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Park HR, Seok SH, Park ES. Complexation of levocetirizine with ion-exchange resins and its effect on the stability of powder mixtures containing levocetirizine and montelukast. JOURNAL OF PHARMACEUTICAL INVESTIGATION 2022. [DOI: 10.1007/s40005-022-00604-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Coronavirus disease 2019 and asthma, allergic rhinitis: molecular mechanisms and host-environmental interactions. Curr Opin Allergy Clin Immunol 2021; 21:1-7. [PMID: 33186186 DOI: 10.1097/aci.0000000000000699] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW Coronavirus disease 2019 (COVID-19), a respiratory infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 virus), is a pandemic in over 120 countries worldwide. Risk factors for severe COVID-19 include older age, ethnicity, sex, comorbidities, and living conditions. Although asthmatics and those with allergies are susceptible to more severe outcomes to viral infections, interestingly, asthma has not been reported to be a major comorbidity of COVID-19. However, there are some conflicting reports on the impact of asthma on COVID-19. The underlying immunological and molecular mechanisms may explain at least in part these observations. Furthermore, environmental factors like air pollution that have detrimental effects on asthma and respiratory illnesses also have an impact on COVID-19. RECENT FINDINGS Angiotensin-converting enzyme 2 (ACE2) is the receptor for the attachment and entry of SARS-CoV-2 into the host cells that is upregulated by Th1-mediated responses. In asthmatics, ACE2 gene expression is generally reduced and recent studies have shown a negative correlation between the levels of Th2 cytokines including IL-4, IL-5, and IL-13 in airway epithelial cells and other type 2 biomarkers with ACE2 expression. This may explain in part the potential protective role of asthma on COVID-19. Here, we review the relation of respiratory viral illnesses and asthma, the immune-molecular mechanisms of SARS-CoV-2 infection, the impact of asthma on COVID-19 and that of SARS-CoV-2 on asthma and allergic rhinitis, and the impact of environmental factors like air pollution on COVID-19. SUMMARY Expression of ACE2 in airway epithelial cells in SARS-COV-2 is influenced by inflammatory profile. Respiratory allergic diseases like asthma appear to have a protective effect against SARS-COV-2 infection. However, the clinical association between asthma and SARS-COV-2 is not fully established and the underlying immune-molecular mechanisms may explain these observations.
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Prevalence and clinical characteristics of allergic rhinitis in the elderly Korean population. Eur Arch Otorhinolaryngol 2020; 277:3367-3373. [PMID: 32743711 DOI: 10.1007/s00405-020-06256-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 07/27/2020] [Indexed: 02/03/2023]
Abstract
PURPOSE The proportion of elderly people aged ≥ 65 years is increasing worldwide. Although the reported prevalence of sinonasal disease can vary according to the diagnostic methods used, differences in allergic rhinitis prevalence in the elderly according to diagnostic method have not been reported. We thus aimed to evaluate allergic rhinitis prevalence in the elderly according to diagnostic criteria obtained from questionnaires, physician diagnoses, and allergy tests. METHODS We compared the allergic rhinitis prevalence in the elderly aged ≥ 65 years with adults aged 19-64 years, using data from the Korean National Health and Nutrition Examination Survey 2008-2012. Total serum IgE and IgE levels specific to allergens of Dermatophagoides farina, cockroach, and dog dander were examined, and factors affecting specific IgE levels were investigated. RESULTS Allergic rhinitis prevalence according to the questionnaire responses, physician diagnoses, and allergy test results was 35.02%, 14.89%, and 17.56%, respectively. The prevalence based on all diagnostic methods assessed was significantly lower in the elderly than in the general adult group (p < 0.001). Rhinorrhea incidence was significantly increased in the elderly (p = 0.018). Sensitization to Dermatophagoides farina was significantly decreased in the elderly (p = 0.006) and did not correlate with socioeconomic status and/or general health factors. CONCLUSIONS The elderly population has a distinct clinical presentation, including a low prevalence of allergic rhinitis, and an increased incidence of rhinorrhea symptoms, compared with the general adult population. The management of allergic rhinitis in elderly patients may therefore require a different therapeutic approach to improve rhinorrhea rather than nasal obstruction.
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Huang C, Zhang J, Sun C, Liu W, Zhang Y, Li B, Zhao Z, Deng Q, Zhang X, Qian H, Zou Z, Yang X, Sun Y, Xia Z, Weschler LB, Sundell J. Associations between household renovation and rhinitis among preschool children in China: A cross-sectional study. INDOOR AIR 2020; 30:827-840. [PMID: 32297363 DOI: 10.1111/ina.12675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 02/12/2020] [Accepted: 04/08/2020] [Indexed: 06/11/2023]
Abstract
During 2010-2012, we surveyed 40,010 3- to 6-year-old children in seven Chinese cities (Beijing, Taiyuan, Urumqi, Shanghai, Nanjing, Changsha, and Chongqing). Their parents reported information on household renovation, including the timing of renovation and the choice of materials for walls and floors in the child's room, and the incidence of their child's rhinitis. Multivariate and two-level (city-child) logistic regression analyses yielding adjusted odds ratios (AOR) with 95% confidence intervals were performed. Sensitivity analyses stratifying data for location and economic level were also performed. About 48.0% of the children had ever had allergic rhinitis, 41.2% had current allergic rhinitis, and 9.0% had had doctor-diagnosed rhinitis. Exposure to household renovation during early lifetime (birth to 1-year-old) had an AOR of 1.43 (1.04-1.9) for allergic rhinitis. The incidence of allergic rhinitis was significantly different in children exposed to different floor and wall covering materials. Floor or wall covering material composed of organic materials significantly increased the risk of childhood allergic rhinitis compared with tile flooring or lime wall covering. Oil paint had an AOR of 1.66 (1.28-2.14) for diagnosed rhinitis compared with lime wall covering. Adding new furniture the year before pregnancy was associated with an AOR of 1.18 (1.10-1.27) and 1.18 (1.11-1.25) for lifetime and current rhinitis. Solid wood or tiles/ceramic as floor materials, and using wallpaper, oil paint, or emulsion panels as wall materials were risk factors for doctor-diagnosed rhinitis. Sensitivity analyses showed that children living in southern or higher economic level China cities were more likely to have allergic rhinitis with household renovation.
