Impacts of meteorological and environmental factors on allergic rhinitis in children

Air pollution mixture associated with oxidative stress exacerbation and symptoms deterioration in allergic rhinitis patients: Evidence from a panel study

With allergic rhinitis (AR) on the rise globally, there has been a growing focus on the role of environmental pollutants in the onset of AR. However, the potential mechanisms by how and which these pollutants exacerbate AR conditions remain unknown. This panel study of 49 patients diagnosed with AR over one year aimed to assess the individual and combined effects of short-term exposure to multiple ambient pollutants on oxidative stress, symptoms, and quality of life among patients with AR. All participants underwent four repeated assessments of health conditions and personal environmental exposures (PM2.5, O3, SO2, and NO2) over warm and cold seasons during 2017-2018. We evaluated two oxidative stress biomarkers (malondialdehyde [MDA], and superoxide dismutase [SOD]) via nasal lavage. We collected information on self-reported symptoms and quality of life using the Rhinitis Symptom Scale (SRS), the Visual Analog Scale (VAS), and the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) through in-person interviews. Bayesian kernel machine regression (BKMR) was used to evaluate the joint effects of pollutant mixture and identify key contributors. The results revealed a significant association of the pollutant mixture when all four pollutants were at or above their median levels, with increased oxidative stress. This was evidenced by elevated MDA and reduced SOD. We found a joint detrimental effect of the pollutant mixture on AR symptoms with a strong association with increased SRS scores, but a non-significant positive association with VAS and RQLQ scores. PM2.5, O3, and SO2 presented as the potentially primary contributors to the adverse health effects associated with the pollutant mixture in Taiyuan city. Patients with AR exposed to short-term air pollutant mixture are more likely to have greater nasal symptoms and worse quality of life from increased oxidative stress and reduced antioxidant capacity. Further research is warranted to better elucidate the underlying mechanisms.

An Assessment of Human Opportunistic Pathogenic Bacteria on Daily Necessities in Nanjing City during Plum Rain Season

The plum rain season is a special climatic phenomenon in east Asia, which is characterized by persistent rainfall, a high temperature, and humidity, providing suitable environmental conditions for certain pathogenic bacteria, thus increasing the incidence of respiratory, gastrointestinal, and urinary diseases. However, studies on human opportunistic pathogenic bacteria communities during the plum rain season are still limited. In this study, the characteristics of human opportunistic pathogenic bacterial communities on daily necessities during the non-plum and plum rain seasons were investigated using high-throughput sequencing technology. The results revealed that the relative abundance of human opportunistic pathogenic bacteria was higher in the plum rain season (cotton cloth: 2.469%, electric bicycles: 0.724%, rice: 3.737%, and washbasins: 5.005%) than in the non-plum rain season (cotton cloth: 1.425%, electric bicycles: 0.601%, rice: 2.426%, and washbasins: 4.801%). Both temperature and relative humidity affected human opportunistic pathogenic bacterial communities. Stochastic processes dominated the assembly process of human opportunistic pathogenic bacterial communities, and undominated processes prevailed. The stability of the co-occurrence network was higher in the non-plum rain season than that in the plum rain season. In addition, the proportion of deterministic processes showed the same trend as the complexity of the co-occurrence network.

Short-term association of fine particulate matter and its constituents with oxidative stress, symptoms and quality of life in patients with allergic rhinitis: A panel study

BACKGROUND

Short-term exposure to fine particulate matter (PM2.5) and its specific constituents might exacerbate allergic rhinitis (AR) conditions. However, the evidence is still inconclusive.

METHOD

We conducted a panel study of 49 patients diagnosed with AR > 1 year prior to the study in Taiyuan, China, to investigate associations of individual exposure to PM2.5 and its constituents with oxidative parameters, symptoms, and quality of life among AR patients. All participants underwent repeated assessments of health and PM exposure at 4 time points in both the heating and nonheating seasons from June 2017 to January 2018. AR patients' oxidative parameters were assessed using nasal lavage, and their subjective symptoms and quality of life were determined through in-person interviews using a structured questionnaire. Short-term personal exposure to PM2.5 and its constituents was estimated using the time-microenvironment-activity pattern and data from the nearest air sampler, respectively. We applied mixed-effects regression models to estimate the short-term effects of PM2.5 and its constituents.

