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Luo W, Hou X, Sun Y, Zhang H, Ren H, Ma X, Li G, Yu Y, Sun J, Wu H, Wu J, Zhong R, Wang S, Li Z, Zhao Y, Wu L, Zheng X, Xu M, Ye Q, Hao C, Sun B. Developing and validating clinical models to identify candidates for allergic rhinitis pre-exposure prophylaxis. Ann Med 2023; 55:2287188. [PMID: 38039557 PMCID: PMC10836286 DOI: 10.1080/07853890.2023.2287188] [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: 10/12/2023] [Accepted: 11/17/2023] [Indexed: 12/03/2023] Open
Abstract
PURPOSE Few risk-forecasting models of allergic rhinitis (AR) exist that may aid AR pre-exposure prophylaxis (PrEP) in clinical practice. Therefore, this study aimed to develop and validate an effective clinical model for identifying candidates for AR PrEP using a routine medical questionnaire. METHODS This study was conducted in 10 Chinese provinces with 13 medical centers (n = 877) between 2019 and 2021. Clinical characteristics and exposure history were collected via face-to-face interviews. Well-trained physicians diagnosed patients with AR based on skin prick test results and clinical performance. The least absolute shrinkage and selection operator model was used to identify potential risk factors for AR, and the logistic regression model was used to construct the risk-forecasting model. Predictive power and model reliability were assessed using area under the receiver operating characteristic curve and calibration curves, respectively. RESULTS This study diagnosed 625 patients with AR who had positive responses to at least one indoor or outdoor allergen and 460 to at least one outdoor pollen allergen. Two nomograms were established to identify two types of AR with various sensitization patterns. Both models had an area under curve of approximately 0.7 in the development and internal validation datasets. Additionally, our findings found good agreement for the calibration curves of both models. CONCLUSION Early identification of candidates for AR PrEP using routine medical information may improve the deployment of limited resources and effective health management. Our models showed good performance in predicting AR; therefore, they can serve as potential automatic screening tools to identify AR PrEP candidates.
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Affiliation(s)
- Wenting Luo
- Department of Clinical Laboratory, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | | | - Yun Sun
- Department of Pediatrics, Yinchuan Maternal and Child Health Care Hospital, Yinchuan, China
| | - Hong Zhang
- Department of Pediatrics, Gansu Provincial Hospital, Lanzhou, China
| | - Huali Ren
- Department of Allergy, State Grid Beijing Electric Power Hospital, Capital Medical University Electric Power Teaching Hospital, Beijing, China
| | - Xiangping Ma
- Department of Pediatrics, First Affiliated Hospital of Xinjiang Medical University, Wulumuqi, China
| | - Guoping Li
- Laboratory of Allergy and Precision Medicine, Chengdu Institute of Respiratory Health, the Third People’s Hospital of Chengdu, Chengdu, China
| | - Yongmei Yu
- Department of Pediatrics, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jianxin Sun
- Department of Respiratory, The Second People’s Hospital of Zhaoqing, Zhaoqing, China
| | - Huajie Wu
- Department of Pediatrics, Xijing Hospital, the Fourth Military Medical University, Xi’an, China
| | - Jing Wu
- Department of Allergy and Clinical Immunology, Inner Mongolia Cancer Hospital, Inner Mongolia, China
| | - Ruifen Zhong
- Department of Clinical Lab, Dongguan Eighth People’s Hospital, Dongguan, China
| | - Siqin Wang
- Department of Allergy and Clinical Immunology, Henan Provincial People’s Hospital, Zhengzhou, China
| | - Zhenan Li
- Department of Otolaryngology, Foshan Maternal Child Health Hospital, Foshan, China
| | - Yan Zhao
- Department of Allergy, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Liting Wu
- Department of Clinical Laboratory, Shenzhen Pingle Orthopedic Hospital (Shenzhen Pingshan Traditional Chinese Medicine Hospital), Shenzhen, China
| | - Xianhui Zheng
- Department of Clinical Laboratory, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Miaoyuan Xu
- KingMed School of Laboratory Medicine, Guangzhou Medical University, Guangzhou, China
| | - Qingyuan Ye
- KingMed School of Laboratory Medicine, Guangzhou Medical University, Guangzhou, China
| | - Chuangli Hao
- Department of Respirology, Children’s Hospital, Soochow University, Suzhou, China
| | - Baoqing Sun
- Department of Clinical Laboratory, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
- Guangzhou National Laboratory, Guangzhou, China
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Matricardi PM, Hoffmann T, Dramburg S. The "allergic nose as a pollen detector" concept: e-Diaries to predict pollen trends. Pediatr Allergy Immunol 2023; 34:e13966. [PMID: 37366207 DOI: 10.1111/pai.13966] [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: 11/15/2022] [Revised: 05/11/2023] [Accepted: 05/15/2023] [Indexed: 06/28/2023]
Abstract
