 0.011). Ectoine significantly improved the singular symptoms "sneezing," "watery eyes" and "itchy eyes" (p ≤ 0.021) as well as "itchy ear/palate" (p = 0.036) in comparison to placebo. Mean cross sectional areas of the nasal cavity were reduced to a lesser extent after treatment with ectoine (-0.020 ± 0.022) than with placebo (-0.047 ± 0.029). The current study also demonstrated a very good safety profile of ectoine treatment. Few AEs with comparable numbers in both treatment groups were reported during the study, which were mild in severity and resolved without medical treatment. CONCLUSION The study suggests that ectoine is effective in reducing nasal and ocular symptoms associated with ARC. Being a natural, bacteria derived stress protection molecule functioning by a physical mode of action, it therefore represents an alternative nonpharmacological treatment option.
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Affiliation(s)
| | | | | | - Ralph Mösges
- CRI-Clinical Research International Ltd., Cologne, Germany
| | - Esther Raskopf
- CRI-Clinical Research International Ltd., Cologne, Germany.,ClinCompetence Cologne GmbH, Cologne, Germany
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Cox L. Pharmacoeconomics of allergy immunotherapy versus pharmacotherapy. Expert Rev Clin Immunol 2021; 17:255-268. [PMID: 33645387 DOI: 10.1080/1744666x.2021.1886079] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Introduction: The purpose of this review is to evaluate the cost-effectiveness of allergy immunotherapy (AIT) in the treatment of allergic rhinitis, asthma, and other allergic conditions.Area covered: An extensive search of the PubMed and Medline database (January 1996 up to June of 2020) was conducted using the search terms allergy immunotherapy, pharmacoeconomics, cost-effectiveness, allergic rhinitis, and asthma. Studies were included if they included information on the economics of AIT in comparison to pharmacotherapy in the treatment of allergic rhinitis or asthma either as actual costs or based on theoretical models. Systematic reviews were included if they included information about the cost-effectiveness of AIT.Most clinical trials found significant cost-savings with AIT. The cost-effective time-point ranged from a few months to several years after treatment initiation.. Cost savings were demonstrated as early as 3 months after treatment initiation and were as great as 80% less than SDT in some studies.Expert opinion: There is strong evidence in the collective literature that AIT is cost-effective as compared to SDT alone. The magnitude of AIT's cost-effectiveness is likely underestimated because most of the studies considered during treatment costs and not AIT's long-term benefits or preventive/prophylactic effects or its impact on co-morbid conditions.
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Affiliation(s)
- Linda Cox
- Department of Medicine, Associate Professor of Medicine Nova Southeastern University, Ft. Lauderdale, Florida, USA
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94
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A Retrospective Nationwide Non-Interventional Study of an Aqueous Sublingual Immunotherapy Formulation Administered with a 200-µL Dosing Pump. Drugs Real World Outcomes 2021; 8:241-251. [PMID: 33591547 PMCID: PMC8128946 DOI: 10.1007/s40801-021-00233-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2021] [Indexed: 11/27/2022] Open
Abstract
Background Convenient dosing is a key component of treatment adherence and thus efficacy and safety. Aqueous sublingual immunotherapy (SLIT) formulations can be administered with a dosing pump that delivers 200 µL of volume per actuation. Objective The objective of this study was to describe the use of Staloral® 300 Rapid in its new dosing pump presentation and to evaluate the safety and satisfaction from both the patient and doctor. Patients and Methods We performed a retrospective non-interventional study in a population (aged 5 years or over) of individuals with allergic rhinitis or allergic asthma who were being treated with aqueous 300 index of reactivity SLIT formulations of various allergens (grass pollen, tree pollen, house dust mites). Based on a detailed, SLIT-specific, patient self-questionnaire (Quartis®) and the inspection of medical records, we assessed the characteristics of the SLIT, safety, patient satisfaction and willingness to continue SLIT. The physician’s satisfaction with the treatment was measured on a 0–100 visual analogue scale. Adverse events were coded with the Medical Dictionary for Regulatory Activities. Results A total of 801 valid patients were included (52.4% male; mean ± standard deviation age: 25.9 ± 17.2 years; mean time since diagnosis: 4.56 ± 4.68 years; mean time using the previous dosing pump: 19.2 ± 13.0 months; time using the 200-µL dosing pump: 14.95 ± 3.80 months). Among the study population, 317 subjects comprised the paediatric subgroup (57%: male; mean age: 9.8 ± 2.5 years). Overall, 54 patients (6.7%) reported a total of 68 adverse events (including 51 gastrointestinal adverse events). The large majority of adverse events were mild, local and transient and did not require treatment. There were no severe adverse events. The level of patient satisfaction with the ease of SLIT administration was high (84.3% overall, and 82.6% in the paediatric subgroup). The mean ± standard deviation visual analogue scale score for physician satisfaction with the treatment was 70.6 ± 25.1 out of 100. Conclusions Administration of 300 index of reactivity SLIT with a 200-µL dosing pump is safe, well tolerated and associated with good levels of patient satisfaction.