RESULTS

The results showed that exposure to PM2.5 and its constituents, including BaP, PAHs, SO42-, NH4+, V, Cr, Cu, As, Se, Cd, and Pb, was significantly associated with increased oxidative stress, as indicated by an increase in the malondialdehyde (MDA) index. Exposure to PM2.5 and its components (V, Mn, Fe, Zn, As, and Se) was associated with decreased antioxidant activity, as indicated by a decrease in the superoxide dismutase (SOD) index. Additionally, increased visual analog scale (VAS) and rhinoconjunctivitis quality of life questionnaire (RQLQ) scores indicated that exposure to PM2.5 and its constituents exacerbated inflammatory symptoms and affected quality of life in AR patients.

CONCLUSION

Exposure to PM2.5 and specific constituents, could exacerbate AR patients' inflammatory symptoms and adversely affect their quality of life in the heavily industrialized city of Taiyuan, China. These findings may have potential biological and policy implications.

Climate and human health: a review of publication trends in the International Journal of Biometeorology

The climate-health nexus is well documented in the field of biometeorology. Since its inception, Biometeorology has in many ways become the umbrella under which much of this collaborative research has been conducted. Whilst a range of review papers have considered the development of biometeorological research and its coverage in this journal, and a few have reviewed the literature on specific diseases, none have focused on the sub-field of climate and health as a whole. Since its first issue in 1957, the International Journal of Biometeorology has published a total of 2183 papers that broadly consider human health and its relationship with climate. In this review, we identify a total of 180 (8.3%, n = 2183) of these papers that specifically focus on the intersection between meteorological variables and specific, named diagnosable diseases, and explore the publication trends thereof. The number of publications on climate and health in the journal increases considerably since 2011. The largest number of publications on the topic was in 2017 (18) followed by 2021 (17). Of the 180 studies conducted, respiratory diseases accounted for 37.2% of the publications, cardiovascular disease 17%, and cerebrovascular disease 11.1%. The literature on climate and health in the journal is dominated by studies from the global North, with a particular focus on Asia and Europe. Only 2.2% and 8.3% of these studies explore empirical evidence from the African continent and South America respectively. These findings highlight the importance of continued research on climate and human health, especially in low- and lower-middle-income countries, the populations of which are more vulnerable to climate-sensitive illnesses.

Allergic rhinitis children with obesity are more vulnerable to air pollution: a cross sectional study

The association between air pollution, allergic rhinitis (AR), and obesity has not been studied. From 2007 to 2011, 52 obese and 152 non-obese children (7-17 years old) with AR were recruited. Pediatric-Rhinoconjunctivitis-Quality-of-Life Questionnaire (PRQLQ) and nasal peak expiratory flow (NPEF) were tested. Association between the scores and rates of the two tests and mean air pollutant concentrations within 7 days before the tests were compared. When exposed to higher concentrations of CO, PM₁₀, and PM_2.5, the rates of worse nasal discomfort were 39.4%, 44.4% and 39.3% in obese children; and 18.0%, 21.9% and 19.7% in non-obese children, respectively. Compare to non-obese children, the rates in obese children were higher for CO (odds ratio (OR) 3.54, 95% confidence interval (CI) 1.15 ~ 10.92); PM₁₀ (OR 3.26, 95% CI 1.01 ~ 10.57) and PM2.5 (OR 3.30; 95% CI 1.03 ~ 10.54). In obese children, correlations between higher concentrations of CO, PM₁₀, PM_2.5 and higher nasal discomfort (higher PRQLQ); and correlations between higher concentrations of CO, PM₁₀, PM_2.5, NMHC (non-methane hydrocarbon) and higher nasal mucosa inflammation (lower NPEF) were noted. Obesity negatively affected AR severity when AR children experienced higher concentrations of CO, PM₁₀, and PM_2.5. Increased nasal inflammation induced by air pollutants might be the underlying mechanism.

The effect of greenness on allergic rhinitis outcomes in children and adolescents: A systematic review and meta-analysis

BACKGROUND

The relationship between greenness and health emerges as new public health concern. More published studies from multiple areas have explored the relationship between greenness and allergic rhinitis (AR) in children and adolescents. This study aims to determine the association between greenness and allergic rhinitis by systematic review and meta-analysis, in order to provide a more comprehensive assessment of the impact of greenness on AR in children and adolescents.

METHODS

The relative literature was systematically searched in PubMed, Embase, and Web of science lastly on September 25, 2022. Terms related to greenness and allergic rhinitis were used for searching. Summary effect estimates of greenness on AR in children and adolescents were calculated for per 10 % increase of greenness exposure with different buffer sizes by random-effects model.

