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Chen H, Zhu G, Liu Y, Huang D, Zhang X, She L. Allergic Diseases and Chronic Adenotonsillar Diseases: A Mendelian Randomization Study. Laryngoscope 2024; 134:2653-2658. [PMID: 38193619 DOI: 10.1002/lary.31275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/22/2023] [Accepted: 12/27/2023] [Indexed: 01/10/2024]
Abstract
OBJECTIVE The existing epidemiological evidence regarding the intricate relationship between allergic diseases and chronic adenotonsillar diseases (CATD) remains inconclusive. Herein, the objective of our study is to explore the causal association using Mendelian randomization (MR). METHODS Employing data from large genome-wide association studies, a comprehensive two-sample bidirectional MR study was conducted. The studied traits encompassed allergic rhinitis (cases n = 9707, controls n = 331173), allergic asthma (cases n = 8525, controls n = 193857), allergic conjunctivitis (cases n = 18321, controls n = 324178), atopic dermatitis (cases n = 11964, controls n = 306909), and CATD (cases n = 38983, controls n = 258553). All the patients were of European descent and participants in cohort studies. The primary analysis was executed using inverse-variance-weighted MR. Furthermore, six additional MR methods (MR-Egger, weighted median, simple mode, weighted mode, MR pleiotropy residual sum and outlier, MR robust adjusted profile score) were employed to ensure the reliability and detect potential horizontal pleiotropy within the results. The estimates obtained from the MR analysis were factored into the overall effect calculation. RESULTS Genetically anticipated outcomes demonstrated a significant association between CATD risk and allergic rhinitis (OR = 1.141, p = 6.30E-06), allergic asthma (OR = 1.115, p = 8.31E-05), allergic conjunctivitis (OR = 1.197, p = 8.69E-07), and a suggestive association with atopic dermatitis (OR = 1.053, p = 0.040). However, no substantial correlation was observed in the reverse direction. CONCLUSIONS Findings of our study provide evidence supporting a causal role of allergic diseases in the development of CATD, whereas the converse relationship does not appear to hold true. LEVEL OF EVIDENCE 3 Laryngoscope, 134:2653-2658, 2024.
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Affiliation(s)
- Huihong Chen
- Department of Otolaryngology-Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, People's Republic of China
- Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, People's Republic of China
- Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Changsha, People's Republic of China
| | - Gangcai Zhu
- Department of Otolaryngology-Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Yong Liu
- Department of Otolaryngology-Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, People's Republic of China
- Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, People's Republic of China
- Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Changsha, People's Republic of China
- National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha, People's Republic of China
| | - Donghai Huang
- Department of Otolaryngology-Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, People's Republic of China
- Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, People's Republic of China
- Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Changsha, People's Republic of China
- National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha, People's Republic of China
| | - Xin Zhang
- Department of Otolaryngology-Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, People's Republic of China
- Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, People's Republic of China
- Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Changsha, People's Republic of China
- National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha, People's Republic of China
| | - Li She
- Department of Otolaryngology-Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, People's Republic of China
- Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, People's Republic of China
- Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Changsha, People's Republic of China
- National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha, People's Republic of China
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Rajput S, Vininski MS, Lehmann LA, Hobbs NJ, Dolence JJ. Androgen receptor signaling protects male mice from the development of immune response to peanut. AMERICAN JOURNAL OF CLINICAL AND EXPERIMENTAL IMMUNOLOGY 2023; 12:60-71. [PMID: 37736075 PMCID: PMC10509486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 07/09/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVES Peanut (PN) allergy is a major public health concern. Recent research has brought clarity about how individuals become sensitized to PN allergen with routes known through the skin, as well as the airway. Still unclear, however, is the role of sex hormones on the development of allergic immune responses to PN. This study examines the role of androgen receptor (AR) signaling in regulating PN-specific immune responses. METHODS We utilized a 4-week inhalation mouse model of PN allergy that is known to drive the production of PN-specific antibodies and elicit systemic anaphylaxis following PN challenge. Wildtype (WT) male, female, and androgen receptor-deficient testicular feminization mutant (ARTfm) male mice were examined using this model to document sex differences in PN allergy. To determine if sex differences also existed in the cellular immune response, this study utilized a 3-day inhalation mouse model of PN to examine the response of group 2 innate lymphoid cells (ILC2s). WT male and female mice were examined using this model to document sex differences in ILC2 response within the lungs. RESULTS AR use is critical in regulating PN-specific antibody levels. We found that ARTfm males have a higher antibody response and significantly worse anaphylactic response following PN challenge relative to WT males. WT males also exhibit a less severe anaphylactic response compared to ARTfm male and female mice. Lastly, we discovered that lung ILC2s from female mice respond more robustly to PN compared to ILC2s within WT male mice. CONCLUSIONS Taken together, this study suggests that male sex hormones, namely androgens, negatively regulate allergic immune responses to PN.
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Affiliation(s)
- Sunanda Rajput
- Department of Biology, University of Nebraska at Kearney Kearney, NE, USA
| | - McKenna S Vininski
- Department of Biology, University of Nebraska at Kearney Kearney, NE, USA
| | - Leigh-Anne Lehmann
- Department of Biology, University of Nebraska at Kearney Kearney, NE, USA
| | - Nicholas J Hobbs
- Department of Biology, University of Nebraska at Kearney Kearney, NE, USA
| | - Joseph J Dolence
- Department of Biology, University of Nebraska at Kearney Kearney, NE, USA
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Wang S, Liu H, Yang P, Wang Z, Hu P, Ye P, Xia J, Chen S. Exploring the genetic association of allergic diseases with cardiovascular diseases: a bidirectional Mendelian randomization study. Front Immunol 2023; 14:1175890. [PMID: 37334359 PMCID: PMC10272545 DOI: 10.3389/fimmu.2023.1175890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 05/19/2023] [Indexed: 06/20/2023] Open
Abstract
Background In observational and experimental studies, allergic diseases (AD) have been reported to be associated with some types of cardiovascular diseases (CVD), as both share common pathophysiological processes involving inflammation and metabolic disorders. However, the direction of the causal association between them remains unclear. This Mendelian randomization (MR) study aims to examine the bidirectional causality between AD and CVD. Methods We utilized publicly available genome-wide association study (GWAS) summary statistics data from European participants in the UK Biobank and the IEU Open GWAS database. Genetic variants associated with AD, asthma, and CVD were identified and used as instrumental variables to investigate the genetically causal association between them. MR analyses were performed using various analytical methods, including inverse variance weighted-fixed effects (IVW-FE), inverse variance weighted-multiplicative random effects (IVW-RE), MR-Egger, weighted median, weighted mode, and maximum likelihood. Sensitivity tests were conducted to assess the validity of the causality. Results The MR analysis with the IVW method revealed a genetically predicted association between AD and essential hypertension [odds ratio (OR)=0.9987, 95% confidence interval (CI): 0.9976-0.9998, P=0.024], as well as between asthma and atrial fibrillation (OR=1.001, 95% CI: 1.0004-1.0017, P=6.43E-05). In the reverse MR analyses, heart failure was associated with allergic diseases (OR=0.0045, 95% CI: 1.1890E-04 - 0.1695, P=0.004), while atherosclerosis (OR=8.7371E-08, 95% CI: 1.8794E-14 - 4.0617E-01, P=0.038) and aortic aneurysm and dissection (OR=1.7367E-07, 95% CI: 3.8390E-14 - 7.8567E-01, P=0.046) might be protective factors of asthma. However, after a Bonferroni correction, only the association between asthma and atrial fibrillation remained robust. Conclusion The MR study revealed that asthma is a predominant risk of atrial fibrillation in European individuals, consistent with most experimental and observational studies. Whether AD affects other CVD and the causality between them needs further investigation.
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Affiliation(s)
- Shilin Wang
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hao Liu
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Peiwen Yang
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhiwen Wang
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Poyi Hu
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ping Ye
- Department of Cardiology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiahong Xia
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shu Chen
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Jaskiewicz K, Maleszka-Kurpiel M, Michalski A, Ploski R, Rydzanicz M, Gajecka M. Non-allergic eye rubbing is a major behavioral risk factor for keratoconus. PLoS One 2023; 18:e0284454. [PMID: 37053215 PMCID: PMC10101517 DOI: 10.1371/journal.pone.0284454] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 04/01/2023] [Indexed: 04/14/2023] Open
Abstract
Since the environmental, behavioral, and socioeconomic factors in the etiology of keratoconus (KTCN) remain poorly understood, we characterized them as features influencing KTCN phenotype, and especially affecting the corneal epithelium (CE). In this case-control study, 118 KTCN patients and 73 controls were clinically examined and the Questionnaire covering the aforementioned aspects was completed and then statistically elaborated. Selected KTCN-specific findings were correlated with the outcomes of the RNA-seq assessment of the CE samples. Male sex, eye rubbing, time of using a computer after work, and dust in the working environment, were the substantial KTCN risk factors identified in multivariate analysis, with ORs of 8.66, 7.36, 2.35, and 5.25, respectively. Analyses for genes whose expression in the CE was correlated with the eye rubbing manner showed the enrichment in apoptosis (TP53, BCL2L1), chaperon-related (TLN1, CTDSP2, SRPRA), unfolded protein response (NFYA, TLN1, CTDSP2, SRPRA), cell adhesion (TGFBI, PTPN1, PDPK1), and cellular stress (TFDP1, SRPRA, CAPZB) pathways. Genes whose expression was extrapolated to the allergy status didn't contribute to IgE-related or other inflammatory pathways. Presented findings support the hypothesis of chronic mechanical corneal trauma in KTCN. Eye-rubbing causes CE damage and triggers cellular stress which through its influence on cell apoptosis, migration, and adhesion affects the KTCN phenotype.
