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Chen H, Meng X, Yu Y, Sun J, Niu Z, Wei J, Zhang L, Lu C, Yu W, Wang T, Zheng X, Norbäck D, Svartengren M, Zhang X, Zhao Z. Greenness and its composition and configuration in association with allergic rhinitis in preschool children. ENVIRONMENTAL RESEARCH 2024; 251:118627. [PMID: 38460662 DOI: 10.1016/j.envres.2024.118627] [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: 12/28/2023] [Revised: 02/23/2024] [Accepted: 03/04/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND Few studies focus on the associations of green space composition and configuration with children's allergic rhinitis (AR). METHODS A multi-center population-based cross-sectional study was performed in 7 cities in mainland of China between 2019 and 2020, recruiting 36,867 preschool children. Information on the current AR symptoms and demographics were collected by questionnaire. Exposure to residential greenness was estimated by Normalized Difference Vegetation Index (NDVI, 1000 m buffer) around the residences. Greenness composition was estimated in 3 main categories: forest, grassland, shrubland. Configuration of each category and total greenness (a spatial resolution of 10 m × 10 m) was estimated by 6 landscape pattern metrics to quantify their area, shape complexity, aggregation, connectivity, and patch density. Exposure to daily ambient particulate matter (PM1, PM2.5 and PM10, a spatial resolution of 1 km × 1 km) was estimated. Multilevel logistic regression models were applied to analyze the associations of greenness and its composition and configuration with AR, and mediation effects by PMs were examined by mediation analysis models. RESULTS The prevalence of self-reported current AR in preschool children was 33.1%. Two indicators of forest, Aggregation Index of forest patches (AIforest) (odds ratio (OR):0.92, 95% Confidential Interval (CI): 0.88-0.97), and Patch Cohesion of forest (COHESIONforest) (OR: 0.93, 95% CI:0.89-0.98) showed significantly negative associations with AR symptoms. Mediation analyses found the associations were partially mediated by PMs. Age, exclusive breastfeed duration and season were the potential effect modifiers. The associations varied across seven cities. CONCLUSION Our findings suggest the inverse associations of the aggregation and connectivity of forest patches surrounding residence addresses with AR symptoms. Since the cross-sectional study only provides associations rather than causation, further studies are needed to confirm our results as well as the underlying mechanisms.
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Affiliation(s)
- Han Chen
- Department of Environmental Health, School of Public Health, NHC Key Laboratory of Health Technology Assessment (Fudan University), Fudan University, Shanghai, 200032, China
| | - Xia Meng
- Department of Environmental Health, School of Public Health, NHC Key Laboratory of Health Technology Assessment (Fudan University), Fudan University, Shanghai, 200032, China; Key Laboratory of Public Health Safety of the Ministry of Education, Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai, 200030, China; IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, 200438, China
| | - Yongfu Yu
- Department of Environmental Health, School of Public Health, NHC Key Laboratory of Health Technology Assessment (Fudan University), Fudan University, Shanghai, 200032, China
| | - Jin Sun
- Department of Environmental Health, School of Public Health, NHC Key Laboratory of Health Technology Assessment (Fudan University), Fudan University, Shanghai, 200032, China
| | - Zhiping Niu
- Department of Environmental Health, School of Public Health, NHC Key Laboratory of Health Technology Assessment (Fudan University), Fudan University, Shanghai, 200032, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, USA
| | - Ling Zhang
- Department of Environmental Hygiene and Occupational Medicine, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Chan Lu
- Department of Occupational and Environmental Health, School of Public Health, Xiangya Medical College, Central South University, Changsha, 410078, China
| | - Wei Yu
- Key Laboratory of Three Gorges Reservoir Region's Eco-Environment, Chongqing University, Chongqing, 400030, China
| | - Tingting Wang
- School of Nursing & Health Management, Shanghai University of Medicine & Health Sciences, Shanghai, 201318, China
| | - Xiaohong Zheng
- School of Energy & Environment, Southeast University, Nanjing, 210096, China
| | - Dan Norbäck
- Department of Occupational and Environmental Medicine, Uppsala University Hospital, 751 85, Uppsala, Sweden
| | - Magnus Svartengren
- Department of Occupational and Environmental Medicine, Uppsala University Hospital, 751 85, Uppsala, Sweden
| | - Xin Zhang
- Institute of Environmental Science, Shanxi University, Taiyuan, Shanxi, China.
| | - Zhuohui Zhao
- Department of Environmental Health, School of Public Health, NHC Key Laboratory of Health Technology Assessment (Fudan University), Fudan University, Shanghai, 200032, China; Key Laboratory of Public Health Safety of the Ministry of Education, Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai, 200030, China; IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, 200438, China.