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Affiliation(s)
- Chen Huang
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Jialing Zhang
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Chanjuan Sun
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Wei Liu
- School of Architecture, Tsinghua University, Beijing, China
| | - Yinping Zhang
- School of Architecture, Tsinghua University, Beijing, China
| | - Baizhan Li
- Key Laboratory of Three Gorges Reservoir Region's Eco-Environment, Chongqing University, Chongqing, China
| | - Zhuohui Zhao
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Key Lab of Health Technology Assessment, National Health and Family Planning Commission of the People's Republic of China, Fudan University, Shanghai, China
| | - Qihong Deng
- School of Public Health, Central South University, Changsha, China
| | - Xin Zhang
- Research Center for Environmental Science and Engineering, Shanxi University, Taiyuan, China
| | - Hua Qian
- School of Energy and Environment, Southeast University, Nanjing, China
| | - Zhijun Zou
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Xu Yang
- College of Life Sciences, Central China Normal University, Wuhan, China
| | - Yuexia Sun
- School of Environmental Science and Engineering, Tianjin University, Tianjin, China
| | - Zhenzhen Xia
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | | | - Jan Sundell
- School of Environmental Science and Engineering, Tianjin University, Tianjin, China
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Kim MK, Lee SY, Park HS, Yoon HJ, Kim SH, Cho YJ, Yoo KH, Lee SK, Kim HK, Park JW, Park HW, Chung JH, Choi BW, Lee BJ, Chang YS, Jo EJ, Lee SY, Cho YS, Jee YK, Lee JM, Jung J, Park CS. A Randomized, Multicenter, Double-blind, Phase III Study to Evaluate the Efficacy on Allergic Rhinitis and Safety of a Combination Therapy of Montelukast and Levocetirizine in Patients With Asthma and Allergic Rhinitis. Clin Ther 2018; 40:1096-1107.e1. [PMID: 29945738 DOI: 10.1016/j.clinthera.2018.04.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 04/25/2018] [Accepted: 04/30/2018] [Indexed: 12/30/2022]
Abstract
PURPOSE The aim of this study was to evaluate the efficacy and safety of a fixed-dose combination of montelukast and levocetirizine in patients with perennial allergic rhinitis with mild to moderate asthma compared with the efficacy and safety of montelukast alone. METHODS This study was a 4-week, randomized, multicenter, double-blind, Phase III trial. After a 1-week placebo run-in period, the subjects were randomized to receive montelukast (10 mg/day, n = 112) or montelukast (10 mg/day)/levocetirizine (5 mg/day) (n = 116) treatment for 4 weeks. The primary efficacy end point was mean daytime nasal symptom score. Other efficacy end points included mean nighttime nasal symptom score, mean composite symptom score, overall assessment of allergic rhinitis by both subjects and physicians, forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC, asthma control test score, and the frequency of rescue medication used during the treatment period. FINDINGS Of 333 patients screened for this study, 228 eligible patients were randomized to treatment. The mean (SD) age of patients was 43.32 (15.02) years, and two thirds of subjects were female (66.67%). The demographic characteristics were similar between the treatment groups. Compared with the montelukast group, the montelukast/levocetirizine group reported significant reductions in mean daytime nasal symptom score (least squares mean [SE] of combination vs montelukast, -0.98 [0.06] vs -0.81 [0.06]; P = 0.045). For all other allergic rhinitis efficacy end points, the montelukast/levocetirizine group showed greater improvement than the montelukast group. Similar results were observed in overall assessment scores and in FEV1, FVC, FEV1/FVC, and asthma control test score changes from baseline for the 2 treatment groups. Montelukast/levocetirizine was well tolerated, and the safety profile was similar to that observed in the montelukast group. IMPLICATIONS The fixed-dose combination of montelukast and levocetirizine was effective and safe in treating perennial allergic rhinitis in patients with asthma compared with montelukast alone. ClinicalTrials.gov identifier: NCT02552667.
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Affiliation(s)
- Mi-Kyeong Kim
- Subdivision of Allergy, Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Sook Young Lee
- Division of Allergy, Department of Internal Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hae-Sim Park
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Ho Joo Yoon
- Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Sang-Ha Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Young Joo Cho
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Kwang-Ha Yoo
- Pulmonary-Allergy Division, Department of Internal Medicine, Konkuk University College of Medicine, Seoul, Republic of Korea
| | - Soo-Keol Lee
- Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Republic of Korea
| | - Hee-Kyoo Kim
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Republic of Korea
| | - Jung-Won Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Heung-Woo Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jin-Hong Chung
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Republic of Korea
| | - Byoung Whui Choi
- Division of Respirology and Allergy, Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Byung-Jae Lee
- Division of Allergy, Department of Medicine, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Republic of Korea
| | - Yoon-Seok Chang
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Eun-Jung Jo
- Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University College of Medicine, Busan, Republic of Korea
| | - Sang-Yeub Lee
- Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - You Sook Cho
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Young-Koo Jee
- Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Jong-Myung Lee
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Jina Jung
- Hanmi Pharmaceutical Co, Seoul, Republic of Korea
| | - Choon-Sik Park
- Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea.