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Affiliation(s)
| | - Magdalena Maleszka-Kurpiel
- Optegra Eye Health Care Clinic in Poznan, Poznan, Poland
- Chair of Ophthalmology and Optometry, Poznan University of Medical Sciences, Poznan, Poland
| | - Andrzej Michalski
- Chair of Ophthalmology and Optometry, Poznan University of Medical Sciences, Poznan, Poland
| | - Rafal Ploski
- Department of Medical Genetics, Medical University of Warsaw, Warsaw, Poland
| | | | - Marzena Gajecka
- Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
- Chair and Department of Genetics and Pharmaceutical Microbiology, Poznan University of Medical Sciences, Poznan, Poland
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Rafiq M, Abel G, Renzi C, Lyratzopoulos G. Steroid prescribing in primary care increases prior to Hodgkin lymphoma diagnosis: A UK nationwide case-control study. Cancer Epidemiol 2022; 81:102284. [PMID: 36370656 DOI: 10.1016/j.canep.2022.102284] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 10/06/2022] [Accepted: 10/23/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Steroid use is associated with increased risk of Hodgkin lymphoma (HL). However, allergic symptoms commonly treated with steroids are also presenting features of HL in some patients, thereby introducing protopathic bias in estimates of aetiological associations. It is therefore important to examine steroid prescribing patterns pre-diagnosis to understand timing of associations and when healthcare use increases before cancer diagnosis to inform future epidemiological study design. METHODS We analysed steroid prescribing in 1232 HL patients and 7392 matched controls using primary care electronic health records (Clinical Practice Research Datalink (CPRD), 1987-2016). Using Poisson regression, we calculated monthly steroid prescribing rates for the 24-months preceding HL diagnosis, identifying the inflection point when they start to increase from baseline in cases, comparing rates with synchronous controls, and stratifying by route-of-administration and allergic disease status. RESULTS 46 % of HL patients had a steroid prescription in the 24-months preceding diagnosis compared to 26 % of controls (OR 2.55, 95 %CI 2.25-2.89, p < 0.001). Odds of underlying HL were greatest in patients receiving multiple steroid prescriptions, oral steroids and in patients with a new allergic disease diagnosis. Among HL patients, steroid prescribing rates increased progressively from 7-months pre-diagnosis, doubling from 52 to 111 prescriptions/1000 patients/month. CONCLUSION Steroid prescribing increases during periods leading up to HL diagnosis, suggesting steroid-treated symptoms may be early presenting features of HL. A diagnostic window of appreciable length exists for potential earlier HL diagnosis in some patients; this 7-month 'lag-period' pre-diagnosis should be excluded in studies examining aetiological associations between steroids and HL.
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Affiliation(s)
- Meena Rafiq
- Epidemiology of Cancer Healthcare & Outcomes (ECHO), Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, UCL, London, UK; Centre for Cancer Research and Department of General Practice, University of Melbourne, Melbourne, Australia.
| | - Gary Abel
- University of Exeter Medical School, Exeter, UK
| | - Cristina Renzi
- Epidemiology of Cancer Healthcare & Outcomes (ECHO), Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, UCL, London, UK; Faculty of Medicine, University Vita-Salute San Raffaele, Milan, Italy
| | - Georgios Lyratzopoulos
- Epidemiology of Cancer Healthcare & Outcomes (ECHO), Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, UCL, London, UK
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Roach K, Roberts J. A comprehensive summary of disease variants implicated in metal allergy. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2022; 25:279-341. [PMID: 35975293 PMCID: PMC9968405 DOI: 10.1080/10937404.2022.2104981] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Allergic disease represents one of the most prominent global public health crises of the 21st century. Although many different substances are known to produce hypersensitivity responses, metals constitute one of the major classes of allergens responsible for a disproportionately large segment of the total burden of disease associated with allergy. Some of the most prevalent forms of metal allergy - including allergic contact dermatitis - are well-recognized; however, to our knowledge, a comprehensive review of the many unique disease variants implicated in human cases of metal allergy is not available within the current scientific literature. Consequently, the main goal in composing this review was to (1) generate an up-to-date reference document containing this information to assist in the efforts of lab researchers, clinicians, regulatory toxicologists, industrial hygienists, and other scientists concerned with metal allergy and (2) identify knowledge gaps related to disease. Accordingly, an extensive review of the scientific literature was performed - from which, hundreds of publications describing cases of metal-specific allergic responses in human patients were identified, collected, and analyzed. The information obtained from these articles was then used to compile an exhaustive list of distinctive dermal/ocular, respiratory, gastrointestinal, and systemic hypersensitivity responses associated with metal allergy. Each of these disease variants is discussed briefly within this review, wherein specific metals implicated in each response type are identified, underlying immunological mechanisms are summarized, and major clinical presentations of each reaction are described.Abbreviations: ACD: allergic contact dermatitis, AHR: airway hyperreactivity, ASIA: autoimmune/ autoinflammatory syndrome induced by adjuvants, BAL: bronchoalveolar lavage, CBD: chronic beryllium disease, CTCL: cutaneous T-cell lymphoma, CTL: cytotoxic T-Lymphocyte, DRESS: drug reaction with eosinophilia and systemic symptoms, GERD: gastro-esophageal reflux disease, GI: gastrointestinal, GIP: giant cell interstitial pneumonia, GM-CSF: granulocyte macrophage-colony stimulating factor, HMLD: hard metal lung disease, HMW: high molecular weight, IBS: irritable bowel syndrome, Ig: immunoglobulin, IL: interleukin, LMW: low molecular weight, PAP: pulmonary alveolar proteinosis, PPE: personal protective equipment, PRR: pathogen recognition receptor, SLE: systemic lupus erythematosus, SNAS: systemic nickel allergy syndrome, Th: helper T-cell, UC: ulcerative colitis, UV: ultraviolet.
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Affiliation(s)
- Ka Roach
- Allergy and Clinical Immunology Branch (ACIB), National Institute of Occupational Safety and Health (NIOSH), Morgantown, WV, USA
| | - Jr Roberts
- Allergy and Clinical Immunology Branch (ACIB), National Institute of Occupational Safety and Health (NIOSH), Morgantown, WV, USA
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Raimondo A, Lembo S. Atopic Dermatitis: Epidemiology and Clinical Phenotypes. Dermatol Pract Concept 2021; 11:e2021146. [PMID: 35024238 DOI: 10.5826/dpc.1104a146] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2021] [Indexed: 10/31/2022] Open
Abstract
Atopic dermatitis (AD) is a chronic, lifelong, relapsing condition. The wide spectrum of the possible clinical presentations, depending on patient' s age, age of onset of disease, topography and morphology of dermatitis, limits the epidemiologic information on its prevalence and incidence. A clear definition of the different clinical AD phenotypes and epidemiology is essential for an appropriate patient's treatment and management, in particular for adults. This review summarizes the most recent epidemiologic data from the 21st century, on AD prevalence and incidence rates either in children or adults, with a special focus on their trends in Europe. Moreover, an effort to categorize diverse AD clinical expressions, has been made, aiming to facilitate differential diagnosis and speed up the start of the correct therapy.
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Affiliation(s)
- Annunziata Raimondo
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - Serena Lembo
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
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Increased Risk of Atrial Fibrillation in Patients with Atopic Triad: A Nationwide Population-Based Study. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:3422-3430.e5. [PMID: 33965590 DOI: 10.1016/j.jaip.2021.04.056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 04/21/2021] [Accepted: 04/22/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Despite a sharp increase in the global prevalence of allergy over the past decade, the relation between multiple atopic conditions and atrial fibrillation (AF) has not been fully elucidated. OBJECTIVE To determine whether there is an association between atopic diseases and AF and to examine the effect of multiple atopic diseases on the incidence of AF. METHODS This retrospective population-based study used the database from the 2009 National Health Insurance Services-Health Screening Cohort in Korea. A total of 6,748,564 subjects without a previous history of AF were included in the final analysis and observed until 2017. The atopic triad included asthma, allergic rhinitis, and atopic dermatitis. A total of 1,168,196 subjects (17.3%) with at least one atopic disease were classified as the atopic group. The primary outcome was new-onset AF. RESULTS During a median 7.2 ± 1.0 years of follow-up, 136,253 subjects were given the new diagnosis of AF (30,300 in the atopic group and 105,953 in the nonatopic group). The incidence of AF was 3.63/1000 person-years in the atopic group and 2.64/1000 person-years in the nonatopic group. The risk for AF showed a positive correlation with the number of diseases in the atopic triad (adjusted hazard ratio [aHR], 95% confidence interval [CI]: one disease: aHR = 1.15, CI, 1.14-1.17; two diseases: aHR = 1.34, CI, 1.31-1.38; and three diseases: aHR = 1.35, CI, 1.11-1.66; P for trend < .001). CONCLUSIONS The atopic triad of asthma, allergic rhinitis, and atopic dermatitis was associated with an increased risk for AF. Moreover, multiple atopic conditions have a higher risk for AF.