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Gu J, Liang ZP, Xu W, Liu TZ, Li ZR, Qin G. Quantitative assessment and correlational analysis of subjective and objective indicators in patients with allergic rhinitis. Asia Pac Allergy 2024; 14:45-55. [PMID: 38827256 PMCID: PMC11142756 DOI: 10.5415/apallergy.0000000000000141] [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: 08/14/2023] [Accepted: 01/26/2024] [Indexed: 06/04/2024] Open
Abstract
Background The diagnosis of allergic rhinitis is mainly based on the typical medical history, clinical manifestations, and corresponding allergen test results of the patients. However, there are often clinical inconsistencies among the 3. Objective To study the clinical characteristics of patients with allergic rhinitis from both subjective and objective aspects to determine the correlations between the quantitative assessment outcomes of subjective and objective indicators. Methods A total of 111 patients with allergic rhinitis who visited our outpatient clinic from June 2022 to December 2022 were selected. The 22-item sino-nasal outcome test (SNOT-22) and the visual analog scale (VAS) for the severity of the disease were used to score the subjective indicators of allergic rhinitis. The objective indicators of allergic rhinitis were evaluated by serum inhalant allergens immunoglobulin E test, nasal endoscopy modified Lund-Kennedy (MLK) scoring method, and acoustic rhinometry. Results SNOT-22 score, total VAS score for symptoms, and the VAS score for nasal itching were positively correlated with the number of positive allergens (r = 0.266, P = 0.005, r = 0.576, P < 0.001, and r = 0.271, P = 0.004, respectively). No differences were found in all subjective indicators scores between the total immunoglobulin E positive and negative groups (P > 0.05). SNOT-22 score, total VAS score for symptoms, and the VAS score for nasal congestion were positively correlated with MLK total score of nasal endoscopy (r = 0.343, P < 0.001, r = 0.438, P < 0.001, and r = 0.225, P = 0.018, respectively). Parameters of acoustic rhinometry were not correlated with the subjective indicators scores of allergic rhinitis (P > 0.05). Conclusion A multifaceted quantitative assessment of allergic rhinitis using a combination of subjective and objective methods can help physicians make an accurate diagnosis and create reasonable treatment plans.
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Affiliation(s)
- Jia Gu
- Department of Otolaryngology Head and Neck Surgery, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Zhuo-Ping Liang
- Department of Otolaryngology Head and Neck Surgery, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Wei Xu
- Department of Otolaryngology Head and Neck Surgery, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Tian-Zhen Liu
- Department of Otolaryngology Head and Neck Surgery, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Zhen-Rong Li
- Department of Otolaryngology Head and Neck Surgery, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Gang Qin
- Department of Otolaryngology Head and Neck Surgery, Affiliated Hospital of Southwest Medical University, Luzhou, China
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Safia A, Elhadi UA, Karam M, Merchavy S, Khater A. A meta-analysis of the prevalence and risk of mental health problems in allergic rhinitis patients. J Psychosom Res 2024:111813. [PMID: 38871533 DOI: 10.1016/j.jpsychores.2024.111813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 05/21/2024] [Accepted: 05/29/2024] [Indexed: 06/15/2024]
Abstract
OBJECTIVE Allergic rhinitis (AR), a prevalent global health concern, is increasingly recognized for its impact beyond physical symptoms, affecting mental health. This research examined the extent of AR's psychological burden and sleep disturbances. METHODS A systematic search of four databases yielded 49 studies reporting mental health problems in 18,269,265 individuals (15,151,322 AR patients and 3,117,943 controls). The primary outcomes included all mental health problems in AR patients. Subgroup analyses based on outcome and AR severity, country, AR diagnosis, recruitment setting, and age were performed. Secondary outcomes included the risk of these problems compared to controls (healthy or without AR). RESULTS In AR, depression (25%), anxiety (25%), stress (65%), distress (57%), suicidal thoughts (14%) and attempts (4%), poor sleep quality (48%), insomnia (36%), sleep impairment (33%), and insufficient sleep duration <7 h (59%) were prevalent. The severity of these outcomes differed significantly. Patients' country, AR diagnostic method, recruitment method/setting, and age group were significant effect modifiers. Compared to controls, AR resulted in significantly higher risk of depression, anxiety, stress, suicidal attempts and thoughts, insomnia, and sleep impairment. CONCLUSION AR patients had significantly lower sleep duration. Mental health problems are very common among AR patients, further exacerbating their sleep quality and duration and intention to suicide.