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Smith MP, Berdel D, Bauer CP, Koletzko S, Nowak D, Heinrich J, Schulz H. Asthma and Rhinitis Are Associated with Less Objectively-Measured Moderate and Vigorous Physical Activity, but Similar Sport Participation, in Adolescent German Boys: GINIplus and LISAplus Cohorts. PLoS One 2016; 11:e0161461. [PMID: 27560942 PMCID: PMC4999273 DOI: 10.1371/journal.pone.0161461] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 08/05/2016] [Indexed: 01/16/2023] Open
Abstract
INTRODUCTION Physical activity (PA) protects against most noncommunicable diseases and has been associated with decreased risk of allergic phenotype, which is increasing worldwide. However, the association is not always present; furthermore it is not clear whether it is strongest for asthma, rhinitis, symptoms of these, or atopic sensitization; which sex is most affected; or whether it can be explained by either avoidance of sport or exacerbation of symptoms by exercise. Interventions are thus difficult to target. METHODS PA was measured by one-week accelerometry in 1137 Germans (mean age 15.6 years, 47% boys) from the GINIplus and LISAplus birth cohorts, and modeled as a correlate of allergic symptoms, sensitization, or reported doctor-diagnosed asthma or rhinitis. RESULTS 8.3% of children had asthma, of the remainder 7.9% had rhinitis, and of the remainder 32% were sensitized to aero-allergens (atopic). 52% were lung-healthy controls. Lung-healthy boys and girls averaged 46.4 min and 37.8 min moderate-to-vigorous PA per day, of which 14.6 and 11.4 min was vigorous. PA in allergic girls was not altered, but boys with asthma got 13% less moderate and 29% less vigorous PA, and those with rhinitis with 13% less moderate PA, than lung-healthy boys. Both sexes participated comparably in sport (70 to 84%). Adolescents with wheezing (up to 68%, in asthma) and/or nose/eye symptoms (up to 88%, in rhinitis) were no less active. CONCLUSIONS We found that asthma and rhinitis, but not atopy, were independently associated with low PA in boys, but not in girls. These results indicate that allergic boys remain a high-risk group for physical inactivity even if they participate comparably in sport. Research into the link between PA and allergy should consider population-specific and sex-specific effects, and clinicians, parents, and designers of PA interventions should specifically address PA in allergic boys to ensure full participation.
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Affiliation(s)
- Maia P. Smith
- Institute of Epidemiology I, Helmholtz Zentrum München – German Research Center for Environmental Health, Neuherberg/Munich, Germany
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-University, Munich, Germany
| | - Dietrich Berdel
- Research Institute, Department of Pediatrics, Marien-Hospital Wesel, Wesel, Germany
| | - Carl-Peter Bauer
- Department of Pediatrics, Technical University of Munich, Munich, Germany
| | - Sibylle Koletzko
- Dr. von Hauner Children’s Hospital, Ludwig-Maximilians University, Munich, Germany
| | - Dennis Nowak
- Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Munich, Germany
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-University, Munich, Germany
| | - Joachim Heinrich
- Institute of Epidemiology I, Helmholtz Zentrum München – German Research Center for Environmental Health, Neuherberg/Munich, Germany
- Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Munich, Germany
| | - Holger Schulz
- Institute of Epidemiology I, Helmholtz Zentrum München – German Research Center for Environmental Health, Neuherberg/Munich, Germany
- Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Munich, Germany
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Chang ML, Cui C, Liu YH, Pei LC, Shao B. Analysis of total immunoglobulin E and specific immunoglobulin E of 3,721 patients with allergic disease. Biomed Rep 2015; 3:573-577. [PMID: 26171168 DOI: 10.3892/br.2015.455] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 03/31/2015] [Indexed: 11/05/2022] Open
Abstract
Due to the increase in the prevalence and incidence of allergic diseases, improving the sensitivity and specificity of screening indexes is critical. Total immunoglobulin E (IgE) is a traditional index for judging allergic diseases, while its specificity is relatively poor. Serum-specific IgE (sIgE) is an objective index with high specificity in the diagnosis of allergic diseases. In the present research, the total IgE and sIgE of 3,721 patients with allergic diseases were analyzed to further illuminate the association between them. The data were derived from 3,721 patients. The serum-sIgE to 14 types of common allergens and total IgE were detected. A total of 2,419 cases (65.0%) of 3,721 patients exhibited increasing total IgE and 1,215 patients (32.7%) exhibited positive sIgE. The consistency rate of the two indexes was 60.4%, and the κ-value was 0.28. In 135 patients with normal total IgE, 82.2% exhibited one sIgE positive and 17.8% exhibited two or more sIgE positive. While the number of positive sIgE increased and the detecting level enhanced, the number of positive total IgE markedly increased. Patients (84.1%) with increasing total IgE were associated with positive sIgE, but the increase of total IgE could not be completely explained by the total accumulation of sIgE. Total IgE may play an important role on screening allergic disease while sIgE could be used as crucial evidence for allergy diagnosis. Although the consistency of the two methods was poor, neither total IgE nor sIgE could replace each other. Combining the two indexes with clinical manifestations together will improve the method.
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Affiliation(s)
- Man-Li Chang
- Department of Laboratory Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Can Cui
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Yan-Hong Liu
- Department of Laboratory Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Li-Chun Pei
- Department of Geriatrics, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Bing Shao
- Department of Molecular Epidemiology, Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
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Nasiri R, Movahedi M, Amirzargar AA, Hirbod-Mobarakeh A, Farhadi E, Ansaripour B, Moradi B, Rezaei N. Association of interleukin 6 single nucleotide polymorphisms with allergic rhinitis. Int J Pediatr Otorhinolaryngol 2014; 78:1426-9. [PMID: 24974143 DOI: 10.1016/j.ijporl.2014.04.035] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 04/17/2014] [Accepted: 04/20/2014] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Allergic rhinitis (AR) is a polygenic inflammatory disorder of the nasal mucosa with an increasing prevalence worldwide. As interleukin 6 (IL-6) seems to be involved in development of allergic disorders, such as allergic rhinitis, this study was performed to evaluate the association of two promotor variants of IL-6 gene in the AR. METHODS Ninety eight patients with AR were enrolled in this study. Genotyping was done for two polymorphisms in a promoter region of IL-6 gene (G/C at -174, rs1800795 and G/A at -597, rs1800797), using a PCR sequence-specific-primers method. RESULTS Patients homozygous for the G allele of rs1800795 in IL-6 had a 3.35-fold risk of having AR than those with the C allele. AA genotype in rs1800797 of IL-6 was associated with the increased risk of developing AR. G/G haplotype for IL-6 (rs1800795, rs1800797) was significantly higher in the patient group. In some subgroups of patients, there were significant relationships between IgE levels, eosinophil count, eosinophil percentage, nature of sensitivity and persistency of disease and these two variants. CONCLUSION We found that two promotor variants in IL-6, especially rs1800795, were predisposing factors for AR with a negative heterosis pattern. These SNPs could also affect the clinical parameters, the nature of sensitivity and persistency of the disease in some subgroups of the patients.