Hirst pollen traps and operator pollen recognition are worldwide used by aerobiologists, providing essential services for the diagnosis and monitoring of allergic patients. More recently, semiautomated or fully automated detector systems have been developed, which facilitate prediction of pollen exposure and risk for the individual patient. In parallel, smartphone apps consisting of short questionnaires filled in daily by the patient/user provide daily scores, time trajectories, and descriptive reports of the severity of respiratory allergies in patients with pollen allergy. The usual scientific and clinical approach to this matter is to monitor the environment (pollen concentration) in order to predict the risk of symptoms (allergic rhinitis) in a population. We discuss here the opposite, contraintuitive possibility, that is, the use of e-diaries to collect daily information of mono-sensitized pollen-allergic patients in order to predict the clinically efficient airborne exposure to a given pollen, area, and time period. In line with the "Patient as Sensor" concept, proposed in 2013 by Bernd Resch, the "allergic nose" may be used as a pollen detector in addition to existing calibrated hardware sensors, namely the pollen stations, thus contributing with individual measurements, sensations, and symptoms' perception. The target of this review is to present a novel concept of pollen monitoring based on "pollen-detector" patients to inspire future cooperative studies aimed at investigating and hopefully validating our hypothesis.
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Affiliation(s)
- Paolo Maria Matricardi
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Tara Hoffmann
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Stephanie Dramburg
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Beggs PJ, Clot B, Sofiev M, Johnston FH. Climate change, airborne allergens, and three translational mitigation approaches. EBioMedicine 2023:104478. [PMID: 36805358 PMCID: PMC10363419 DOI: 10.1016/j.ebiom.2023.104478] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 01/16/2023] [Accepted: 01/31/2023] [Indexed: 02/19/2023] Open
Abstract
One of the important adverse impacts of climate change on human health is increases in allergic respiratory diseases such as allergic rhinitis and asthma. This impact is via the effects of increases in atmospheric carbon dioxide concentration and air temperature on sources of airborne allergens such as pollen and fungal spores. This review describes these effects and then explores three translational mitigation approaches that may lead to improved health outcomes, with recent examples and developments highlighted. Impacts have already been observed on the seasonality, production and atmospheric concentration, allergenicity, and geographic distribution of airborne allergens, and these are projected to continue into the future. A technological revolution is underway that has the potential to advance patient management by better avoiding associated increased exposures, including automated real-time airborne allergen monitoring, airborne allergen forecasting and modelling, and smartphone apps for mitigating the health impacts of airborne allergens.
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Affiliation(s)
- Paul J Beggs
- School of Natural Sciences, Faculty of Science and Engineering, Macquarie University, Sydney, New South Wales 2109, Australia.
| | - Bernard Clot
- Federal Office of Meteorology and Climatology MeteoSwiss, 1530 Payerne, Switzerland
| | - Mikhail Sofiev
- Finnish Meteorological Institute, 00560 Helsinki, Finland
| | - Fay H Johnston
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania 7005, Australia
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Ma X, Zhu X, Xie Q, Jin J, Zhou Y, Luo Y, Liu Y, Tian J, Zhao Y. Monitoring nature's calendar from space: Emerging topics in land surface phenology and associated opportunities for science applications. GLOBAL CHANGE BIOLOGY 2022; 28:7186-7204. [PMID: 36114727 PMCID: PMC9827868 DOI: 10.1111/gcb.16436] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/09/2022] [Accepted: 09/11/2022] [Indexed: 06/15/2023]
Abstract
Vegetation phenology has been viewed as the nature's calendar and an integrative indicator of plant-climate interactions. The correct representation of vegetation phenology is important for models to accurately simulate the exchange of carbon, water, and energy between the vegetated land surface and the atmosphere. Remote sensing has advanced the monitoring of vegetation phenology by providing spatially and temporally continuous data that together with conventional ground observations offers a unique contribution to our knowledge about the environmental impact on ecosystems as well as the ecological adaptations and feedback to global climate change. Land surface phenology (LSP) is defined as the use of satellites to monitor seasonal dynamics in vegetated land surfaces and to estimate phenological transition dates. LSP, as an interdisciplinary subject among remote sensing, ecology, and biometeorology, has undergone rapid development over the past few decades. Recent advances in sensor technologies, as well as data fusion techniques, have enabled novel phenology retrieval algorithms that refine phenology details at even higher spatiotemporal resolutions, providing new insights into ecosystem dynamics. As such, here we summarize the recent advances in LSP and the associated opportunities for science applications. We focus on the remaining challenges, promising techniques, and emerging topics that together we believe will truly form the very frontier of the global LSP research field.
