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Zeiger RS, Schatz M, Pomichowski ME, Li Q, Slezak JM, Nolte H, Takhar HS. Real-world assessment of anaphylaxis and eosinophilic esophagitis with 12 SQ house dust mite SLIT-tablet sublingual immunotherapy. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. GLOBAL 2024; 3:100250. [PMID: 38699651 PMCID: PMC11063596 DOI: 10.1016/j.jacig.2024.100250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 03/02/2024] [Accepted: 03/05/2024] [Indexed: 05/05/2024]
Abstract
Background Sublingual immunotherapy (SLIT) with 12 SQ house dust mile SLIT-tablet (HDM SLIT-tablet) for dust mite-induced perennial allergic rhinitis is reported as effective and safe. Although serious allergic reactions (SARs) and eosinophilic esophagitis (EoE) have infrequently occurred under trial conditions, the safety of HDM SLIT-tablet challenge under real-world conditions is unknown. Objective Our aim was to estimate the incidence of SARs and EoE due to HDM SLIT-tablet challenge. Methods Through use of administrative data from Kaiser Permanente Southern California, this prospective observational study identified patients newly administered HDM SLIT-tablet with follow-up until SLIT discontinuation or end of study. Suspected cases of SARs and EoE were detected by using International Classification of Diseases, 10th Revision, diagnosis and Current Procedural Terminology procedure codes and medication dispensing records. A 3-member clinical review committee of allergists adjudicated suspected reactions. The incidence rate of confirmed SARs and EoE per 1000 person years of exposure were determined. Results A total of 521 patients (93.9% adult and 6.1% pediatric) were exposed to HDM SLIT-tablet challenge from January 2018 through May 2023, for 440.4 person years of exposure. The patients' average age (SD) was 39.3 (14.1) years, 58.7% were female, 44.3% were non-Hispanic White, 40.3% had asthma, and 15.0% had gastroesophageal reflux disease. A SAR occurred in 1 adult patient, and during initial HDM SLIT-tablet challenge, SARs occurred in 2 pediatric adolescents, for an overall incidence of 6.8 SARs per 1000 patient years (95% CI = 2.2-21.1). EoE occurred in 1 adult patient, for an overall incidence of 2.3 cases of EoE per 1000 patient years (95% CI = 0.3-16.1). Conclusions This real-world study demonstrated that SARs and EoE were infrequent events with HDM SLIT-tablet use, supporting the safety of HDM SLIT-tablets and need for physician supervision with initial challenge.
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Affiliation(s)
- Robert S. Zeiger
- Department of Allergy Kaiser Permanente Southern California, San Diego, Calif
- Department of Clinical Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, Calif
| | - Michael Schatz
- Department of Allergy Kaiser Permanente Southern California, San Diego, Calif
| | | | - Qiaowu Li
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, Calif
| | - Jeff M. Slezak
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, Calif
| | | | - Harpreet S. Takhar
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, Calif
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Ahatov R, Pinto-Cuberos J, Wagner RF, Winsett F. Tarsonemidae Mite Infestation in a Mohs Laboratory. Dermatol Surg 2024; 50:681-682. [PMID: 38427919 DOI: 10.1097/dss.0000000000004141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Affiliation(s)
- Renat Ahatov
- Department of Dermatology, The University of Texas Medical Branch, Galveston, Texas
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Cheng DT, Wee LYJ, Teoh OH, Thomas B. Approach to difficult-to-treat asthma in childhood: a narrative review. Singapore Med J 2024:00077293-990000000-00095. [PMID: 38363652 DOI: 10.4103/singaporemedj.smj-2023-137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 09/02/2023] [Indexed: 02/18/2024]
Abstract
ABSTRACT Asthma is a major chronic disease affecting children, and children with difficult-to-treat asthma account for a disproportionate share of resource utilisation and healthcare costs. This review presents a comprehensive and up-to-date overview of the treatment strategies in difficult-to-treat paediatric asthma. Mimickers of asthma must first be ruled out, and the diagnosis confirmed with objective tests whenever possible. The effect of comorbid conditions such as obesity, smoking, other atopic conditions and psychosocial factors on asthma control and severity should be considered. Treatment can then be optimised by implementing personalised strategies, including the use of appropriate drug delivery devices and adherence monitoring. Biologics can be an alternative treatment option for selected patients but should not be a substitute for addressing poor adherence. Many patients with difficult-to-treat asthma may not have severe asthma, and the physician should work with patients and families to achieve good asthma control via an individualised approach.
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Affiliation(s)
- Duo-Tong Cheng
- Department of Paediatrics, Respiratory Medicine Service, KK Women's and Children's Hospital, Singapore
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Aldem Budak M, Geckil E. The effect of home environment modification nursing intervention on symptom control, quality of life, and number of triggers in children with allergic rhinitis: A randomized controlled trial. J Pediatr Nurs 2024; 74:e28-e37. [PMID: 37996355 DOI: 10.1016/j.pedn.2023.10.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/30/2023] [Accepted: 10/30/2023] [Indexed: 11/25/2023]
Abstract
PURPOSE The study was conducted to investigate the effects of a nursing intervention aimed at home environment modification on symptom control, quality of life, and the number of triggers in children with allergic rhinitis. DESIGN AND METHODS This one-to-one, parallel-arm, randomized controlled trial was conducted with a pre-test/post-test design. The study used stratified sampling method. A total of 52 participants were randomly assigned to the intervention group (n = 26) and the control group (n = 26). The intervention group received education on home environment modification and the child was provided with anti-allergic bedding set. The control group continued with routine practices. Statistical significance was set at p < 0.05. RESULTS After the nursing intervention for home environment modification, a significant difference was found between the groups in terms of the number of home environment triggers (p < 0.05). According to the mean scores of the Pediatric Rhinoconjunctivitis Quality of Life Questionnaire, no significant difference was found between the groups (p > 0.05). There was no significant difference between the groups in terms of the mean scores for nasal discharge, nasal congestion, sneezing, nasal itching, and eye itching (p > 0.05) after the nursing intervention for home environment modification. CONCLUSION The findings indicate that the nursing intervention for home environment modification is an effective method in reducing the number of triggers in the home environment. However, no significant impact was observed on symptom control and quality of life. PRACTICAL IMPLICATIONS Awareness can be increased by educating children with allergic rhinitis and their families about triggers in the home environment.
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Affiliation(s)
| | - Emine Geckil
- Necmettin Erbakan University, Faculty of Nursing, Konya, Turkey
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Mallach G, Sun L(S, McKay M, Kovesi T, Lawlor G, Kulka R, Miller JD. Indoor air quality in remote first nations communities in Ontario, Canada. PLoS One 2023; 18:e0294040. [PMID: 37992001 PMCID: PMC10664901 DOI: 10.1371/journal.pone.0294040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/24/2023] [Indexed: 11/24/2023] Open
Abstract
A recent study of the health of Indigenous children in four First Nations Communities in remote northwestern Ontario found that 21% of children had been admitted to hospital for respiratory infections before age 2 years. Here we report a detailed analysis of the housing conditions in these communities. We employed a variety of statistical methods, including linear regression, mixed models, and logistic regression, to assess the correlations between housing conditions and loadings of biocontaminants (dust mite allergens, fungal glucan, and endotoxin) and indoor concentrations of PM2.5, CO2, benzene, and formaldehyde. The houses (n = 101) were crowded with an average of approximately 7 people. Approximately 27% of the homes had sustained CO2 concentrations above 1500 ppm. Most homes had more than one smoker. Commercial tobacco smoking and the use of non-electric heating (e.g., wood, oil) were associated with increased fine particle concentrations. Over 90% of the homes lacked working Heat Recovery Ventilators (HRVs), which was associated with increased fine particle concentrations and higher CO2. Of the 101 homes, 12 had mold damage sufficient to increase the relative risk of respiratory disease. This resulted from roof leaks, through walls or around the windows due to construction defects or lack of maintenance. A similar percentage had mold resulting from condensation on windows. Endotoxin loadings were much higher than any previous study in Canada. This work provides evidence for the need for more effort to repair existing houses and to ensure the HRVs are properly installed and maintained.
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Affiliation(s)
- Gary Mallach
- Water and Air Quality Bureau, Health Canada, Ottawa, Canada
| | | | | | - Thomas Kovesi
- Department of Pediatrics, Children’s Hospital of Eastern Ontario (CHEO), University of Ottawa, Ottawa, Canada
| | | | - Ryan Kulka
- Water and Air Quality Bureau, Health Canada, Ottawa, Canada
| | - J. David Miller
- Department of Chemistry, Carleton University, Ottawa, Canada
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Kırmızıtaş Aydoğdu A, Özdemir A. Relationship Between the Type of Allergen and Night Sweat in Allergic Children. Cureus 2023; 15:e48174. [PMID: 38046775 PMCID: PMC10693384 DOI: 10.7759/cureus.48174] [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: 11/01/2023] [Indexed: 12/05/2023] Open
Abstract
BACKGROUND Atopic diseases can accompany allergic sensitization. The amount of allergen is as important to know since allergen exposure affects sensitization development. Some allergic children complain of intense sweating during the first few hours of transition to sleep especially at night. This study was carried out to investigate the relationship between the type of allergen to which children are sensitized and night sweating. METHODS Children aged two to 18 years old with single allergic sensitization were included. A specific immunoglobulin E (IgE) skin prick test results were obtained from the medical records of the patients. Then, the patients' families were asked to evaluate the levels of sweating from 0 to 10 with the Visual Analogue Scale (VAS) questionnaire and the Sleep Disturbance Scale for Children (SDSC). RESULTS Sensitization to mites was more prevalent in the group of patients with night sweating (p<0.001), and pollen allergy was more prevalent in the group of patients without night sweating (p<0.001). Conclusion: The amount of mites and wetness in bed sheets might be responsible for allergic sensitization. A change in clothes and bed sheets for those with intense sweating might ensure better sleep and reduce the severity of the atopic symptoms. Such a recommendation might provide a better clinical outcome in these patients.
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Affiliation(s)
| | - Ali Özdemir
- Pediatric Pulmonology, Mersin City Training and Research Hospital, Mersin, TUR
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Pham DL, Le KM, Truong DDK, Le HTT, Trinh THK. Environmental allergen reduction in asthma management: an overview. FRONTIERS IN ALLERGY 2023; 4:1229238. [PMID: 37868650 PMCID: PMC10587592 DOI: 10.3389/falgy.2023.1229238] [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: 05/26/2023] [Accepted: 09/12/2023] [Indexed: 10/24/2023] Open
Abstract
Asthma is a prevalent non-communicable disease that affects both children and adults. Many patients with severe, uncontrolled asthma could not achieve total control despite using anti-asthmatic drugs. There is increasing evidence that allergy to environmental allergens, including both indoor and outdoor allergens, is associated with asthma symptoms and severe asthma. Frequently reported sensitized allergens were dust mites, cockroaches, grass pollens, molds, pets, and rodents in allergic asthma patients, although the patterns of widespread allergens differed from each country. Allergen avoidance is the cornerstone of asthma management, especially in sensitized subjects. This review summarizes environmental allergen avoidance and clarifies their effects on asthma control. Despite contrasting results about the impact of allergen exposure reduction on asthma control, several studies supported the beneficial effects of reducing asthma-related symptoms or risk of exacerbations as a nondrug therapy. Identifying environmental allergens is helpful for asthma patients, and further studies on clinically effective avoidance methods are required.
