Younger pubertal age is associated with allergy and other atopic conditions in girls

Associations between HT, BMI, and allergic rhinitis in perimenopausal women

BACKGROUND

Increasing evidence suggests that hormone therapy (HT) and obesity exert an influence on allergic rhinitis (AR). It is important to investigate the association and interactions between HT, BMI, and AR in perimenopausal women.

METHODS

From May 2020 to March 2021, a cross-sectional survey was completed by patients who visited the Allergy Department and Gynecology Department of Shijitan Hospital. The patients completed a questionnaire and stratified analyses by BMI in tertiles were performed. Logistic analyses were performed to evaluate the relationships between HT, BMI, and AR.

RESULTS

A total of 950 patients completed the study, among which, 393 patients were receiving HT. HT was found to be associated with increased risks for AR (OR = 1.51 [95% CI: 1.151-1.985]), asthma (OR = 3.61 [95% CI: 2.21-5.89]), and their accompanying symptoms (OR = 3.54 [95% CI: 2.146-5.831]). In lean women, the use of HT was significantly associated with a higher risks for AR (OR = 2.26 [95% CI: 1.31-3.91]), the time course of AR (OR = 2.54 [95% CI: 1.37-4.74]), hay fever (OR = 2.54 [95% CI: 1.37-4.74]), and accompanying symptoms (including canker sores, diarrhea, and stomachache) (OR = 2.26 [95% CI: 1.309-3.907]) when compared to normal or heavier weight women (course of AR: pinteraction = 0.032; hay fever; pinteraction = 0.006; accompanying symptoms: pinteraction = 0.009).

CONCLUSIONS

HT can reduce the risk for AR in perimenopausal women. Lean women who used HT were at a higher risk for AR when compared to overweight women who used AR. There exists an interaction between HT and BMI that influences AR. Furthermore, HT and obesity increase the risk for AR by some common pathways, more follow-up work is needed to explore common pathways.

Apigenin Attenuates the Allergic Reactions by Competitively Binding to ER With Estradiol

Apigenin (API) is a natural phytoestrogen with properties including anti-inflammatory and other abilities. This study aims to 1) systematically validate that excessive estrogen exacerbates allergic reactions; 2) explore the anti-allergic effects and mechanisms of API. We conduct a survey of college students, indicating that of the 505 effective results, 70 individuals were self-reported allergic and 74.1% of them were women, which proved the gender difference in allergic reactions. BALB/c mice are grouped into the negative control group (N-Ctrl), the OVA-sensitized group (P-Ctrl), the estrogenized OVA-sensitized group (E2), and three treatment groups administrating different dose of API (E2 + API/L/M/H). In vivo data indicated that API treatment significantly inhibited the enhancement of estradiol on clinical symptoms. Moreover, we found that high doses of API inhibited Th2 type humoral response and mast cell degranulation levels in vivo and in vitro. Additionally, medium, and high doses of API significantly reduced the potentiation of estradiol on ER expression, attenuated the transmission of estrogen/ER signaling, thereby inhibiting the phosphorylation of ERK1/2 and JNK1/2/3 in the MAPK. Besides, we found that API competitively bound to ER with estradiol, and showed a weak selectivity to ERβ. Overall, we identified API can be beneficial in allergic disease.

Impaired Respiratory Function in Women With PCOS Compared With Matched Controls From a Population-Based Study

CONTEXT

Increased prevalence of asthma has been reported from epidemiological studies in women with polycystic ovary syndrome (PCOS).

OBJECTIVE

To investigate respiratory function in women with PCOS compared with controls in a clinical setting.

DESIGN

An 8-year clinical follow-up study including self-reported asthma diagnoses and spirometry of women with PCOS randomized to metformin or placebo during pregnancy in the original studies (the Pilot and the PregMet-study), compared with matched controls from a population-based cohort study (The HUNT Study).

SETTING

Secondary and tertiary care centers.

PARTICIPANTS

A total of 145 women with PCOS (54% of original cohort) were matched 1:3 to controls, on gender, age, and smoking-status.

MAIN OUTCOMES AND MEASURES

Self-reported doctor-diagnosed asthma (DDA), percentage of predicted forced expiratory volume in the first second of expiration (FEV1 % predicted), percentage of predicted forced vital capacity (FVC % predicted).

RESULTS

Women with PCOS reported more DDA compared with controls (19% vs 9%; P < 0.01). Spirometry indicated a combined obstructive (FEV1 % predicted, 93.7 vs 102.0; P < 0.01) and restrictive (FVC % predicted, 94.5 vs 103.7; P < 0.01) respiratory impairment in PCOS compared with controls. Metformin in pregnancy did not affect respiratory function at follow-up.