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Knibb RC, Gore C. Challenges for transition from paediatric to adult services for young people with allergic conditions in the United Kingdom. Clin Exp Allergy 2021; 50:1120-1121. [PMID: 33463809 DOI: 10.1111/cea.13737] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 09/08/2020] [Accepted: 09/09/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Rebecca C Knibb
- School of Psychology, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Claudia Gore
- Department of Paediatrics, Imperial College Healthcare NHS Trust, London, UK.,Section of Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London, London, UK
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Janković S, Tomić-Spirić V, Kovačević G, Marinković J, Janković J, Ćirković A, Đerić A, Relić N. Sulfur dioxide and exacerbation of allergic respiratory diseases: A time-stratified case-crossover study. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2021; 26:109. [PMID: 35126572 PMCID: PMC8765521 DOI: 10.4103/jrms.jrms_6_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 07/13/2020] [Accepted: 07/07/2021] [Indexed: 11/08/2022]
Abstract
Background: Strong epidemiological evidence suggests that air pollution plays a significant role in the exacerbation of allergic respiratory diseases. This study aimed to assess the potential relationship between daily levels of sulfur dioxide (SO2) and emergency department (ED) visits for allergic diseases. Materials and Methods: Data regarding ED visits for allergic respiratory diseases were routinely collected from the EDs in the Zlatibor district, and the General Hospital, Užice. The daily average concentrations of SO2 were obtained from the regional automatic air quality monitoring stations. All data were collected from June 2012 to July 2014. A time-stratified case-crossover design was used. Crude odds ratios (ORs) and ORs adjusted for weather conditions were calculated using conditional logistic regression. Results: Statistically significant associations were seen between 0-day lagged exposure to SO2 and ED visits for all allergic diseases (OR = 1.62; 95% confidence interval [CI]: 1.05–2.48; P = 0.028) and between 2-day lagged exposure to SO2 and ED visits for asthma with allergic rhinitis (OR = 2.00; 95% CI: 1.03–3.88; P = 0.042). These results were adjusted for temperature, temperature2, and humidity. Conclusion: Our results suggest that short-term exposure to SO2 conferred an increased risk of ED visits for allergic respiratory diseases, particularly for asthma with concomitant allergic rhinitis.
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Mackey E, Thelen KM, Bali V, Fardisi M, Trowbridge M, Jordan CL, Moeser AJ. Perinatal androgens organize sex differences in mast cells and attenuate anaphylaxis severity into adulthood. Proc Natl Acad Sci U S A 2020; 117:23751-23761. [PMID: 32917815 PMCID: PMC7519313 DOI: 10.1073/pnas.1915075117] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Mast cell (MC)-associated diseases, including allergy/anaphylaxis and neuroinflammatory pain disorders, exhibit a sex bias, with females at increase risk. While much attention has been directed toward adult sex hormones as drivers of sex differences, that female sex bias in MC-associated diseases is evident in prepubertal children, suggesting early-life origins of sex differences which have yet to be explored. Utilizing rodent models of MC-mediated anaphylaxis, our data here reveal that, 1) compared with females, males exhibit significantly reduced severity of MC-mediated anaphylactic responses that emerge prior to puberty and persist into adulthood, 2) reduced severity of MC-mediated anaphylaxis in males is linked with the naturally high level of perinatal androgens and can be recapitulated in females by perinatal exposure to testosterone proprionate, 3) perinatal androgen exposure guides bone marrow MC progenitors toward a masculinized tissue MC phenotype characterized by decreased concentration of prestored MC granule mediators (e.g., histamine, serotonin, and proteases) and reduced mediator release upon degranulation, and 4) engraftment of MC-deficient Kit W-sh/W-sh mice with adult male, female, or perinatally androgenized female MCs results in MC-mediated anaphylaxis response that reflects the MC sex and not host sex. Together, these data present evidence that sex differences in MC phenotype and resulting disease severity are established in early life by perinatal androgens. Thus, factors affecting levels of perinatal androgens could have a significant impact on MC development and MC-associated disease risk across the life span.
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Affiliation(s)
- Emily Mackey
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824
- Comparative Biomedical Sciences Program, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27603
| | - Kyan M Thelen
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824
| | - Vedrana Bali
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824
- Department of Physiology, Michigan State University, East Lansing, MI 48824
| | - Mahsa Fardisi
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824
| | - Madalyn Trowbridge
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824
| | - Cynthia L Jordan
- Department of Physiology, Michigan State University, East Lansing, MI 48824
- Neuroscience Program, Michigan State University, East Lansing, MI 48824
- Psychology Department, Michigan State University, East Lansing, MI 48824
| | - Adam J Moeser
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824;
- Department of Physiology, Michigan State University, East Lansing, MI 48824
- Neuroscience Program, Michigan State University, East Lansing, MI 48824
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Chinn AM, Insel PA. Cyclic AMP in dendritic cells: A novel potential target for disease-modifying agents in asthma and other allergic disorders. Br J Pharmacol 2020; 177:3363-3377. [PMID: 32372523 DOI: 10.1111/bph.15095] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 03/27/2020] [Accepted: 04/03/2020] [Indexed: 12/14/2022] Open
Abstract
Allergic diseases are immune disorders that are a global health problem, affecting a large portion of the world's population. Allergic asthma is a heterogeneous disease that alters the biology of the airway. A substantial portion of patients with asthma do not respond to conventional therapies; thus, new and effective therapeutics are needed. Dendritic cells (DCs), antigen presenting cells that regulate helper T cell differentiation, are key drivers of allergic inflammation but are not the target of current therapies. Here we review the role of dendritic cells in allergic conditions and propose a disease-modifying strategy for treating allergic asthma: cAMP-mediated inhibition of dendritic cells to blunt allergic inflammation. This approach contrasts with current treatments that focus on treating clinical manifestations of airway inflammation. Disease-modifying agents that target cAMP and its signalling pathway in dendritic cells may provide a novel means to treat asthma and other allergic diseases.
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Affiliation(s)
- Amy M Chinn
- Department of Pharmacology, University of California, San Diego, La Jolla, California, USA
| | - Paul A Insel
- Department of Pharmacology, University of California, San Diego, La Jolla, California, USA.,Department of Medicine, University of California, San Diego, La Jolla, California, USA
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Proctor T, Morrough E, Fenske O, Allatt S, Hughes SM, Sharma V, Arkwright PD. Impact on quality of life and safety of sublingual and subcutaneous immunotherapy in children with severe house dust mite and pollen-associated allergic rhinoconjunctivitis. Clin Transl Allergy 2020; 10:10. [PMID: 32337019 PMCID: PMC7171800 DOI: 10.1186/s13601-020-00315-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 04/04/2020] [Indexed: 11/30/2022] Open
Abstract
Background Pollen and house dust mite (HDM) subcutaneous immunotherapy (SLIT) and pollen subcutaneous immunotherapy (SCIT) are effective therapies for children with allergic rhinoconjunctivitis (AR). There are no previous direct comparative studies investigating quality of life (QoL) of all three immunotherapy regimes. The aim of this study was to compare QoL and safety in children receiving these immunotherapies for AR. Methods Demographic characteristics, Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) and Visual Analogue (VAS) scores were assessed in 249 children undergoing HDM and pollen immunotherapy at a UK specialist paediatric centre between 2007 and 2019. Results All three immunotherapy regimes led to a > 50% improvement in QoL and VAS after 3 years of therapy, with significant improvements by the end of the first year (p < 0.05) and further improvements between 1 and 3 years (p < 0.05). Age, gender, ethnicity and route of administration had no significant bearing on efficacy. Older, polysensitised children and those receiving HDM SLIT were all more likely to discontinue their treatment (all with p < 0.05). The only patient to suffer from anaphylaxis requiring intramuscular adrenaline, and 80% experiencing exacerbations of their asthma had received pollen SCIT. Conclusions Pollen SCIT and pollen and HDM SLIT all lead to significant improvements in QoL. The risk of anaphylaxis is low, but SCIT is associates with a 1 in 5 chance of asthma flares in the days after its administration. Discontinuation of therapy is more frequent in older, polysensitised children, and those undergoing HDM immunotherapy.