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Affiliation(s)
- Xuanlong Ma
- College of Earth and Environmental Sciences, Lanzhou UniversityLanzhouChina
| | - Xiaolin Zhu
- Department of Land Surveying and Geo‐InformaticsThe Hong Kong Polytechnic UniversityHong KongChina
| | - Qiaoyun Xie
- School of Life Sciences, Faculty of ScienceUniversity of Technology SydneySydneyNew South WalesAustralia
| | - Jiaxin Jin
- College of Hydrology and Water Resources, Hohai UniversityNanjingChina
| | - Yuke Zhou
- Key Laboratory of Ecosystem Network Observation and ModellingInstitute of Geographic Sciences and Natural Resources Research, Chinese Academy of SciencesBeijingChina
| | - Yunpeng Luo
- Swiss Federal Institute for Forest, Snow and Landscape Research WSLBirmensdorfSwitzerland
- Department of Environmental System ScienceETH ZurichZurichSwitzerland
| | - Yuxia Liu
- School of Life Sciences, Faculty of ScienceUniversity of Technology SydneySydneyNew South WalesAustralia
- Geospatial Sciences Center of Excellence (GSCE)South Dakota State UniversityBrookingsSouth DakotaUSA
| | - Jiaqi Tian
- Department of Land Surveying and Geo‐InformaticsThe Hong Kong Polytechnic UniversityHong KongChina
- Department of GeographyNational University of SingaporeSingaporeSingapore
| | - Yuhe Zhao
- College of Earth and Environmental Sciences, Lanzhou UniversityLanzhouChina
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5
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Dramburg S, Perna S, Di Fraia M, Tripodi S, Arasi S, Castelli S, Villalta D, Buzzulini F, Sfika I, Villella V, Potapova E, Brighetti MA, Travaglini A, Verardo P, Pelosi S, Matricardi PM. Validation Parameters of Patient-Generated Data for Digitally Recorded Allergic Rhinitis Symptom and Medication Scores in the @IT.2020 Project: Exploratory Study. JMIR Mhealth Uhealth 2022; 10:e31491. [PMID: 35657659 PMCID: PMC9206201 DOI: 10.2196/31491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/30/2021] [Accepted: 12/07/2021] [Indexed: 11/17/2022] Open
Abstract
Background Mobile health technologies enable allergists to monitor disease trends by collecting daily patient-reported outcomes of allergic rhinitis. To this end, patients with allergies are usually required to enter their symptoms and medication repetitively over long time periods, which may present a risk to data completeness and quality in the case of insufficient effort reporting. Completeness of patient’s recording is easily measured. In contrast, the intrinsic quality and accuracy of the data entered by the patients are more elusive. Objective The aim of this study was to explore the association of adherence to digital symptom recording with a predefined set of parameters of the patient-generated symptom and medication scores and to identify parameters that may serve as proxy measure of the quality and reliability of the information recorded by the patient. Methods The @IT.2020 project investigates the diagnostic synergy of mobile health and molecular allergology in patients with seasonal allergic rhinitis. In its pilot phase, 101 children with seasonal allergic rhinitis were recruited in Rome and instructed to record their symptoms, medication intake, and general conditions daily via a mobile app (AllergyMonitor) during the relevant pollen season. We measured adherence to daily recording as the percentage of days with data recording in the observation period. We examined the patient’s trajectories of 3 disease indices (Rhinoconjunctivitis Total Symptom Score [RTSS], Combined Symptom and Medication Score [CSMS], and Visual Analogue Scale [VAS]) as putative proxies of data quality with the following 4 parameters: (1) intravariation index, (2) percentage of zero values, (3) coefficient of variation, and (4) percentage of changes in trend. Lastly, we examined the relationship between adherence to recording and each of the 4 proxy measures. Results Adherence to recording ranged from 20% (11/56) to 100% (56/56), with 64.4% (65/101) and 35.6% (36/101) of the patients’ values above (highly adherent patients) or below (low adherent patients) the threshold of 80%, respectively. The percentage of zero values, the coefficient of variation, and the intravariation index did not significantly change with the adherence to recording. By contrast, the proportion of changes in trend was significantly higher among highly adherent patients, independently from the analyzed score (RTSS, CSMS, and VAS). Conclusions The percentage of changes in the trend of RTSS, CSMS, and VAS is a valuable candidate to validate the quality and accuracy of the data recorded by patients with allergic rhinitis during the pollen season. The performance of this parameter must be further investigated in real-life conditions before it can be recommended for routine use in apps and electronic diaries devoted to the management of patients with allergic rhinitis.
