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Dykewicz MS, Wallace DV, Bandi S, Mahdavinia M, Sedaghat AR. Patient-Reported Outcome Measures in Rhinitis and Chronic Rhinosinusitis. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:2574-2582. [PMID: 39004415 DOI: 10.1016/j.jaip.2024.06.049] [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: 05/05/2024] [Revised: 06/19/2024] [Accepted: 06/27/2024] [Indexed: 07/16/2024]
Abstract
Patient-reported outcome measures (PROMs) are valuable in the assessment and management of rhinitis and chronic rhinosinusitis (CRS). They measure outcomes that may include symptoms, disease control, well-being, and health-related quality of life (QOL). PROMs for rhinitis and rhinosinusitis are often used before and after an intervention, for example, medication, therapeutic procedure, or, in allergic rhinitis (AR), allergen immunotherapy. Although widely used in clinical trials for AR and conjunctivitis, symptom score PROMs are less validated than disease control or QOL measures. The best validated PROM for AR is the Rhinitis Quality of Life Questionnaire, but there is no universally accepted criterion standard for symptom and disease control PROMs. For CRS, at least 15 different criteria have been used to assess disease control in clinical studies, but what CRS disease control means and how it should be measured are concepts in evolution. The most used QOL measure for CRS is the 22-item Sinonasal Outcome Test. The use of PROMs to support clinical decisions and for shared decision-making for rhinitis and rhinosinusitis still has many challenges, including the selection of the preferred instrument, when and how to administer, the impact of comorbidities, and questionnaire fatigue for both patient and provider.
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Affiliation(s)
- Mark S Dykewicz
- Section of Allergy and Immunology, Department of Internal Medicine, Saint Louis University School of Medicine, Saint Louis, Mo.
| | - Dana V Wallace
- Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, Fla
| | - Sindhura Bandi
- Division of Allergy and Immunology, Department of Internal Medicine, Rush University Medical Center, Chicago, Ill
| | - Mahboobeh Mahdavinia
- Division of Allergy/Immunology, Department of Internal Medicine, University of Texas Health, Houston, Texas
| | - Ahmad R Sedaghat
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio
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Fried J, Yuen E, Li A, Zhang K, Nguyen SA, Gudis DA, Rowan NR, Schlosser RJ. Rhinologic disease and its impact on sleep: a systematic review. Int Forum Allergy Rhinol 2020; 11:1074-1086. [PMID: 33275331 DOI: 10.1002/alr.22740] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 10/28/2020] [Accepted: 11/05/2020] [Indexed: 01/26/2023]
Abstract
BACKGROUND Rhinologic disease can be responsible for systemic symptoms affecting mood, cognition, and sleep. It is unclear whether sleep disturbance in specific rhinologic disorders (chronic rhinosinusitis [CRS], rhinitis, and nasal septal deviation [NSD]) is an obstructive phenomenon or due to other mechanisms. In this review we examine the impact of CRS, rhinitis, and NSD on objective and subjective sleep outcome metrics and draw comparisons to normal controls and patients with known obstructive sleep apnea (OSA). METHODS A systematic review of 4 databases (PubMed, Scopus, Cochrane Library, and Web of Science) was performed. Studies reporting on objective (apnea-hypopnea index [AHI], respiratory disturbance index [RDI], oxygen nadir) and subjective (Epworth Sleepiness Scale [EpSS], Pittsburgh Sleep Quality Index [PSQI], Fatigue Severity Scale [FSS]) sleep parameters and disease-specific patient-reported outcome measures (PROMs; 22-item Sino-Nasal Outcome Test [SNOT-22], Rhinoconjunctivitis Quality of Life Questionnaire [RQLQ], Nasal Obstruction Symptom Evaluation [NOSE]) were included. RESULTS The database search yielded 1414 unique articles, of which 103 were included for analysis. Baseline PROMs were at the high end of normal to abnormal for all 3 conditions: EpSS: CRS (9.8 ± 4.0), rhinitis (9.7 ± 4.3), and NSD (8.9 ± 4.6); and PSQI: CRS (11.0 ± 4.5), rhinitis (6.1 ± 3.7), and NSD (8.6 ± 3.5). Objective measures demonstrated a mild to moderate OSA in the studied diseases: AHI: CRS (10.4 ± 11.5), rhinitis (8.6 ± 8.8), and NSD (13.0 ± 6.9). There were significant differences when compared with reported norms in all measured outcomes (p < 0.001). CONCLUSION Sleep quality is impacted by rhinologic (CRS, rhinitis, NSD) disease. There is likely a mild obstructive component contributing to poor sleep, but other contributing factors may be involved.