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Affiliation(s)
- Thomas Proctor
- 1Department of Paediatric Allergy and Immunology, Royal Manchester Children's Hospital, Oxford Rd, Manchester, M13 9WL UK
| | - Elodie Morrough
- 1Department of Paediatric Allergy and Immunology, Royal Manchester Children's Hospital, Oxford Rd, Manchester, M13 9WL UK
| | - Otto Fenske
- 1Department of Paediatric Allergy and Immunology, Royal Manchester Children's Hospital, Oxford Rd, Manchester, M13 9WL UK
| | - Sarah Allatt
- 1Department of Paediatric Allergy and Immunology, Royal Manchester Children's Hospital, Oxford Rd, Manchester, M13 9WL UK
| | - Stephen M Hughes
- 1Department of Paediatric Allergy and Immunology, Royal Manchester Children's Hospital, Oxford Rd, Manchester, M13 9WL UK
| | - Vibha Sharma
- 1Department of Paediatric Allergy and Immunology, Royal Manchester Children's Hospital, Oxford Rd, Manchester, M13 9WL UK
| | - Peter D Arkwright
- 1Department of Paediatric Allergy and Immunology, Royal Manchester Children's Hospital, Oxford Rd, Manchester, M13 9WL UK.,2Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, UK
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Zhou S, Huang G. Synthesis of anti-allergic drugs. RSC Adv 2020; 10:5874-5885. [PMID: 35497436 PMCID: PMC9049304 DOI: 10.1039/c9ra10659f] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 01/20/2020] [Indexed: 01/01/2023] Open
Abstract
Histamine is formed by the decarboxylation of histidine catalyzed by enzymes. It is an endogenous biologically active substance involved in multiple complex physiological processes as an important chemical transmitter. Histamine receptors have four subtypes, H1, H2, H3 and H4, all of which are G protein coupling receptors (GPCRs) with different physiological functions. Histamine plays an important role in the pathophysiological mechanism of allergic diseases, and the antagonistic effect of histamine has become an important way to study anti-allergic drugs, wherein the anti-allergic drugs used in clinical practice are mainly H1 receptor antagonists. Currently, there are many varieties of H1 receptor antagonists in clinical applications, which can be divided into ethylenediamine antagonists, amino ether antagonists, propylamine antagonists, tricyclic antagonists, piperazine antagonists and piperidine antagonists depending on their chemical structures. This article mainly reviews the research progress of allergic reactions with histamine H1 receptor antagonists and expounds the important aspects of the design and synthesis of various new compounds. Histamine is formed by the decarboxylation of histidine catalyzed by enzymes. It is an endogenous biologically active substance involved in multiple complex physiological processes as an important chemical transmitter.![]()
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Affiliation(s)
- Shiyang Zhou
- Chongqing Key Laboratory of Green Synthesis and Application
- Active Carbohydrate Research Institute
- Chongqing Normal University
- Chongqing
- China
| | - Gangliang Huang
- Chongqing Key Laboratory of Green Synthesis and Application
- Active Carbohydrate Research Institute
- Chongqing Normal University
- Chongqing
- China
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16
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Tomić-Spirić V, Kovačević G, Marinković J, Janković J, Ćirković A, Milošević Đerić A, Relić N, Janković S. Evaluation of the Impact of Black Carbon on the Worsening of Allergic Respiratory Diseases in the Region of Western Serbia: A Time-Stratified Case-Crossover Study. ACTA ACUST UNITED AC 2019; 55:medicina55060261. [PMID: 31181862 PMCID: PMC6631303 DOI: 10.3390/medicina55060261] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 06/06/2019] [Accepted: 06/06/2019] [Indexed: 11/24/2022]
Abstract
Background and Objectives: Many epidemiological studies have shown a positive association between black carbon (BC) and the exacerbation of allergic rhinitis and allergic asthma. However, none of the studies in Serbia examined this relationship yet. The aim of this study was to examine the associations between BC and emergency department (ED) visits for allergic rhinitis and allergic asthma in the Užice region of Serbia. Materials and Methods: A time-stratified case-crossover design was applied to 523 ED visits for allergic rhinitis and asthma exacerbation that occurred in the Užice region of Serbia between 2012–2014. Data regarding ED visits were routinely collected in the Health Center of Užice. The daily average concentrations of BC were measured by automatic ambient air quality monitoring stations. Odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were estimated using conditional logistic regression adjusted for the potential confounding influence of weather variables (temperature, humidity, and air pressure). Results: Statistically significant associations were observed between ED visits for allergic rhinitis and 2-day lagged exposure to BC (OR = 3.20; CI = 1.00–10.18; p = 0.049) and allergic asthma and 3-day lagged exposure to BC (OR = 3.23; CI = 1.05–9.95; p = 0.041). Conclusion: Exposure to BC in the Užice region increases the risk of ED visits for allergic rhinitis and asthma, particularly during the heating season.
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Affiliation(s)
- Vesna Tomić-Spirić
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
- Clinic for Allergology and Immunology, Clinical Centre of Serbia, 11000 Belgrade, Serbia.
| | | | - Jelena Marinković
- Institute of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
| | - Janko Janković
- Institute of Social Medicine, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
| | - Anđa Ćirković
- Institute of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
| | | | - Nenad Relić
- Department of Otorhinolaryngology, Faculty of Medicine, University of Priština, 38220 Kosovska Mitrovica, Serbia.
| | - Slavenka Janković
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
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Killoran KE, Kropp LE, Lindrose AR, Curtis HE, Cook D, Mitre E. Rush desensitization with a single antigen induces subclinical activation of mast cells and protects against bystander challenge in dually sensitized mice. Clin Exp Allergy 2019; 49:484-494. [DOI: 10.1111/cea.13323] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 09/14/2018] [Accepted: 10/20/2018] [Indexed: 01/30/2023]
Affiliation(s)
- Kristin E. Killoran
- Department of Microbiology and Immunology Uniformed Services University of the Health Sciences Bethesda Maryland
| | - Laura E. Kropp
- Department of Microbiology and Immunology Uniformed Services University of the Health Sciences Bethesda Maryland
| | - Alyssa R. Lindrose
- Department of Microbiology and Immunology Uniformed Services University of the Health Sciences Bethesda Maryland
| | - Holly E. Curtis
- Department of Microbiology and Immunology Uniformed Services University of the Health Sciences Bethesda Maryland
| | - David Cook
- Department of Microbiology and Immunology Uniformed Services University of the Health Sciences Bethesda Maryland
| | - Edward Mitre
- Department of Microbiology and Immunology Uniformed Services University of the Health Sciences Bethesda Maryland
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Westwood M, Ramaekers B, Lang S, Armstrong N, Noake C, de Kock S, Joore M, Severens J, Kleijnen J. ImmunoCAP® ISAC and Microtest for multiplex allergen testing in people with difficult to manage allergic disease: a systematic review and cost analysis. Health Technol Assess 2018; 20:1-178. [PMID: 27623692 DOI: 10.3310/hta20670] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Allergy is a form of immune-mediated exaggerated sensitivity (hypersensitivity) to a substance that is either inhaled, swallowed, injected or comes into contact with the skin. Foreign substances that provoke allergies are called allergens. It has been claimed that multiplex allergen testing may help in diagnosing the cause of symptoms in patients with an unclear cause of allergy or who are allergic to more than one substance. OBJECTIVES To evaluate multiplex allergen testing [devices that can measure the presence of multiple immunoglobulin E (IgE) antibodies in a patient's blood at the same time], by assessing (1) clinical effectiveness (allergy symptoms, incidence of acute exacerbations, mortality, adverse events of testing and treatment, health-care presentations or admissions, health-related quality of life); (2) effects on treatment (diet, immunotherapy medications, other potential testing); (3) any additional diagnostic information provided by multiplex allergen testing; and (4) cost-effectiveness (cost of different assessment strategies). METHODS Fifteen databases were searched from 2005 to April 2015, including MEDLINE (via OvidSp), MEDLINE In-Process Citations, MEDLINE Daily Update, PubMed (National Library of Medicine), EMBASE, Cochrane Database of Systematic Reviews (CDSR), Cochrane Central Register of Controlled Trials (CENTRAL), Database of Abstracts of Reviews of Effects (DARE), Health Technology Assessment (HTA) database, Science Citation Index (SCI), Conference Proceedings Citation Index-Science (CPCI-S), BIOSIS Previews, Latin American and Caribbean Health Sciences Literature (LILACS), National Institute for Health Research (NIHR) HTA programme, and the US Food and Drug Administration (FDA); supplementary searches of conference proceedings and trials registries were performed. Review methods followed published guidance from the Cochrane Collaboration and the Centre for Reviews and Dissemination, University of York, UK. The methodological quality of included studies was assessed using appropriate published tools or a review-specific tool designed by the project team. Studies were summarised in a narrative synthesis. Owing to a lack of data on the clinical effectiveness of multiplex allergen testing, no long-term cost-effectiveness model was developed. A conceptual model structure was developed and cost analyses were performed to examine the short-term costs of various possible diagnostic pathways. RESULTS Fifteen studies were included in the review. The very limited available data indicated that the addition of multiplex allergen testing [ImmunoCAP(®) Immuno Solid-phase Allergen Chip (ISAC), Thermo Fisher Scientific/Phadia AB, Uppsala, Sweden] to standard diagnostic work-up can change the clinicians' views on the diagnosis, management and treatment of patients. There was some indication that the use of ImmunoCAP ISAC testing may be useful to guide decisions on the discontinuation of restrictive diets, the content of allergen-specific immunotherapy (SIT) prescriptions, and whether or not patients should receive SIT. However, none of the studies that we identified reported any information on clinical outcomes subsequent to changes in treatment or management. There was some evidence that ImmunoCAP ISAC may be useful for discriminating allergens that are structurally similar and are recognised by the same IgE antibody (cross-immunoreactive). No data were available for Microtest (Microtest Matrices Ltd, London, UK). Detailed cost analyses suggested that multiplex allergen testing would have to result in a substantial reduction of the proportions of patients receiving single IgE testing and oral food challenge tests in order to be cost-saving in the short term. CONCLUSIONS No recommendations for service provision can be made based on the analyses included in this report. It is suggested that a consensus-based protocol for the use of multiplex allergen testing be developed. The clinical effectiveness and cost-effectiveness of the proposed protocol should then be assessed by comparing long-term clinical and quality of life outcomes and resource use in patients managed using the protocol with those managed using a standard diagnostic pathway. STUDY REGISTRATION This study is registered as PROSPERO CRD42015019739. FUNDING This project was a Diagnostic Assessment Report commissioned by the NIHR HTA programme on behalf of the National Institute for Health and Care Excellence.