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Affiliation(s)
- Alaa Safia
- Department of Otolaryngology, Head & Neck Surgery Unit, Rebecca Ziv Medical Center, Safed, Israel; True Doctor, Research Wing, Israel.
| | - Uday Abd Elhadi
- Department of Otolaryngology, Head & Neck Surgery Unit, Rebecca Ziv Medical Center, Safed, Israel; True Doctor, Research Wing, Israel
| | - Marwan Karam
- Department of Otolaryngology, Head & Neck Surgery Unit, Rebecca Ziv Medical Center, Safed, Israel
| | - Shlomo Merchavy
- Department of Otolaryngology, Head & Neck Surgery Unit, Rebecca Ziv Medical Center, Safed, Israel
| | - Ashraf Khater
- Department of Otolaryngology, Head & Neck Surgery Unit, Rebecca Ziv Medical Center, Safed, Israel
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Birinci M, Ozdemir D, Pusuroglu M, Sevim Ö, Yemiş T, Cihan SN, Yılmaz E, Çeliker M, Çelebi Erdivanlı Ö. Rhinitis medicomentosa and substance addiction. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08723-9. [PMID: 38740578 DOI: 10.1007/s00405-024-08723-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 05/03/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Rhinitis medicomentosa (RM) is a form of non-allergic rhinitis caused by the use of nasal decongestants for longer than the recommended duration. Because of this problem of use, addiction to the drug occurs in individuals. In our study, we aimed to evaluate the susceptibility of RM patients to substance addiction. METHODS The study was planned as a prospective, multicentric study between September 2022 and September 2023. Patients diagnosed with RM were included in the study. Beck depression scale, Drug use disorders identification test, Substance Abuse Proclivity Scale were applied to the patients participating in the study. The research data were analyzed electronically with SPSS program version 25. RESULTS The study included 86 patients with an average age of 31 years. The average duration of medication use was 22 months. Age, gender, duration of nasal congestion, duration of drug use and smoking were not independent predictors for depression and substance use tendency. CONCLUSION The relationship between RM and addictive substances is not clear. The tendency to use drugs did not increase in RM patients. In the light of these data, we think that there is no need for a practice other than routine functioning in the use of drugs and similar substances that are likely to cause addiction in RM patients.
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Affiliation(s)
- Mehmet Birinci
- Faculty of Medicine, Department of Otorhinolaryngology, Recep Tayyip Erdogan University, Rize, Turkey.