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Affiliation(s)
- Jacob Fried
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
| | - Erick Yuen
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
| | - Andraia Li
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
| | - Kathy Zhang
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
| | - Shaun A Nguyen
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
| | - David A Gudis
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Irving Medical Center, New York, NY
| | - Nicholas R Rowan
- Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Rodney J Schlosser
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
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Gultuna S, Tezel N, Ozalp Ates FS. Fibromyalgia in the Patients With Allergic Rhinitis: Its Prevalence and Impact on the Quality of Life. Am J Rhinol Allergy 2019; 33:716-722. [DOI: 10.1177/1945892419864526] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background Allergic rhinitis (AR) is a common allergic diseases which affect a patient’s quality of life. Another important disease which has a negative impact on quality of life is fibromyalgia (FM). Some studies have suggested that a probable relationship exists between atopic diseases and FM. Objectives This study was designed to determine the prevalence of FM and its impact on quality of life among AR patients. Methods One hundred five consecutive adult patients with AR who were between 18 and 57 years old were prospectively recruited in this study between April 2017 and May 2018. All patients were evaluated for the presences of FM. Patients were diagnosed with FM according to the classification criteria of the 2010 American College of Rheumatology. The patients’ quality of life was evaluated by Turkish versions of the Rhinoconjunctivitis Quality of Life Questionnaire and the Nottingham Health Profile (NHP). Results Thirty-four patients were diagnosed as having FM (32.4%). The percentage of FM was considerably higher than in the general population (2%–5%). Median individual domain scores except practical problems ( P = .108) and eyes symptoms ( P = .227) were significantly higher in AR with FM patients ( P < .001). All median levels of the NHP domains were significantly higher in AR with FM patients ( P < .001). Conclusion We would like to suggest that FM may be considered as one of the overlooked comorbid conditions in AR patients. Physicians should be aware of the occurrence of FM, especially in patients with impaired quality of life.
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Affiliation(s)
- Selcan Gultuna
- Department of Immunology and Allergy, Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Nihal Tezel
- Department of Physical Medicine and Rehabilitation, Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ankara, Turkey
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Calderón MA, Casale TB, Demoly P. Validation of Patient-Reported Outcomes for Clinical Trials in Allergic Rhinitis: A Systematic Review. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 7:1450-1461.e6. [PMID: 30797777 DOI: 10.1016/j.jaip.2019.01.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Revised: 01/05/2019] [Accepted: 01/07/2019] [Indexed: 01/07/2023]
Abstract
Although regulatory authorities have recently recommended the use of a combined symptom-medication score as a primary efficacy end point, none has been psychometrically validated. Here, we sought to determine to what extent allergic rhinitis (AR)-related patient-reported outcomes (symptom scores, medication scores, disease control scores, and satisfaction or quality-of-life scales) have been assessed for construct, content, and/or criterion validity, reliability, responsiveness, and the minimal clinically important difference. We searched the PubMed database from January 1997 to June 2018 with logical combinations of key words related to validation, AR, and patient-rated outcomes and scales. From a total of 1705 potentially relevant publications, 55 were reviewed. Despite the current emphasis on a combined symptom-medication score for evaluating the efficacy of allergen immunotherapy in AR, symptom scores have not been extensively validated, and we did not find any publications describing the validation of a medication score. Disease control scales (mainly the Rhinitis Control Assessment Test, the Control of Allergic Rhinitis and Asthma Test, and the Allergic Rhinitis Control Test) and health-related quality-of-life scales (mainly the Rhinoconjunctivitis Quality of Life Questionnaire [RQLQ] and the mini-RQLQ) have been extensively validated in AR but have some practical disadvantages as primary efficacy criteria in clinical trials.