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Affiliation(s)
- Duy Le Pham
- Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- University Medical Center Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Kieu-Minh Le
- Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Diem D. K. Truong
- Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Huyen T. T. Le
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Tu H. K. Trinh
- Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
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Biagioni B, Cecchi L, D'Amato G, Annesi-Maesano I. Environmental influences on childhood asthma: Climate change. Pediatr Allergy Immunol 2023; 34:e13961. [PMID: 37232282 DOI: 10.1111/pai.13961] [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: 04/12/2023] [Accepted: 05/03/2023] [Indexed: 05/27/2023]
Abstract
Climate change is a key environmental factor for allergic respiratory diseases, especially in childhood. This review describes the influences of climate change on childhood asthma considering the factors acting directly, indirectly and with their amplifying interactions. Recent findings on the direct effects of temperature and weather changes, as well as the influences of climate change on air pollution, allergens, biocontaminants and their interplays, are discussed herein. The review also focusses on the impact of climate change on biodiversity loss and on migration status as a model to study environmental effects on childhood asthma onset and progression. Adaptation and mitigation strategies are urgently needed to prevent further respiratory diseases and human health damage in general, especially in younger and future generations.
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Affiliation(s)
- Benedetta Biagioni
- Allergy and Clinical Immunology Unit, San Giovanni di Dio Hospital, Florence, Italy
| | - Lorenzo Cecchi
- Centre of Bioclimatology, University of Florence, Florence, Italy
- SOS Allergy and Clinical Immunology, USL Toscana Centro, Prato, Italy
| | - Gennaro D'Amato
- Division of Respiratory Diseases and Allergy AORN Cardarelli and University of Naples, Federico II, Naples, Italy
| | - Isabella Annesi-Maesano
- Department of Allergic and Respiratory Diseases, Montpellier University Hospital, Institute Desbrest of Epidemiology and Public Health, University of Montpellier and INSERM, Montpellier, France
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Abstract
PURPOSE OF REVIEW Over the past 40 years, the circumstances where fungal bioaerosols are major issues have shifted because of changes in the industrial sector from mainly agriculture to operations, including composting, cannabis production and forestry in hot humid conditions. Changes in the design and operation of nonindustrial workplaces meant that mould and dampness became major issues that are just being reduced. This review attempts to frame that history offers a perspective on the current thinking on mechanisms and provide potentially useful sources of information for physicians and their patients. RECENT FINDINGS The major impact of fungal exposures is not only from their allergens but also from an array of Danger-Associated Molecular Pattern molecules, possibly the most important of which is the type of glucan found in moulds that grow in damp buildings, wood chips and crops, that is beta 1, 3 D glucan in triple helical form. Located in lung epithelia, the dectin receptor is exquisitely sensitive to this compound. Except in some agricultural workplaces, low molecular weight secondary metabolites often mischaracterized as mycotoxins play little, if any, role on population health. SUMMARY There has been a convergence in thinking between the allergy and industrial hygiene communities as well as government agencies on mould and occupational health. This has led to some useful strategies for better managing these issues as well as increasing consumer awareness.
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Affiliation(s)
- J David Miller
- Department of Chemistry, Carleton University, Ottawa, Ontario, Canada
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10
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McGowan EC, Medernach J, Keshavarz B, Workman LJ, Li RC, Barnes BH, Sauer B, Wilson JM, Platts-Mills TAE. Food antigen consumption and disease activity affect food-specific IgG4 levels in patients with eosinophilic esophagitis (EoE). Clin Exp Allergy 2023; 53:307-315. [PMID: 35980663 PMCID: PMC9938092 DOI: 10.1111/cea.14215] [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: 03/30/2022] [Revised: 07/15/2022] [Accepted: 08/16/2022] [Indexed: 12/01/2022]
Abstract
INTRODUCTION High levels of serum food-specific IgG4 (sIgG4) have been reported in patients with EoE. The objective of this study was to examine whether serum sIgG4 levels to foods and aeroallergens are higher in EoE patients than allergic controls and to investigate the association between sIgG4 and EoE clinical characteristics. METHODS This was a case-control study nested in a prospective EoE Cohort. EoE cases were defined per consensus guidelines, and controls were individuals with symptoms who were confirmed to be EoE-negative on upper endoscopy. Demographic and clinical information was prospectively collected. Serum IgE and sIgG4 were measured to foods and aeroallergens by ImmunoCAP. Mean levels of sIgG4 were compared between cases and controls, and logistic regression models were used to examine predictors of elevated milk sIgG4 levels. RESULTS The analysis included 123 individuals (EoE n = 93, control n = 30) with a similar distribution of allergic disease between EoE patients and controls (86% vs. 93%; p = .30). EoE patients had significantly higher sIgG4 levels to all allergens evaluated, with the exception of birch (p = .24). Milk sIgG4 levels were independently associated with milk consumption (OR 4.95; p = .01) and the presence of sIgE to milk (OR 4.23; p = .008). CONCLUSION Serum sIgG4 levels to food and aeroallergen proteins were higher in patients with EoE than non-EoE controls, and higher levels of milk sIgG4 were independently associated with milk consumption and the presence of sIgE to milk proteins. Whether sIgG4 plays a pathogenic role in EoE or could be used as an EoE biomarker remains unknown and warrants further study.
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Affiliation(s)
- Emily C McGowan
- Department of Medicine, Division of Allergy and Clinical Immunology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
- Division of Allergy and Clinical Immunology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jonathan Medernach
- Department of Pediatrics, Division of Pediatric Gastroenterology/Nutrition, University of Virginia School of Medicine, Charlottesville, Virginia, United States
| | - Behnam Keshavarz
- Department of Medicine, Division of Allergy and Clinical Immunology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Lisa J Workman
- Department of Medicine, Division of Allergy and Clinical Immunology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Rung-Chi Li
- Department of Medicine, Division of Allergy and Clinical Immunology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Barrett H Barnes
- Department of Pediatrics, Division of Pediatric Gastroenterology/Nutrition, University of Virginia School of Medicine, Charlottesville, Virginia, United States
| | - Bryan Sauer
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Virginia School of Medicine, Charlottesville, Virginia, United States
| | - Jeffrey M Wilson
- Department of Medicine, Division of Allergy and Clinical Immunology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Thomas A E Platts-Mills
- Department of Medicine, Division of Allergy and Clinical Immunology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
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Fernandes AMS, da Silva ES, Silveira EF, Belitardo EMMDA, Santiago LF, Silva RC, Dos Santos Alves V, Carneiro DM, Ferreira F, Jacquet A, Pacheco LGC, Alcantara-Neves NM, Pinheiro CS. Recombinant T-cell epitope conjugation: A new approach for Dermatophagoides hypoallergen design. Clin Exp Allergy 2023; 53:198-209. [PMID: 36176209 DOI: 10.1111/cea.14238] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 09/15/2022] [Accepted: 09/25/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Allergen-specific immunotherapy (AIT) is the only clinical approach that can potentially cure some allergic diseases by inducing immunological tolerance. Dermatophagoides pteronyssinus is considered as the most important source of mite allergens worldwide, with high sensitization rates for the major allergens Der p 1, Der p 2 and Der p 23. The aim of this work is to generate a hypoallergenic hybrid molecule containing T-cell epitopes from these three major allergens. METHODS The hybrid protein termed Der p 2231 containing T-cell epitopes was purified by affinity chromatography. The human IgE reactivity was verified by comparing those with the parental allergens. The hybrid was also characterized immunologically through an in vivo mice model. RESULTS The hybrid rDer p 2231 stimulated in peripheral blood mononuclear cells (PBMCs) isolated from allergic patients with higher levels of IL- 2, IL-10, IL-15 and IFN-γ, as well as lower levels of IL-4, IL-5, IL-13, TNF-α and GM-CSF. The use of hybrid molecules as a therapeutic model in D. pteronyssinus allergic mice led to the reduction of IgE production and lower eosinophilic peroxidase activity in the airways. We found increased levels of IgG antibodies that blocked the IgE binding to the parental allergens in the serum of allergic patients. Furthermore, the stimulation of splenocytes from mice treated with rDer p 2231 induced higher levels of IL-10 and IFN-γ and decreased the secretion of IL-4 and IL-5, when compared with parental allergens and D. pteronyssinus extract. CONCLUSIONS rDer p 2231 has the potential to be used in AIT in patients co-sensitized with D. pteronyssinus major allergens, once it was able to reduce IgE production, inducing allergen-specific blocking antibodies, restoring and balancing Th1/Th2 immune responses, and inducing regulatory T-cells.
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Affiliation(s)
- Antônio Márcio Santana Fernandes
- Laboratório de Alergia e Acarologia, Departamento de Ciências da Biointeração, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil.,Programas de Pós-Graduação em Biotecnologia da Universidade Federal da Bahia, Salvador, Brazil
| | - Eduardo Santos da Silva
- Laboratório de Alergia e Acarologia, Departamento de Ciências da Biointeração, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil
| | - Elisânia Fontes Silveira
- Laboratório de Alergia e Acarologia, Departamento de Ciências da Biointeração, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil
| | | | - Leonardo Freire Santiago
- Laboratório de Alergia e Acarologia, Departamento de Ciências da Biointeração, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil
| | - Raphael Chagas Silva
- Laboratório de Alergia e Acarologia, Departamento de Ciências da Biointeração, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil
| | - Vitor Dos Santos Alves
- Laboratório de Alergia e Acarologia, Departamento de Ciências da Biointeração, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil
| | - Deise Malta Carneiro
- Laboratório de Alergia e Acarologia, Departamento de Ciências da Biointeração, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil
| | - Fatima Ferreira
- Department of Biosciences and Medical Biology, University of Salzburg, Salzburg, Austria
| | - Alain Jacquet
- Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Luis Gustavo Carvalho Pacheco
- Laboratório de Alergia e Acarologia, Departamento de Ciências da Biointeração, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil.,Programas de Pós-Graduação em Biotecnologia da Universidade Federal da Bahia, Salvador, Brazil
| | - Neuza Maria Alcantara-Neves
- Laboratório de Alergia e Acarologia, Departamento de Ciências da Biointeração, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil.,Programas de Pós-Graduação em Biotecnologia da Universidade Federal da Bahia, Salvador, Brazil
| | - Carina Silva Pinheiro
- Laboratório de Alergia e Acarologia, Departamento de Ciências da Biointeração, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil.,Programas de Pós-Graduação em Biotecnologia da Universidade Federal da Bahia, Salvador, Brazil
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Siegel J, Gill N, Ramanathan M, Patadia M. Unified Airway Disease. Otolaryngol Clin North Am 2023; 56:39-53. [DOI: 10.1016/j.otc.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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13
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Karenzmaßnahmen bei Milbenallergie - ein Update. ALLERGO JOURNAL 2023. [DOI: 10.1007/s15007-022-5667-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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14
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Kumar R, Gaur S, Agarwal M, Menon B, Goel N, Mrigpuri P, Spalgais S, Priya A, Kumar K, Meena R, Sankararaman N, Verma A, Gupta V, Sonal, Prakash A, Safwan MA, Behera D, Singh A, Arora N, Prasad R, Padukudru M, Kant S, Janmeja A, Mohan A, Jain V, Nagendra Prasad K, Nagaraju K, Goyal M. Indian Guidelines for diagnosis of respiratory allergy. INDIAN JOURNAL OF ALLERGY, ASTHMA AND IMMUNOLOGY 2023. [DOI: 10.4103/0972-6691.367373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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15
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Biologie von Hausstaub- und Vorratsmilben. ALLERGO JOURNAL 2022. [DOI: 10.1007/s15007-022-5637-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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16
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Woo C, Bhuiyan MIU, Kim D, Kumari P, Lee SK, Park JY, Dong K, Lee K, Yamamoto N. DNA metabarcoding-based study on bacteria and fungi associated with house dust mites (Dermatophagoides spp.) in settled house dust. EXPERIMENTAL & APPLIED ACAROLOGY 2022; 88:329-347. [PMID: 36301451 DOI: 10.1007/s10493-022-00755-2] [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: 04/25/2022] [Accepted: 10/12/2022] [Indexed: 06/16/2023]
Abstract
House dust mites (HDMs) including Dermatophagoides spp. are an important cause of respiratory allergies. However, their relationship with microorganisms in house dust has not been fully elucidated. Here, we characterized bacteria and fungi associated with HDMs in house dust samples collected in 107 homes in Korea by using DNA barcode sequencing of bacterial 16S rRNA gene, fungal internal transcribed spacer 2 (ITS2) region, and arthropod cytochrome c oxidase I (COI) gene. Our inter-kingdom co-occurrence network analysis and/or indicator species analysis identified that HDMs were positively related with a xerophilic fungus Wallemia, mycoparasitic fungi such as Cystobasidium, and some human skin-related bacterial and fungal genera, and they were negatively related with the hygrophilous fungus Cephalotrichum. Overall, our study has succeeded in adding novel insights into HDM-related bacteria and fungi in the house dust ecosystem, and in confirming the historically recognized fact that HDMs are associated with xerophilic fungi such as Wallemia. Understanding the microbial ecology in house dust is thought to be important for elucidating the etiology of human diseases including allergies, and our study revealed baseline information of house dust ecology in relation to HDMs. The findings could be useful from a perspective of human health.