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Affiliation(s)
- Stephanie Dramburg
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Serena Perna
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Marco Di Fraia
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Salvatore Tripodi
- Pediatric Allergology Unit, Sandro Pertini Hospital, Rome, Italy
- Allergology Service, Policlinico Casilino, Rome, Italy
| | - Stefania Arasi
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Translational Research in Pediatric Specialities Area, Division of Allergy, Bambino Gesù Children's Hospital, Scientific Institute for Research, Hospitalization and Healthcare, Rome, Italy
| | - Sveva Castelli
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Danilo Villalta
- Department of Immunology and Allergy, Santa Maria degli Angeli Hospital, Pordenone, Italy
| | - Francesca Buzzulini
- Department of Immunology and Allergy, Santa Maria degli Angeli Hospital, Pordenone, Italy
| | - Ifigenia Sfika
- Pediatric Allergology Unit, Sandro Pertini Hospital, Rome, Italy
| | - Valeria Villella
- Pediatric Allergology Unit, Sandro Pertini Hospital, Rome, Italy
| | - Ekaterina Potapova
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | | | | | - Pierluigi Verardo
- Center of Aerobiology, Regional Agency for the Protection of the Environment, Pordenone, Italy
| | | | - Paolo Maria Matricardi
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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6
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Idrose NS, Vicendese D, Peters RL, Koplin JJ, Douglass JA, Walters EH, Perret JL, Lowe AJ, Tang MLK, Newbigin EJ, Erbas B, Lodge CJ, Dharmage SC. Children With Food Allergy Are at Risk of Lower Lung Function on High-Pollen Days. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:2144-2153.e10. [PMID: 35398553 DOI: 10.1016/j.jaip.2022.03.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 03/02/2022] [Accepted: 03/18/2022] [Indexed: 12/28/2022]
Abstract
BACKGROUND Grass pollen exposure is a risk factor for childhood asthma hospital attendances. However, its short-term influence on lung function, especially among those with other allergic conditions, has been less well-studied. OBJECTIVE To investigate this association in a population-based sample of children. METHODS Within the HealthNuts cohort, 641 children performed spirometry during the grass pollen season. Grass pollen concentration was considered on the day of testing (lag 0), up to 3 days before (lag 1-lag 3), and cumulatively (lag 0-3). We used linear regression to assess the relevant associations and examined potential interactions with current asthma, hay fever or eczema, and food allergy. RESULTS Associations were observed only in children with allergic disease (P value for interaction ≤ 0.1). In children with food allergy, grass pollen concentration was associated with a lower ratio of forced expiratory volume in 1 second to forced vital capacity (FEV1/FVC) and lower mid-forced expiratory flows (FEF25%-75%) at all lags (eg, at lag 2, FEV1/FVC z-score = -0.50 [95% CI -0.80 to -0.20] and FEF25%--75% z-score = -0.40 [-0.60 to -0.04] per 20 grains/m3 pollen increase), and increased bronchodilator responsiveness (BDR) at lag 2 and lag 3 (eg, at lag 2, BDR = (31 [95% CI -0.005 to 62] mL). In children with current asthma, increasing grass pollen concentration was associated with lower FEF25%-75% and increased BDR, whereas children with current hay fever or eczema had increased BDR only. CONCLUSIONS A proactive approach needs to be enforced to manage susceptible children, especially those with food allergy, before high-grass pollen days.