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Affiliation(s)
- Moises A Calderón
- National Heart & Lung Institute, Imperial College London, Royal Brompton Hospital NHS, London, United Kingdom
| | - Thomas B Casale
- Division of Allergy and Immunology, University of South Florida, Tampa, Fla
| | - Pascal Demoly
- Division of Allergy, Department of Pulmonology, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, France; Sorbonne Universités, UMR-S 1136, IPLESP, Equipe EPAR, Paris, France.
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Efficacy of allergen-blocker mechanical barrier gel on symptoms and quality of life in patients with allergic rhinitis. Eur Arch Otorhinolaryngol 2018; 276:729-734. [PMID: 30554359 DOI: 10.1007/s00405-018-5251-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 12/12/2018] [Indexed: 10/27/2022]
Abstract
PROPOSE Allergic rhinitis (AR) is a very common, chronic and global health problem. In the last two decades, the efficiency of barrier-enforcing measures in AR has been investigated. In this study, we aimed to evaluate the effect of allergen-blocker mechanical barrier gel (MBG) (AlerjiSTOP®) treatment on symptoms and quality of life score (QoLS) in patients with seasonal and perennial allergic rhinitis. METHODS A single-center, prospective study was conducted between January 2017 and May 2018. Patients diagnosed with allergic rhinitis with a visual analogue scale (VAS) of 5 or higher (moderate/severe) were enrolled in the study. Patients were evaluated in terms of VAS, nasal symptom score (NSS), ocular symptom score (OSS), total symptom score (TSS) and QoLS at baseline, 1 week and 1 month of MBG treatment. RESULTS A total of 83 patients with AR were enrolled in the study. Clinical and laboratory examinations showed that 50 (60.2%) patients were mono-sensitized. Allergen-blocker mechanical barrier gel treatment was performed as monotherapy in 22 (26.5%) patients. Median VAS, NSS, OSS and TSS decreased from 7 to 4, 8 to 3, 4 to 0 and 12 to 4, respectively (p < 0.0001). Correlation analysis revealed positive correlations between lower pediatric rhinoconjunctivitis quality of life questionnaire scores for patients under 12 years of age and decrease in VAS, NSS and TSS (r = 0.380, p = 0.008; r = 0.544, p < 0.0001; r = 0.543, p < 0.0001). Positive correlations were detected between lower rhinoconjunctivitis quality of life questionnaire (self-administered) scores for patients ≥ 12 years of age and decrease in VAS, NSS, OSS and TSS (r = 0.703, p < 0.0001; r = 0.465, p = 0.005; r = 0.526, p = 0.001; r = 0.624, p < 0.0001). CONCLUSION In conclusion, we found significant decrease in all symptom scores and improvement in QoLS of patients treated with MBG as monotherapy and combination therapy.
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Turhal G, Göde S, Tunakan Dalgıç C, Sin AZ, Kısmalı E, Kaya İ, Öztürk A, Göksel Ö, Midilli R, Öztürk K, Karcı B. Evaluation of Inferior Turbinate Stroma with Ultrasound Elastography in Allergic Rhinitis Patients. Balkan Med J 2017; 34:318-322. [PMID: 28443598 PMCID: PMC5615964 DOI: 10.4274/balkanmedj.2016.1339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: Diagnosis of allergic rhinitis is primarily based on history, physical examination and allergy testing. A technique that noninvasively evaluates the soft tissue changes in the nasal mucosa of allergic rhinitis patients has not been defined. Aims: To assess nasal mucosal changes and measure the submucosal fibrosis in allergic rhinitis patients with sonoelastography. Study Design: Case control study. Methods: Eighty-eight turbinates of 44 patients were included in the study. There were 23 prick test positive allergic rhinitis patients. The control group constituted 21 patients. The rhinitis quality of life questionnaire and the visual analogue scale were applied to the allergic rhinitis patients. A higher visual analogue scale score indicated more severe allergic rhinitis symptoms. Sonoelastographic measurements were made from the lateral nasal wall. The propagation speed of sound waves was recorded in m/s. The presence of asthma and the type of allergic rhinitis (seasonal or perennial) was noted. Results: Ten patients had seasonal allergic rhinitis and thirteen patients had perennial allergic rhinitis. Six patients (26.1%) had accompanying asthma along with allergic rhinitis. The median visual analogue scale score was 7 (3-9) in allergic rhinitis patients. The median symptom duration was 7 (1-24) months. The median quality of life questionnaire score was 3.39 (1.68-5.43) points. The median sonoelastography scores of allergic rhinitis patients and healthy subjects were 2.38 m/s (0.9-4.47) and 2.42 m/s (1.62-3.50), respectively. Sonoelastographic measurements of seasonal and perennial allergic rhinitis patients did not differ significantly (p>0.05). The presence of asthma did not have a significant impact on the elastography measurements (p>0.05). However, regression analysis revealed a significant inverse correlation (coefficients: B=0.005, standard error=0.097, beta 0=0.008) between the visual analogue scale and sonoelastography scores (p<0.05). Conclusion: Sonoelastography was not suitable as a diagnostic tool in allergic rhinitis. Reduced sonoelastography scores were measured in more symptomatic patients. Higher visual analogue scale scores could be an indicator of disease severity.