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Affiliation(s)
| | - Bram Ramaekers
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Shona Lang
- Kleijnen Systematic Reviews Ltd, York, UK
| | | | - Caro Noake
- Kleijnen Systematic Reviews Ltd, York, UK
| | | | - Manuela Joore
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Johan Severens
- Institute of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Jos Kleijnen
- School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
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Reliably estimating prevalences of atopic children: an epidemiological study in an extensive and representative primary care database. NPJ Prim Care Respir Med 2017; 27:23. [PMID: 28408759 PMCID: PMC5435092 DOI: 10.1038/s41533-017-0025-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 02/25/2017] [Accepted: 02/28/2017] [Indexed: 12/02/2022] Open
Abstract
Electronic health records stored in primary care databases might be a valuable source to study the epidemiology of atopic disorders and their impact on health-care systems and costs. However, the prevalence of atopic disorders in such databases varies considerably and needs to be addressed. For this study, all children aged 0–18 years listed in a representative primary care database in the period 2002–2014, with sufficient data quality, were selected. The effects of four different strategies on the prevalences of atopic disorders were examined: (1) the first strategy examined the diagnosis as recorded in the electronic health records, whereas the (2) second used additional requirements (i.e., the patient had at least two relevant consultations and at least two relevant prescriptions). Strategies (3) and (4) assumed the atopic disorders to be chronic based on strategy 1 and 2, respectively. When interested in cases with a higher probability of a clinically relevant disorder, strategy 2 yields a realistic estimation of the prevalence of atopic disorders derived from primary care data. Using this strategy, of the 478,076 included children, 28,946 (6.1%) had eczema, 29,182 (6.1%) had asthma, and 28,064 (5.9%) had allergic rhinitis; only 1251 (0.3%) children had all three atopic disorders. Prevalence rates are highly dependent on the clinical atopic definitions used. The strategy using cases with a higher probability of clinically relevant cases, yields realistic prevalences to establish the impact of atopic disorders on health-care systems. However, studies are needed to solve the problem of identifying atopic disorders that are missed or misclassified. The prevalence of atopic disorders in children can be more reliably calculated by incorporating clinical information with diagnosis data. Researchers in the Netherlands, led by David Pols from the Erasmus University Medical Center Rotterdam, examined the electronic health records of more than 660,000 children, aged 0 to 18, from a Dutch primary care database to determine the number of cases of atopic eczema, asthma, and allergic rhinitis. They looked for diagnosed children who also had at least two relevant clinical consultations and at least two relevant prescriptions. This strategy helps correct for the problem of overestimation, because it doesnot assume that a child, once diagnosed, will have an atopic disorder for life. However, other methods are still needed to identify cases that are missed or misclassified in the health database.
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Ye J, Zhang Q, Xuan Y, Chen S, Ma L, Zhang Y, Zheng H. Factors Associated with Echinococcosis-Induced Perioperative Anaphylactic Shock. THE KOREAN JOURNAL OF PARASITOLOGY 2017; 54:769-775. [PMID: 28095662 PMCID: PMC5266365 DOI: 10.3347/kjp.2016.54.6.769] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 07/27/2016] [Accepted: 09/11/2016] [Indexed: 12/28/2022]
Abstract
This retrospective case-control study explored the factors associated with anaphylactic shock during surgery for cystic echinococcosis (CE) at the First Affiliated Hospital of Xinjiang Medical University between October 2008 and September 2013. Patients who suffered from anaphylactic shock (n=16) were age-matched 3:1 to patients who did not (n=43). Multivariate analysis suggested that IL-4 levels (odds ratio=1.096; 95% confidence interval=1.015–1.185; P=0.02) and cyst size (odds ratio=3.028, 95% confidence interval=1.259–7.283, P=0.013) were independently associated with CE-induced perioperative anaphylactic shock. Using the receiver operating characteristic (ROC) curves and a cut-off value of 415.7 ng/ml, IL-4 showed an area under the ROC (AUC) of 0.926, sensitivity of 75.0%, and specificity of 97.7%. Using a cut-off value of 7.8 cm, cyst size showed an AUC of 0.828, sensitivity of 81.3%, and specificity of 76.7%. In conclusion, results suggest that levels of IL-4 and cyst size were independently associated with echinococcosis-induced perioperative anaphylactic shock. These results could help identifying patients with echinococcosis at risk of anaphylactic shock in whom appropriate prophylaxis could be undertaken.
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Affiliation(s)
- Jianrong Ye
- Department of Anesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, P. R. China
| | - Qin Zhang
- Department of Anesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, P. R. China
| | - Yan Xuan
- Department of Anesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, P. R. China
| | - Siyu Chen
- Department of Anesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, P. R. China
| | - Long Ma
- Department of Anesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, P. R. China
| | - Yongqiang Zhang
- Department of Anesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, P. R. China
| | - Hong Zheng
- Department of Anesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, P. R. China
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Zhang Q, Ye JR, Ma HM, Wu JJ, Jiang T, Zheng H. Role of immune tolerance in BALB/c mice with anaphylactic shock after Echinococcus granulosus infection. Immunol Res 2016; 64:233-41. [PMID: 26603168 DOI: 10.1007/s12026-015-8741-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
This study tested the hypothesis that immune tolerance mediated by regulatory T (Treg) cells is protective against cystic echinococcosis (CE)-induced anaphylactic shock. BALB/c mice were inoculated with protoscoleces of Echinococcus granulosus. After 3 months, the presence of cysts in the peritoneal cavity was confirmed after which a subset of mice was sensitized using a cyst fluid suspension to induce anaphylactic shock. While IgE levels were significantly higher in both groups inoculated with E. granulosus as compared to the healthy control group (both P < 0.01), sensitized mice had higher IgE levels as compared with those with E. granulosus alone (P < 0.05). Mice inoculated with E. granulosus alone and sensitized mice both had significantly higher histamine levels as compared to the healthy controls. The proportion of CD4(+)CD25(+)Foxp3(+) Treg cells relative to CD4(+) cells was significantly higher in mice inoculated with E. granulosus alone (P < 0.0167); significantly higher interleukin-10 (IL-10) and tumor growth factor-β (TGF-β1) levels were also noted in this group (all P < 0.01). In contrast, IL-13 and IL-17A levels were significantly higher in the sensitized mice (both P < 0.05). Taken together, these data suggest that the biphasic changes in Treg cell and cytokine levels may be associated with anaphylactic shock induced by CE.
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Affiliation(s)
- Qin Zhang
- Department of Anaesthesiology, The First Affiliated Hospital of Xinjiang Medical University, No. 137, Li yu Shan Street, Ürümqi, 830011, China
| | - Jian-Rong Ye
- Department of Anaesthesiology, The First Affiliated Hospital of Xinjiang Medical University, No. 137, Li yu Shan Street, Ürümqi, 830011, China
| | - Hai-Mei Ma
- Department of Anaesthesiology, The First Affiliated Hospital of Xinjiang Medical University, No. 137, Li yu Shan Street, Ürümqi, 830011, China
| | - Jian-Jiang Wu
- Department of Anaesthesiology, The First Affiliated Hospital of Xinjiang Medical University, No. 137, Li yu Shan Street, Ürümqi, 830011, China
| | - Tao Jiang
- Department of Anaesthesiology, The First Affiliated Hospital of Xinjiang Medical University, No. 137, Li yu Shan Street, Ürümqi, 830011, China
| | - Hong Zheng
- Department of Anaesthesiology, The First Affiliated Hospital of Xinjiang Medical University, No. 137, Li yu Shan Street, Ürümqi, 830011, China.
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Bono-Lunn D, Villeneuve C, Abdulhay NJ, Harker M, Parker W. Policy and regulations in light of the human body as a ‘superorganism’ containing multiple, intertwined symbiotic relationships. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/10601333.2016.1210159] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Pols DHJ, Wartna JB, Moed H, van Alphen EI, Bohnen AM, Bindels PJE. Atopic dermatitis, asthma and allergic rhinitis in general practice and the open population: a systematic review. Scand J Prim Health Care 2016; 34:143-50. [PMID: 27010253 PMCID: PMC4977936 DOI: 10.3109/02813432.2016.1160629] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 01/31/2016] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To examine whether significant differences exist between the self-reported prevalence of atopic disorders in the open population compared with physician diagnosed prevalence of atopic disorders in general practice. METHODS Medline (OvidSP), PubMed Publisher, EMBASE, Google Scholar and the Cochrane Controlled Clinical Trials Register databases were systematically reviewed for articles providing data on the prevalence of asthma, allergic rhinitis and eczema in a GP setting. Studies were only included when they had a cross-sectional or cohort design and included more than 100 children (aged 0-18 years) in a general practice setting. All ISAAC studies (i.e. the open population) that geographically matched a study selected from the first search, were also included. A quality assessment was conducted. The primary outcome measures were prevalence of eczema, asthma and allergic rhinitis in children aged 0-18 years. RESULTS The overall quality of the included studies was good. The annual and lifetime prevalences of the atopic disorders varied greatly in both general practice and the open population. On average, the prevalence of atopic disorders was higher in the open population. CONCLUSION There are significant differences between the self-reported prevalence of atopic disorders in the open population compared with physician diagnosed prevalence of atopic disorders in general practice. Data obtained in the open population cannot simply be extrapolated to the general practice setting. This should be taken into account when considering a research topic or requirements for policy development. GPs should be aware of the possible misclassification of allergic disorders in their practice. Key Points Epidemiological data on atopic disorders in children can be obtained from various sources, each having its own advantages and limitations. On average, the prevalence of atopic disorders is higher in the open population. GPs should take into account the possible misclassification of atopic disorders in their practice population. Policymakers should be aware that data obtained in the open population cannot simply be extrapolated to the general practice setting.