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Affiliation(s)
- N Sabrina Idrose
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Melbourne, Victoria, Australia; Centre for Food and Allergy Research, Murdoch Children's Research Institute, Parkville, Melbourne, Victoria, Australia
| | - Don Vicendese
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Melbourne, Victoria, Australia; Department of Mathematics and Statistics, La Trobe University, Bundoora, Victoria, Australia
| | - Rachel L Peters
- Centre for Food and Allergy Research, Murdoch Children's Research Institute, Parkville, Melbourne, Victoria, Australia; Department of Pediatrics, The University of Melbourne, Parkville, Melbourne, Victoria, Australia
| | - Jennifer J Koplin
- Centre for Food and Allergy Research, Murdoch Children's Research Institute, Parkville, Melbourne, Victoria, Australia; Department of Pediatrics, The University of Melbourne, Parkville, Melbourne, Victoria, Australia
| | - Jo A Douglass
- Department of Clinical Immunology and Allergy, Royal Melbourne Hospital, Parkville, Melbourne, Victoria, Australia; Department of Medicine, University of Melbourne, Parkville, Melbourne, Victoria, Australia
| | - E Haydn Walters
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Melbourne, Victoria, Australia; Department of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Jennifer L Perret
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Melbourne, Victoria, Australia
| | - Adrian J Lowe
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Melbourne, Victoria, Australia; Centre for Food and Allergy Research, Murdoch Children's Research Institute, Parkville, Melbourne, Victoria, Australia
| | - Mimi L K Tang
- Centre for Food and Allergy Research, Murdoch Children's Research Institute, Parkville, Melbourne, Victoria, Australia; Department of Pediatrics, The University of Melbourne, Parkville, Melbourne, Victoria, Australia; Department of Allergy and Immunology, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Ed J Newbigin
- School of BioSciences, The University of Melbourne, Parkville, Melbourne, Victoria, Australia
| | - Bircan Erbas
- School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Caroline J Lodge
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Melbourne, Victoria, Australia
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Melbourne, Victoria, Australia; Centre for Food and Allergy Research, Murdoch Children's Research Institute, Parkville, Melbourne, Victoria, Australia.
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7
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van Nunen SA, Burk MB, Burton PK, Ford G, Harvey RJ, Lozynsky A, Pickford E, Rimmer JS, Smart J, Sutherland MF, Thien F, Weber HC, Zehnwirth H, Newbigin E, Katelaris CH. 5-grass-pollen SLIT effectiveness in seasonal allergic rhinitis: Impact of sensitization to subtropical grass pollen. World Allergy Organ J 2022; 15:100632. [PMID: 35280502 PMCID: PMC8873945 DOI: 10.1016/j.waojou.2022.100632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 01/24/2022] [Accepted: 01/27/2022] [Indexed: 01/08/2023] Open
Abstract
Background Temperate grass (eg, ryegrass) pollen is a major driver of seasonal allergic rhinitis (SAR) and asthma risks, including thunderstorm asthma. Data for the effectiveness of temperate grass pollen allergen immunotherapy (AIT) in SAR patients from the southern hemisphere, who are frequently polysensitized to subtropical grass pollens, are limited. The 300 IR 5-grass pollen sublingual immunotherapy tablet (300 IR 5-grass SLIT) is known to be effective in polysensitized SAR patients with primary allergy to temperate grasses, however, the influence of polysensitization to subtropical grass pollen on treatment responses has yet to be specifically addressed. Key aims of this study were to measure patient treatment satisfaction during 300 IR 5-grass SLIT treatment and evaluate how polysensitization to subtropical grass pollens affects treatment responses. Methods A prospective observational study was conducted in 63 patients (aged ≥5 years) in several temperate regions of Australia prescribed 300 IR 5-grass SLIT for SAR over 3 consecutive grass pollen seasons. Ambient levels of pollen were measured at representative sites. Patient treatment satisfaction was assessed using a QUARTIS questionnaire. Rhinoconjunctivitis Total Symptom Score (RTSS) and a Hodges-Lehmann Estimator analysis was performed to evaluate if polysensitization to subtropical grass pollen affected SAR symptom intensity changes during SLIT. Results A diagnosis of ryegrass pollen allergy was nearly universal. There were 74.6% (47/63) polysensitized to subtropical and temperate grass pollens. There were 23.8% (15/63) monosensitized to temperate grass pollens. From the first pollen season, statistically significant improvements occurred in SAR symptoms compared with baseline in both monosensitized and polysensitized patients, particularly in those polysensitized (P = 0.0297). Improvements in SAR symptoms were sustained and similar in both groups in the second and third pollen seasons, reaching 70–85% improvement (P < 0.01). Polysensitized patients from both northerly and southerly temperate regions in Australia showed similar improvements. Grass pollen counts in both regions were consistently highest during springtime. Conclusions 300 IR 5-grass SLIT is effective in a real-life setting in SAR patients in the southern hemisphere with primary allergy to temperate grass pollen and predominantly springtime grass pollen exposures. Importantly, SLIT treatment effectiveness was irrespective of the patient's polysensitization status to subtropical grass pollens.