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95
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Hoogeveen MJ, van Gorp ECM, Hoogeveen EK. Can pollen explain the seasonality of flu-like illnesses in the Netherlands? THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 755:143182. [PMID: 33131881 PMCID: PMC7580695 DOI: 10.1016/j.scitotenv.2020.143182] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 10/11/2020] [Accepted: 10/12/2020] [Indexed: 05/20/2023]
Abstract
Current models for flu-like epidemics insufficiently explain multi-cycle seasonality. Meteorological factors alone, including the associated behavior, do not predict seasonality, given substantial climate differences between countries that are subject to flu-like epidemics or COVID-19. Pollen is documented to be allergenic, it plays a role in immuno-activation and defense against respiratory viruses, and seems to create a bio-aerosol that lowers the reproduction number of flu-like viruses. Therefore, we hypothesize that pollen may explain the seasonality of flu-like epidemics, including COVID-19, in combination with meteorological variables. We have tested the Pollen-Flu Seasonality Theory for 2016-2020 flu-like seasons, including COVID-19, in the Netherlands, with its 17.4 million inhabitants. We combined changes in flu-like incidence per 100 K/Dutch residents (code: ILI) with pollen concentrations and meteorological data. Finally, a predictive model was tested using pollen and meteorological threshold values, inversely correlated to flu-like incidence. We found a highly significant inverse correlation of r(224) = -0.41 (p < 0.001) between pollen and changes in flu-like incidence, corrected for the incubation period. The correlation was stronger after taking into account the incubation time. We found that our predictive model has the highest inverse correlation with changes in flu-like incidence of r(222) = -0.48 (p < 0.001) when average thresholds of 610 total pollen grains/m3, 120 allergenic pollen grains/m3, and a solar radiation of 510 J/cm2 are passed. The passing of at least the pollen thresholds, preludes the beginning and end of flu-like seasons. Solar radiation is a co-inhibitor of flu-like incidence, while temperature makes no difference. However, higher relative humidity increases with flu-like incidence. We conclude that pollen is a predictor of the inverse seasonality of flu-like epidemics, including COVID-19, and that solar radiation is a co-inhibitor, in the Netherlands.
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Affiliation(s)
- Martijn J Hoogeveen
- Department Technical Sciences & Environment, Open University, the Netherlands.
| | - Eric C M van Gorp
- Department of Viroscience and Department of Infectious Diseases, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Ellen K Hoogeveen
- Department of Internal Medicine, Jeroen Bosch Hospital, Den Bosch, the Netherlands
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Piromchai P, Pornumnouy W, Saeseow P, Chainansamit S. The minimum effective dose of abobotulinum toxin A injection for allergic rhinitis: A dose-escalation randomized controlled trial. Laryngoscope Investig Otolaryngol 2021; 6:6-12. [PMID: 33614923 PMCID: PMC7883613 DOI: 10.1002/lio2.499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 10/28/2020] [Accepted: 11/05/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To find the lowest effective injection dose of abobotulinum toxin A (Dysport) for allergic rhinitis. STUDY DESIGN Dose-escalation randomized controlled trial. METHODS We included all patients aged 18 years or older who had persistent allergic rhinitis and positive allergy skin prick test. The patients were randomly allocated to receive 40, 30, or 20 U of abobotulinum toxin A by injection at the inferior turbinate. We followed up on patients for 12 weeks to evaluate nasal symptoms, ocular symptoms, minimum nasal cross-sectional area as measured using acoustic rhinometry, and complications. RESULTS Seventeen patients were included in this study, with 7 receiving 20 U of abobotulinum toxin A and 5 each receiving 30 U and 40 U. Abobotulinum toxin A significantly improved nasal congestion, rhinorrhea, sneezing, and loss of smell at 40 U (P < .05) and nasal congestion, sneezing, and loss of smell at 30 U (P < .05). However, at a dose of 20 U, only nasal congestion and loss of smell improved (P < .05). Nasal patency had also significantly improved two weeks after treatment at doses of 40 and 30 U (P < .05). Complications included epistaxis (11.8%) and nasal dryness (23.5%). CONCLUSION Abobotulinum toxin A at a dose of at least 30 U effectively reduced most nasal symptoms. LEVEL OF EVIDENCE 2. TRIAL REGISTRATION Clinicaltrials.in.th/ TCTR20200526014.