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Affiliation(s)
- Cheolwoon Woo
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, 08826, Republic of Korea
| | - Mohammad Imtiaj Uddin Bhuiyan
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, 08826, Republic of Korea
| | - Donghyun Kim
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, 08826, Republic of Korea
| | - Priyanka Kumari
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, 08826, Republic of Korea
- Institute of Health and Environment, Graduate School of Public Health, Seoul National University, Seoul, 08826, Republic of Korea
| | - Seung-Kyung Lee
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, 08826, Republic of Korea
- Institute of Health and Environment, Graduate School of Public Health, Seoul National University, Seoul, 08826, Republic of Korea
| | - Ji Young Park
- Institute of Health and Environment, Graduate School of Public Health, Seoul National University, Seoul, 08826, Republic of Korea
| | - Ke Dong
- Major of Life Science, College of Natural Sciences, Kyonggi University, Suwon, 16227, Republic of Korea
| | - Kiyoung Lee
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, 08826, Republic of Korea
- Institute of Health and Environment, Graduate School of Public Health, Seoul National University, Seoul, 08826, Republic of Korea
| | - Naomichi Yamamoto
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, 08826, Republic of Korea.
- Institute of Health and Environment, Graduate School of Public Health, Seoul National University, Seoul, 08826, Republic of Korea.
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17
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Li Z, Zheng N, An Q, Li X, Sun S, Zhang W, Ji Y, Wang S, Li P. Impact of environmental factors and bacterial interactions on dust mite allergens in different indoor dust. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 844:157177. [PMID: 35803427 DOI: 10.1016/j.scitotenv.2022.157177] [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: 03/07/2022] [Revised: 06/11/2022] [Accepted: 07/01/2022] [Indexed: 06/15/2023]
Abstract
Indoor dust is the main carrier of indoor pollutants, especially dust mite allergens and bacteria, they can trigger asthma, rhinitis, eczema and other allergic diseases. However, the interactions between dust mite allergens and bacterial communities in different types of indoor dust are not clear. The study focused on particulate and flocculent fibrous dust, explored the concentrations of Der p 1 (Dermatophagoides pteronyssinus) and Der f 1 (D. farinae) in 46 households in Changchun and their environmental influences, characterized the bacterial communities by high-throughput sequencing, and the interactions between Der p 1, Der f 1 and bacterial communities were explored. The results showed that Der p 1 and Der f 1 tended to accumulate more in flocculent fibrous dust, and Der p 1 predominated in the indoor dust samples. The floor height, years of housing occupancy and the living areas all affected the concentrations of dust mite allergens. In bacterial community, Proteobacteria, Firmicutes and Actinobacteria were leading phyla in the two types of dust. Kocuria, Blastococcus and Massilia were dominating genera in particulate dust and Acinetobacter, Lactobacillus, Corynebacterium_1 were dominating genera in flocculent fibrous dust. The overall diversity and species richness of bacteria in particulate dust were significantly higher than those in flocculent dust (p < 0.001). The living area was an important environmental factor affecting the bacterial community in flocculent fibrous dust (p < 0.01). The interaction between the relative abundance of Proteobacteria, Firmicutes and Actinobacteria and dust mite allergen concentrations significantly differed between the two dust types, indicating that bacteria could be used both as food and to establish symbiotic relationships with household dust mites (HDMs) hosts and provide nutrition.
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Affiliation(s)
- Zimeng Li
- College of New Energy and Environment, Jilin University, Changchun, 130012, China
| | - Na Zheng
- College of New Energy and Environment, Jilin University, Changchun, 130012, China; Key Laboratory of Groundwater Resources and Environment, Ministry of Education, Jilin University, Changchun, 130012, China.
| | - Qirui An
- College of New Energy and Environment, Jilin University, Changchun, 130012, China
| | - Xiaoqian Li
- College of New Energy and Environment, Jilin University, Changchun, 130012, China
| | - Siyu Sun
- College of New Energy and Environment, Jilin University, Changchun, 130012, China
| | - Wenhui Zhang
- College of New Energy and Environment, Jilin University, Changchun, 130012, China
| | - Yining Ji
- College of New Energy and Environment, Jilin University, Changchun, 130012, China
| | - Sujing Wang
- College of New Energy and Environment, Jilin University, Changchun, 130012, China
| | - Pengyang Li
- College of New Energy and Environment, Jilin University, Changchun, 130012, China
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18
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Johnston JD, Cowger AE, Weber KS. Bioaerosol and microbial exposures from residential evaporative coolers and their potential health outcomes: A review. INDOOR AIR 2022; 32:e13082. [PMID: 36168234 PMCID: PMC9826010 DOI: 10.1111/ina.13082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 06/10/2022] [Accepted: 07/08/2022] [Indexed: 06/16/2023]
Abstract
Evaporative cooling is an energy efficient form of air conditioning in dry climates that functions by pulling hot, dry outdoor air across a wet evaporative pad. While evaporative coolers can help save energy, they also have the potential to influence human health. Studies have shown residential evaporative coolers may pull outdoor air pollutants into the home or contribute to elevated levels of indoor bioaerosols that may be harmful to health. There is also evidence that evaporative coolers can enable a diverse microbial environment that may confer early-life immunological protection against the development of allergies and asthma or exacerbate these same hypersensitivities. This review summarizes the current knowledge of bioaerosol and microbiological studies associated with evaporative coolers, focusing on harmful and potentially helpful outcomes from their use. We evaluate the effects of evaporative coolers on indoor bacterial endotoxins, fungal β-(1 → 3)-D-glucans, dust mite antigens, residential microbial communities, and Legionella pneumophila. To our knowledge, this is the first review to summarize and evaluate studies on the influence that evaporative coolers have on the bioaerosol and microbiological profile of homes. This brings to light a gap in the literature on evaporative coolers, which is the lack of data on health effects associated with their use.
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Affiliation(s)
| | | | - K. Scott Weber
- Department of Microbiology & Molecular BiologyBrigham Young UniversityProvoUtahUSA
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19
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Mortelliti CL, Banzon TM, Phipatanakul W, Vieira CZ. Environmental Exposures Impact Pediatric Asthma Within the School Environment. Immunol Allergy Clin North Am 2022; 42:743-760. [DOI: 10.1016/j.iac.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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20
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Determination of immunogenic epitopes in major house dust mite allergen, Der p 2, via nanoallergens. Ann Allergy Asthma Immunol 2022; 129:231-240.e2. [PMID: 35405356 PMCID: PMC9808607 DOI: 10.1016/j.anai.2022.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 04/01/2022] [Accepted: 04/04/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Despite the high prevalence of allergic asthma, currently, avoidance of the responsible allergens, which is nearly impossible for allergens such as house dust mite (HDM), remains among the most effective treatment. Consequently, determination of the immunogenic epitopes of allergens will aid in developing a better understanding of the condition for diagnostic and therapeutic purposes. Current methods of epitope identification, however, only evaluate immunoglobulin E-epitope binding interactions, which is not directly related to epitope immunogenicity. OBJECTIVE To determine and rank the immunogenicity of the epitopes of major HDM allergen, Der p 2. METHODS We performed degranulation assays with RBL-SX38 cells primed using patient plasma and challenged with nanoallergens which multivalently displayed epitopes to study the relative immunogenicity of various epitopes of Der p 2. Nanoallergens were used to evaluate epitopes individually or in combination. RESULTS When evaluated using 3 patient samples, 3 epitopes in 2 distal regions of Der p 2 were identified as highly immunogenic when presented in combination, whereas no individual epitope triggered relevant degranulation. One of the epitopes (69-DPNACHYMKCPLVKGQQY-86) was identified to be cooperatively immunogenic when combined with other epitopes. CONCLUSION Our study highlights the importance of conformational epitopes in HDM-related allergies. This study also provides further evidence of the versatility of nanoallergens and their value for functional characterization of allergy epitopes, by ranking the Der p 2 epitopes according to immunogenicity. We believe that nanoallergens, by aiding in identification and understanding of immunogenic epitopes, will provide a better understanding of the manifestation of the allergic condition and potentially aid in developing new treatments.
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21
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Banzon TM, Phipatanakul W. Environmental Interventions for Asthma. Semin Respir Crit Care Med 2022; 43:720-738. [PMID: 35803266 DOI: 10.1055/s-0042-1749453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Exposure and sensitization to environmental factors play a fundamental role in asthma development and is strongly associated with asthma morbidity. While hereditary factors are critical determinants of asthma, exposures to environmental factors are implicated in the phenotypic expression of asthma and have been strongly associated in the risk of its development. Significant interest has thus been geared toward potentially modifiable environmental exposures which may lead to the development of asthma. Allergen exposure, in particular indoor allergens, plays a significant role in the pathogenesis of asthma, and remediation is a primary component of asthma management. In the home, multifaceted and multitargeted environmental control strategies have been shown to reduce home exposures and improve asthma outcomes. In addition to the home environment, assessment of the school, daycare, and workplace environments of patients with asthma is necessary to ensure appropriate environmental control measures in conjunction with medical care. This article will discuss the role of the environment on asthma, review targeted environmental therapy, and examine environmental control measures to suppress environmental exposures in the home and school setting.
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Affiliation(s)
- Tina M Banzon
- Deparmtent of Allergy and Immunology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Wanda Phipatanakul
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.,Division of Immunology, Clinical Research Center, Boston Children's Hospital, Asthma, Allergy and Immunology, Boston, Massachusetts
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22
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Creticos PS. Subcutaneous allergen immunotherapy in the treatment of allergic respiratory disease. Allergy Asthma Proc 2022; 43:260-266. [PMID: 35818144 DOI: 10.2500/aap.2022.43.220033] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Subcutaneous immunotherapy is recognized as a cornerstone in the management of allergic respiratory disease in patients who are properly characterized with allergy and with allergic rhinoconjunctivis and/or well-controlled asthma, and who are willing to adhere to the rigorous treatment program. A key tenet is that it affords the opportunity to effect long-term clinical remission through its disease-modifying properties. Furthermore, it has the potential to prevent the progression of allergic rhinitis to asthma, prevent new allergen sensitivities, and improve a patient's quality of life.