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8
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Schusteff RA, Chervinko MA, Nyenhuis SM, Lee VS. Ecological momentary assessment of outcomes in allergic rhinitis and chronic rhinosinusitis: A review. Int Forum Allergy Rhinol 2022; 12:1282-1290. [DOI: 10.1002/alr.22982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 01/10/2022] [Accepted: 01/26/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Rachel A. Schusteff
- Graduate Medical Education College of Medicine, University of Illinois Chicago Chicago IL
| | - Margaret A. Chervinko
- Department of Ophthalmology and Visual Sciences College of Medicine, University of Illinois Chicago Chicago IL
| | - Sharmilee M. Nyenhuis
- Department of Medicine, Division of Pulmonary, Critical Care, Sleep and Allergy College of Medicine, University of Illinois Chicago Chicago IL
| | - Victoria S. Lee
- Department of Otolaryngology – Head and Neck Surgery College of Medicine, University of Illinois Chicago Chicago IL
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9
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Alvarez-Perea A, Dimov V, Popescu FD, Zubeldia JM. The applications of eHealth technologies in the management of asthma and allergic diseases. Clin Transl Allergy 2021; 11:e12061. [PMID: 34504682 PMCID: PMC8420996 DOI: 10.1002/clt2.12061] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 08/20/2021] [Accepted: 08/25/2021] [Indexed: 01/14/2023] Open
Abstract
Portable devices, such as smartphones and mobile Internet access have become ubiquitous in the last decades. The term 'eHealth' stands for electronic health. The tools included in the eHealth concept utilize phones, computers and the Internet and related applications to improve the health care industry. Implementation of eHealth technologies has been documented for the management of different chronic diseases, including asthma and allergic conditions. Clinicians and patients have gained opportunity to communicate in new ways, which could be used cost-effectively to improve disease control and quality of life of those affected. Additionally, these innovations bring new opportunities to academic researchers. For example, eHealth has allowed researchers to compile data points that were previously unavailable or difficult to access, and analyse them using novel tools, collectively described as 'big data'. The role of eHealth become more important since early 2020, due to the physical distancing rules and the restrictions on mobility that have been applied worldwide as a response to the coronavirus disease 2019 pandemic. In this review, we summarize the most recent developments in various eHealth platforms and their relevance to the speciality of allergy and immunology, from the point of view of three major stakeholders: clinicians, patients and researchers.