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Affiliation(s)
- Rasoul Nasiri
- Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Pediatrics, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Masoud Movahedi
- Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Akbar Amirzargar
- Molecular Immunology Research Center; and Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Armin Hirbod-Mobarakeh
- Molecular Immunology Research Center; and Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Farhadi
- Molecular Immunology Research Center; and Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Hematology Department, School of Allied Medical Science, Tehran University of Medical Sciences, Tehran, Iran
| | - Bita Ansaripour
- Molecular Immunology Research Center; and Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Batoul Moradi
- Molecular Immunology Research Center; and Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Nima Rezaei
- Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; Molecular Immunology Research Center; and Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
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Gene polymorphisms of Interleukin-4 in allergic rhinitis and its association with clinical phenotypes. Am J Otolaryngol 2013; 34:676-81. [PMID: 24075353 DOI: 10.1016/j.amjoto.2013.05.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Revised: 04/29/2013] [Accepted: 05/05/2013] [Indexed: 02/06/2023]
Abstract
BACKGROUND Allergic rhinitis (AR) is an inflammatory disorder of the upper airway. T-helper (Th)2 cytokines seems to have major roles behind the scene of unpleasant symptoms resulted from AR. Expression of interleukin (IL)-4 and its receptor could be affected by single nucleotide polymorphisms (SNPs). This study assessed the effect of 4 genetic variants within genes of IL-4 and IL-4R in AR. METHODS Allele frequencies of one IL-4R variant (rs1801275) and three SNPs of IL-4 (rs2243248, rs2243250, and rs2070874) were investigated in 98 patients with AR, compared to a group of controls, using PCR sequence-specific-primers (PCR-SSP) method. RESULTS Homozygosity for the C allele of rs2243250 in IL-4 was significantly overrepresented in the patient group. CC genotype in rs2070874 significantly was correlated with AR. GG/CC/CC and TT/TT/TT (rs2243248, rs2243250, and rs2070874) haplotypes in the IL-4 gene had a significant negative correlation with AR. CONCLUSION SNPs in IL-4 are associated with AR and could change the clinical picture of the disease in patients.
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Ghaderi M. How Closely Related are Allergic Rhinitis, Asthma, and Chronic Sinusitis? EAR, NOSE & THROAT JOURNAL 2013. [DOI: 10.1177/014556131309200902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Mahmoud Ghaderi
- Clinical Professor Department of Otolaryngology-Head and Neck Surgery-Philadelphia College of Osteopathic Medicine Springfield, Pennsylvania Adjunct Clinical Professor Department of Otolaryngology-Head and Neck Surgery Drexel University College of Medicine Philadelphia
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11
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Maio S, Simoni M, Baldacci S, Angino A, Martini F, Cerrai S, Sarno G, Silvi P, Borbotti M, Pala AP, Bresciani M, Paggiaro PL, Viegi G. The ARGA study with Italian general practitioners: prescriptions for allergic rhinitis and adherence to ARIA guidelines. Curr Med Res Opin 2012; 28:1743-51. [PMID: 22958052 DOI: 10.1185/03007995.2012.724393] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND General practitioners (GPs) are the healthcare professionals to whom patients with rhinitis firstly refer for their symptoms. OBJECTIVE In the present study, we assessed drug prescriptions for allergic rhinitis (AR) and evaluated prescriptive adherence to ARIA treatment guidelines. METHODS Data on 1379 AR patients were collected by 107 Italian GPs. Adherence to ARIA guidelines was evaluated according to AR severity classification. RESULTS AR was diagnosed by GPs as mild intermittent for 46.2% of patients, mild persistent for 26.6%, moderate-severe intermittent for 20.2%, and moderate-severe persistent for 7%; 43.7% of AR patients had concomitant asthma. The most frequently prescribed therapeutic groups were antihistamines (anti-H, 76%) and nasal corticosteroids (NCS, 46%). Anti-H were significantly used more often to treat AR alone than AR + asthma (85 vs. 68%, p < 0.001), whereas NCS were used more often to treat AR + asthma than AR alone (50 vs. 42%, p = 0.01). Among patients with only mild intermittent AR, 39% were prescribed combined therapy. Among patients with moderate-severe persistent AR, 30% of those with AR alone and 18% of those with AR + asthma were prescribed monotherapy based on anti-H. GPs were more compliant with ARIA guidelines while treating AR alone (57%) than AR + asthma (46%) patients. The adherence increased according to the severity grade and was satisfactory for moderate-severe persistent AR (89% for AR alone and 95% for AR + asthma). CONCLUSIONS Adherence to ARIA guidelines is satisfactory only for treatment of more severe patients, thus GPs often tend to treat patients independently from ARIA guidelines. Since prescription data only provide limited information to judge prescribing quality, some deviation from the gold standard are to be expected.
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Affiliation(s)
- S Maio
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Italy.
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Bostock-Cox B. Recognising and managing allergic disease in the community. Br J Community Nurs 2012; 17:302, 304, 306-8. [PMID: 22875180 DOI: 10.12968/bjcn.2012.17.7.302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Allergic disease and its symptoms, whether seasonal or perennial, can have a significant impact on individuals' quality of life. Asthma, allergic rhinitis, eczema, urticaria and food allergy are among the common allergies that nurses may encounter in the community. This article discusses the causes of allergic disease, the importance of considering allergen avoidance, and the alternative treatment options available.