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23
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Maciag MC, Phipatanakul W. Update on indoor allergens and their impact on pediatric asthma. Ann Allergy Asthma Immunol 2022; 128:652-658. [PMID: 35227902 PMCID: PMC9149060 DOI: 10.1016/j.anai.2022.02.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/08/2022] [Accepted: 02/11/2022] [Indexed: 01/10/2023]
Abstract
OBJECTIVE In recent decades, many indoor allergens have been identified, including dust mite, cat, dog, mouse, cockroach, and indoor molds, which have important health effects particularly in sensitized individuals with asthma. This review aims to update our understanding regarding the extent of these exposures in the indoor environment, review strategies for reducing their levels in the environment, and highlight innovative recent trials targeting these exposures and their impact on pediatric asthma morbidity. DATA SOURCES Recent practice parameter updates on indoor allergen exposures, seminal studies, and recent peer-reviewed journal articles are referenced. STUDY SELECTIONS This review cites recent cohort studies of well-characterized pediatric patients with asthma and innovative randomized controlled trials evaluating exposure to environmental allergens, interventions to limit these exposures, and their outcomes. RESULTS Links between indoor aeroallergen exposures and health outcomes have been well established. However, only some allergen reduction interventions have been successful in improving health outcomes. CONCLUSION There are many complicating factors involved in allergic exposures and health outcomes. The interplay between patient genetic factors, indoor allergic triggers, airborne irritants and pollutants, and microbial exposures complicates the study of indoor allergen exposures and their impact on asthma morbidity.
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Affiliation(s)
- Michelle C Maciag
- Boston Children's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Asthma and Allergy Affiliates, Salem, Massachusetts
| | - Wanda Phipatanakul
- Boston Children's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
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24
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Xiong Q, Wan ATY, Liu X, Fung CSH, Xiao X, Malainual N, Hou J, Wang L, Wang M, Yang KY, Cui Y, Leung ELH, Nong W, Shin SK, Au SWN, Jeong KY, Chew FT, Hui JHL, Leung TF, Tungtrongchitr A, Zhong N, Liu Z, Tsui SKW. Comparative Genomics Reveals Insights into the Divergent Evolution of Astigmatic Mites and Household Pest Adaptations. Mol Biol Evol 2022; 39:6582989. [PMID: 35535514 PMCID: PMC9113151 DOI: 10.1093/molbev/msac097] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Highly diversified astigmatic mites comprise many medically important human household pests such as house dust mites causing ∼1–2% of all allergic diseases globally; however, their evolutionary origin and diverse lifestyles including reversible parasitism have not been illustrated at the genomic level, which hampers allergy prevention and our exploration of these household pests. Using six high-quality assembled and annotated genomes, this study not only refuted the monophyly of mites and ticks, but also thoroughly explored the divergence of Acariformes and the diversification of astigmatic mites. In monophyletic Acariformes, Prostigmata known as notorious plant pests first evolved, and then rapidly evolving Astigmata diverged from soil oribatid mites. Within astigmatic mites, a wide range of gene families rapidly expanded via tandem gene duplications, including ionotropic glutamate receptors, triacylglycerol lipases, serine proteases and UDP glucuronosyltransferases. Gene diversification after tandem duplications provides many genetic resources for adaptation to sensing environmental signals, digestion, and detoxification in rapidly changing household environments. Many gene decay events only occurred in the skin-burrowing parasitic mite Sarcoptes scabiei. Throughout the evolution of Acariformes, massive horizontal gene transfer events occurred in gene families such as UDP glucuronosyltransferases and several important fungal cell wall lytic enzymes, which enable detoxification and digestive functions and provide perfect drug targets for pest control. This comparative study sheds light on the divergent evolution and quick adaptation to human household environments of astigmatic mites and provides insights into the genetic adaptations and even control of human household pests.
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Affiliation(s)
- Qing Xiong
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong.,Hong Kong Bioinformatics Centre, The Chinese University of Hong Kong, Hong Kong
| | - Angel Tsz-Yau Wan
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong.,Hong Kong Bioinformatics Centre, The Chinese University of Hong Kong, Hong Kong
| | - Xiaoyu Liu
- Shenzhen Key Laboratory of Allergy and Immunology, School of Medicine, Shenzhen University, China
| | - Cathy Sin-Hang Fung
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong
| | - Xiaojun Xiao
- Shenzhen Key Laboratory of Allergy and Immunology, School of Medicine, Shenzhen University, China
| | - Nat Malainual
- Department of Parasitology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Jinpao Hou
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong.,Centre for Microbial Genomics and Proteomics, The Chinese University of Hong Kong, Hong Kong
| | - Lingyi Wang
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong
| | - Mingqiang Wang
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong.,Hong Kong Bioinformatics Centre, The Chinese University of Hong Kong, Hong Kong
| | - Kevin Yi Yang
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong.,Hong Kong Bioinformatics Centre, The Chinese University of Hong Kong, Hong Kong
| | - Yubao Cui
- Department of Clinical Laboratory, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, China
| | - Elaine Lai-Han Leung
- Macau Institute for Applied Research in Medicine and Health, Macau University of Science and Technology, Macau
| | - Wenyan Nong
- School of Life Sciences, The Chinese University of Hong Kong, Hong Kong
| | - Soo-Kyung Shin
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong
| | | | - Kyoung Yong Jeong
- Institute of Allergy, Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Korea
| | - Fook-Tim Chew
- Department of Biological Sciences, National University of Singapore, Singapore
| | - Jerome Ho-Lam Hui
- School of Life Sciences, The Chinese University of Hong Kong, Hong Kong
| | - Ting-Fan Leung
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong
| | - Anchalee Tungtrongchitr
- Department of Parasitology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Nanshan Zhong
- State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhigang Liu
- Shenzhen Key Laboratory of Allergy and Immunology, School of Medicine, Shenzhen University, China
| | - Stephen Kwok-Wing Tsui
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong.,Hong Kong Bioinformatics Centre, The Chinese University of Hong Kong, Hong Kong.,Centre for Microbial Genomics and Proteomics, The Chinese University of Hong Kong, Hong Kong
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25
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Maya‐Manzano JM, Pusch G, Ebner von Eschenbach C, Bartusel E, Belzner T, Karg E, Bardolatzy U, Scheja M, Schmidt‐Weber C, Buters J. Effect of air filtration on house dust mite, cat and dog allergens and particulate matter in homes. Clin Transl Allergy 2022; 12:e12137. [PMID: 35474731 PMCID: PMC9022093 DOI: 10.1002/clt2.12137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/09/2022] [Accepted: 03/11/2022] [Indexed: 11/09/2022] Open
Abstract
Background Methods Results Conclusions
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Affiliation(s)
- José María Maya‐Manzano
- Center of Allergy & Environment (ZAUM) Member of the German Center for Lung Research (DZL) Technical University and Helmholtz Center Munich Germany
| | - Gudrun Pusch
- Center of Allergy & Environment (ZAUM) Member of the German Center for Lung Research (DZL) Technical University and Helmholtz Center Munich Germany
| | - Cordula Ebner von Eschenbach
- Center of Allergy & Environment (ZAUM) Member of the German Center for Lung Research (DZL) Technical University and Helmholtz Center Munich Germany
| | - Elke Bartusel
- Center of Allergy & Environment (ZAUM) Member of the German Center for Lung Research (DZL) Technical University and Helmholtz Center Munich Germany
| | - Thomas Belzner
- Center of Allergy & Environment (ZAUM) Member of the German Center for Lung Research (DZL) Technical University and Helmholtz Center Munich Germany
| | - Erwin Karg
- Center of Allergy & Environment (ZAUM) Member of the German Center for Lung Research (DZL) Technical University and Helmholtz Center Munich Germany
| | - Ulrich Bardolatzy
- Center of Allergy & Environment (ZAUM) Member of the German Center for Lung Research (DZL) Technical University and Helmholtz Center Munich Germany
| | | | - Carsten Schmidt‐Weber
- Center of Allergy & Environment (ZAUM) Member of the German Center for Lung Research (DZL) Technical University and Helmholtz Center Munich Germany
| | - Jeroen Buters
- Center of Allergy & Environment (ZAUM) Member of the German Center for Lung Research (DZL) Technical University and Helmholtz Center Munich Germany
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26
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Gray-Ffrench M, Fernandes RM, Sinha IP, Abrams EM. Allergen Management in Children with Type 2-High Asthma. J Asthma Allergy 2022; 15:381-394. [PMID: 35378923 PMCID: PMC8976481 DOI: 10.2147/jaa.s276994] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 03/17/2022] [Indexed: 11/30/2022] Open
Abstract
Children exposed to various indoor and outdoor allergens are placed at an increased risk of developing asthma in later life, with sensitization in these individuals being a strong predictor of disease morbidity. In addition, aeroallergen exposure influences asthma outcomes through an interplay with adverse determinants of health. The goal of this review is to provide an introductory overview of factors related to aeroallergen exposure in type 2-high childhood asthma. These include the relevance of exposure in asthma exacerbations and severity, and the evidence-base for avoidance and treatment for sensitization to these allergens. This review will focus on both indoor aeroallergens (house dust mite, pet, cockroach, mold, and rodent) and outdoor aeroallergens (pollens and molds). Treatment of aeroallergen sensitization in children with asthma includes avoidance and removal measures, although there is limited evidence of clinical benefit especially with single-strategy approaches. We will also address the interplay of aeroallergens and climate change, adverse social determinants, and the current COVID-19 pandemic, when we have seen a dramatic reduction in asthma exacerbations and emergency department visits among children. While there are many factors that are hypothesized to contribute to this reduction, among them is a reduced exposure to outdoor seasonal aeroallergens.
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Affiliation(s)
| | - Ricardo M Fernandes
- Clinical Pharmacology Unit, Faculty of Medicine and Instituto de Medicina Molecular, Universidade de Lisboa, Lisbon, Portugal
- Department of Pediatrics, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Lisbon, Portugal
| | - Ian P Sinha
- Alder Hey Children’s Hospital, Liverpool, UK
- Department of Women’s and Children’s Health, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
| | - Elissa M Abrams
- Department of Pediatrics, Section of Allergy and Clinical Immunology, University of Manitoba, Winnipeg, Canada
- Department of Pediatrics, Division of Allergy and Immunology, University of British Columbia, Vancouver, British Columbia, Canada
- Correspondence: Elissa M Abrams, Department of Pediatrics, Section of Allergy and Clinical Immunology, University of Manitoba, FE125-685 William Avenue, Winnipeg, MB, R2A 5L9, Canada, Tel +1 204-255-7650, Fax +1 204-254-0730, Email
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27
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Gutema GD, Geremew A, Megistu DA, Dammu YM, Bayu K. Trends and Associated Factors of Under-five Mortality Based on 2008–2016 Data in Kersa Health and Demographic Surveillance Site, Eastern Ethiopia. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2022; 59:469580221090394. [PMID: 35379036 PMCID: PMC8988672 DOI: 10.1177/00469580221090394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Of the 6.2 million estimated deaths of children under 15 years of age globally, the death toll of children under 5 years of age accounted for 5.3 million. In Ethiopia, even though significant progress has been made, facility-based research shows that the mortality rate of children under 5 is still high. In the country, particularly in the eastern part, evidence on trends in under-five mortality and associated factors from population-based longitudinal data is limited. Objective: The objective of the study was to assess under-five mortality focusing on the trends and associated factors based on 2008–2016 data in Kersa Health and Demographic Surveillance Site, Eastern Ethiopia. The method: The study was based on 9 years of surveillance data. The surveillance site was founded in 2007 with the aim of producing community-based health and demographic data in the eastern Ethiopia. Data were collected from the surveillance site and analyzed with STATA version 15 (for factor analysis) and/or Statistical Package for Social Sciences (SPSS) version 26 (for trend analysis) and Microsoft (MS) Excel software. The autoregressive integrated moving average (ARIMA) model and Mann–Kendall were used to analyze mortality trends. Multi-level logistic regression was used to assess the associated factors. Result: There were a total of 18 759 newborns in the surveillance sites, of which 1602 died of children under 5 years of age, and the total mortality rate for children under 5 years of age was 85 per 1000 live births. Trend analysis shows that the mortality rate of children under 5 has been steadily declining during the study period. Multi-level logistic regression shows that the variance of the random component model related to the intercept term is statistically significant, which means that there is a change in the mortality rate of children under 5 between the survey years, which is explained by the random intercept term. Antenatal care visits by mothers (AOR = .61, 95% CI = .49, .74), primary education (AOR = .58, 95% CI = .49, .68), normal birth weight (AOR = .78, 95% CI = .64, .95), and having 2 or fewer total births (AOR = .37, 95% CI = .22, .37) were all associated with child death. Conclusion: Despite the downward trend, the mortality rate of children under 5 years old at the surveillance sites is high. Effective intervention measures should be implemented.