| | - Dogukan Ozdemir
- Faculty of Medicine, Department of Otorhinolaryngology, Samsun University, Samsun, Turkey
| | - Meltem Pusuroglu
- Faculty of Medicine, Department of Psychiatry, Recep Tayyip Erdogan University, Rize, Turkey
| | - Ömer Sevim
- Faculty of Medicine, Department of Otorhinolaryngology, Recep Tayyip Erdogan University, Rize, Turkey
| | - Tuğba Yemiş
- Faculty of Medicine, Department of Otorhinolaryngology, Recep Tayyip Erdogan University, Rize, Turkey
| | - Seda Nur Cihan
- Faculty of Medicine, Department of Otorhinolaryngology, Samsun University, Samsun, Turkey
| | - Esra Yılmaz
- Faculty of Medicine, Department of Otorhinolaryngology, Samsun University, Samsun, Turkey
| | - Metin Çeliker
- Faculty of Medicine, Department of Otorhinolaryngology, Recep Tayyip Erdogan University, Rize, Turkey
| | - Özlem Çelebi Erdivanlı
- Faculty of Medicine, Department of Otorhinolaryngology, Recep Tayyip Erdogan University, Rize, Turkey
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Lv H, Liu K, Xie Y, Wang Y, Chen S, Liu P, Guan M, Cong J, Xu Y. No causal association between allergic rhinitis and migraine: a Mendelian randomization study. Eur J Med Res 2024; 29:78. [PMID: 38281051 PMCID: PMC10821569 DOI: 10.1186/s40001-024-01682-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 01/17/2024] [Indexed: 01/29/2024] Open
Abstract
PURPOSE Allergic rhinitis (AR) and migraine are among the most common public health problems worldwide. Observational studies on the correlation between AR and migraine have reported inconsistent results. This study aimed to investigate the causal relationship of AR with migraine and its subtypes, including migraine with aura (MA) and migraine without aura (MO). METHODS Bidirectional two-sample Mendelian randomization (MR) analysis was performed with publicly available summary-level statistics of large genome-wide association studies to estimate the possible causal effects. The inverse variance-weighted method was selected for primary analysis and was supplemented with the weighted median, weighted mode, and MR-Egger methods. The causal analysis using summary effect estimates (CAUSE) were further performed to verify the causality. Several sensitivity tests, including the leave-one-out, Cochran's Q, MR-Egger intercept, and MR-PRESSO tests, were performed to assess the robustness of the results. RESULTS AR did not exhibit a significant causal correlation with the elevated risk of any migraine (odd ratio (OR), 0.816; 95% confidence interval (CI), 0.511-1.302; P = 0.394), MA (OR, 0.690; 95% CI 0.298-1.593; P = 0.384), or MO (OR, 1.022; 95% CI 0.490-2.131; P = 0.954). Consistently, reverse MR analysis did not reveal causal effects of any migraine or its subtypes on AR. Almost all sensitivity analyses supported the robustness of the results. CONCLUSIONS This MR study did not reveal a clear causal association between AR and migraine risk. More research is warranted to reveal the complex association between AR and migraine.
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Affiliation(s)
- Hao Lv
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
| | - Kunyu Liu
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
| | - Yulie Xie
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
| | - Yunfei Wang
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
| | - Siyuan Chen
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
| | - Peiqiang Liu
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
| | - Mengting Guan
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
| | - Jianchao Cong
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
| | - Yu Xu
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China.
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China.
- Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China.
- Hubei Province Key Laboratory of Allergy and Immunology, Wuhan, 430071, Hubei, China.
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Yu RL, Ning HY, Lan TF, He H, Zheng CB, Wang XY, Wang HT, Wang XY. Self-Reported Allergic Rhinitis Prevalence and Risk Factors in Employees of the China National Railway. Aerosp Med Hum Perform 2023; 94:821-826. [PMID: 37853588 DOI: 10.3357/amhp.6229.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
BACKGROUND: Allergic rhinitis (AR) is a common allergic disease globally and its prevalence is increasing year by year. This study aimed to analyze the prevalence and risk factors of self-reported AR among the Chinese National Railway train crew in the China Railway Beijing Group.METHODS: This prospective questionnaire study surveyed 1511 randomly recruited train crewmembers from 20 cities in the China National Railway network, and 494 reported having AR. A structured questionnaire was tailored, designed, and delivered electronically to all subjects. Prevalence of and risk factors for AR were analyzed based on self-reported results.RESULTS: The prevalence of self-reported AR among train crewmembers was 32.6%. Among respondents, 86.03% worked in passenger cars and 64.6% reported having worse AR symptoms while on trains. AR frequencies were 40.15% perennially and 59.85% seasonally. Among the Total Nasal Symptoms Scores (TNSS), significant differences were found between rhinorrhea and sneezing and between nasal itching and sneezing. The Rhino-Conjunctivitis Quality of Life Questionnaire (RQLQ) showed significant correlations between all seven sections. TNSS was significantly associated with the RQLQ. Scores of both the TNSS and RQLQ showed that the severity of AR symptoms (rp = 0.103) and the impact on quality of life (rp = 0.113) correlated significantly with seniority.CONCLUSIONS: The prevalence of self-reported AR among train crew working in passenger cars is higher than that of the general Chinese population. The severity of AR symptoms and the impact on quality of life are associated with seniority, meaning the number of years working on trains.Yu R-L, Ning H-Y, Lan T-F, He H, Zheng C-B, Wang X-Y, Wang H-T, Wang X-Y. Self-reported allergic rhinitis prevalence and risk factors in employees of the China National Railway. Aerosp Med Hum Perform. 2023; 94(11):821-826.