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Baldacci S, Maio S, Simoni M, Cerrai S, Sarno G, Silvi P, Di Pede F, Borbotti M, Pala AP, Bresciani M, Viegi G. The ARGA study with general practitioners: impact of medical education on asthma/rhinitis management. Respir Med 2012; 106:777-85. [PMID: 22436656 DOI: 10.1016/j.rmed.2012.02.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Revised: 01/26/2012] [Accepted: 02/21/2012] [Indexed: 11/20/2022]
Abstract
AIM To evaluate the impact of a medical education course (MEC) on the behaviour of general practitioners (GPs) to treat asthma and allergic rhinitis (AR). METHODS Data on 1820 patients (mean age 41 yrs ± 17 yrs) with asthma or AR were collected by 107 Italian GPs: 50% attended a MEC and 50% didn't (group B). The adherence for AR and asthma treatment was evaluated according to ARIA and GINA guidelines (GL). RESULTS AR and asthma were diagnosed in 78% and 56% of patients; 34% had concomitant AR and asthma. Regardless of the MEC, the adherence to GL was significantly higher for AR than for asthma treatment (52 versus 19%). Group B GPs were more compliant to ARIA guidelines in the treatment of mild AR, whereas group A were more compliant in the treatment of moderate-severe AR; the adherence didn't differ between the groups for AR patients with comorbid asthma. Adherence to GINA GL for asthma treatment did not differ between GPs of groups A and B, independently from concomitant AR. Though insignificantly, group A were more compliant to GINA GL in the treatment of patients with only severe persistent asthma (63 versus 46%) as group B were for patients with severe persistent asthma and concomitant AR. CONCLUSIONS GPs often tend to treat patients independently from GL. The impact of a single MEC did not improve adherence to GL in treating less severe AR and asthma patients, while there was a trend towards the opposite attitude in more severe AR patients without concomitant asthma.
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Affiliation(s)
- Sandra Baldacci
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Via Trieste, 41 - 56126 Pisa, Italy.
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Amlani S, Nadarajah T, McIvor RA. Montelukast for the treatment of asthma in the adult population. Expert Opin Pharmacother 2011; 12:2119-28. [PMID: 21777174 DOI: 10.1517/14656566.2011.600689] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Asthma is a complex process that results from airway inflammation and manifests as bronchoconstriction. Infiltration of the airway mucosa and lumen by activated inflammatory cells, along with release of mediators, can occur extensively. Chemical mediators known as leukotrienes are believed to play a major role in this process. At present, inhaled corticosteroids (ICS) are the pharmacologic cornerstone of asthma management. However, asthma control may remain suboptimal when relying on ICS because of problems with compliance, poor inhaler technique and concerns about the side effects of steroids; additional agents are often required to control symptoms. Leukotriene receptor antagonists (LTRA), namely montelukast, provide a safe and effective additional anti-inflammatory treatment option. There is particular benefit for patients with asthma and concomitant allergic rhinitis. AREAS COVERED Montelukast has been well studied through rigorous clinical trials. A thorough review of the literature has been undertaken to assess the evidence supporting the use of LTRAs. This review focuses on the role of montelukast not only as monotherapy but also as add-on therapy to ICS in the adult asthma population, as well as adult asthmatics with concomitant allergic rhinitis. In addition, there is often some discrepancy between the evidence generated in the idealized asthma patients recruited into randomized clinical trials and results obtained in the real-life setting. This review assesses recent clinical trials evaluating the real-life evaluation of montelukast, achieved mainly through open-label observational studies. EXPERT OPINION Oral LTRA bring remarkable ease of anti-inflammatory treatment administration and symptom improvement with minimal side effects to the management of adult asthma. Basic asthma mechanisms and much-valued scientific groundwork has been identified by exploring target asthma treatment with anti-leukotriene therapy. This will have a significant impact in the future development of targeted asthma therapies as well as the current management of asthma and other inflammatory medical conditions.
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Affiliation(s)
- Salima Amlani
- McMaster University, Internal Medicine Residency Program, 1200 Main Street West, Hamilton, Ontario, Canada
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Amlani S, McIvor RA. Montelukast in childhood asthma: what is the evidence for its use? Expert Rev Respir Med 2011; 5:17-25. [PMID: 21348582 DOI: 10.1586/ers.10.90] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Asthma is a complex process involving extensive infiltration of the airway mucosa and lumen by activated inflammatory cells and release of mediators that result in airway inflammation and bronchoconstriction. Leukotrienes are mediators believed to play a major role in this process. At present, inhaled corticosteroids are the cornerstone of asthma management. However, asthma control may remain suboptimal and there is well-documented concern regarding adverse events with the use of inhaled corticosteroids in children. Leukotriene receptor antagonists, such as montelukast, provide a safe and effective treatment option with ease of administration, particularly in preschool children and as add-on therapy in patients with difficult-to-control asthma.
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Affiliation(s)
- Salima Amlani
- Firestone Institute of Respiratory Health, St Joseph's Health Care Hamilton, 50 Charlton Avenue East, Hamilton, Ontario, Canada
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16
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Kim YH, Jang TY. Clinical characteristics and therapeutic outcomes of patients with localized mucosal allergy. Am J Rhinol Allergy 2011; 24:e89-92. [PMID: 20819459 DOI: 10.2500/ajra.2010.24.3497] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Many researchers have focused on the definition and pathophysiology of localized mucosal allergy. However, there are few studies on its clinical characteristics and therapeutic outcomes. The goal of this study was to analyze the prevalence, epidemiology, clinical characteristics, and response to antiallergic medication of localized mucosal allergy patients compared with those in patients with allergic rhinitis. METHODS Among 836 patients suspected to have rhinitis, 29 patients with localized mucosal allergy (group A) and 29 patients with allergic rhinitis (group B) were selected. Medical history, family history, symptoms, and their severity were obtained using a questionnaire. The change in minimal cross-sectional area (MCA) after provocation was measured by acoustic rhinometry. After 2 weeks of antihistamine medication, the changes in symptoms were compared between groups. RESULTS The prevalence of localized mucosal allergy was approximately 3.5%. There were no differences in patient history, symptoms, or symptom severity. The decrease in MCA after provocation was not significantly different. After two weeks of oral antihistamine (ebastine 10 mg once daily), group A reported significantly less symptom improvement than group B. CONCLUSION Because patient or family history and clinical picture are very similar in localized mucosal allergy and allergic rhinitis, clinicians should take more care in differentiating them. Based on the reduced effectiveness of an oral antihistamine alone, a combined regimen of oral and topical antihistamine or anti-inflammatory medication is recommended for patients with localized mucosal allergy.