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Affiliation(s)
- Gebisa Dirirsa Gutema
- Gebisa Dirirsa Gutema, Haramaya University College of Health and Medical Science, Harar 235, Ethiopia. Email address:
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28
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Sun L, Miller JD, Van Ryswyk K, Wheeler AJ, Héroux M, Goldberg MS, Mallach G. Household determinants of biocontaminant exposures in Canadian homes. INDOOR AIR 2022; 32:e12933. [PMID: 34561903 PMCID: PMC9293439 DOI: 10.1111/ina.12933] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 08/12/2021] [Accepted: 09/11/2021] [Indexed: 06/13/2023]
Abstract
Exposure to biocontaminants, such as dust mites, animal dander, bacteria, and mold, is associated with a range of health effects. This study identified household characteristics associated with indoor biocontaminant loadings in four Canadian cities. Floor dust was collected in 290 Canadian homes in Edmonton, Halifax, Montreal, and Windsor. The dust samples were analyzed for house dust mite allergens (Der f 1 and Der p 1), cat allergen (Fel d 1), cockroach allergen (Bla g 1), beta-(1,3)-D-glucan, and endotoxin. Household information was obtained through questionnaires and home inspections. We performed univariate and multivariate analyses to identify household determinants of biocontaminant loadings and mold odor presence. We observed large regional variations for all biocontaminants, except for cockroach allergen. The ranges of the contaminants measured in loadings and concentrations were similar to that of previous Canadian studies. Household characteristics including presence of carpeting, low floor cleaning frequency, older home age, presence of pets, and indoor relative humidity above 45% were positively associated with the presence of multiple indoor biocontaminants. High floor cleaning frequency and use of dehumidifiers were negatively associated with the presence of multiple indoor biocontaminants. Mold odor was positively associated with older home age, past water damage, and visible mold growth.
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Affiliation(s)
- Liu Sun
- Air Health Effects Assessment Division, Water and Air Quality BureauHealth CanadaOttawaOntarioCanada
| | - J. David Miller
- Department of ChemistryCarleton UniversityOttawaOntarioCanada
| | - Keith Van Ryswyk
- Air Health Effects Assessment Division, Water and Air Quality BureauHealth CanadaOttawaOntarioCanada
| | - Amanda J. Wheeler
- Behaviour, Environment, and Cognition Research Program, Mary MacKillop Institute for Health ResearchAustralian Catholic UniversityMelbourneVictoriaAustralia
| | - Marie‐Eve Héroux
- Air Health Effects Assessment Division, Water and Air Quality BureauHealth CanadaOttawaOntarioCanada
| | - Mark S. Goldberg
- Department of MedicineMcGill UniversityMontrealQuébecCanada
- Department of Epidemiology, Biostatistics and Occupational HealthMcGill UniversityMontrealQuébecCanada
- Centre for Outcomes Research and EvaluationResearch Institute of the McGill University Hospital CentreMontrealQuébecCanada
| | - Gary Mallach
- Air Health Effects Assessment Division, Water and Air Quality BureauHealth CanadaOttawaOntarioCanada
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New insights in mite immunotherapy - sublingual tablets. Curr Opin Allergy Clin Immunol 2021; 21:602-610. [PMID: 34494616 DOI: 10.1097/aci.0000000000000785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Sublingual tablet immunotherapy has been demonstrated to be effective for allergies induced by exposure to grass, ragweed, specific trees (Japanese Cedar; birch homologous tree mix), and house dust mites (HDM). This review provides both an overview of the evidence-based clinical studies that address the use of the HDM SLIT-tablet for the treatment of HDM-induced allergic rhinitis/conjunctivitis and its appropriate use in carefully selected asthmatic patients and provides the clinician with practical management considerations. RECENT FINDINGS Solid evidence-based clinical studies have shown that the HDM SLIT-tablet is both well tolerated in patients with mild-to-moderate asthma and has demonstrated a meaningful improvement in exacerbations, need for rescue medication, quality of life, and asthma control. SUMMARY The HDM SLIT-tablet provides the allergy specialist with a well-tolerated treatment that has established superior safety to subcutaneous injection therapy, which can be administered easily as a sublingual dissolvable tablet, and which provides the opportunity to address one of the more difficult aspects in the management of an inducer of perennial allergic disease - that of persistent airway inflammation and allergic asthma.
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Martín-López L, López-Matas MA, Calzada D, Benjumeda-Maira A, Martín E, García E, Carnés J. Environmental exposure of Der p 23 in household dust samples. Clin Exp Allergy 2021; 51:1645-1647. [PMID: 34427963 DOI: 10.1111/cea.14004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/22/2021] [Indexed: 01/02/2023]
Affiliation(s)
- Laura Martín-López
- R&D Allergy & Immunology Unit, LETIPharma S.L.U., Tres Cantos, Madrid, Spain
| | - María A López-Matas
- R&D Allergy & Immunology Unit, LETIPharma S.L.U., Tres Cantos, Madrid, Spain
| | - David Calzada
- R&D Allergy & Immunology Unit, LETIPharma S.L.U., Tres Cantos, Madrid, Spain
| | - Alfredo Benjumeda-Maira
- Allergology Section, Department of Internal Medicine, Hospital Dr. José Molina Orosa, Lanzarote, Spain
| | - Elena Martín
- Allergology Section, Department of Internal Medicine, Hospital Dr. José Molina Orosa, Lanzarote, Spain
| | - Eduardo García
- Endocrinology Section, Department of Internal Medicine, Hospital Dr. José Molina Orosa, Lanzarote, Spain
| | - Jerónimo Carnés
- R&D Allergy & Immunology Unit, LETIPharma S.L.U., Tres Cantos, Madrid, Spain
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Van Mason J, Portnoy JM. Immunologic Strategies for Prevention of Asthma. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 8:834-847. [PMID: 32147137 DOI: 10.1016/j.jaip.2019.11.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 11/25/2019] [Accepted: 11/26/2019] [Indexed: 12/16/2022]
Abstract
A new understanding of factors leading to the development of asthma has pointed to potential primary, secondary, and tertiary prevention strategies. Some, such as genetic makeup, are not yet modifiable. Interventions targeting other factors such as maternal intake of vitamin D or environmental control can be used to decrease the risk of asthma development (primary prevention). The benefits of a diversified microbiome could be considered when recommending allergen avoidance and pet ownership. In addition to reducing symptoms, allergen immunotherapy is also worth considering for prevention of new sensitivities (secondary prevention) in addition to the development of asthma. Ongoing studies involving the use of bacterial vaccines and biologics may provide additional strategies for primary prevention of asthma and for reducing symptoms once it has developed (tertiary prevention). As the relative benefits of these strategies are defined, they should have an increasingly important place in the prevention and management of asthma.
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Affiliation(s)
- Jessica Van Mason
- Section of Allergy, Asthma & Immunology, Children's Mercy Hospital, Kansas City, Mo
| | - Jay M Portnoy
- Section of Allergy, Asthma & Immunology, Children's Mercy Hospital, Kansas City, Mo.
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Ecevit MC, Özcan M, Haberal Can İ, Çadallı Tatar E, Özer S, Esen E, Atan D, Göde S, Elsürer Ç, Eryılmaz A, Uslu Coşkun B, Yazıcı ZM, Dinç ME, Özdoğan F, Günhan K, Bilal N, Korkut AY, Kasapoğlu F, Türk B, Araz Server E, Önerci Çelebi Ö, Şimşek T, Kum RO, Adalı MK, Eren E, Yüksel Aslıer NG, Bayındır T, Çakır Çetin A, Enise Göker A, Adadan Güvenç I, Köseoğlu S, Soylu Özler G, Şahin E, Şahin Yılmaz A, Güne C, Aksoy Yıldırım G, Öca B, Durmuşoğlu M, Kantekin Y, Özmen S, Orhan Kubat G, Köybaşı Şanal S, Altuntaş EE, Selçuk A, Yazıcı H, Baklacı D, Yaylacı A, Hancı D, Doğan S, Fidan V, Uygur K, Keleş N, Cingi C, Topuz B, Çanakçıoğlu S, Önerci M. Turkish Guideline for Diagnosis and Treatment of Allergic Rhinitis (ART). Turk Arch Otorhinolaryngol 2021; 59:1-157. [PMID: 34212158 PMCID: PMC8221269 DOI: 10.4274/tao.2021.suppl.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECT To prepare a national guideline for Otorhinolaryngologist who treat allergic rhinitis patients. METHODS The study was conducted by three authors, namely the writing support team. The support team made the study plan, determined the writing instructions, chose the subgroups including the advisory committee, the advisors for authors and the authors. A workshop was organized at the very beginning to explain the details of the study to the team. Advisors took the chance to meet their coworkers in their subgroups and determined the main headings and subheadings of the guideline, together with the authors. After key words were determined by the authors, literature search was done in various databases. The authors keep in touch with the advisors and the advisors with the advisory committee and the support group at every stage of the study. National and International published articles as well as the abstracts of unpublished studies, imperatively presented in National Congresses, were included in this guideline. Only Guideline and meta-analyses published in last seven years (2013-2017) and randomized controlled studies published in last two years (2015-2017) were included. After all work was completed by the subgroups, support team brought all work together and edited the article. RESULTS A detailed guideline about all aspects of allergic rhinitis was created. CONCLUSION The authors believe that this guideline will enable a compact and up-to-date information on allergic rhinitis to healthcare professionals. This guideline is the first in the field of Otolaryngology in Turkey. It should be updated at regular intervals.