RESULTS

A total of 579 studies were screened, and fourteen studies from Europe, Asia and North America were finally included. Most greenness exposure were measured by normalized difference vegetation index (NDVI). Enhanced vegetation index, outdoor-green environmental score and existed to measuring different greenness types. Greenness surrounding residences and schools were assessed. The overall effect of greenness on primary outcome was 1.00 (95%CI = 0.99-1.00). Most effect estimates of greenness were included in the NDVI-500 m group, and the pooled OR was 0.99 (95%CI = 0.97-1.01). No significant pooled estimates were found in analyses with study locations.

CONCLUSION

This study indicates no significant association between greenness exposure and AR in children and adolescents. Various exposure measures and conversion of data may affect the results of this meta-analysis. More precise assessment of personal greenness exposure in well-designed prospective studies are vital for drawing a definite association in future. Furthermore, greenness exposure surrounding schools should be paid considerable attention for its effect on AR in school-aged children and adolescents.

The effect of fine particulate matter exposure on allergic rhinitis of adolescents aged 10-13 years: A cross-sectional study from Chongqing, China

Background

Allergic rhinitis (AR) has become a tremendous disease burden worldwide. Only a few studies have explored the effects of environmental exposure on the prevalence of AR in children in China.

Methods

In the present study, we investigated the associations of environmental exposure (including fine particulate matter (PM_2.5), air humidity, temperature, and passive smoking) with AR in adolescents aged 10-13 years in Chongqing. Data from 4,146 participants in urban and rural areas between March 2019 and May 2019 were collected.

Results

The overall prevalence of AR was 17.50% in adolescents. After adjusting for other covariates, AR was positively correlated with the annual mean PM_2.5 concentration, monthly mean PM_2.5 concentration and air temperature, and negatively related to air humidity. Furthermore, the annual mean PM_2.5 was positively associated with the risk of AR after adjusting for air temperature and humidity. Passive smoking (PS) was marginally associated with a high risk of AR.

Conclusion

High PM_2.5 exposure, high air temperature, and low air humidity were associated with a high risk of AR in adolescents. Our findings have potential implications for public health strategies and interventions aimed at reducing the burden of AR in adolescents.

Correlation of Pollen Concentration and Meteorological Factors with Medical Condition of Allergic Rhinitis in Shenyang Area

Background

The pathogenesis of allergic rhinitis (AR) was affected by meteorological and environmental factors. This study investigated the association between clinical symptoms of AR patients with pollen dispersal and meteorological conditions.

Methods

The clinical features of 10,838 AR patients who were treated in the Department of Otorhinolaryngology, The First Hospital of China Medical University, Shenyang, from March 2021 to October 2021 were retrospectively analyzed. We collected pollen by a pollen collector, read and counted it under a microscope, identified the species of the pollen particles, and recorded meteorological data (average daily temperature, maximum and minimum temperature, average daily wind, average daily precipitation, average daily humidity, average pressure, air quality index, PM2.5, PM10, SO₂, NO₂, CO, and O₃), to analyze the correlation among meteorological conditions, pollen dispersal, and number of AR visits. Finally, pollen allergen-positive and symptoms were scored.

Results

Among the AR visits, patients >41 years old accounted for the highest proportion (64.15%). 43.67% of the patients were complicated with bronchial asthma, and the disease incidence peaked in September. During the period of the study, a total of 27,512 pollen grains were collected, and 17 species were identified. The pollens of Compositae and Moraceae were the main allergenic sources leading to the increase in AR visits from August to September. The peak of pollen dispersal was in spring, summer, and autumn. The total amount of pollen was not only related to the average daily minimum temperature, average daily precipitation, and average daily humidity but also had a significant correlation with air quality index and air pollutants (PM2.5 and PM10, SO₂, NO₂, and CO). In addition, there was a significant correlation between the number of daily pollen allergen-positive patients and the pollen concentration of Compositae and Moraceae as well as air pollution components. The clinical symptoms of pollen allergen-positive patients were mainly nasal congestion, red/itchy eyes, and epiphora.

Conclusion

The peak seasons of pollen dispersal in Shenyang were in spring, summer, and autumn, and the allergenic pollens were mainly Compositae and Moraceae. In addition, AR was substantially correlated with pollen concentration and meteorological factors. This study may help provide early warning information and prevention for AR patients.

Screening of Concentration and Antimicrobial Effectiveness of Antimicrobial Preservative in Betastatin Besylate Nasal Spray

Objective

To explore the optimal concentration and antimicrobial effectiveness of antimicrobial preservative in betastatin besylate nasal spray.

Methods

By using Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, Candida albicans, and Aspergillus niger as test strains, the antimicrobial effectiveness of betastatin besylate nasal spray containing different concentrations of antimicrobial preservative (0.02%, 0.0125%, and 0.005% benzalkonium chloride, respectively) was determined by using bacteriostatic effect test (Chinese Pharmacopoeia, 2015 edition).