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Affiliation(s)
- Young Hyo Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Inha University College of Medicine, Incheon, Korea
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17
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Clinical characteristics of allergic rhinitis according to allergic rhinitis and its impact on asthma guidelines. Clin Exp Otorhinolaryngol 2008; 1:196-200. [PMID: 19434267 PMCID: PMC2671762 DOI: 10.3342/ceo.2008.1.4.196] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2008] [Accepted: 09/18/2008] [Indexed: 11/15/2022] Open
Abstract
Objectives The Allergic rhinitis and its impact on asthma (ARIA) guidelines were suggested for use to classify allergic rhinitis (AR). However, few studies have been performed in Asians. The objective of this study is to identify the clinical characteristics of AR in Korean patients according to the ARIA guidelines. Methods For the study, 610 patients who had been diagnosed with allergic rhinitis at Seoul National University Bundang Hospital and 545 patients who had been diagnosed with allergic rhinitis at 3 local clinics were included. All the patients were categorized into 4 groups, such as the mild intermittent, mild persistent, moderate-severe intermittent and moderate-severe persistent groups. The patients were given a questionnaire on allergic rhinitis-related symptoms and they underwent blood tests, including the blood eosinophil count and the serum total IgE level. Results The most prevalent type was the moderate-severe persistent group (34.7%), and the moderate-severe intermittent group (17.1%) was the rarest. There were significant differences among the 4 groups for olfaction (P<0.001), self-awareness of rhinitis (P=0.013), a previous history of AR (P<0.001), self-awareness of asthma (P=0.001) and allergic conjunctivitis (P<0.001). On the allergy laboratory tests, there was a significant difference between the groups for the eosinophi count (P=0.004). The number of blood eosinophil was more in the persistent groups than in the intermittent groups. Conclusion According to the ARIA guidelines, the moderate-severe persistent group was the most prevalent for Korean patients. Blood eosinophilia and olfactory dysfunction were the most severe in the moderate-severe persistent group.
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18
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Lim JH, Kim HW, Jeon JH, Lee HS. Acaricidal constituents isolated from Sinapis alba L. seeds and structure-activity relationships. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2008; 56:9962-9966. [PMID: 18844359 DOI: 10.1021/jf8022244] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Allyl isothiocyanate (AITC) and phenethyl isothiocyanate (PEITC) were isolated from Sinapis alba L. seeds and their effects against Dermatophagoides farinae and D. pteronyssinus were evaluated using the impregnated fabric disk method. The LD 50 values of their compounds and derivatives were then compared with those of a commercial acaricide, benzyl benzoate. On the basis of the LD 50 values against D. farinae, PEITC (0.21 microg/cm(2)) was the most toxic, followed by benzyl isothiocyanate (0.55 microg/cm(2)), phenyl isothiocyanate (1.09 microg/cm(2)), butyl isothiocyanate (1.24 microg/cm(2)), and AITC (1.36 microg/cm(2)); acetyl isothiocyanate (195.01 microg/cm(2)) was the least toxic. In addition, the acaricidal effects of AITC and PEITC against D. farinae were 7.4- and 47.8-fold greater than those of benzyl benzoate, respectively. Against D. pteronyssinus, PEITC was the most toxic (0.19 microg/cm(2)), followed by benzyl isothiocyanate (0.77 microg/cm(2)), phenyl isothiocyanate (1.37 microg/cm(2)), butyl isothiocyanate (1.50 microg/cm(2)), and AITC (2.88 microg/cm(2)); acetyl isothiocyanate (168.82 microg/cm(2)) was the least toxic. AITC and PEITC were 3.3- and 50.4-fold more active than benzyl benzoate against D. pteronyssinus, respectively. Taken together, these findings indicate that AITC, PEITC, and partial derivatives may be useful as preventive agents against dust mites. In addition, these results indicate that structure-activity is related to the aromatic structure, the number of carbon atoms, and the compounds hydrophobicity.
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Affiliation(s)
- Jeong-Hyeon Lim
- Department of Agricultural Chemistry and Institute of Agricultural Science & Technology, College of Agriculture & Life Science, Chonbuk National University, Chonju 561-756, South Korea
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Kessel A, Halloun H, Bamberger E, Kugelman A, Toubi E. Abnormal spirometry in children with persistent allergic rhinitis due to mite sensitization: the benefit of nasal corticosteroids. Pediatr Allergy Immunol 2008; 19:61-6. [PMID: 17651381 DOI: 10.1111/j.1399-3038.2007.00588.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Inflammatory processes affecting nasal and bronchial mucosa are similar in nature. The purpose of this study was to examine whether children with perennial allergic rhinitis, without underlying asthma, have impaired pulmonary function. We also investigated whether nasal corticosteroids and loratidine would improve the pulmonary function tests of those children with impaired lung function. Fifty subjects with moderate/severe persistent allergic rhinitis due to exclusively dust mite sensitization and no past medical history suggestive of asthma were assessed. The control group consisted of 26 matched healthy subjects. Subjects with airway obstruction, as detected by forced expiratory volume/1 s (FEV1) or forced expiratory flow from 25/% to 75% (FEF(25-75)) values <80% of those predicted, were treated with loratidine, once a day for 10 days, and daily nasal budesonide for 3 months. We found that 11 of 50 patients (22%) with perennial allergic rhinitis had impaired pulmonary function (FEF(25-75) values <80%), compared to 1/26 (3.8%) of the control group (p < or = 0.05). Reversibility was observed in 9/11 (81.8%), mean 24.7% +/- 10.3%. Within 3 months of treatment, 7/10 had FEF(25-75) > 80% of their predicted values as well as significant improvements in their FEV1 (p = 0.04), and FEV1/FVC (p = 0.04). We conclude that a substantial proportion of children with perennial allergic rhinitis have diminished FEF (25-75) values and reversible airway obstruction. Nasal corticosteroids improve the pulmonary function tests of these children with impaired lung function.