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Affiliation(s)
- Mustafa Cenk Ecevit
- Department of Otorhinolaryngology, Dokuz Eylül University Faculty of Medicine, İzmir
| | - Müge Özcan
- Department of Otorhinolaryngology, University of Health Sciences Turkey Faculty of Medicine, Ankara
| | - İlknur Haberal Can
- Department of Otorhinolaryngology, Yozgat Bozok University Faculty of Medicine, Yozgat
| | - Emel Çadallı Tatar
- Department of Otorhinolaryngology, University of Health Sciences Turkey Faculty of Medicine, Ankara
| | - Serdar Özer
- Department of Otorhinolaryngology, Hacettepe University Faculty of Medicine, Ankara
| | - Erkan Esen
- Department of Otorhinolaryngology, Derince Training and Research Hospital, İzmit
| | - Doğan Atan
- Department of Otorhinolaryngology, Lokman Hekim Hospital, Ankara
| | - Sercan Göde
- Department of Otorhinolaryngology, Ege University Faculty of Medicine, İzmir
| | - Çağdaş Elsürer
- Department of Otorhinolaryngology, Selçuk University Faculty of Medicine, Konya
| | - Aylin Eryılmaz
- Department of Otorhinolaryngology, Adnan Menderes University Faculty of Medicine, Aydın
| | - Berna Uslu Coşkun
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul
| | - Zahide Mine Yazıcı
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Faculty of Medicine, İstanbul
| | - Mehmet Emre Dinç
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Prof. Dr. Cemil Taşçıoğlu City Hospital, İstanbul
| | - Fatih Özdoğan
- Department of Otorhinolaryngology, Derince Training and Research Hospital, İzmit
| | - Kıvanç Günhan
- Department of Otorhinolaryngology, Celal Bayar University, Manisa
| | - Nagihan Bilal
- Department of Otorhinolaryngology, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş
| | - Arzu Yasemin Korkut
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul
| | - Fikret Kasapoğlu
- Department of Otorhinolaryngology, Uludağ University Faculty of Medicine, Bursa
| | - Bilge Türk
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul
| | - Ela Araz Server
- Department of Otorhinolaryngology, University of Health Sciences Turkey, İstanbul Training and Research Hospital, İstanbul
| | - Özlem Önerci Çelebi
- Department of Otorhinolaryngology, University of Health Sciences Turkey, İstanbul Training and Research Hospital, İstanbul
| | - Tuğçe Şimşek
- Department of Otorhinolaryngology, Amasya University Sabuncuoğlu Şerefeddin Training and Research Hospital, Amasya
| | - Rauf Oğuzhan Kum
- Department of Otorhinolaryngology, University of Health Sciences Turkey Faculty of Medicine, Ankara
| | - Mustafa Kemal Adalı
- Department of Otorhinolaryngology, Trakya University Faculty of Medicine, Edirne
| | - Erdem Eren
- Department of Otorhinolaryngology, Atatürk Training and Research Hospital, İzmir
| | - Nesibe Gül Yüksel Aslıer
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Bursa Yüksek İhtisas Training and Research Hospital, Bursa
| | - Tuba Bayındır
- Department of Otorhinolaryngology, İnönü University Faculty of Medicine, Malatya
| | - Aslı Çakır Çetin
- Department of Otorhinolaryngology, Dokuz Eylül University Faculty of Medicine, İzmir
| | - Ayşe Enise Göker
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Prof. Dr. Cemil Taşçıoğlu City Hospital, İstanbul
| | - Işıl Adadan Güvenç
- Department of Otorhinolaryngology, Bakırçay University Faculty of Medicine, Çiğli Training and Research Hospital, İzmir
| | - Sabri Köseoğlu
- Department of Otorhinolaryngology, Sıtkı Koçman University Faculty of Medicine, Muğla
| | - Gül Soylu Özler
- Department of Otorhinolaryngology, Mustafa Kemal University Faculty of Medicine, Hatay
| | - Ethem Şahin
- Bayındır Heathcare Group İçerenköy Hospital, İstanbul
| | - Aslı Şahin Yılmaz
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Ümraniye Training and Research Hospital, İstanbul
| | - Ceren Güne
- Department of Otorhinolaryngology, Atatürk Training and Research Hospital, İzmir
| | - Gökçe Aksoy Yıldırım
- University of Health Sciences Turkey, Bozyaka Training and Research Hospital, Department of Otorhinolaryngology, İzmir
| | - Bülent Öca
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Prof. Dr. Cemil Taşçıoğlu City Hospital, İstanbul
| | - Mehmet Durmuşoğlu
- Department of Otorhinolaryngology, Bakırçay University Faculty of Medicine, Çiğli Training and Research Hospital, İzmir
| | - Yunus Kantekin
- Department of Otorhinolaryngology University of Health Sciences Turkey, Kayseri City Hospital, Kayseri
| | - Süay Özmen
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Bursa Yüksek İhtisas Training and Research Hospital, Bursa
| | - Gözde Orhan Kubat
- Department of Otorhinolaryngology, Alanya Alaaddin Keykubat University Faculty of Medicine, Antalya
| | - Serap Köybaşı Şanal
- Department of Otorhinolaryngology, Abant İzzet Baysal University Faculty of Medicine, Bolu
| | - Emine Elif Altuntaş
- Department of Otorhinolaryngology, Sivas Cumhuriyet University Faculty of Medicine, Sivas
| | - Adin Selçuk
- Department of Otorhinolaryngology, Bahçeşehir University Faculty of Medicine, İstanbul
| | - Haşmet Yazıcı
- Department of Otorhinolaryngology, Balıkesir University Faculty of Medicine, Balıkesir
| | - Deniz Baklacı
- Department of Otorhinolaryngology, Bülent Ecevit University Faculty of Medicine, Zonguldak
| | - Atılay Yaylacı
- Department of Otorhinolaryngology, Kocaeli University Faculty of Medicine, Kocaeli
| | - Deniz Hancı
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Prof. Dr. Cemil Taşçıoğlu City Hospital, İstanbul
| | - Sedat Doğan
- Department of Otorhinolaryngology, Adıyaman University Faculty of Medicine, Adıyaman
| | - Vural Fidan
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Eskişehir City Hospital, Eskişehir
| | - Kemal Uygur
- Department of Otorhinolaryngology, Gazi University Faculty of Medicine, Ankara
| | - Nesil Keleş
- Department of Otorhinolaryngology, İstanbul University İstanbul Faculty of Medicine, İstanbul
| | - Cemal Cingi
- Department of Otorhinolaryngology, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir
| | - Bülent Topuz
- Department of Otorhinolaryngology, Pamukkale University Faculty of Medicine, Denizli
| | - Salih Çanakçıoğlu
- Department of Otorhinolaryngology, İstanbul University İstanbul Faculty of Medicine, İstanbul
| | - Metin Önerci
- Department of Otorhinolaryngology, Hacettepe University Faculty of Medicine, Ankara
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Avoidance of allergens as an environmental method in the prevention of inhaled allergy symptoms. Allergol Immunopathol (Madr) 2020; 48:745-752. [PMID: 31879043 DOI: 10.1016/j.aller.2019.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Accepted: 06/25/2019] [Indexed: 11/20/2022]
Abstract
Asthma and other inhaled allergies are some of the most common paediatric diseases. The association of exposure to allergens with induction and exacerbation of symptoms has been proven. The majority of allergens are permanently or periodically suspended in the air, which leads to impaired quality of life for sensitive patients. Therefore, many methods of prevention and therapy of allergic diseases have been developed. The method of allergen exposure avoidance is often the first and the most significant measure. The present research has been conducted to evaluate, based on scientific data, which measures have the most reliable evidence of effectiveness. Environmental allergen avoidance methods, despite limited evidence supporting their clinical efficacy, are listed as the main therapeutic approaches in most recommendations. The significance of the holistic approach is also emphasised: only simultaneous introduction of several avoidance methods can bring possibly beneficial effects for the patient.
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Poole TB, King SP, Suphioglu C. Effectiveness of vacuuming and carpet washing in the removal of the major cat allergen, Fel d 1. Allergy 2020; 75:2694-2695. [PMID: 32383483 DOI: 10.1111/all.14356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Timothy B. Poole
- NeuroAllergy Research Laboratory (NARL) School of Life and Environmental Science Faculty of Science, Engineering and Built Environment Deakin University Waurn Ponds Vic Australia
| | - Samuel Peter King
- NeuroAllergy Research Laboratory (NARL) School of Life and Environmental Science Faculty of Science, Engineering and Built Environment Deakin University Waurn Ponds Vic Australia
| | - Cenk Suphioglu
- NeuroAllergy Research Laboratory (NARL) School of Life and Environmental Science Faculty of Science, Engineering and Built Environment Deakin University Waurn Ponds Vic Australia
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Johnston JD, Hawks ME, Johnston HB, Johnson LA, Beard JD. Comparison of Liquefied Petroleum Gas Cookstoves and Wood Cooking Fires on PM 2.5 Trends in Brick Workers' Homes in Nepal. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5681. [PMID: 32781568 PMCID: PMC7460176 DOI: 10.3390/ijerph17165681] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 08/04/2020] [Accepted: 08/04/2020] [Indexed: 11/17/2022]
Abstract
Prior studies document a high prevalence of respiratory symptoms among brick workers in Nepal, which may be partially caused by non-occupational exposure to fine particulate matter (PM2.5) from cooking. In this study, we compared PM2.5 levels and 24 h trends in brick workers' homes that used wood or liquefied petroleum gas (LPG) cooking fuel. PM2.5 filter-based and real-time nephelometer data were collected for approximately 24 h in homes and outdoors. PM2.5 was significantly associated with fuel type and location (p < 0.0001). Pairwise comparisons found significant differences between gas, indoor (geometric mean (GM): 79.32 μg/m3), and wood, indoor (GM: 541.14 μg/m3; p = 0.0002), and between wood, indoor, and outdoor (GM: 48.38 μg/m3; p = 0.0006) but not between gas, indoor, and outdoor (p = 0.56). For wood fuel homes, exposure peaks coincided with mealtimes. For LPG fuel homes, indoor levels may be explained by infiltration of ambient air pollution. In both wood and LPG fuel homes, PM2.5 levels exceeded the 24 h limit (25.0 µg/m3) proposed by the World Health Organization. Our findings suggest that increasing the adoption of LPG cookstoves and decreasing ambient air pollution in the Kathmandu valley will significantly lower daily PM2.5 exposures of brick workers and their families.
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Affiliation(s)
- James D. Johnston
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA; (M.E.H.); (J.D.B.)
| | - Megan E. Hawks
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA; (M.E.H.); (J.D.B.)
| | - Haley B. Johnston
- Department of Plant and Wildlife Sciences, Brigham Young University, Provo, UT 84602, USA;
| | - Laurel A. Johnson
- Marriott School of Business, Marketing & Global Supply Chain, Brigham Young University, Provo, UT 84602, USA;
| | - John D. Beard
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA; (M.E.H.); (J.D.B.)
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Abstract
PURPOSE OF REVIEW Sensitization and exposure to triggers in the indoor environment, including aeroallergens, indoor air pollution, and environmental tobacco smoke, have a significant role in asthma development and morbidity. This review discusses indoor environmental exposures and their effect on children with asthma as well as environmental interventions and their role in improving asthma morbidity. RECENT FINDINGS Recent research has emphasized the role of aeroallergen sensitization and exposure in asthma morbidity and the importance of the school indoor environment. There is an established association between indoor exposures and asthma development and morbidity. Recent evidence has highlighted the importance of the indoor environment in childhood asthma, particularly the role of the school indoor environment. While home environmental interventions have had mixed results, interventions in the school environment have the potential to significantly impact the health of children, and ongoing research is needed to determine their effectiveness.
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Cox LS, Murphey A, Hankin C. The Cost-Effectiveness of Allergen Immunotherapy Compared with Pharmacotherapy for Treatment of Allergic Rhinitis and Asthma. Immunol Allergy Clin North Am 2020; 40:69-85. [PMID: 31761122 DOI: 10.1016/j.iac.2019.09.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This article evaluates the cost-effectiveness of allergy immunotherapy (AIT) in the treatment of allergic rhinitis, asthma, and other allergic conditions. An extensive search of the PubMed and Medline databases (up to December 2018) was conducted. There is strong evidence in the collective literature, which included individual studies and systematic reviews, that AIT is cost-effective in the management of allergic rhinitis and asthma as compared with standard drug treatment alone. The magnitude of AIT's cost-effectiveness is likely underestimated because most of the studies considered during-treatment costs and not the long-term benefits or preventive or prophylactic effects of AIT.