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Ramsridhar S. Allergic Rhinitis-Induced Anxiety and Depression: An Autobiographical Case Report. Cureus 2023; 15:e36560. [PMID: 37102007 PMCID: PMC10123236 DOI: 10.7759/cureus.36560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2023] [Indexed: 04/28/2023] Open
Abstract
Allergic rhinitis (AR) formerly perceived to be a nuisance disease is of global health concern now, causing significant economic and social burden worldwide. It is a common inflammatory condition of the nasal mucosa characterized by four cardinal symptoms: nasal pruritus, sneezing, rhinorrhea, and nasal congestion. Poorly controlled AR can also lead to impairment in sleep and a decrease in school/work performance, thereby affecting the quality of life. In addition, AR can produce serious mental and psychological disorders such as depression and anxiety. Yoga can be used as an alternative therapy to treat AR as it has been proven to have beneficial effects in alleviating the symptoms of AR and can also have an overall relaxing effect on the body and mind. The aim of this case report is to share my first-hand experience of enduring endless suffering due to AR because of my negligent behavior. My chronic symptoms that did not resolve on medication led me to anxiety and depression, and I finally resorted to yoga and meditation to battle the disorder.
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Affiliation(s)
- Saranya Ramsridhar
- Department of Oral Pathology, Sathyabama Dental College and Hospital, Sathyabama Institute of Science and Technology, Chennai, IND
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Rhyou HI, Nam YH. The Psychological Relieving Effect of Drug Provocation Test in Drug Hypersensitivity. J Asthma Allergy 2022; 15:1337-1345. [PMID: 36189190 PMCID: PMC9518683 DOI: 10.2147/jaa.s380516] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/06/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Hyo-In Rhyou
- Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Young-Hee Nam
- Department of Internal Medicine, College of Medicine, Dong-A University Hospital, Busan, Korea
- Correspondence: Young-Hee Nam, Department of Internal Medicine, College of Medicine, Dong-A University, 26 Daesingongwon-ro, Seo-Gu, Busan, Korea, Tel +8251-240-5860, Fax +82-51-242-5864, Email
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Association between Perceived Stress and Rhinitis-Related Quality of Life: A Multicenter, Cross-Sectional Study. J Clin Med 2021; 10:jcm10163680. [PMID: 34441978 PMCID: PMC8397163 DOI: 10.3390/jcm10163680] [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: 05/24/2021] [Revised: 08/12/2021] [Accepted: 08/13/2021] [Indexed: 11/17/2022] Open
Abstract
Allergic rhinitis (AR), a common chronic disease, impairs patients’ quality of life (QoL). This study aimed to determine the effect of perceived stress on disease-related QoL in AR patients. There were 741 patients from eight medical centers of the Allergic Rhinitis Cohort (ARCO) study. Data on sociodemographics, chronic conditions, AR severity, perceived stress level and Rhinoconjunctivitis QoL Questionnaire (RQLQ) results, and laboratory test findings were collected. The relationship between perceived stress and total RQLQ was analyzed using multiple linear regression. Potential confounding variables were adjusted. A high perceived stress level was associated with a high total RQLQ, which reflected worsening disease-related QoL. The high stress level was associated with an increased total RQLQ of 1.210 (95% confidence interval, 0.831–1.589; p < 0.0001) compared with the very low level. In the final model, the multiple regression-adjusted R2 for RQLQ in AR participants was 0.5279, and perceived stress levels contributed 4.08% in additional explanatory power to RQLQ in AR patients. In conclusion, perceived stress is a potentially modifiable risk factor for decreased disease-related QoL in patients with AR, which may be improved with stress management.