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Affiliation(s)
- Göksel Turhal
- Department of Otolaryngology, Ege University School of Medicine, İzmir, Turkey
| | - Sercan Göde
- Department of Otolaryngology, Ege University School of Medicine, İzmir, Turkey
| | - Ceyda Tunakan Dalgıç
- Department of Allergy and Immunology, Ege University School of Medicine, İzmir, Turkey
| | - Aytül Zerrin Sin
- Department of Allergy and Immunology, Ege University School of Medicine, İzmir, Turkey
| | - Erkan Kısmalı
- Department of Radiology, Ege University School of Medinice, İzmir, Turkey
| | - İsa Kaya
- Department of Otolaryngology, Ege University School of Medicine, İzmir, Turkey
| | - Arın Öztürk
- Department of Otolaryngology, Ege University School of Medicine, İzmir, Turkey
| | - Özlem Göksel
- Department of Pulmonology, Ege University School of Medicine, İzmir, Turkey
| | - Raşit Midilli
- Department of Otolaryngology, Ege University School of Medicine, İzmir, Turkey
| | - Kerem Öztürk
- Department of Otolaryngology, Ege University School of Medicine, İzmir, Turkey
| | - Bülent Karcı
- Department of Otolaryngology, Ege University School of Medicine, İzmir, Turkey
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Soyyigit S, Guloglu D, Ikinciogullari A, Secil D, Oztuna D, Mungan D, Misirligil Z, Sin BA. Immunologic alterations and efficacy of subcutaneous immunotherapy with Dermatophagoides pteronyssinus in monosensitized and polysensitized patients. Ann Allergy Asthma Immunol 2016; 116:244-251.e2. [PMID: 26945497 DOI: 10.1016/j.anai.2016.01.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 12/17/2015] [Accepted: 01/07/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND There is a continuing debate about whether monoallergen subcutaneous immunotherapy (SCIT) is able to modulate immune and clinical responses toward main causal allergen in polysensitized patients. OBJECTIVE To investigate short-term immunologic changes and clinical effectiveness of SCIT with Dermatophagoides pteronyssinus in monosensitized and polysensitized patients who have rhinitis with or without asthma. METHODS Nineteen monosensitized and 24 polysensitized patients participated in this prospective, self-placebo-controlled, interventional study. Cluster immunotherapy with D pteronyssinus was administered after 2 months of placebo in both groups. Immunologic parameters, including CD203c expression on basophils after allergen stimulation, total IgE, specific IgE, and specific IgG4, were evaluated at baseline, after placebo, and after immunotherapy. Clinical effectiveness was assessed using monthly symptom-medication scores, visual analog scale, quality-of-life questionnaire, and nasal allergen provocation test. RESULTS At baseline, polysensitized patients had higher CD203c expression on basophils than monosensitized patients (P = .007). Activated basophils expressing CD203c, total IgE, and specific IgG4 were significantly increased after immunotherapy compared with baseline and placebo in the polysensitized group (P < .025). After immunotherapy, specific IgE and D pteronyssinus-induced CD203c expression were significantly higher in polysensitized than monosensitized patients (P < .05). The total symptom scores and the Mini Rhinoconjunctivitis Quality of Life Questionnaire scores in polysensitized patients and the visual analog scale scores in both groups were lower after immunotherapy compared with baseline and placebo (P < .025). Titrated nasal allergen provocation test with D pteronyssinus increased after immunotherapy in the monosensitized group (P < .05). CONCLUSION This study indicates that monosensitized and polysensitized patients have distinct humoral response and basophil behavior to SCIT. However, a single-allergen immunotherapy corresponding to the most clinically troublesome allergy in polysensitized patients can lead to early clinical efficacy comparable to that seen in monosensitized patients. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01795846.