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Affiliation(s)
- Linda S Cox
- Nova Southeastern University, 1108 S. Wolcott Street, Casper, Wyoming 82601, USA.
| | - Andrew Murphey
- Asthma Allergy and Sinus Center, 1965 Andrew Drive, West Chester, PA 19380, USA
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Abstract
House dust mites are an unsurpassed cause of atopic sensitization and allergic illness throughout the world. The major allergenic dust mites Dermatophagoides pteronyssinus, Dermatophagoides farinae, Euroglyphus maynei, and Blomia tropicalis are eight-legged members of the Arachnid class. Their approximately 3-month lifespan comprises egg, larval, protonymph, tritonymph, and adult stages, with adults, about one fourth to one third of a millimeter in size, being at the threshold of visibility. The geographic and seasonal distributions of dust mites are determined by their need for adequate humidity, while their distribution within substrates is further determined by their avoidance of light. By contacting the epithelium of the eyes, nose, lower airways, skin, and gut, the allergen-containing particles of dust mites can induce sensitization and atopic symptoms in those organs. Various mite allergens, contained primarily in mite fecal particles but also in shed mite exoskeletons and decaying mite body fragments, have properties that include proteolytic activity, homology with the lipopolysaccharide-binding component of Toll-like receptor 4, homology with other invertebrate tropomyosins, and chitin-cleaving and chitin-binding activity. Mite proteases have direct epithelial effects including the breaching of tight junctions and the stimulation of protease-activated receptors, the latter inducing pruritus, epithelial dysfunction, and cytokine release. Other components, including chitin, unmethylated mite and bacterial DNA, and endotoxin, activate pattern recognition receptors of the innate immune system and act as adjuvants promoting sensitization to mite and other allergens. Clinical conditions resulting from mite sensitization and exposure include rhinitis, sinusitis, conjunctivitis, asthma, and atopic dermatitis. Systemic allergy symptoms can also occur from the ingestion of cross-reacting invertebrates, such as shrimp or snail, or from the accidental ingestion of mite-contaminated foods. Beyond their direct importance as a major allergen source, an understanding of dust mites leads to insights into the nature of atopy and of allergic sensitization in general.
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Abstract
The school is a complex microenvironment of indoor allergens, pollutants, and other exposures. The school represents an occupational model for children and exposures in this environment have a significant health effect. Current research establishes an association between school exposure and asthma morbidity in children. This review will focus on common school environmental exposures (cockroach, rodents, cat, dog, classroom pets, dust mite, fungus, and pollution) and their impact on children with allergies and asthma. Understanding and evaluation of school-based environments is needed to help guide school-based interventions. School-based interventions have the potential for substantial benefit to the individual, school, community, and public health. However, there is a paucity data on school-based environmental interventions and health outcomes. The studies performed to date are small and cross-sectional with no control for home exposures. Randomized controlled school-based environmental intervention trials are needed to assess health outcomes and the cost-effectiveness of these interventions. The School Inner-City Asthma Intervention Study (SICAS 2), a NIH/NIAID randomized controlled clinical trial using environmental interventions modeled from successful home-based interventions, is currently underway with health outcome results pending. If efficacious, these interventions could potentially help further guide school-based interventions potentially with policy implications. In the meanwhile, the allergist/immunologist can continue to play a vital role in improving the quality of life in children with allergies and asthma at school through the use of the ADA policy and Section 504 of the Rehabilitation Act as well as encouraging adoption of toolkits to build successful school-based asthma programs and asthma-friendly schools.
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Kennedy K, Allenbrand R, Bowles E. The Role of Home Environments in Allergic Disease. Clin Rev Allergy Immunol 2020; 57:364-390. [PMID: 30684120 DOI: 10.1007/s12016-018-8724-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Allergic diseases are surprisingly common, chronic health conditions. The primary location where the vast majority of people are exposed to allergens and other substances is in their home. This means it is important to understand home environments and how a home's systems function and interact-and that how we occupy these spaces plays a crucial role in both environmental exposure and management of allergic disease. This review provides an overview of what is understood about home environmental exposure and its impact on our health, and proposes a systematic process for using a patient's environmental history to develop individualized, manageable and cost-effective recommendations. Once occupant-related information has been gathered, a home environmental exposure assessment should be performed focused on identifying the relationships between any identified sources of contaminants and the housing systems, and conditions that may be contributing to exposure. The results and recommendations from this assessment can then be used to guide exposure-reduction efforts by patients and/or their caregivers in an effort to improve disease management. In this review, we'll discuss three different types of home interventions-active, which must be routinely performed by the patient and/or caregiver, passive, which are interventions that work without routine, direct interaction from the homeowner, and behavioral changes in how the home environment is cleaned and maintained for long-term reduction of allergens. In this review, and others evaluated for this discussion, a significant number of home environmental assessment and intervention programs were shown to be cost effective, with the majority of programs showing a net positive return on investment. It is important to recognize that to be cost effective, the level and intensity of services offered through home visit programs need be stratified, based on the estimated health risks of the patient, in order to tailor the assessment and target the interventions to a patient's needs while maximizing cost effectiveness.
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Affiliation(s)
- Kevin Kennedy
- Section of Toxicology and Environmental Health, Children's Mercy Kansas City, Kansas City, USA.
| | - Ryan Allenbrand
- Section of Toxicology and Environmental Health, Children's Mercy Kansas City, Kansas City, USA
| | - Eric Bowles
- Section of Toxicology and Environmental Health, Children's Mercy Kansas City, Kansas City, USA
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Naclerio R, Ansotegui IJ, Bousquet J, Canonica GW, D'Amato G, Rosario N, Pawankar R, Peden D, Bergmann KC, Bielory L, Caraballo L, Cecchi L, Cepeda SAM, Chong Neto HJ, Galán C, Gonzalez Diaz SN, Idriss S, Popov T, Ramon GD, Ridolo E, Rottem M, Songnuan W, Rouadi P. International expert consensus on the management of allergic rhinitis (AR) aggravated by air pollutants: Impact of air pollution on patients with AR: Current knowledge and future strategies. World Allergy Organ J 2020; 13:100106. [PMID: 32256939 PMCID: PMC7132263 DOI: 10.1016/j.waojou.2020.100106] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 01/17/2020] [Accepted: 01/23/2020] [Indexed: 02/07/2023] Open
Abstract
Allergic rhinitis affects the quality of life of millions of people worldwide. Air pollution not only causes morbidity, but nearly 3 million people per year die from unhealthy indoor air exposure. Furthermore, allergic rhinitis and air pollution interact. This report summarizes the discussion of an International Expert Consensus on the management of allergic rhinitis aggravated by air pollution. The report begins with a review of indoor and outdoor air pollutants followed by epidemiologic evidence showing the impact of air pollution and climate change on the upper airway and allergic rhinitis. Mechanisms, particularly oxidative stress, potentially explaining the interactions between air pollution and allergic rhinitis are discussed. Treatment for the management of allergic rhinitis aggravated by air pollution primarily involves treating allergic rhinitis by guidelines and reducing exposure to pollutants. Fexofenadine a non-sedating oral antihistamine improves AR symptoms aggravated by air pollution. However, more efficacy studies on other pharmacological therapy of coexisting AR and air pollution are currently lacking.
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Key Words
- AER, Allergic eosinophilic rhinitis
- AP, Activator protein
- AR, Allergic rhinitis
- ARE, Antioxidant response element
- Air pollutants
- Air pollution
- Allergic rhinitis
- Antioxidant enzymes
- CFS, Chronic fatigue syndrome
- CO, Carbon monoxide
- COPD, Chronic obstructive pulmonary disease
- Climate change
- DAMP, Damage-associated molecular patterns
- DEP, Diesel exhaust particles
- ECAT, Elemental carbon attributable to traffic
- ECP, Eosinophil cationic protein
- GSH-Px, Glutathione peroxidase
- HDM, House dust mites
- HEPA, High efficiency particulate air
- HO, Hemeoxygenase
- HVAC, Heating, ventilation and air conditioning
- IAP, Indoor air pollution
- IAQ, Indoor air quality
- INS, Intranasal steroids
- Indoor air quality
- LDH, Lactate dehydrogenase
- MCP, Monocyte chemotactic protein
- MSQPCR, Mold specific quantitative PCR
- NAR, Non allergic rhinitis
- NF-κβ, Nuclear factor kappa β
- NO2, Nitrogen dioxide
- NOx, Nitric oxides
- Nrf2, Nuclear factor erythroid-2 related factor
- O3, Ozone
- OAP, Outdoor air pollution
- Occupational rhinitis
- Oxidative stress
- PAMP, Pathogen-associated molecular patterns
- PM, Particulate matter
- PON, Paraoxonase
- RNS, Reactive nitrosative species
- ROS, Reactive oxygen species
- SO2, Sulphur dioxide
- SOD, Superoxide dismutase
- TLR, Toll like receptor
- TNF, Tumor necrosis factor
- TOS, Total oxidative status
- TRAP, Traffic related air pollutants
- UFP, Ultra-fine particles
- VOCs, Volatile organic compound
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Affiliation(s)
| | | | - Jean Bousquet
- INSERM U 1168, VIMA: Ageing and Chronic Diseases Epidemiological and Public Health Approaches, Villejuif, France
- University Versailles St-Quentin-en-Yvelines, France
- Allergy-Centre-Charité, Charité–Universita¨tsmedizin Berlin, Berlin, Germany
| | | | - Gennaro D'Amato
- Division of Respiratory and Allergic Diseases, High Specialty Hospital A. Cardarelli, Napoli, Italy; School of Specialization in Respiratory Diseases University Federico II Naples, Italy
| | - Nelson Rosario
- Pediatric Respiratory Medicine Division, Complexo Hospital de Clinicas, UFPR, Curitiba, Brazil
| | - Ruby Pawankar
- Dept. of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - David Peden
- UNC Center for Environmental Medicine, Asthma, and Lung Biology; Division of Allergy, Immunology and Rheumatology, Dpt. of Pediatrics UNS School of Medicine, USA
| | | | - Leonard Bielory
- Medicine & Ophthalmology Hackensack Meridian School of Medicine at Seton Hall University Nutley, New Jersey, USA
| | - Luis Caraballo
- Institute for Immunological Research, University of Cartagena, Cartagena de Indias, Colombia
| | - Lorenzo Cecchi
- Centre de Bioclimatology, University de Florence, Florence, Italy
- SOS Allergy and Immunology, Prato - USL Toscana Centro, Italy
| | - S. Alfonso M. Cepeda
- Fundación Hospital Universitario Metropolitano de Barranquilla, Barranquilla, Colombia
| | | | - Carmen Galán
- Department of Botany, Ecology and Plant Physiology, University of Córdoba, Spain
| | | | - Samar Idriss
- Department of Otolaryngology- Head and Neck Surgery, Eye and Ear University Hospital, Beirut, Lebanon
| | - Todor Popov
- Alexander's University Hospital Clinic of Allergy & Asthma, Bulgaria
| | - German D. Ramon
- Alergia e Inmunología, Hospital Italiano Regional del Sur, Bahía Blanca-Buenos Aires, Argentina
| | - Erminia Ridolo
- Department of Clinical and Experimental Medicine, Università; di Parma, Parma, Italy
| | - Menachem Rottem
- Allergy Asthma and Immunology, Emek Medical Center, Afula, Israel
- Rappaport Faculty of Medicine Technion, Israel Institute of Technology, Haifa, Israel
| | - Wisuwat Songnuan
- Department of Plant Science, Faculty of Science, Mahidol University, Bangkok, Thailand
- Systems Biology of Diseases Research Unit, Faculty of Science, Mahidol University, Bangkok, Thailand
| | - Philip Rouadi
- Department of Otolaryngology- Head and Neck Surgery, Eye and Ear University Hospital, Beirut, Lebanon
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Doyen V, Casset A, Divaret-Chauveau A, Khayath N, Peiffer G, Bonniaud P, Dalphin JC, De Blay F. [Diagnosis of allergy in asthma]. Rev Mal Respir 2020; 37:243-256. [PMID: 32057505 DOI: 10.1016/j.rmr.2019.07.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 07/06/2019] [Indexed: 01/01/2023]
Abstract
Allergy is a hypersensitivity reaction induced by immunological mechanisms. In asthma, allergy has a complex role and is usually IgE mediated. Allergy must be evaluated during the work up but evidence of IgE sensitivity does not mean that allergens play a role in the pathophysiology of the disease. The clinical relevance of the sensitivity has to be considered. This paper describes current available tools to screen for IgE sensitivity, allergen exposure and their role in asthma.