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Affiliation(s)
- Patorn Piromchai
- Department of Otorhinolaryngology, Faculty of MedicineKhon Kaen UniversityKhon KaenThailand
| | - Worakit Pornumnouy
- Department of Otorhinolaryngology, Faculty of MedicineKhon Kaen UniversityKhon KaenThailand
| | - Patchareeporn Saeseow
- Department of Otorhinolaryngology, Faculty of MedicineKhon Kaen UniversityKhon KaenThailand
| | - Seksun Chainansamit
- Department of Otorhinolaryngology, Faculty of MedicineKhon Kaen UniversityKhon KaenThailand
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Li J, Liu L, Jiao L, Liao K, Xu L, Zhou X, Xiong J. Clinical acupuncture therapy for children with allergic rhinitis: A protocol for systematic review and meta analysis. Medicine (Baltimore) 2021; 100:e24086. [PMID: 33546014 PMCID: PMC7837844 DOI: 10.1097/md.0000000000024086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 12/07/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Allergic rhinitis (AR) in children has become a common clinical allergic disease, the incidence of which is increasing in pediatric. The side effects of the drug cause parents to worry about the health of their child. However, a large number of current clinical studies have shown that acupuncture therapy is effective in treating children with AR. Therefore, this systematic review aims to explore the safety and effectiveness of acupuncture in the treatment of AR in children. METHODS We will conduct a comprehensive literature search in Medline, PubMed, Cochrane Database of Systematic Reviews, Embase, Chinese Biomedical Literatures Database (CBM), China National Knowledge Infrastructure (CNKI), Wang Fang Database (WF), Chinese Scientific Journal Database (VIP) from inception to November 2020 without any language restriction. In addition, we will retrieve the unpublished studies and the references of initially included literature manually. Reviewers will identify studies, extract data, and assess the quality independently. The outcomes of interest include: total effective rate; the total nasal symptom score; Rhinitis quality of life questionnaire (RQLQ); Visual Analog Scale (VAS); Laboratory inspection indicators: the level of IgE, IL6, IL10 or TNF-α; Recurrence rate; adverse events. Randomized clinical trials will be collected, methodological quality will be evaluated using the Cochrane risk-of-bias assessment tool, and the level of evidence will be rated using the Grading of Recommendations, Assessment, Development and Evaluation approach. Meta-analysis will be performed using RevMan 5.4.0 software. The heterogeneity test will be conducted between the studies, P < .1 and I2 > 50% are the thresholds for the tests. We will utilize the fixed effects model or the random effects model according to the size of heterogeneity. RESULTS The results of this systematic review will provide a synthesis of current evidence of AR in children. We will report this result shortly. CONCLUSION This study will explore whether or not acupuncture therapy can be used as one of the non drug therapies to prevent or treat allergic rhinitis in children. TRIAL REGISTRATION NUMBER INPLASY2020110053.
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Effects and mechanism of Chinese medicine Jiawei Yupingfeng in a mouse model of allergic rhinitis. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2021; 19:354-361. [PMID: 33863693 DOI: 10.1016/j.joim.2021.01.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 12/30/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Chinese medicine has the potential to modulate allergic rhinitis (AR). There have been studies investigating the treatment efficacy of Yupingfeng San, alone or in combination with other ingredients, in AR, though few have studied the potential mechanisms of these drugs. In the present study, we measured the effects of Jiawei Yupingfeng (JWYPF), a traditional Chinese medicine formula, on mice with ovalbumin-induced AR and explored its underlying mechanism of action. METHODS Forty BALB/c mice were randomly divided into normal control, allergy control and two treatment groups of ten mice each. In the normal control group, mice were sensitized and challenged with saline. The mice in the allergy control and treatment groups were sensitized and challenged with ovalbumin and aluminum hydroxide gel. The treatments of JWYPF and Nasonex were administered intranasally in the AR mice for one week. Several signs of allergic inflammation, such as nasal eosinophils and inflammatory cytokines, were measured to determine the underlying mechanisms. RESULTS Mice in the JWYPF and Nasonex groups had significantly lower AR symptom scores than those in the allergy control group (the mean differences between JWYPF and the allergy control, and Nasonex and the allergy control were -2.00 ± 0.35 and -2.40 ± 0.32). After treatment with JWYPF and Nasonex, the levels of ovalbumin-specific IgE and histamine were significantly reduced, as were the levels of interlukin-4 and transforming growth factor-β, while interferon-γ levels were increased (all P < 0.0001, vs. allergy control). These two treatments also significantly inhibited eosinophil and mast cell infiltration into the nasal cavity but were not statistically different from one-another. CONCLUSION JWYPF has a potential therapeutic effect on AR via adjusting the rebalance of T helper 1 and T helper 2.