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Affiliation(s)
- Aharon Kessel
- Division of allergy and clinical Immunology, Department of Clinical Microbiology, Faculty of Medicine Technion, Haifa, Israel.
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20
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Abstract
The 'one airway' model for upper and lower respiratory tract disease is a concept gaining increasing momentum in both respiratory medicine and otorhinolaryngology. The specific common aetiology and pathophysiology of concomitant bronchiectasis and sino-nasal disease, such as chronic rhinosinusitis, are discussed here, as well as the clinical manifestations, along with a review of all the relevant literature in the field.
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Affiliation(s)
- C M Philpott
- Department of Otorhinolaryngology, Essex Rivers Healthcare NHS Trust, Colchester, UK.
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21
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English RG, Fairall LR, Bateman ED. Keeping allergy on the agenda: integrated guidelines for respiratory disease in developing countries. Allergy 2007; 62:224-9. [PMID: 17298338 DOI: 10.1111/j.1398-9995.2007.01321.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Efforts to improve the care of patients with asthma and allergic conditions is in some developing countries being overwhelmed by the burden of tuberculosis, HIV/AIDS and other infectious diseases. Innovative approaches are required to ensure that these diseases are not neglected. METHODS The Practical Approach to Lung Health in South Africa is an example of a syndromic integrated algorithm-based diagnostic and management tool for priority chronic respiratory diseases and tuberculosis. It was developed for the needs of nurse care practitioners in poorly-resourced and predominantly rural clinics and includes allergic diseases and asthma. Its diagnostic accuracy and effectiveness at improving the care offered to patients with asthma and rhinitis has been confirmed in two large studies performed in primary care clinics. DISCUSSION AND CONCLUSION An integrated approach to the management of allergic diseases alongside other priority lung diseases may hold the key to ensuring that the needs of patients with these diseases gain and maintain recognition, and that health resources are appropriately allocated in developing countries.
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Affiliation(s)
- R G English
- The University of Cape Town Lung Institute, Mowbray, Cape Town, South Africa
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22
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Valovirta E, Pawankar R. Survey on the impact of comorbid allergic rhinitis in patients with asthma. BMC Pulm Med 2006; 6 Suppl 1:S3. [PMID: 17140421 PMCID: PMC1698496 DOI: 10.1186/1471-2466-6-s1-s3] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Background Allergic rhinitis (AR) and asthma are inflammatory conditions of the airways that often occur concomitantly. This global survey was undertaken to understand patient perspectives regarding symptoms, treatments, and the impact on their well-being of comorbid AR and asthma. Methods Survey participants were adults with asthma (n = 813) and parents of children with asthma (n = 806) from four countries each in the Asia-Pacific region and Europe. Patients included in the survey also had self-reported, concomitant AR symptoms. Patients and parents were recruited by telephone interview or by direct interview. Results Most patients (73%) had pre-existing symptoms of AR when their asthma was first diagnosed. Shortness of breath (21%) was the most troublesome symptom for adults, and wheezing (17%) and coughing (17%) the most troublesome for children. Patients used different medications for treating asthma (most commonly short-acting β-agonists and inhaled corticosteroids) and for treating AR (most commonly oral antihistamines). The concomitant presence of AR and asthma disrupted the ability to get a good night's sleep (79%), to participate in leisure and sports activities (75%), to concentrate at work or school (69% of adults, 73% of children), and to enjoy social activities (57% of adults, 51% of children). Most patients (79%) reported worsening asthma symptoms when AR symptoms flared up. Many (56%) avoided the outdoors during the allergy season because of worsening asthma symptoms. Many (60%) indicated difficulty in effectively treating both conditions, and 72% were concerned about using excessive medication. In general, respondents from the Asia-Pacific region reported more disruption of activities caused by symptoms and more concerns and difficulties with medications than did those from Europe. Differences between the two regions in medication use included more common use of inhaled corticosteroids in Europe and more common use of Chinese herbal remedies in the Asia-Pacific region. Conclusion Results of this survey suggest that comorbid asthma and AR substantially impact patient well-being and that the worsening of AR symptoms in patients with asthma can be associated with worsening asthma symptoms. These findings underscore the need for physicians who treat patients with asthma to evaluate treatment options for improving symptoms of both AR and asthma when present concomitantly.