Results

The antimicrobial effectiveness of betastatin besylate nasal spray containing 0.02% and 0.0125% benzalkonium chloride, respectively, complied with the regulations of Chinese Pharmacopoeia (2015 Edition) against five test strains. However, the antimicrobial effectiveness of betastatin besylate nasal spray containing 0.005% benzalkonium chloride against P. aeruginosa did not meet the requirements of Chinese Pharmacopoeia.

Conclusion

Benzalkonium chloride at a concentration of 0.125% can be used as an added antimicrobial preservative in betastatin besylate nasal spray.

Allergic Rhinitis: Association with Air Pollution and Weather Changes, and Comparison with That of Allergic Conjunctivitis in Taiwan

Allergic conjunctivitis (AC) and rhinitis (AR) are common allergic diseases that may be environmentally related. We used a systematic sampling cohort database, which was applied in an AC study previously, to examine the association of AR with air pollution and weather changes. A case-crossover design coupled with conditional logistic analysis was implemented in the analysis; we identified 140,365 eligible AR subjects, and matched their diagnoses with environmental monitoring data. Unlike AC, the descriptive statistics indicated that AR occurred the most in adults under 50 years old by age (44.7%), and in winter by season (28.7%) (p < 0.001); similar to AC, AR occurred more in women than to men. Nitrogen dioxide (NO2) was found to be positively associated with AR (p < 0.001), whereas relative humidity and temperature were negatively related (p < 0.001). We found that the risk of AR increased with descending NO2 levels relative to AC (OR = 0.984, p = 0.003) after adjustment for covariates. It is suggested that AR could be triggered or exacerbated by lower levels of NO2 than is AC. We recommend that AR patients pay extra attention to air pollution and mitigate their allergic problem accordingly.

Investigation of the impact of PM2.5 on the ciliary motion of human nasal epithelial cells

Nasal epithelium provides a physical barrier to potentially harmful stimuli. Cilia, which is on the apical side of the human nasal epithelial cells (HNEpCs), plays a critical role in removing inhaled harmful matter. Ciliary beat frequency (CBF) and ciliary beat pattern (CBP) are the two important indicators for ciliary beat function. However, impacts of the fine particulate matter (PM_2.5) on CBF and CBP are still unknown. We aimed to evaluate the impact of PM_2.5 on the ciliary beat function of the HNEpCs and its potential mechanisms. After exposed to PM_2.5 for 12 h, cilia of HNEpCs were in disordered arrangement. The ciliary coverage rate was decreased after PM_2.5 exposure of a series of concentration, while the proportion of basal cells was continuously increased and could be observed on the apical side of the HNEpCs which is hardly be observed without PM_2.5 exposure. PM_2.5 increased the CBF after 12 h exposure, while 24 h exposure increased the CBF at the relative lower dosage groups and then made a decrease at relative higher dosage groups. CBF were classified into two different types, which had different changes following PM_2.5 exposure. CBP showed significant changes characterized as the increased dyskinesia index. Total levels of cellular ATP and the mitochondrial membrane potential were decreased following 12 h exposure of PM_2.5, while no change was found in O₂ consumption. In conclusion, PM_2.5 impact the ciliary beat function of HNEpCs, and the mitochondrial dysfunction might play an important role in it.

The short-term effects of cold spells on pediatric outpatient admission for allergic rhinitis in Hefei, China

BACKGROUND

Some studies have reported that cold weather is associated with the development of allergic rhinitis (AR), but the study of extreme cold temperatures and AR is scarced. This study was conducted to find out the optimal definition of the cold spells in Hefei and to explore the relationship between cold spells and childhood AR, further to identify potential susceptible populations.

METHODS

Data of daily AR, meteorological variables and air pollutants from January 1, 2014 to December 31, 2016 were collected in Hefei. Poisson generalized linear regression with a distributed-lag nonlinear model (DLNM) was used to explore the relationship between cold spells and daily pediatric outpatient with allergic rhinitis, by comparing the number of the admission during the cold spells with those during non-cold spells in cold seasons (December to April), after adjusting for relative humidity, air pollutants, seasonality, long-term trends, calendar month, holiday and day of the week (DOW).

RESULTS

All definitions of cold spells both had a certain impact on children with allergic rhinitis, and the trend of their effects was similar. The optimal cold spells was defined as the daily average temperature for below 10th with two consecutive days during the study period, and the greatest impact of cold spells was at lag0, with a 12.5% (95%CI: 6.3%-19.1%) increase of AR than non-cold spell days, and its impact could last for 2 days. Male children, children aged 5-18 years and non-scattered children were considered to be more vulnerable to AR in cold spell days.