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Affiliation(s)
- Sadan Soyyigit
- Division of Immunology and Allergic Diseases, Department of Chest Diseases, Ankara University, School of Medicine, Ankara, Turkey
| | - Deniz Guloglu
- Department of Pediatric Immunology and Allergy, Ankara University, School of Medicine, Ankara, Turkey
| | - Aydan Ikinciogullari
- Department of Pediatric Immunology and Allergy, Ankara University, School of Medicine, Ankara, Turkey
| | - Derya Secil
- Division of Immunology and Allergic Diseases, Department of Chest Diseases, Ankara University, School of Medicine, Ankara, Turkey
| | - Derya Oztuna
- Department of Biostatistics, Ankara University, School of Medicine, Ankara, Turkey
| | - Dilsad Mungan
- Division of Immunology and Allergic Diseases, Department of Chest Diseases, Ankara University, School of Medicine, Ankara, Turkey
| | - Zeynep Misirligil
- Division of Immunology and Allergic Diseases, Department of Chest Diseases, Ankara University, School of Medicine, Ankara, Turkey
| | - Betul Ayse Sin
- Division of Immunology and Allergic Diseases, Department of Chest Diseases, Ankara University, School of Medicine, Ankara, Turkey.
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Comert S, Karakaya G, Kalyoncu AF. Wraparound eyeglasses improve symptoms and quality of life in patients with seasonal allergic rhinoconjunctivitis. Int Forum Allergy Rhinol 2016; 6:722-30. [DOI: 10.1002/alr.21737] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 12/04/2015] [Accepted: 12/31/2015] [Indexed: 01/05/2023]
Affiliation(s)
- Sule Comert
- Department of Chest Diseases, Division of Allergy and Clinical Immunology; School of Medicine, Hacettepe University; Ankara Turkey
| | - Gul Karakaya
- Department of Chest Diseases, Division of Allergy and Clinical Immunology; School of Medicine, Hacettepe University; Ankara Turkey
| | - Ali Fuat Kalyoncu
- Department of Chest Diseases, Division of Allergy and Clinical Immunology; School of Medicine, Hacettepe University; Ankara Turkey
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Kepil Özdemir S, Sin BA, Güloğlu D, İkincioğulları A, Gençtürk Z, Mısırlıgil Z. Short-term preseasonal immunotherapy: is early clinical efficacy related to the basophil response? Int Arch Allergy Immunol 2014; 164:237-45. [PMID: 25170594 DOI: 10.1159/000365628] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Accepted: 06/27/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND An aluminum hydroxide-adsorbed depot allergoid preparation of six-grass pollen allergens has been developed for short-term preseasonal immunotherapy in pollinosis. However, only limited knowledge exists about its immunological and clinical effects. The aim of this study was to evaluate the basophil response, which can explain early clinical findings of short-term preseasonal allergoid immunotherapy in allergic rhinitis. METHODS In a double-blind, placebo-controlled study, 31 patients allergic to grass pollens received one course of short-term preseasonal allergoid immunotherapy or placebo. Immunogenicity was assessed by the levels of specific IgG4, IgE antibodies and an allergen-induced CD203c basophil activation test. The primary clinical end point was the combined symptom and medication score/average combined score (ACS). RESULTS There was a 52.9% difference in ACS between the treatment and placebo groups in favor of immunotherapy (p = 0.01). Active treatment induced Phleum pratense-specific IgG4 and IgE antibodies (p < 0.05). A decrease in allergen-induced basophil activation at submaximal allergen concentrations was demonstrated at the end of immunotherapy and at the peak of the grass pollen season after immunotherapy. CONCLUSIONS This study shows that grass pollen-allergic patients treated with one course of short-term preseasonal allergoid immunotherapy exhibit a decrease in allergen-induced basophil activation, an increase in allergen-specific IgG4 antibodies and early clinical improvement.
