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Xu X, Liu X, Li J, Deng X, Dai T, Ji Q, Xiong D, Xie H. Environmental Risk Factors, Protective Factors, and Biomarkers for Allergic Rhinitis: A Systematic Umbrella Review of the Evidence. Clin Rev Allergy Immunol 2023; 65:188-205. [PMID: 37490237 PMCID: PMC10567804 DOI: 10.1007/s12016-023-08964-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2023] [Indexed: 07/26/2023]
Abstract
Many potential environmental risk factors, protective factors, and biomarkers of AR have been published, but so far, the strength and consistency of their evidence are unclear. We conducted a comprehensive review of environmental risk, protective factors, and biomarkers for AR to establish the evidence hierarchy. We systematically searched Embase, PubMed, Cochrane Library, and Web of Science electronic database from inception to December 31, 2022. We calculated summary effect estimate (odds ratio (OR), relative risk (RR), hazard ratio (HR), and standardized mean difference (SMD)), 95% confidence interval, random effects p value, I2 statistic, 95% prediction interval, small study effects, and excess significance biases, and stratification of the level of evidence. Methodological quality was assessed by AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews 2). We retrieved 4478 articles, of which 43 met the inclusion criteria. The 43 eligible articles identified 31 potential environmental risk factors (10,806,206 total population, two study not reported), 11 potential environmental protective factors (823,883 total population), and 34 potential biomarkers (158,716 total population) for meta-analyses. The credibility of evidence was convincing (class I) for tic disorders (OR = 2.89, 95% CI 2.11-3.95); and highly suggestive (class II) for early-life antibiotic use (OR = 3.73, 95% CI 3.06-4.55), exposure to indoor dampness (OR = 1.49, 95% CI 1.27-1.75), acetaminophen exposure (OR = 1.54, 95% CI 1.41-1.69), childhood acid suppressant use (OR = 1.40, 95% CI 1.23-1.59), exposure to indoor mold (OR = 1.66, 95% CI 1.26-2.18), coronavirus disease 2019 (OR = 0.11, 95% CI 0.06-0.22), and prolonged breastfeeding (OR = 0.72, 95% CI 0.65-0.79). This study is registered in PROSPERO (CRD42022384320).
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Affiliation(s)
- Xianpeng Xu
- Department of Otorhinolaryngology, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
- Department of Otorhinolaryngology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Xinghong Liu
- Department of Otorhinolaryngology, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
- Department of Otorhinolaryngology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Jiongke Li
- Department of Otorhinolaryngology, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
- Department of Otorhinolaryngology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Xinxing Deng
- Department of Otorhinolaryngology, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
- Department of Otorhinolaryngology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Tianrong Dai
- Department of Otorhinolaryngology, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
- Department of Otorhinolaryngology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Qingjie Ji
- Department of Dermatology, Quzhou hospital of Traditional Chinese Medicine, 324000, Quzhou, China
| | - Dajing Xiong
- Department of Otorhinolaryngology, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
- Department of Otorhinolaryngology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China
| | - Hui Xie
- Department of Otorhinolaryngology, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China.
- Department of Otorhinolaryngology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China.
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Peñaranda A, Pérez-Herrera LC, Gantiva M, Moreno-López S, Manrique J, Peñaranda D, García E. Factors associated with allergic rhinitis and combined allergic rhinitis and asthma syndrome (CARAS) in adults undergoing immunotherapy in a tropical country: Is ISAAC-III questionnaire useful in adult populations? Allergol Immunopathol (Madr) 2023; 51:78-86. [PMID: 37422783 DOI: 10.15586/aei.v51i4.833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 03/30/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND Allergic diseases affect about 10-30% of the population in low- or middle-income tropical countries. Few studies describe the factors associated with allergic diseases in adult patients undergoing immunotherapy in Latin American countries. OBJECTIVE This study aimed to determine the factors associated with allergic rhinitis (AR) and AR in comorbidity with asthma (CARAS) in adults treated with immunotherapy in two allergy referral centers in Bogotá (Colombia). MATERIAL AND METHODS Observational, cross-sectional study conducted between January 2018 and January 2019. ISAAC-III and sociodemographic questionnaires were applied to determine the factors associated with AR and CARAS in adults treated with immunotherapy who attended the allergy consult at the Fundación Santa Fe de Bogotá and Unimeq-Orl. RESULTS Among 416 adults aged 18-68 years, 71.4% (n = 297) were women. Regarding the sensitization results obtained by skin prick test, the most frequent allergens were house dust mites (64.18%): 49.03% were positive for both Dermatophagoides pteronyssinus and Dermatophagoides farinae, while 28.61% were positive for Blomia tropicalis. Excluding house dust mites, the most frequent allergens were dog hair (31.01%), cat hair (15.1%), grasses (15.9%), and food (15.9%). The main factor associated with exclusive AR was regular acetaminophen use more than four times a year: Prevalence ratio (PR) = 1.77 (95% CI: 1.12-2.25). The main factor associated with CARAS was cesarean delivery PR: 1.44 (95% CI: 1.09-1.78). CONCLUSION The main factor associated with AR was regular acetaminophen use, while that associated with CARAS was cesarean delivery. The ISAAC-III questionnaire can be a useful low-cost tool to assess the factors associated with allergic diseases in adults in tropical countries.