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MESH Headings
- Adolescent
- Adult
- Age Distribution
- Anti-Asthmatic Agents/therapeutic use
- Asia/epidemiology
- Asthma/diagnosis
- Asthma/epidemiology
- Asthma/therapy
- Causality
- Child
- Comorbidity
- Cost of Illness
- Europe/epidemiology
- Female
- Health Care Surveys
- Health Knowledge, Attitudes, Practice
- Health Surveys
- Histamine H1 Antagonists/therapeutic use
- Humans
- Male
- Middle Aged
- Patient Satisfaction/statistics & numerical data
- Quality of Life
- Rhinitis, Allergic, Perennial/diagnosis
- Rhinitis, Allergic, Perennial/epidemiology
- Rhinitis, Allergic, Perennial/therapy
- Rhinitis, Allergic, Seasonal/diagnosis
- Rhinitis, Allergic, Seasonal/epidemiology
- Rhinitis, Allergic, Seasonal/therapy
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23
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Abstract
PURPOSE OF REVIEW This article reviews recent findings concerning occupational upper airway diseases, which, although very frequent, are usually not considered serious. However, the concept of the 'united airway', evoked during recent years, should change our attitude regarding these diseases. Moreover, new agents in the occupational environment must be characterized. Furthermore, exposure to carcinogens has changed over the years, and in most cases risk should be reassessed. RECENT FINDINGS Recent findings concerning work-related upper airway diseases caused by allergens and irritants, and their relationship to lower airway diseases, are reviewed. Findings of studies aimed at characterizing occupational allergens of plant and animal origin are presented. Recognition of work-related upper airway diseases both in clinic and in epidemiological studies is discussed. Current evidence on occupational cancer of the upper airways, its risk factors and changes in them over the years resulting from preventative measures are also described. SUMMARY There is significant evidence that occupational allergic diseases of the upper airways can pose important health problems because they represent an early stage of allergy throughout the respiratory system. However, how to detect those rhinitic patients who will develop asthma remains unresolved. New occupational health problems due to irritants were recently reported, and both follow-up studies and evaluations of their implications for the lower airways are warranted. Although preventative measures have been effective to some extent, risk for occupational cancer of the upper airways persists and more targeted epidemiological studies in this area are needed.
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Affiliation(s)
- Jolanta Walusiak
- Department of Occupational Diseases, Nofer Institute of Occupational Medicine, Lodz, Poland.
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Matsuno O, Miyazaki E, Takenaka R, Ando M, Ito T, Sawabe T, Shigenaga T, Ito K, Sugisaki K, Kumamoto T. Links between bronchial asthma and allergic rhinitis in the Oita Prefecture, Japan. J Asthma 2006; 43:165-7. [PMID: 16517435 DOI: 10.1080/02770900500499053] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Recent studies have strengthened the concept that bronchial asthma and allergic rhinitis are manifestations of an inflammatory process within a continuous airway. This study was performed to compare clinical findings in asthma with or without rhinitis in Japan. Nasal symptoms were present in 99.6% of asthma patients. The prevalence of allergic rhinitis in patients with asthma was 52.4%. Bronchial asthma attacks in one third of patients with rhinitis were coincident with worsening of nasal symptoms. In adults (> 16 years of age), rhinitis frequently preceded asthma, whereas asthma preceded rhinitis in children (< 16 years of age). The frequency of rhinitis in asthma decreases with increasing age. This study demonstrated a clear link between upper and lower airway disorders in Japan.
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Affiliation(s)
- Osamu Matsuno
- Division of Pulmonary Medicine, Department of Brain and Nerve, Oita University Faculty of Medicine, Oita, Japan.
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25
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26
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Affiliation(s)
- Hun-Jong Dhong
- Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Korea.
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27
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Castro Almarales RL, Mateo Morejón M, Naranjo Robalino RM, Navarro Viltre BI, Alvarez Castelló M, Ronquillo Díaz M, García Gómez I, Oliva Díaz Y, González León M, Rodríguez Canosa JS, Labrada Rosado A. Correlation between skin tests to Dermatophagoides pteronyssinus, Dermatophagoides siboney and Blomia tropicalis in Cuban asthmatics. Allergol Immunopathol (Madr) 2006; 34:23-6. [PMID: 16540067 DOI: 10.1157/13084223] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND Dermatophagoides pteronyssinus, Dermatophagoides siboney and Blomia tropicalis are the most important allergenic mites in Cuba. The aim of this study was to determine the degree of polysensitization and correlation of the skin prick test (SPT) reaction size to these mites in asthmatic patients. METHODS A total of 232 adult patients with asthmatic symptoms caused by house dust and positive SPT to at least one mite were included. Standardized allergenic extracts were used in SPT. RESULTS A total of 88.4% of patients were positive to D. siboney, 87.1% to D. pteronyssinus, and 68.1% to B. tropicalis. Sensitization to Dermatophagoides species was predominant, demonstrated by the fact that 31.9% of patients showed positive SPT to either D. siboney or D. pteronyssinus only, whereas only 5.6% was sensitized solely to B. tropicalis. Nevertheless, most patients (58.6%) were polysensitized to the 3 species. The mean wheal size produced by the different allergens in positive patients was similar (n.s. p > 0.05). Reaction size was strongly correlated (r = 0.71, p = 5.3 x 10-09) between D. siboney and D. pteronyssinus, whereas no significant correlation was found between D. pteronyssinus or D. siboney and B. tropicalis. CONCLUSIONS The results of this study support the need to include the 3 allergens in diagnostic panels and for combined allergen-specific immunotherapy.
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Abstract
Prevalence of allergic rhinitis has increased in the past years. The determination of the aeroallergens involved is important. Children with persistent rhinitis must be evaluated for asthma. Early treatment of allergic rhinitis may avoid asthma onset. The management of allergic rhinitis must include allergen avoidance, pharmacological treatment and immunotherapy. Sublingual swallow immunotherapy is a safe and effective method of treatment.
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MESH Headings
- Adolescent
- Allergens
- Asthma/diagnosis
- Child
- Desensitization, Immunologic
- Diagnosis, Differential
- Histamine Antagonists/administration & dosage
- Histamine Antagonists/therapeutic use
- Humans
- Radioallergosorbent Test
- Radiography
- Rhinitis, Allergic, Perennial/diagnosis
- Rhinitis, Allergic, Perennial/diagnostic imaging
- Rhinitis, Allergic, Perennial/drug therapy
- Rhinitis, Allergic, Perennial/therapy
- Rhinitis, Allergic, Seasonal/diagnosis
- Rhinitis, Allergic, Seasonal/diagnostic imaging
- Rhinitis, Allergic, Seasonal/drug therapy
- Rhinitis, Allergic, Seasonal/therapy
- Time Factors
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Affiliation(s)
- P Rufin
- Laboratoire EFR, service de pneumologie et d'allergologie pédiatriques, hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France.
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