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Affiliation(s)
- D. H. J. Pols
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, The Netherlands
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Zhang Q, Ye J, Zheng H. Dexamethasone attenuates echinococcosis-induced allergic reactions via regulatory T cells in mice. BMC Immunol 2016; 17:4. [PMID: 26968945 PMCID: PMC4787038 DOI: 10.1186/s12865-016-0141-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 02/29/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cystic echinococcosis (CE), caused by infection with Echinococcus granulosus larvae, is a potentially life-threatening disease in humans. Anaphylactic shock caused by CE is very dangerous, and is highly prevalent during surgery. Dexamethasone (DEX) is used clinically before operations to prevent allergic reactions; Regulatory T cells (Treg cells) are believed to be associated with negative immune response, which play an important role in alleviating allergic reactions. However, the association of Treg cells with DEX remains unknown. METHODS In this study, C57BL/6 mice were divided into uninfected group, untreated group and DEX group which were inoculated with protoscoleces from E. granulosus and sensitized using a cyst fluid suspension to induce anaphylactic shock. In addition, the mice in DEX group were treated with 10 mg/kg DEX by intraperitoneal injection 30 min before being sensitized. RESULTS It was found that 93.75 % of all sensitized mice experienced allergic symptoms. The levels of IgE, IgE/IgG, and IgE/IgG1 were significantly higher in both untreated group and DEX group. The proportion of CD4 + CD25 + FOXP3 + Treg cells relative to CD4+ Treg cells, and the levels of interleukin-10 (IL-10) and tumor growth factor-β (TGF-β1) were significantly higher in DEX group. The level of IL-13 was significantly higher in the sensitized mice than in the other groups. These cells may play a key role in alleviating the immune response in CE-induced anaphylactic shock. CONCLUSIONS The protective effect of DEX may be due to Treg cell upregulating IL-10 and TGF-β1 levels, and inhibiting helper T cell 2 cytokines.
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Affiliation(s)
- Qin Zhang
- Department of Anaesthesiology, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Jianrong Ye
- Department of Anaesthesiology, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Hong Zheng
- Department of Anaesthesiology, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China.
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Nitin J, Palagani R, Shradha NH, Vaibhav J, Kowshik K, Manoharan R, Nelliyanil M. Prevalence, severity and risk factors of allergic disorders among people in south India. Afr Health Sci 2016; 16:201-9. [PMID: 27358633 DOI: 10.4314/ahs.v16i1.27] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Allergic disorders are not usually life-threatening conditions but they impair the person's ability to function. It thus adversely affects the psychological wellbeing and quality of life. These implications of allergic disorders can be minimized if strategies are planned for its early identification followed by appropriate interventions. OBJECTIVES To find out the prevalence and risk factors of allergic disorders. METHODS Data was collected by house to house survey among participants aged 18 years and above using a standardized allergy assessment questionnaire. RESULTS Mean age of the 400 participants was 42.8±14.7 years. Majority 105(26.2%) were in the age group 36 to 45 years. Majority were females 287(71.7%) and were house wives 217(54.2%). Majority of participants were of upper socio economic class 98(44.7%) out of 219 and majority were from urban areas 326(81.5%). The prevalence of allergy among participants was found to be 115(28.7%). Out of these 115, 37(32.2%) had possibility of allergy, 60(52.2%) had probability of allergy and the rest 18(15.6%) had very high likelihood for allergy. People residing in semi urban areas had increased risk of allergy (p=0.024) than those from urban areas. The prevalence of asthma was 30(7.5%) and skin allergy was 23(5.8%). Most common precipitating factors for allergy were dust exposure 103(25.8%) followed by seasonal changes 71(17.8%). Family history of allergy was associated with allergy among participants (p<0.001). Usage of firewood was associated with symptoms of respiratory allergy among participants (p=0.01). CONCLUSION The study revealed some important determinants of allergic disorders which have important implications to frame appropriate prevention and health educational strategies.
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Affiliation(s)
- Joseph Nitin
- Kasturba Medical College, Manipal University, Mangalore, Community Medicine
| | - Revathi Palagani
- Kasturba Medical College, Manipal University, Mangalore, Community Medicine
| | - N H Shradha
- Kasturba Medical College, Manipal University, Mangalore, Community Medicine
| | - Jain Vaibhav
- Kasturba Medical College, Manipal University, Mangalore, Community Medicine
| | - K Kowshik
- Kasturba Medical College, Manipal University, Mangalore, Community Medicine
| | - Roshan Manoharan
- Kasturba Medical College, Manipal University, Mangalore, Community Medicine
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Garber EAE, Parker CH, Handy SM, Cho CY, Panda R, Samadpour M, Reynaud DH, Ziobro GC. Presence of Undeclared Food Allergens in Cumin: The Need for Multiplex Methods. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2016; 64:1202-1211. [PMID: 26769163 DOI: 10.1021/acs.jafc.5b05497] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Beginning in the autumn of 2014, millions of dollars of food and over 675 products were recalled in the United States due to the presence of undeclared peanut, attributed to cumin used in the manufacture of the products. Initial analyses also indicated the presence of almond. Subsequent research showed that the presence of peanut and almond did not fully explain the analytical results for the cumin samples. Using a combination of mass spectrometry, DNA-based methods (i.e., PCR and Sanger DNA Sequencing), microscopy, and antibody-based technologies (i.e., ELISA, Western blot analysis, and a novel xMAP multiplex assay) the presence of peanut was confirmed. Screening for secondary sources of adulteration (e.g., tree nuts, mahleb, peach, and cherry) supported the assessment that the cumin contained multiple contaminants. These results demonstrate the limitations of single analyte-specific assays and the need for orthogonal multiplex methods to detect food allergens irrespective of varietal or other differences.
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Affiliation(s)
- Eric A E Garber
- Office of Regulatory Science, Center for Food Safety and Applied Nutrition, Food and Drug Administration , College Park, Maryland 20740, United States
| | - Christine H Parker
- Office of Regulatory Science, Center for Food Safety and Applied Nutrition, Food and Drug Administration , College Park, Maryland 20740, United States
| | - Sara M Handy
- Office of Regulatory Science, Center for Food Safety and Applied Nutrition, Food and Drug Administration , College Park, Maryland 20740, United States
| | - Chung Y Cho
- Office of Regulatory Science, Center for Food Safety and Applied Nutrition, Food and Drug Administration , College Park, Maryland 20740, United States
| | - Rakhi Panda
- Office of Regulatory Science, Center for Food Safety and Applied Nutrition, Food and Drug Administration , College Park, Maryland 20740, United States
| | - Mansour Samadpour
- IEH Laboratories and Consulting Group, Inc. , Lake Forest Park, Washington 98155, United States
| | - Danica H Reynaud
- AuthenTechnologies LLC , Richmond, California 94806, United States
| | - George C Ziobro
- Office of Food Safety, Center for Food Safety and Applied Nutrition, Food and Drug Administration , College Park, Maryland 20740, United States
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Nwaru BI, Nurmatov U, Sheikh A. Endogenous and exogenous sex steroid hormones in asthma and allergy in females: protocol for a systematic review and meta-analysis. NPJ Prim Care Respir Med 2016; 26:15078. [PMID: 26820644 PMCID: PMC4730990 DOI: 10.1038/npjpcrm.2015.78] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 11/11/2015] [Accepted: 11/24/2015] [Indexed: 12/02/2022] Open
Affiliation(s)
- Bright I Nwaru
- Asthma UK Centre for Applied Research, Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK.,School of Health Sciences, University of Tampere, Tampere, Finland
| | - Ulugbek Nurmatov
- Asthma UK Centre for Applied Research, Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - Aziz Sheikh
- Asthma UK Centre for Applied Research, Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
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Nurmatov UB, Tagiyeva N, Semple S, Devereux G, Sheikh A. Volatile organic compounds and risk of asthma and allergy: a systematic review. Eur Respir Rev 2015; 24:92-101. [PMID: 25726560 DOI: 10.1183/09059180.00000714] [Citation(s) in RCA: 105] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Volatile organic compounds (VOCs) are ubiquitous domestic pollutants. Their role in asthma/allergy development and exacerbations is uncertain. This systematic review investigated whether domestic VOC exposure increases the risk of developing and/or exacerbating asthma and allergic disorders. We systematically searched 11 databases and three trial repositories, and contacted an international panel of experts to identify published and unpublished experimental and epidemiological studies. 8455 potentially relevant studies were identified; 852 papers were removed after de-duplication, leaving 7603 unique papers that were screened. Of these, 278 were reviewed in detail and 53 satisfied the inclusion criteria. Critical appraisal of the included studies indicated an overall lack of high-quality evidence and substantial risk of bias in this body of knowledge. Aromatics (i.e. benzenes, toluenes and xylenes) and formaldehyde were the main VOC classes studied, both in relation to the development and exacerbations of asthma and allergy. Approximately equal numbers of studies reported that exposure increased risks and that exposure was not associated with any detrimental effects. The available evidence implicating domestic VOC exposure in the risk of developing and/or exacerbating asthma and allergy is of poor quality and inconsistent. Prospective, preferably experimental studies, investigating the impact of reducing/eliminating exposure to VOC, are now needed in order to generate a more definitive evidence base to inform policy and clinical deliberations in relation to the management of the now substantial sections of the population who are either at risk of developing asthma/allergy or living with established disease.