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Affiliation(s)
- Augusto Peñaranda
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
- Departmen of Otolaryngology, Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Allergy and Otolaryngology Research Groups, UNIMEQ-ORL, Bogotá, Colombia
| | - Lucía C Pérez-Herrera
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
- Departmen of Otolaryngology, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Manuela Gantiva
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
- Departmen of Otolaryngology, Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Section of Otolaryngology, Fundación Universitaria de Ciencias de la Salud - Hospital de San José, Bogotá, Colombia
| | - Sergio Moreno-López
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
- Departmen of Otolaryngology, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Julian Manrique
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
- Allergy section, Department of Pediatrics, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Daniel Peñaranda
- Allergy and Otolaryngology Research Groups, UNIMEQ-ORL, Bogotá, Colombia
- Section of Otolaryngology, Fundación Universitaria de Ciencias de la Salud - Hospital de San José, Bogotá, Colombia
| | - Elizabeth García
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
- Departmen of Otolaryngology, Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Section of Otolaryngology, Fundación Universitaria de Ciencias de la Salud - Hospital de San José, Bogotá, Colombia;
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Correlation between B-cell lymphoma 6 with the balance of T helper-1/2 and severity of allergic rhinitis. Allergol Immunopathol (Madr) 2023; 51:1-8. [PMID: 36617815 DOI: 10.15586/aei.v51i1.673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 06/22/2022] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Allergic rhinitis (AR) is a prevailing immune disorder affecting the nasal mucosa. B-cell lymphoma 6 (BCL6) imposes essential roles in immunity. This study probed into the serum expression of BCL6 and its effect on AR diagnosis and patients' quality of life (QOL). METHODS A total of 113 patients with AR including 38 cases with mild AR (MAR) and 75 cases with moderate-severe AR (MSAR) were enrolled, with 101 healthy people enrolled as control. Serum expression of BCL6 was detected by RT-qPCR and the diagnostic efficacy of BCL6 for AR was analyzed using the receiver operating characteristic curve. The proportion of T helper-1/2 (Th1/Th2) cells in CD4+ T cells in peripheral blood mononuclear cells was detected using flow cytometry. The correlation between BCL6 and Th1/Th2 cells and the effects of BCL6 expression on patients' QOL were assessed by Pearson analysis and Mini-RQLQ questionnaire. RESULTS BCL6 was downregulated in patients with AR, serum BCL6 level < 0.8450 had certain auxiliary diagnostic values for AR, and serum BCL6 level < 0.5400 could assist the diagnosis of AR severity. Th1 cell proportion in CD4+ T cells was decreased, whereas Th2 cell proportion was increased with AR severity. BCL6 was positively-linked with Th1 cells but inversely-correlated with Th2 cells in patients with AR. Patients with AR with low BCL6 expression had a poorer QOL compared with high BCL6 expression. The domains most affected by BCL6 expression were practical problems, nasal symptoms, and lacrimation. CONCLUSION Serum BCL6 is downregulated and low BCL6 expression greatly deteriorates QOL in patients with AR.