CONCLUSION

Women with PCOS reported higher prevalence of DDA compared with controls matched for age and smoking status. In addition, respiratory function was decreased, with both obstructive and restrictive components. Further insight to the underlying pathogenesis of these observations is needed.

CLINICAL TRIAL REGISTRATION

ClinicalTrials.gov: The PregMet study: NCT00159536. The Pilot study: NCT03259919.

Estrogen and estrogen receptor signaling promotes allergic immune responses: Effects on immune cells, cytokines, and inflammatory factors involved in allergy

Hypersensitivity occurs when the body is stimulated by an antigen, resulting in an immune response, and leads to a physiological disorder or abnormal tissue trauma. Various immune cells, cytokines, and inflammatory mediators are involved in the immune responses related to allergic diseases, which are the core of anaphylaxis. Estrogen receptors are widely distributed in immune cells, which combine with estrogen and participate in allergic responses by affecting immune cells, cytokines, and inflammatory factors. We aimed to summarize the association between estrogen and allergic reactions to provide a scientific basis for understanding and studying the mechanisms of allergic diseases.

Life-long endogenous estrogen exposure is associated with prevalence of allergic rhinitis in postmenopausal women

OBJECTIVES

The aim of the study was to investigate the influence of life-long endogenous estrogen exposure on prevalence of chronic rhinitis including allergic rhinitis (AR) in the postmenopausal period.

METHODS

In this cross-sectional study, a total of 3,043 postmenopausal women who participated in the Korea National Health and Nutrition Examination Survey V were included. Participants with symptoms including sneezing, rhinorrhea, nasal obstruction, or nasal itching were considered to have chronic rhinitis. In subgroup analysis, the AR group comprised participants with rhinitis with positive findings in at least one of three specific immunoglobulin E. Univariable and multivariable logistic analyses were performed to evaluate the relationship between rhinitis and estrogen-related factors including age at menarche, age at menopause, age at first delivery, parity, and duration of breast-feeding.

RESULTS

Participants with chronic rhinitis (17.6%) had higher parity (odd ratio [OR] = 1.17, P = 0.0135) and shorter duration of breast-feeding (OR = 0.98, P = 0.0388) than controls. In subgroup analysis, participants with AR (7.1%) had younger age at menarche (OR = 0.56, P = 0.0028) and older age at menopause (OR = 1.42, P = 0.0060) after adjustment of confounding factors. There was a positive association between age at menopause and specific immunoglobulin E for both cockroach (OR = 1.38, P = 0.0132) and dogs (OR = 1.38, P = 0.0302). Longer postmenopausal duration was positively associated with cockroach allergen sensitization (OR = 1.25, P = 0.201).

CONCLUSIONS

Longer duration of reproductive period was associated with higher prevalence of AR and aeroallergen sensitization in the postmenopausal period. Moreover, cockroach allergen sensitization was associated with a longer postmenopausal period.

Early menarche and new onset of asthma: Results from the SAPALDIA cohort study

RATIONALE

The association between early menarche and new onset of asthma warrants further investigation in those aged >30 years.

OBJECTIVES

Using data from the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults (SAPALDIA), we investigated whether early menarche was associated with new onset of asthma in women aged 18-60 years at baseline.

METHODS

Our analysis included 2492 women with information on age at menarche and doctor-diagnosed asthma, who had been asthma free at the time of menarche and had complete covariate information. New onset of asthma was defined as newly reported doctor-diagnosed asthma which occurred at least one year after menarche. Asthma incidence and its association with early menarche was analysed using logistic regression, adjusting for age, atopy, smoking, BMI, parental asthma, urbanity, education and study area, and additionally stratifying by atopy and BMI.

RESULTS

After adjustment of relevant confounders, women with early menarche did not have a significantly higher risk of onset of asthma than women without early menarche (OR 1.23, 95% CI 0.85-1.80). Young atopic women with early menarche appeared to have an increased risk of asthma compared with non-atopic women (OR 2.21, 95% CI 0.90-5.43); however, our results did not reach statistical significance.

CONCLUSION

We could not substantiate an association of early menarche with new onset of asthma in this Swiss population-based cohort aged 18-60 years at baseline. Future studies may need to prospectively assess age of menarche to investigate the association with new onset of asthma in those aged >30 years.

A new childhood asthma phenotype: obese with early menarche

Three concomitant phenomena occur in the later years of childhood: increases in the incidence of asthma, obesity and early menarche. This article is an overview of the current epidemiologic, basic, genetic and epigenetic evidence about this relationship. As a consequence we propose that obese girls who have an early menarche (≤ 11 years of age) constitute a new asthma phenotype in childhood. Future studies need to be carried out in order to find the best control and treatment of this new asthma phenotype.