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Affiliation(s)
- Ulugbek B Nurmatov
- Allergy and Respiratory Research Group, Centre for Population Health Sciences, The University of Edinburgh, Medical School, Edinburgh, UK
| | - Nara Tagiyeva
- Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Sean Semple
- Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Graham Devereux
- Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Aziz Sheikh
- Allergy and Respiratory Research Group, Centre for Population Health Sciences, The University of Edinburgh, Medical School, Edinburgh, UK Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA
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29
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Odongo L, Mulyowa G, Goebeler M, Trautmann A. Bet v 1- and Bet v 2-Associated Plant Food Sensitization in Uganda and Germany: Differences and Similarities. Int Arch Allergy Immunol 2015; 167:264-9. [PMID: 26437181 DOI: 10.1159/000439533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 08/17/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Birch pollen allergy and concomitant plant food sensitization are well documented in Europe. However, there are currently no data available on pollen-associated plant food sensitization or even pollen allergy in tropical Africa. Our study aimed to investigate Bet v 1- and Bet v 2-associated plant food sensitization in atopic patients from Uganda and compare it with sensitization rates in German patients. METHODS Sera from 83 Ugandan and 97 German atopic patients were analysed using UniCAP100™ for allergen-specific IgE against the birch tree pollen allergens Bet v 1 and Bet v 2 as well as the plant foods hazelnut, apple, kiwi, pea, peach, cherry, litchi, peanut, and soy. RESULTS As expected, sensitization to Bet v 1 and cross-reactive plant food allergens was more common in German atopic patients. In contrast, the prevalence of sensitization against Bet v 2 was remarkably similar in Ugandan and German patients. Interestingly, in Ugandan patients we found IgE-mediated sensitization against plant foods such as hazelnut, pea, peach, cherry, and litchi that are neither cultivated nor consumed in Uganda. CONCLUSIONS For Ugandan atopic patients, sensitization against the Bet v 2 allergen (a plant profilin) may explain cross-reactivity to several plant foods which are not consumed in Uganda. Additionally, it is probable that sensitization of Ugandan atopics to alder pollen (Alnus acuminata, plant family Betulaceae) caused serological cross-reactivity with Betula verrucosa-related allergens.
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Affiliation(s)
- Leo Odongo
- Department of Dermatology, University Hospital Mbarara, Mbarara, Uganda
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30
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Cho CY, Nowatzke W, Oliver K, Garber EAE. Multiplex detection of food allergens and gluten. Anal Bioanal Chem 2015; 407:4195-206. [PMID: 25814275 DOI: 10.1007/s00216-015-8645-y] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 02/04/2015] [Accepted: 03/16/2015] [Indexed: 10/23/2022]
Abstract
To help safeguard the food supply and detect the presence of undeclared food allergens and gluten, most producers and regulatory agencies rely on commercial test kits. Most of these are ELISAs with a few being PCR-based. These methods are very sensitive and analyte specific, requiring different assays to detect each of the different food allergens. Mass spectrometry offers an alternative approach whereby multiple allergens may be detected simultaneously. However, mass spectrometry requires expensive equipment, highly trained analysts, and several years before a quantitative approach can be achieved. Using multianalyte profiling (xMAP®) technology, a commercial multiplex test kit based on the use of established antibodies was developed for the simultaneous detection of up to 14 different food allergens plus gluten. The assay simultaneously detects crustacean seafood, egg, gluten, milk, peanut, soy, and nine tree nuts (almond, Brazil nut, cashew, coconut, hazelnut, macadamia, pine nut, pistachio, and walnut). By simultaneously performing multiple tests (typically two) for each analyte, this magnetic bead-based assay offers built-in confirmatory analyses without the need for additional resources. Twenty-five of the assays were performed on buffer extracted samples, while five were conducted on samples extracted using reduced-denatured conditions. Thus, complete analysis for all 14 allergens and gluten requires only two wells of a 96-well microtiter plate. This makes it possible to include in a single analytical run up to 48 samples. All 30 bead sets in this multiplex assay detected 5 ng/mL of food allergen and gluten with responses greater than background. In addition, 26 of the bead sets displayed signal/noise ratios of five or greater. The bead-based design makes this 30-plex assay expandable to incorporate new antibodies and capture/detector methodologies by ascribing these new detectors to any of the unassigned bead sets that are commercially available.
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Affiliation(s)
- Chung Y Cho
- Office of Regulatory Science, Center for Food Safety and Applied Nutrition (CFSAN), Food and Drug Administration, College Park, MD, 20740, USA
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Ogulur I, Gurhan G, Kombak FE, Filinte D, Barlan I, Akkoc T. Allogeneic pluripotent stem cells suppress airway inflammation in murine model of acute asthma. Int Immunopharmacol 2014; 22:31-40. [PMID: 24957687 DOI: 10.1016/j.intimp.2014.06.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 06/09/2014] [Accepted: 06/10/2014] [Indexed: 01/16/2023]
Abstract
New strategies are needed to suppress airway inflammation and prevent or reverse airway remodeling in asthma. Reprogramming induced pluripotent stem cells (iPSCs) have the potential of embryonic stem cells (ESCs) and provide a resource for stem cell-based utility. The aim of this study was to evaluate the histopathological and immunomodulatory effects of ESCs and iPSCs for potential allogenic application in a murine model of acute asthma. BALB/c mice were sensitized with alum-absorbed ovalbumin (OVA) and then challenged with 1% aerosolized OVA. 5×10(5) ESCs and iPSCs were administrated intranasally on the last day of nebulization. Mice were sacrificed after 24 h, and serum allergen specific antibody level, airway remodeling, cytokine levels in lung supernatants, and eosinophilic infiltration in BAL fluid were examined. As a result, more ESCs and iPSCs integrated into the lungs of mice in OVA groups than those of the controls. Epithelial, smooth muscle and basal membrane thicknesses as well as goblet cell hyperplasia occurring in airway remodeling were significantly suppressed by pluripotent stem cells in both distal and proximal airways. Percentage of eosinophils decreased significantly in BAL fluid as well as serum allergen-specific IgE and IL-4 levels in lung supernatants. On the contrary, regulatory cytokine - IL-10 level - was enhanced. Application of especially ESCs significantly increased the percentage of Treg subsets. Our comparative results showed that i.n. delivery of miRNA-based reprogrammed iPSCs is beneficial in attenuating airway inflammation in a murine model of acute asthma, and that cells also have similar immunomodulatory effects in mice.
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Affiliation(s)
- Ismail Ogulur
- Marmara University Faculty of Medicine, Division of Pediatric Allergy and Immunology, Istanbul, Turkey
| | - Gulben Gurhan
- Marmara University Faculty of Medicine, Division of Pediatric Allergy and Immunology, Istanbul, Turkey
| | - Faruk Erdem Kombak
- Marmara University Faculty of Medicine, Department of Pathology, Istanbul, Turkey
| | - Deniz Filinte
- Marmara University Faculty of Medicine, Department of Pathology, Istanbul, Turkey
| | - Isil Barlan
- Marmara University Faculty of Medicine, Division of Pediatric Allergy and Immunology, Istanbul, Turkey
| | - Tunc Akkoc
- Marmara University Faculty of Medicine, Division of Pediatric Allergy and Immunology, Istanbul, Turkey.
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Induced pluripotent stem cells without c-Myc reduce airway responsiveness and allergic reaction in sensitized mice. Transplantation 2014; 96:958-65. [PMID: 23989473 DOI: 10.1097/tp.0b013e3182a53ef7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Allergic disorders have increased substantially in recent years. Asthma is characterized by airway damage and remodeling. Reprogramming induced pluripotent stem cells (iPSCs) from adult somatic cells transfected by Oct-4/Sox-2/Klf-4, but not c-Myc, has shown the potential of embryonic-like cells. These cells have potential for multilineage differentiation and provide a resource for stem cell-based utility. However, the therapeutic potential of iPSCs without c-Myc (iPSC-w/o-c-Myc) in allergic diseases and airway hyperresponsiveness has not been investigated. The aim of this study was to evaluate the therapeutic effect of iPSC-w/o-c-Myc transplantation in a murine asthma model. METHODS BALB/c mice were sensitized with alum-adsorbed ovalbumin (OVA) and then challenged with aerosolized OVA. Phosphate-buffered saline or iPSC-w/o-c-Myc was then intravenously injected after inhalation. Serum allergen-specific antibody levels, airway hyperresponsiveness, cytokine levels in spleen cells and bronchoalveolar lavage fluid (BALF), and cellular distribution in BALF were then examined. RESULTS Treatment with iPSC-w/o-c-Myc effectively suppressed both Th1 and Th2 antibody responses, which was characterized by reduction in serum allergen-specific IgE, IgG, IgG1, and IgG2a levels as well as in interleukin-5 and interferon-γ levels in BALF and in OVA-incubated splenocytes. Meanwhile, regulatory cytokine, interleukin-10, was enhanced. Transplantation of iPSC-w/o-c-Myc also significantly attenuated cellular infiltration in BALF and allergic airway hyperresponsiveness. However, no tumor formation was observed 6 months after transplantation. CONCLUSIONS Administration of iPSC-w/o-c-Myc not only inhibited Th1 inflammatory responses but also had therapeutic effects on systemic allergic responses and airway hyperresponsiveness. iPSC-w/o-c-Myc transplantation may be a potential modality for treating allergic reactions and bronchial asthma.