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Affiliation(s)
- Alberto Alvarez-Perea
- Allergy Service Hospital General Universitario Gregorio Marañón Madrid Spain.,Gregorio Marañón Health Research Institute Madrid Spain
| | - Ves Dimov
- Cleveland Clinic Florida FAU Charles E. Schmidt College of Medicine Weston Florida USA
| | - Florin-Dan Popescu
- Department of Allergology 'Nicolae Malaxa' Clinical Hospital 'Carol Davila' University of Medicine and Pharmacy Bucharest Romania
| | - José Manuel Zubeldia
- Allergy Service Hospital General Universitario Gregorio Marañón Madrid Spain.,Gregorio Marañón Health Research Institute Madrid Spain.,Biomedical Research Network on Rare Diseases (CIBERER)-U761 Madrid Spain
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10
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AlQuran A, Batra M, Harry Susanto N, Holland AE, Davies JM, Erbas B, Lampugnani ER. Community Response to the Impact of Thunderstorm Asthma Using Smart Technology. ALLERGY & RHINOLOGY 2021; 12:21526567211010728. [PMID: 33996193 PMCID: PMC8083005 DOI: 10.1177/21526567211010728] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 11/27/2022]
Abstract
Background The most severe thunderstorm asthma (TA) event occurred in Melbourne on the 21st November 2016 and during this period, daily pollen information was available and accessible on smart devices via an App. An integrated survey within the App allows users to self-report symptoms. Objective To explore patterns of symptom survey results during the period when the TA event occurred. Methods Symptom data from the Melbourne Pollen Count and Forecast App related to asthma history, hay fever symptoms, and medication use was explored. A one-week control period before and after the event was considered. Chi-square tests and logistic regression were used to assess associations between sex, age, symptoms, and medication use. Results Of the 28,655 responses, during the 2016 pollen season, younger (18 to 40 years) males, with no hay fever and no asthma were the most single and regular responders. During the TA event for new users, sex was only significantly associated with hay fever (p = 0.008) of which 60.2% of females’ responses reported having hay fever, while 43% of males’ responses did not. Those with mild symptoms peaked during the TA event. Conclusions Many individuals completed the survey on the app for the first time during the TA event indicating the potential of digital technologies to be used as indicators of health risk among populations at risk of TA events.
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Affiliation(s)
- Ala AlQuran
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Mehak Batra
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Nugroho Harry Susanto
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia.,Indonesia Research Partnership on Infectious Diseases, Jakarta, Indonesia
| | - Anne E Holland
- Department of Allergy, Immunology and Respiratory Medicine, Monash University, Melbourne, Australia.,Department of Physiotherapy, Alfred Health, Melbourne, Australia.,Institute for Breathing and Sleep, Melbourne, Australia
| | - Janet M Davies
- School of Biomedical Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, and Office of Research, Metro North Hospital and Health Service, Brisbane Australia
| | - Bircan Erbas
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia.,Faculty of Public Health, Universitas AirLangga, Surabaya, Indonesia
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Davies JM, Berman D, Beggs PJ, Ramón GD, Peter J, Katelaris CH, Ziska LH. Global Climate Change and Pollen Aeroallergens: A Southern Hemisphere Perspective. Immunol Allergy Clin North Am 2020; 41:1-16. [PMID: 33228867 DOI: 10.1016/j.iac.2020.09.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Climatic change will have an impact on production and release of pollen, with consequences for the duration and magnitude of aeroallergen seasonal exposure and allergic diseases. Evaluations of pollen aerobiology in the southern hemisphere have been limited by resourcing and the density of monitoring sites. This review emphasizes inconsistencies in pollen monitoring methods and metrics used globally. Research should consider unique southern hemisphere biodiversity, climate, plant distributions, standardization of pollen aerobiology, automation, and environmental integration. For both hemispheres, there is a clear need for better understanding of likely influences of climate change and comprehending their impact on pollen-related health outcomes.
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Affiliation(s)
- Janet M Davies
- School of Biomedical Science, Queensland University of Technology, Herston, Queensland 4006, Australia; Office of Research, Metro North Hospital and Health Service, Herston, Queensland 4006, Australia.
| | - Dilys Berman
- Allergy and Immunology Unit, University of Cape Town Lung Institute, Cape Town 7700, South Africa
| | - Paul J Beggs
- Department of Earth and Environmental Sciences, Faculty of Science and Engineering, Macquarie University, Sydney, New South Wales 2109, Australia
| | - Germán Darío Ramón
- Hospital Italiano Regional DelSur, Bahía Blanca, Buenos Aires, Argentina
| | - Jonny Peter
- Division of Allergy and Clinical Immunology, Department of Medicine, Groote Schuur Hospital, University of Cape Town, 7700
- PO Box 34560, 7937, South Africa; Allergy and Immunology Unit, University of Cape Town Lung Institute, George Street, Cape Town, South Africa
| | | | - Lewis H Ziska
- Mailman School of Public Health, Columbia University, New York, NY 10032, USA
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