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Affiliation(s)
- V Doyen
- Clinique d'immuno-allergologie, université Libre de Bruxelles (ULB), CHU Brugmann, place Van Gehuchten, 4, 1020 Bruxelles, Belgique.
| | - A Casset
- CNRS, CAMB UMR7199, université de Strasbourg, 67000 Strasbourg, France
| | - A Divaret-Chauveau
- Unité d'allergologie pédiatrique, hôpital d'enfants, CHRU de Nancy, 54000 Nancy, France; EA3450 développement adaptation et handicap (DevAH), université de Lorraine, 54000 Nancy, France; UMR 6249 Chrono-environment, CNRS et université de Franche-Comté, Besançon, France
| | - N Khayath
- Chest diseases department, Strasbourg University Hospital, 1, place de l'Hôpital, 67000 Strasbourg, France; Federation of translational medicine EA 3070, University of Strasbourg, BP426, 67091 Strasbourg, France
| | - G Peiffer
- Service de pneumologie, CHU Metz-Thionville, 57000 Metz, France
| | - P Bonniaud
- Service de pneumologie et soins intensifs respiratoires, hôpital François-Mitterrand, CHU Dijon-Bourgogne, 21079 Dijon, France
| | - J-C Dalphin
- UMR 6249 Chrono-environment, CNRS et université de Franche-Comté, Besançon, France; Service de pneumologie, CHU de Besançon, Besançon, France
| | - F De Blay
- Chest diseases department, Strasbourg University Hospital, 1, place de l'Hôpital, 67000 Strasbourg, France; Federation of translational medicine EA 3070, University of Strasbourg, BP426, 67091 Strasbourg, France
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43
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Dupuis P, Prokopich CL, Hynes A, Kim H. A contemporary look at allergic conjunctivitis. Allergy Asthma Clin Immunol 2020; 16:5. [PMID: 31993069 PMCID: PMC6975089 DOI: 10.1186/s13223-020-0403-9] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 01/09/2020] [Indexed: 01/16/2023] Open
Abstract
Allergic eye disease is common, yet often overlooked in North America. In the U.S., up to 40% of the population is deemed to be affected and this number is growing. Symptoms and signs of ocular allergy can lead to decreased productivity and negatively impact quality of life (QoL). Various treatment options exist to achieve symptom control. For allergic conjunctivitis, ophthalmic agents include antihistamines, mast cell stabilizers, dual-activity agents, nonsteroidal anti-inflammatory drugs (NSAIDs), steroids and some off-label treatments. Immunotherapy is recommended as a therapeutic option. This review provides a summary of the forms of ocular allergies, with a focus on symptoms and signs, impact on QoL, physical examination, diagnosis and therapeutic options of allergic conjunctivitis. Through multidisciplinary collaborations, a simplified algorithm for the treatment of allergic conjunctivitis is proposed for Canadian clinical practice.
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Affiliation(s)
- Pascale Dupuis
- 1Division of Clinical Immunology and Allergy, Department of Medicine, St. Joseph's Hospital, Western University, Room B3-102, 268 Grosvenor Street, London, ON N6A 4V2 Canada
| | - C Lisa Prokopich
- 2School of Optometry & Vision Science, University of Waterloo, 200 Columbia St W., Waterloo, ON N2L 3G1 Canada
| | | | - Harold Kim
- 1Division of Clinical Immunology and Allergy, Department of Medicine, St. Joseph's Hospital, Western University, Room B3-102, 268 Grosvenor Street, London, ON N6A 4V2 Canada.,4Division of Clinical Immunology and Allergy, Department of Medicine, McMaster University Health Sciences Centre, 1280 Main St. W., Hamilton, ON L8S 4K1 Canada
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44
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Abstract
This article evaluates the role of allergen immunotherapy (AIT) in the treatment of allergic rhinitis (AR). AIT has been shown to be effective in treating AR symptoms with resultant improvements in overall quality of life, comorbid illnesses, and medication requirements. Persistent clinical benefits have been shown years after AIT treatment discontinuation. AIT may prevent the progression of AR to asthma. AIT may more cost-effective than pharmacotherapy. Multiple individual studies and systematic reviews provide strong evidence for the clinical effectiveness of AIT in the treatment of AR. Cost-effectiveness and disease modification of AIT compared with standard drug treatment are additional advantages.
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Affiliation(s)
- Linda Cox
- Department of Medicine, Nova Southeastern University, Davie, FL, USA; Department of Medicine, University of Miami, Coral Gables, FL, USA.
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45
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Ding B, Lu Y. A Suggested Approach for Management of Pediatric Asthma During the COVID-19 Pandemic. Front Pediatr 2020; 8:563093. [PMID: 33102407 PMCID: PMC7546904 DOI: 10.3389/fped.2020.563093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 08/24/2020] [Indexed: 01/10/2023] Open
Abstract
Asthma is a prevalent pediatric disease causing important health, economic, and emotional burdens around the world. Asthma attacks can be controlled with standardized management, but no cure exists for the disease. Many attacks are triggered by respiratory tract infections and children with basic airway diseases are at high risk for developing severe or critical illnesses. The new COVID-19 pandemic threatens to disrupt children's asthma control management and we have set out to summarize the main factors that need to be considered by pediatricians treating children with asthma at times like these. We discuss the intrinsic nature of asthma and its treatment, and the effects of irregular treatment giving recommendations such as the use of the WeChat platform and WeChat Official Accounts for follow-ups to improve children's asthma compliance during the pandemic. We also cover the COVID-19 protection strategies, and the importance of stress reduction, a balanced diet, exercise, and the avoidance of known attack triggers for maintaining good control of asthma during the pandemic.
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Affiliation(s)
- Bo Ding
- Department of Pediatrics, South Hospital of Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yanming Lu
- Department of Pediatrics, South Hospital of Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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46
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Portnoy J, Miller C. Relationship between exposure to fungi and asthma-an ongoing conundrum. Ann Allergy Asthma Immunol 2019; 122:554-555. [PMID: 31171237 DOI: 10.1016/j.anai.2019.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 04/23/2019] [Accepted: 04/23/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Jay Portnoy
- Section of Allergy, Asthma & Immunology, Children's Mercy Hospital, Kansas City, Missouri.
| | - Christopher Miller
- Section of Allergy, Asthma & Immunology, Children's Mercy Hospital, Kansas City, Missouri
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47
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48
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Why despite the lower prevalence, is asthma more severe in the semiarid region? Allergol Immunopathol (Madr) 2019; 47:551-557. [PMID: 31167727 DOI: 10.1016/j.aller.2019.04.002] [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: 11/20/2018] [Revised: 03/20/2019] [Accepted: 04/05/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION AND OBJECTIVES Asthma is a chronic inflammatory disease which is very prevalent throughout the world, and climatic factors, especially air humidity, have been considered fundamental to its development. This study aims to evaluate the relationship between the climate factor and the severity of asthma episodes in the semiarid region, comparing it to the coast and an intermediate climate region, considering the use of medication as an intervening factor. MATERIALS AND METHODS Ecological study in cities with different climatic conditions (semiarid, intermediate region and Coast). Prevailing data was obtained from the International Study of Asthma and Allergies in Childhood (ISAAC) protocol. We evaluated the temperature, humidity and use of drugs for asthma/100,000 inhabitants. RESULTS The prevalence of asthma was lower in the semiarid (14%; 95%CI=12.1-15.7) than the intermediate region (19.1%; 95%CI=17.7-20.6) and coast (17.9%; 95%CI=16.6-19.2). Episodes of severe asthma attacks were surprisingly higher in semiarid (10.4%; 95%CI=8.9-11.9) when compared to coast (4.1%; 95%CI=3.4-4.9) and intermediate region (5.0%; 95%CI=4.3-5.8). In the semiarid region, the humidity was lower and the temperature higher than the other cities evaluated. The dispensing of medications was lower in the semiarid region. CONCLUSIONS Temperature and humidity may have contributed to a lower prevalence and greater severity of asthma in the semiarid region. The dispensing of medications was lower in the semiarid region, indicating that access to both relief and control drugs was lower in this city. The possibility of lack of health care in the semiarid region can also be another explanatory factor associated.
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49
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Johnston JD, Cowger AE, Graul RJ, Nash R, Tueller JA, Hendrickson NR, Robinson DR, Beard JD, Weber KS. Associations between evaporative cooling and dust-mite allergens, endotoxins, and β-(1 → 3)-d-glucans in house dust: A study of low-income homes. INDOOR AIR 2019; 29:1005-1017. [PMID: 31463967 DOI: 10.1111/ina.12600] [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: 06/25/2019] [Revised: 08/22/2019] [Accepted: 08/25/2019] [Indexed: 06/10/2023]
Abstract
Recent work suggests that evaporative coolers increase the level and diversity of bioaerosols, but this association remains understudied in low-income homes. We conducted a cross-sectional study of metropolitan, low-income homes in Utah with evaporative coolers (n = 20) and central air conditioners (n = 28). Dust samples (N = 147) were collected from four locations in each home and analyzed for dust-mite allergens Der p1 and Der f1, endotoxins, and β-(1 → 3)-d-glucans. In all sample locations combined, Der p1 or Der f1 was significantly higher in evaporative cooler versus central air conditioning homes (OR = 2.29, 95% CI = 1.05-4.98). Endotoxin concentration was significantly higher in evaporative cooler versus central air conditioning homes in furniture (geometric mean (GM) = 8.05 vs 2.85 EU/mg, P < .01) and all samples combined (GM = 3.60 vs 1.29 EU/mg, P = .03). β-(1 → 3)-d-glucan concentration and surface loads were significantly higher in evaporative cooler versus central air conditioning homes in all four sample locations and all samples combined (P < .01). Our study suggests that low-income, evaporative cooled homes have higher levels of immunologically important bioaerosols than central air-conditioned homes in dry climates, warranting studies on health implications and other exposed populations.
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Affiliation(s)
- James D Johnston
- Department of Public Health, Brigham Young University, Provo, Utah
| | - Ashlin E Cowger
- Department of Microbiology & Molecular Biology, Brigham Young University, Provo, Utah
| | - Robert J Graul
- Department of Public Health, Brigham Young University, Provo, Utah
| | - Ryan Nash
- Department of Public Health, Brigham Young University, Provo, Utah
| | - Josie A Tueller
- Department of Microbiology & Molecular Biology, Brigham Young University, Provo, Utah
| | | | | | - John D Beard
- Department of Public Health, Brigham Young University, Provo, Utah
| | - K Scott Weber
- Department of Microbiology & Molecular Biology, Brigham Young University, Provo, Utah
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50
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Home Environmental Interventions for House Dust Mite. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 6:1-7. [PMID: 29310755 DOI: 10.1016/j.jaip.2017.10.003] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 09/26/2017] [Accepted: 10/03/2017] [Indexed: 11/20/2022]
Abstract
It has been 50 years since the dust mite was first appreciated to be a major source of allergen in house dust, and by extension a key trigger of allergic respiratory disease. Since that time a number of protein allergens have been identified and characterized, mainly from mite feces, and standardized mite extracts and IgE assays have been developed. Insights into the lifecycle of dust mites and aspects of mite allergen biology have shed light on the mechanisms that lead to respiratory disease and to the development of interventions that can minimize dust mite allergen exposure. It is now clear that dust mite allergy is a key contributor to asthma in many parts of the world, and that long-term avoidance can be effective for preventing sensitization and minimizing the development and severity of respiratory disease. Here, we discuss the evidence linking dust mites with respiratory disease, outline studies that support the efficacy of home environmental interventions, and highlight practical methods that have been shown to be effective as part of a multifaceted approach to dust mite avoidance.
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