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Stress and Nasal Allergy: Corticotropin-Releasing Hormone Stimulates Mast Cell Degranulation and Proliferation in Human Nasal Mucosa. Int J Mol Sci 2021; 22:ijms22052773. [PMID: 33803422 PMCID: PMC7967145 DOI: 10.3390/ijms22052773] [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: 02/16/2021] [Revised: 02/27/2021] [Accepted: 03/06/2021] [Indexed: 12/12/2022] Open
Abstract
Psychological stress exacerbates mast cell (MC)-dependent inflammation, including nasal allergy, but the underlying mechanisms are not thoroughly understood. Because the key stress-mediating neurohormone, corticotropin-releasing hormone (CRH), induces human skin MC degranulation, we hypothesized that CRH may be a key player in stress-aggravated nasal allergy. In the current study, we probed this hypothesis in human nasal mucosa MCs (hM-MCs) in situ using nasal polyp organ culture and tested whether CRH is required for murine M-MC activation by perceived stress in vivo. CRH stimulation significantly increased the number of hM-MCs, stimulated both their degranulation and proliferation ex vivo, and increased stem cell factor (SCF) expression in human nasal mucosa epithelium. CRH also sensitized hM-MCs to further CRH stimulation and promoted a pro-inflammatory hM-MC phenotype. The CRH-induced increase in hM-MCs was mitigated by co-administration of CRH receptor type 1 (CRH-R1)-specific antagonist antalarmin, CRH-R1 small interfering RNA (siRNA), or SCF-neutralizing antibody. In vivo, restraint stress significantly increased the number and degranulation of murine M-MCs compared with sham-stressed mice. This effect was mitigated by intranasal antalarmin. Our data suggest that CRH is a major activator of hM-MC in nasal mucosa, in part via promoting SCF production, and that CRH-R1 antagonists such as antalarmin are promising candidate therapeutics for nasal mucosa neuroinflammation induced by perceived stress.
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Bai Y, Hu M, Ma F, Liu K, Xu H, Wu X, Wang H. Self-Reported Allergic Rhinitis Prevalence and Related Factors in Civil Aviation Aircrew of China. Aerosp Med Hum Perform 2021; 92:25-31. [PMID: 33357269 DOI: 10.3357/amhp.5727.2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
INTRODUCTION: Allergic rhinitis (AR) is a global health problem with gradually increasing prevalence. No large-scale, systematic, and comprehensive study on AR among civil aviation aircrew of China has been reported. We aimed to demonstrate the prevalence of and risk factors for self-reported AR among Chinese civil aviation aircrew.METHODS: This study randomly surveyed 4059 civil aviation aircrew members from 12 cities in mainland China. A structured questionnaire was tailored, designed, and electronically delivered to all participants. Based on self-reported results, prevalence of and risk factors for AR were calculated/analyzed.RESULTS: The prevalence of self-reported AR was 23.38%. Among aircrew members, 10.37% presented with ear barotraumas, whereas 9.95% reported symptom aggravation during flight. Of aircrew members, 10.32% had symptoms related to flight duration, whereas 4.43% of symptoms related to flight altitude. Significant differences between rhinorrhea and sneezing, as well as between nasal itching and sneezing, were observed in the Total Nasal Symptoms Scores (TNSS). The Rhino-conjunctivitis Quality of Life Questionnaire (RQLQ) showed significant correlation between each section. TNSS was significantly related to RQLQ. Both TNSS and RQLQ significantly correlated with flight time.CONCLUSIONS: The prevalence of self-reported AR among civil aviation aircrew is higher than the general population in China. The severity of nasal symptoms and complications are significantly associated with quality of life and flying duties.Bai Y, Hu M, Ma F, Liu K, Xu H, Wu X, Wang H. Self-reported allergic rhinitis prevalence and related factors in civil aviation aircrew of China. Aerosp Med Hum Perform. 2021; 92(1):2531.