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Affiliation(s)
- Seçil Kepil Özdemir
- Divisions of Immunology and Allergy, Ankara University School of Medicine, Ankara, Turkey
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Ozkaya E, Akduman H, Erenberk U, Demir A, Dundaroz MR. Plasma paraoxonase activity and oxidative stress and their relationship to disease severity in children with allergic rhinitis. Am J Rhinol Allergy 2013; 27:13-7. [PMID: 23406590 DOI: 10.2500/ajra.2013.27.3837] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Oxidative stress may play a role in the pathophysiology of several diseases including allergic rhinitis (AR). In children with AR an antioxidant enzyme paraoxonase (PON1) has not been previously investigated. The aim of this study was to investigate plasma PON1 activity and plasma total oxidant status (TOS), which are in the form of plasma reactive oxidants, and their association with severity of disease in house-mite-sensitive children with AR. METHODS This study included 66 children with persistent AR and 40 healthy controls aged between 7 and 12 years old. Plasma PON1, TOS, and total serum immunoglobulin E (IgE) were measured. The nasal symptom scores and body mass index were evaluated at the time of blood collection. RESULTS Mean serum PON1 levels were significantly lower and, TOS levels were higher in the patient group than in the control group (p ≤ 0.001 and p ≤ 0.002, respectively). A significant negative correlation was observed between serum levels of PON1 and nasal symptom scores. However, serum levels of TOS were correlated with nasal symptom scores positively. There were no correlations between levels of total IgE and levels of PON1 and TOS levels. CONCLUSION Plasma PON1 and TOS levels may serve as predictors of disease severity in children with AR and both of them appear to be attractive candidates for modulating inflammation in AR.
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Affiliation(s)
- Emin Ozkaya
- Division of Pediatric Allergy, Bezmialem Vakif University, Istanbul, Turkey.
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Maspero J, Lee BW, Katelaris CH, Potter PC, Cingi C, Lopatin A, Saffer M, Nadeau G, Walters RD. Quality of life and control of allergic rhinitis in patients from regions beyond western Europe and the United States. Clin Exp Allergy 2012. [DOI: 10.1111/j.1365-2222.2012.04025.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- J. Maspero
- Paraguay 2035 Cuerpo 3°; Fundación Cidea; Buenos Aires; Argentina
| | - B. W. Lee
- Department of Paediatrics; National University Hospital; Singapore
| | - C. H. Katelaris
- Immunology & Allergy; University of Western Sydney; New South Wales; Australia
| | - P. C. Potter
- Allergy Diagnostic and Clinical Research Unit; University of Cape Town Lung Institute; Cape Town; South Africa
| | - C. Cingi
- Department of Otorhinolaryngology; Medical Faculty; Osmangazi University; Eskisehir; Turkey
| | - A. Lopatin
- Clinic of Ear, Nose and Throat Diseases; First State Medical University; Moscow; Russia
| | - M. Saffer
- Ambulatório de Otorrino; Complexo Hospitalar Santa Casa de Porto Alegre; Porto Alegre; Brazil
| | - G. Nadeau
- Medical Affairs; GlaxoSmithKline; Brentford; London; UK
| | - R. D. Walters
- Medical Affairs; GlaxoSmithKline; Brentford; London; UK
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Intranasal steroids or radiofrequency turbinoplasty in persistent allergic rhinitis: effects on quality of life and objective parameters. Eur Arch Otorhinolaryngol 2010; 268:845-50. [DOI: 10.1007/s00405-010-1462-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2010] [Accepted: 12/06/2010] [Indexed: 12/16/2022]
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