CONCLUSIONS

There was evidence showed that the cold spells may significantly increase the pediatric outpatient admission for allergic rhinitis, especially for male children, children aged 5-18 years and non-scattered children. For the serious threat posed by cold spells, caregivers and health practitioners should strengthen their awareness of the prevention of vulnerable people.

The effects of particulate matters on allergic rhinitis in Nanjing, China

Particulate matter pollution is a serious environmental problem. Individuals exposed to particulate matters have an increased prevalence to diseases. In the present study, we performed an epidemiological study to investigate the effects of particulate matter less than 10 μm in aerodynamic diameter (PM₁₀) and particulate matter less than 2.5 μm in aerodynamic diameter (PM_2.5) on allergic rhinitis in Nanjing, China. Daily numbers of allergic rhinitis patients (33,063 patients), PM₁₀, PM_2.5, and weather data were collected from January 2014 to December 2016 in Nanjing, China. Generalized additive models (GAM) were used to evaluate the effects of PM₁₀ and PM_2.5 on allergic rhinitis. We found that the interquartile range (IQR) increases in PM₁₀ (difference of estimates, 5.86%; 95% CI, 3.00-8.81%; P = 4.72 × 10^-5) and PM_2.5 (difference of estimates, 5.39%; 95% CI, 2.73-8.12%; P = 5.67 × 10^-5) concentrations were associated with the higher increased numbers of allergic rhinitis patients with 3-day cumulative effects in single-pollutant model. In addition, we found that the IQR increase in PM₁₀ (age ≥ 18 years: 7.37%, 3.91-10.96%, 2.14 × 10^-5; 0-17 years: 0.83%, - 4.00-5.91%, 0.740) and PM_2.5 (age ≥ 18 years: 7.00%, 3.78-10.32%, 1.40 × 10^-5; 0-17 years: 0.40%, - 4.10-5.10%, 0.866) increased the number of allergic rhinitis patients in adults, but not in children. In summary, our findings suggested that exposure to PM₁₀ and PM_2.5 was associated with the risk of allergic rhinitis.

Onset and remission of childhood wheeze and rhinitis across China - Associations with early life indoor and outdoor air pollution

OBJECTIVE

Few longitudinal studies exist on childhood exposure to indoor and outdoor air pollution and respiratory illness in China. We studied associations between indoor and outdoor environment and prevalence, onset and remission of wheeze and rhinitis among children across China.

METHODS

Children (3-6 y) were recruited from randomized day care centres in six cities. The main data analysis was restricted to children not moving since birth (N = 17,679). Data on wheeze, rhinitis and the home environment were assessed by a parental questionnaire. Prevalence in the first two years of life (baseline) and the last year (follow-up) was used to calculate onset and remission. Outdoor PM_2.5, PM₁₀, and NO₂ at the day care centre were modelled from monitoring station data. Associations were calculated by multilevel logistic regression.

RESULTS

Prenatal NO₂ was associated with decreased remission of wheeze and increased prevalence and increased onset of rhinitis. Prenatal PM_2.5 was associated with increased prevalence of wheeze. Postnatal NO₂ and postnatal PM₁₀ were associated with increased prevalence and lower remission of wheeze and rhinitis. Mould, window pane condensation, renovation and cockroaches at home were associated with increased prevalence and increased onset of wheeze and rhinitis. Gas cooking was associated with increased onset of rhinitis. Children of mothers with industrial work had more wheeze.

CONCLUSIONS

Outdoor PM_2.5, PM₁₀ and NO₂ can increase childhood wheeze and rhinitis. Dampness and mould can increase onset and decrease remission. Crowdedness, cockroaches at home and emissions from new building materials and gas cooking can be risk factors for wheeze and rhinitis.

From genomes to diaries: a 3-year prospective, real-life study of ragweed-specific sublingual immunotherapy

During the last decades, the prevalence of allergy has dramatically increased. Allergen-specific immunotherapy is the only currently available medical intervention that has the potential to affect the natural course of the disease, but there are still many questions and unmet needs hindering its widespread use to fulfill its treatment potential and maximize its benefits for the society. To provide a comprehensive phenome-wide overview in sublingual immunotherapy, using ragweed allergy as a target, we planned and carried out a longitudinal, prospective, observational, open-label study (DesensIT). In this paper we present challenges of using deep and comprehensive phenotypes embracing biological, clinical and patient-reported outcomes in allergen-specific immunotherapy and show how we designed the DesensIT project to optimize data collection, processing and evaluation.