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De Marco Castro E, Calder PC, Roche HM. β-1,3/1,6-Glucans and Immunity: State of the Art and Future Directions. Mol Nutr Food Res 2021; 65:e1901071. [PMID: 32223047 PMCID: PMC7816268 DOI: 10.1002/mnfr.201901071] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 02/28/2020] [Indexed: 12/16/2022]
Abstract
The innate immune system responds in a rapid and non-specific manner against immunologic threats; inflammation is part of this response. This is followed by a slower but targeted and specific response termed the adaptive or acquired immune response. There is emerging evidence that dietary components, including yeast-derived β-glucans, can aid host defense against pathogens by modulating inflammatory and antimicrobial activity of neutrophils and macrophages. Innate immune training refers to a newly recognized phenomenon wherein compounds may "train" innate immune cells, such that monocyte and macrophage precursor biology is altered to mount a more effective immunological response. Although various human studies have been carried out, much uncertainty still exists and further studies are required to fully elucidate the relationship between β-glucan supplementation and human immune function. This review offers an up-to-date report on yeast-derived β-glucans as immunomodulators, including a brief overview of the current paradigm regarding the interaction of β-glucans with the immune system. The recent pre-clinical work that has partly decrypted mode of action and the newest evidence from human trials are also reviewed. According to pre-clinical studies, β-1,3/1,6-glucan derived from baker's yeast may offer increased immuno-surveillance, although the human evidence is weaker than that gained from pre-clinical studies.
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Affiliation(s)
- Elena De Marco Castro
- Nutrigenomics Research GroupSchool of Public Health, Physiotherapy, and Sports ScienceConway Institute, and Institute of Food and HealthUniversity College DublinDublin 4D04 V1W8Ireland
- Diabetes Complications Research CentreConway InstituteUniversity College DublinDublin 4D04 V1W8Ireland
| | - Philip C. Calder
- Faculty of MedicineUniversity of SouthamptonSouthamptonSO16 6YDUK
- NIHR Southampton Biomedical Research CentreUniversity Hospital Southampton NHS Foundation TrustUniversity of SouthamptonSouthamptonSO16 6YDUK
| | - Helen M. Roche
- Nutrigenomics Research GroupSchool of Public Health, Physiotherapy, and Sports ScienceConway Institute, and Institute of Food and HealthUniversity College DublinDublin 4D04 V1W8Ireland
- Diabetes Complications Research CentreConway InstituteUniversity College DublinDublin 4D04 V1W8Ireland
- Institute for Global Food SecurityQueens University BelfastBelfastNorthern IrelandBT9 5DLUK
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Epidemiological Association Between Systemic Diseases and Keratoconus in a Korean Population: A 10-Year Nationwide Cohort Study. Cornea 2020; 39:348-353. [PMID: 31764280 DOI: 10.1097/ico.0000000000002206] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate the association of systemic diseases with keratoconus in the general Korean population. METHODS This is a nationwide population-based retrospective cohort study using the Korean National Health Insurance Service-National Sample Cohort database from 2002 to 2015, involving 1,108,369 individuals. Patients with keratoconus were identified using the Korean standard classification of diseases code H18.6. The prevalence and annual incidence rates were estimated. To examine the risk factors, 5 controls were matched per patient with keratoconus by propensity score matching using age and household income. Univariate and multivariate regression analyses were performed to assess the association between relevant factors and keratoconus. RESULTS A total of 613 subjects were identified as patients with keratoconus from the cohort database. The prevalence rate was 55.31 cases per 100,000 people [95% confidence interval (CI): 51.01-59.86]. The annual incidence rate, calculated using a predate 1-year washout period, was 4.47 cases per 100,000 person-years (95% CI: 4.11-4.85). People with allergic conjunctivitis had a 37% increased odds of being diagnosed with keratoconus [odds ratio: 1.37 (95% CI: 1.12-1.67), P = 0.002] compared with those without allergic conjunctivitis. By contrast, people with allergic rhinitis had a 52% reduced odds of being diagnosed with keratoconus [odds ratio: 0.48 (95% CI: 0.38-0.59), P < 0.001]. Atopy and eczema, asthma, connective tissue disorders, diabetes mellitus, sleep apnea, and inflammatory bowel disease had no significant association with a positive keratoconus diagnosis. CONCLUSIONS Allergic conjunctivitis may increase the risk of developing keratoconus in Koreans.
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