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Schaefer M, Enck P. Effects of a probiotic treatment ( Enterococcus faecalis) and open-label placebo on symptoms of allergic rhinitis: study protocol for a randomised controlled trial. BMJ Open 2019; 9:e031339. [PMID: 31662387 PMCID: PMC6830672 DOI: 10.1136/bmjopen-2019-031339] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 09/03/2019] [Accepted: 09/18/2019] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Several studies suggest that gut microbiota may play an important role in allergic diseases. The present trial aims to examine effects of the probiotic Enterococcus faecalis on symptoms of allergic rhinitis in patients. Effects of this probiotic on the immune system have been reported by several studies, but the majority of the previous trials were animal studies. In addition, it is well known that symptoms in allergic rhinitis are prone to exhibit high placebo responses. Moreover, recent studies report that even placebos without deception (open-label placebos) are highly effective in reducing symptoms of allergic rhinitis. Our study design combines both new approaches to assess effects on allergic symptoms in patients. The objective of this study is to compare the effects of a probiotic treatment (E. faecalis) with effects seen by open-label placebo, concealed placebo treatment and no treatment control. METHODS AND ANALYSIS A total of 120 patients with allergic rhinitis will be randomly assigned to one of four different groups: a double-blind probiotic/placebo group (groups 1 and 2), an open-label placebo group (group 3) and a no-treatment group (group 4) to control for spontaneous variation of symptoms. The primary outcome is the evaluation of allergic symptoms using the Combined Symptoms Medication Score. Furthermore, health-related quality of life is examined (Rhinitis Quality of Life Questionnaire). Secondary outcomes include a visual analogue scale on allergic burden and a second quality of life questionnaire. This report describes the study design of the randomised controlled trial. ETHICS AND DISSEMINATION The study design was approved by the ethical committee of the UKT Department of Psychosomatic Medicine and Psychotherapy, Tübingen, Germany. The trial is registered at the German Clinical Trials Register (www.drks.de, DRKS00015804). The trial results will be published in peer-reviewed journals and at conferences. TRIAL REGISTRATION NUMBER German Clinical Trials Register (www.drks.de, DRKS00015804); Pre-results.
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Affiliation(s)
- Michael Schaefer
- Department Naturwissenschaften, Medical School Berlin, Berlin, Germany
| | - Paul Enck
- Department of Internal Medicine VI: Psychosomatic Medicine and Psychotherapy, University of Tubingen, Tübingen, Germany
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Chen S, Qu SH, Zhang Y, Wen ZH, Guo SN, Zeng WM, Hou XS, Jia YF, Xiao Y, Marmori F, Wang J, Zhao JP. Impact of acupuncture for allergic rhinitis on the activity of the hypothalamus-pituitary-adrenal axis: study protocol for a randomized controlled trial. Trials 2019; 20:372. [PMID: 31221225 PMCID: PMC6585009 DOI: 10.1186/s13063-019-3424-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Accepted: 05/10/2019] [Indexed: 11/15/2022] Open
Abstract
Background Patients with moderate and severe persistent allergic rhinitis (AR) have long-term physical and mental stress, leading to dysfunction of the hypothalamus-pituitary-adrenal (HPA) axis, which results in recurrence of AR. Previous research has proved acupuncture can regulate the function of the neuron-endocrine-immune system and contribute to improving the quality of life of patients with AR. This research aims to investigate the mechanism of acupuncture on the HPA axis in patients with moderate or severe persistent AR. Methods/design This randomized controlled trial aims to study the impact of acupuncture on the HPA axis of patients with moderate and severe AR. This research also aims to compare the curative effects of different treatments in three groups of patients: those receiving western medicine, western medicine and conventional acupuncture, or western medicine and mind-regulating acupuncture. We will study the therapeutic effect of acupuncture and the correlation between the changes of therapeutic indexes and experimental indexes after the treatments. Therapeutic indexes include the Visual Analog Scale (VAS) of nasal symptoms and the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) for AR patients; experimental indexes include corticotropin releasing hormone (CRH), adreno-corticotropic hormone (ACTH), cortisol (CORT), interleukin 4 (IL-4), and interferon-γ (IFN-γ). Discussion The results of this trial will provide evidence for the influence of chronic, long-term, repeated stimulation in patients with moderate and severe persistent AR and the impact of acupuncture on the HPA axis of these patients. Trial registration Acupuncture-Moxibustion Clinical Trial Registry, AMCTR-IOR-16000009. Registered on 22 August 2016.
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Affiliation(s)
- Sheng Chen
- Department of Acupuncture and Moxibustion, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Shu-Han Qu
- Department of Acupuncture and Moxibustion, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Yi Zhang
- Beijing Chaoyang Hospital, Beijing, China
| | - Zhi-Hong Wen
- Department of Acupuncture and Moxibustion, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Sheng-Nan Guo
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Wei-Mei Zeng
- Department of Acupuncture and Moxibustion, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Xue-Si Hou
- Department of Acupuncture and Moxibustion, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Yi-Fan Jia
- Department of Acupuncture and Moxibustion, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Yi Xiao
- Department of Acupuncture and Moxibustion, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Federico Marmori
- European Foundation of TCM, Alicante, Spain.,Acupuncture Department, Medimar International Hospital, Alicante, Spain
| | - Jun Wang
- Department of Acupuncture and Moxibustion, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China.
| | - Ji-Ping Zhao
- Department of Acupuncture and Moxibustion, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China.