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Ma T, Zhang H, Wang R. Effect of Medicine-Separated Moxibustion on Navel Combined with Mind-Regulating Acupuncture on Curative Effect and Quality of Life in Patients with Allergic Rhinitis. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:4093891. [PMID: 35694711 PMCID: PMC9173985 DOI: 10.1155/2022/4093891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/25/2022] [Accepted: 05/05/2022] [Indexed: 11/17/2022]
Abstract
Objective To explore the effect of medicine-separated moxibustion combined with mind-regulating acupuncture on the efficacy and quality of life of patients with allergic rhinitis (AR). Methods Sixty patients with AR cured from February 2019 to April 2021 were enrolled in our hospital. The patients were arbitrarily assigned into control and study groups. The former group was treated with herbal moxibustion on the navel, while the latter group was treated with herbal moxibustion on the navel combined with mind-regulating acupuncture. The curative effect, TNSS score, TNNSS score, RQLQ score, and the incidence of adverse events were compared. Results Compared with the two groups, the study group was markedly effective in 24 cases, effective in 5 cases, and ineffective in 1 case, with an effective rate of 100.00%, while the control group was markedly effective in 13 cases, effective in 10 cases, and ineffective in 7 cases, with an effective rate of 100.00%. The curative effect of the study group was better compared to the control group (P < 0.05). There was no remarkable difference in TNSS score before treatment (P > 0.05). After treatment, the TNSS scores of patients decreased. Compared with the control group, the TNSS score of the study group was lower than that of the control group at 2 weeks, 4 weeks and during the follow-up. No remarkable difference appeared in the TNNSS score before treatment (P > 0.05). After treatment, the TNNSS scores of patients were decreased. Comparing the two groups, the TNNSS scores of the study group were lower compared to the control group after 2 weeks of treatment, 4 weeks of treatment and during the follow-up period (P < 0.05). There was no remarkable difference in the RQLQ score before treatment (P > 0.05). After treatment, the RQLQ scores of patients were decreased. Comparing the two groups, the RQLQ scores of the study group were lower compared to the control group at 2 weeks, 4 weeks after treatment and during the follow-up period (P < 0.05). In terms of the incidence of adverse events, the incidence of adverse events such as subcutaneous hematoma, bruising, and induration in the study group was lower compared to the control group (P < 0.05). Conclusion Medicine-separated moxibustion was combined with mind-regulating acupuncture when treating AR. There were differences in clinical efficacy, single-symptom score, and TNSS, TNNSS, and RQLQ scores, which verified the clinical efficacy of medicine-separated moxibustion combined with mind-regulating acupuncture when treating AR, and expounded the mechanism of medicine-separated moxibustion combined with mind-regulating acupuncture when treating AR. In the meantime, it shows that the umbilical method of medicine-separated moxibustion combined with mind-regulating acupuncture when treating AR has the advantages of definite short-term effect, long-term effect, safe and simple operation, and no adverse reactions, which is worthy of clinical application.
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Affiliation(s)
- Tenggang Ma
- School of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250000, China
| | - Hongyu Zhang
- First Clinical School of Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250000, China
| | - Renzhong Wang
- Department of Otolaryngology, The First Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250000, China
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Increased fecal human beta-defensin-2 expression in preterm infants is associated with allergic disease development in early childhood. World Allergy Organ J 2022; 15:100633. [PMID: 35600835 PMCID: PMC9109190 DOI: 10.1016/j.waojou.2022.100633] [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: 02/24/2021] [Revised: 01/23/2022] [Accepted: 02/07/2022] [Indexed: 02/07/2023] Open
Abstract
Background This study aimed to investigate whether fecal human beta-defensins (HBD)-2 and eosinophil cationic protein (ECP) expression in preterm infants are associated with allergic disease development by age 2 years. Methods Preterm infants' stool samples were collected at the age of 6 and 12 months postnatally. Information regarding medication exposure histories (antibiotics, antipyretics, probiotics) and physician-diagnosed allergic diseases was obtained using age-specific questionnaires and medical records. We compared the 6-month and 12-month fecal HBD-2 and ECP concentrations between the medication exposure and non-exposure group, respectively, and between children who developed allergic diseases and those who did not by 2 years of age. Univariate and multivariable logistic regression analyses were performed to investigate independent variables related to physician-diagnosed allergic diseases by 2 years of age. Results Seventy-four preterm infants (gestational age, 31–36 weeks) were included. Fecal HBD-2 levels were significantly increased at 12 months of age among children who developed allergic diseases compared to those who did not (37.18 ± 11.80 ng/g vs. 8.56 ± 4.33 ng/g, P = 0.011). This association was more apparent among allergic children given antibiotics (50.23 ± 16.15 ng/g vs. 9.75 ± 7.16 ng/g, P = 0.008) or antipyretics (46.12 ± 14.22 ng/g vs. 10.82 ± 6.81 ng/g, P = 0.018) during the first year, whereas among allergic children who were previously not exposed to antibiotics or antipyretics, the differences were not significant. Results of the multivariable logistic regression analysis indicated that HBD-2 concentration in 12-month stools was an independent indicator associated with physician-diagnosed allergic diseases by 2 years of age (adjusted odds ratio: 1.03 [95% confidence interval: 1.00–1.05], P = 0.036). Our data revealed a lack of association between fecal ECP and allergic diseases. Conclusions We found that preterm infants who expressed high fecal HBD-2 at 12 months of age were associated with physician-diagnosed allergic diseases by the age of 2 years. Further studies are needed to determine the role of fecal HBD-2 in the development of allergic diseases.
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