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JIA YF, ZHAO JP, GUO SN, XIE Q, XIAO Y, CHEN S. Long-term effectiveness of moxibustion on herbs for moderate-severe persistent allergic rhinitis population: A study protocol for a randomized controlled trial. WORLD JOURNAL OF ACUPUNCTURE-MOXIBUSTION 2018. [DOI: 10.1016/j.wjam.2018.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Oland AA, Booster GD, Bender BG. Integrated behavioral health care for management of stress in allergic diseases. Ann Allergy Asthma Immunol 2018; 121:31-36. [PMID: 29751088 DOI: 10.1016/j.anai.2018.05.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 05/02/2018] [Accepted: 05/03/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVE This article reviews current findings regarding the management of stress in allergic disease. DATA SOURCES The authors use articles and books published between 1995 and 2017. Approximately 85% of sources used were published in the last 10 years, and 60% were published in the last 5 years. Most of the sources are peer-reviewed articles. STUDY SELECTIONS Articles that focused on allergic diseases such as allergic rhinitis, food allergies, urticaria, and allergic asthma were included. Articles in which whether the underlying disorder was allergic in nature (for example, nonspecified asthma) were not included. Preference was given to articles published within the past five years. RESULTS Patients with allergic diseases, particularly those with chronic or co-occurring allergic diseases, often experience stress and, in turn, this experience of stress can exacerbate disease presentation. High rates of treatment nonadherence in patients with allergic disease also can increase disease burden and stress. Research supports the benefit of behavioral health interventions for patients with allergic disease. Interventions with multidisciplinary teams, which include behavioral health, as well as interventions at the school, workplace, and community level, are recommended. CONCLUSION Medical providers working with patients with allergic disease need to address patients' experience of stress and nonadherence to treatment recommendations. This could be done through routine screening and referrals to behavioral health or, ideally, through incorporation of a behavioral health provider within a multidisciplinary patient team.
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Affiliation(s)
- Alyssa A Oland
- Department of Pediatrics, National Jewish Health, Denver, Colorado.
| | - Genery D Booster
- Department of Pediatrics, National Jewish Health, Denver, Colorado
| | - Bruce G Bender
- Department of Pediatrics, National Jewish Health, Denver, Colorado
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Linneberg A, Dam Petersen K, Hahn-Pedersen J, Hammerby E, Serup-Hansen N, Boxall N. Burden of allergic respiratory disease: a systematic review. Clin Mol Allergy 2016; 14:12. [PMID: 27708552 PMCID: PMC5041537 DOI: 10.1186/s12948-016-0049-9] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 09/22/2016] [Indexed: 11/22/2022] Open
Abstract
This meta-analysis compared the health-related quality of life (HRQL) of patients with allergic rhinitis (AR) and/or allergic asthma (AA) caused by perennial house dust mite (HDM) versus AR and/or AA caused by seasonal pollen allergy. Following a systematic search, the identified studies used the disease-specific rhinitis quality of life questionnaire or generic instruments (SF-36 and SF-12). Summary estimates obtained by meta-analysis showed that HRQL in patients with perennial HDM allergy was significantly worse than that of patients with seasonal pollen allergy, when measured by both disease-specific and generic HRQL instruments, and was reflected by an impact on both physical and mental health. A systematic review of cost data on AR and AA in selected European countries demonstrated that the majority of the economic burden was indirectly caused by high levels of absenteeism and presenteeism; there was little or no evidence of increasing or decreasing cost trends. Increased awareness of the detrimental effects of AR and/or AA on patients’ HRQL and its considerable cost burden might encourage early diagnosis and treatment, in order to minimize the disease burden and ensure beneficial and cost-effective outcomes.
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Affiliation(s)
- A Linneberg
- Research Centre for Prevention and Health, The Capital Region of Denmark, Copenhagen, Denmark ; Department of Clinical Experimental Research, Rigshospitalet, Copenhagen, Denmark ; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - K Dam Petersen
- Department of Business and Management, Faculty of Social Sciences, Aalborg University, Aalborg, Denmark
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