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Zhang Y, Zhang L. Prevalence of allergic rhinitis in china. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2013; 6:105-13. [PMID: 24587945 PMCID: PMC3936037 DOI: 10.4168/aair.2014.6.2.105] [Citation(s) in RCA: 144] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Revised: 07/19/2013] [Accepted: 08/09/2013] [Indexed: 01/11/2023]
Abstract
Allergic rhinitis (AR) is a serious systemic allergic disease, which together with comorbid asthma causes major illness and disability worldwide. Recent epidemiological studies have revealed wide variations in the increasing prevalence of AR and allergies globally, including in China. Despite a markedly higher population than western countries, and a landmass close to Europe in area, little epidemiological data is available on AR in China. Thus, the present study reviewed the prevalence, comorbid allergic diseases, trends and pattern of sensitizing allergens in adults and children suffering from AR in China. Available data indicated that despite variations in the prevalence of AR in different regions of the country, the prevalence of AR has increased in both adults and children over the last 2 decades. Similarly, there has been an increase in a "western"-type lifestyle, industrialization and air pollution over this period, which may have contributed to the increased prevalence of AR observed in China.
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Affiliation(s)
- Yuan Zhang
- Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, PR China. ; Key Laboratory of Otolaryngology, Head and Neck Surgery (Ministry of Education of China), Beijing Institute of Otorhinolaryngology, Beijing 100005, PR China
| | - Luo Zhang
- Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, PR China. ; Key Laboratory of Otolaryngology, Head and Neck Surgery (Ministry of Education of China), Beijing Institute of Otorhinolaryngology, Beijing 100005, PR China
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Kim KH, Jahan SA, Kabir E. A review on human health perspective of air pollution with respect to allergies and asthma. ENVIRONMENT INTERNATIONAL 2013; 59:41-52. [PMID: 23770580 DOI: 10.1016/j.envint.2013.05.007] [Citation(s) in RCA: 186] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 05/10/2013] [Accepted: 05/11/2013] [Indexed: 05/27/2023]
Abstract
The increase in cases of asthma and allergies has become an important health issue throughout the globe. Although these ailments were not common diseases a few short decades ago, they are now affecting a large part of the population in many regions. Exposure to environmental (both outdoor and indoor) pollutants may partially account for the prevalence of such diseases. In this review, we provide a multidisciplinary review based on the most up-to-date survey of literature regarding various types of airborne pollutants and their associations with asthma-allergies. The major pollutants in this respect include both chemical (nitrogen dioxide, ozone, sulfur dioxide, particulate matter, and volatile organic compounds) and biophysical parameters (dust mites, pet allergens, and mold). The analysis was extended further to describe the development of these afflictions in the human body and the subsequent impact on health. This publication is organized to offer an overview on the current state of research regarding the significance of air pollution and its linkage with allergy and asthma.
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Affiliation(s)
- Ki-Hyun Kim
- Department of Environment & Energy, Sejong University, Seoul 143-747, Republic of Korea.
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Nurmatov U, Tagieva N, Semple S, Devereux G, Sheikh A. Volatile organic compounds and risk of asthma and allergy: a systematic review and meta-analysis of observational and interventional studies. PRIMARY CARE RESPIRATORY JOURNAL : JOURNAL OF THE GENERAL PRACTICE AIRWAYS GROUP 2013; 22:PS9-15. [PMID: 23460017 PMCID: PMC6442751 DOI: 10.4104/pcrj.2013.00010] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/14/2012] [Accepted: 11/30/2012] [Indexed: 11/23/2022]
Affiliation(s)
- Ulugbek Nurmatov
- Allergy and Respiratory Research Group, Centre for Population Health Sciences, The University of Edinburgh, Medical School, Edinburgh, UK.
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Baldaçara RPDC, Fernandes MDFM, Baldaçara L, Aun WT, de Mello JF, Pires MC. Prevalence of allergen sensitization, most important allergens and factors associated with atopy in children. SAO PAULO MED J 2013; 131:301-8. [PMID: 24310798 PMCID: PMC10876323 DOI: 10.1590/1516-3180.2013.1315502] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Accepted: 12/26/2012] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE Knowledge of the profile of allergen sensitization among children is important for planning preventive measures. The objective of this study was to assess the prevalence and profile of sensitization to inhaled allergens and food among children and adolescents in an outpatient population in the city of Palmas. DESIGN AND SETTING Cross-sectional study at outpatient clinics in Palmas, Tocantins, Brazil. METHODS Ninety-four patients aged 1-15 years who were attending two pediatric outpatient clinics were selected between September and November 2008. All of the subjects underwent clinical interviews and skin prick tests. RESULTS A positive skin prick test was observed in 76.6% of the participants (72.3% for inhalants and 28.9% for food allergens). The most frequent allergens were Dermatophagoides pteronyssinus (34%), cat epithelium (28.7%), dog epithelium (21.3%), Dermatophagoides farinae (19.1%), Blomia tropicalis (18.1%), cow's milk (9.6%) and grasses (9.6%). A positive skin prick test correlated with a history of atopic disease (odds ratio, OR = 5.833; P = 0.002), a family history of atopic disease (OR = 8.400; P < 0.001), maternal asthma (OR = 8.077; P = 0.048), pet exposure (OR = 3.600; P = 0.012) and cesarean delivery (OR = 3.367; P = 0.019). CONCLUSION Dermatophagoides pteronyssinus was the most frequent aeroallergen and cow's milk was the most prevalent food allergen. There was a positive correlation between a positive skin prick test and several factors, such as a family history of atopic disease, maternal asthma, pet exposure and cesarean delivery.
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Affiliation(s)
| | - Maria de Fátima Marcelos Fernandes
- MD, MSc. Head of the Diagnostic and Therapeutic Division, Department of Allergy and Immunology, Hospital do Servidor Público Estadual de São Paulo (HSPE), São Paulo, Brazil.
| | - Leonardo Baldaçara
- MD, PhD. Associate Professor in the Department of Medicine, Universidade Federal do Tocantins (UFT), Palmas, Tocantins, Brazil.
| | - Wilson Tartuce Aun
- MD. Head of the Immunology Section, Department of Allergy and Immunology, Hospital do Servidor Público Estadual de São Paulo (HSPE), São Paulo, Brazil.
| | - João Ferreira de Mello
- MD, PhD. Director of the Department of Allergy and Immunology, Hospital do Servidor Público Estadual de São Paulo (HSPE), São Paulo, Brazil.
| | - Mario Cesar Pires
- MD, PhD. Head of the Diagnostic and Therapeutic Division, Department of Dermatology, Hospital do Servidor Público Estadual de São Paulo (HSPE), São Paulo, Brazil.
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Hong S, Son DK, Lim WR, Kim SH, Kim H, Yum HY, Kwon H. The prevalence of atopic dermatitis, asthma, and allergic rhinitis and the comorbidity of allergic diseases in children. ENVIRONMENTAL HEALTH AND TOXICOLOGY 2012; 27:e2012006. [PMID: 22359737 PMCID: PMC3282234 DOI: 10.5620/eht.2012.27.e2012006] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2011] [Accepted: 11/17/2011] [Indexed: 05/25/2023]
Abstract
OBJECTIVES Childhood allergic diseases are a major concern because they lead to a heavy economic burden and poor quality of life. The purpose of this study was to investigate the prevalence of childhood atopic dermatitis, asthma, allergic rhinitis, and the comorbidity of allergic diseases in Seoul, Korea. METHODS We conducted a cross-sectional survey between May and October 2010 to evaluate the prevalence of childhood allergic diseases, including atopic dermatitis, asthma, and allergic rhinitis, using a questionnaire from the International Study of Asthma and Allergies in Childhood group. Each questionnaire was completed by the parent or guardian of a child. RESULTS In the 31,201 children studied, the prevalence of atopic dermatitis symptoms in the past 12 months was 19.3% in children 0 to 3 years of age, 19.7% in children 4 to 6 years of age, 16.7% in children 7 to 9 years of age, and 14.5% in children 10 to 13 years of age (p for trend < 0.001). The prevalence of asthma in these age groups was 16.5%, 9.8%, 6.5%, and 5.4%, respectively (p for trend < 0.001). The prevalence of allergic rhinitis in these age groups was 28.5%, 38.0%, 38.5%, and 35.9%, respectively (p for trend = 0.043). The percentage of subjects with both atopic dermatitis and asthma, both asthma and allergic rhinitis, or both atopic dermatitis and allergic rhinitis was 2.5%, 4.7%, and 8.7%, respectively. The prevalence of comorbid allergic diseases decreased with age (p for trend < 0.001). CONCLUSIONS Our study revealed that the prevalence of some allergic diseases, such as atopic dermatitis and asthma, was relatively high in very young children and that all of the principal allergic diseases in children often co-exist.
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Affiliation(s)
- Soyoung Hong
- Atopy Research Institute, Seoul Medical Center, Seoul, Korea
| | - Dong Koog Son
- Atopy Research Institute, Seoul Medical Center, Seoul, Korea
| | - Wan Ryung Lim
- Atopy Research Institute, Seoul Medical Center, Seoul, Korea
| | - Sun Hang Kim
- Atopy Asthma Center, Seoul Medical Center, Seoul, Korea
| | - Hyunjung Kim
- Atopy Research Institute, Seoul Medical Center, Seoul, Korea
- Atopy Asthma Center, Seoul Medical Center, Seoul, Korea
- Department of Dermatology, Seoul Medical Center, Seoul, Korea
| | - Hye Yung Yum
- Atopy Asthma Center, Seoul Medical Center, Seoul, Korea
| | - Hojang Kwon
- Atopy Research Institute, Seoul Medical Center, Seoul, Korea
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Korea
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Abstract
PURPOSE OF REVIEW This review focuses on comorbidities between nose and skin allergies. For this purpose, allergic rhinitis and chronic rhinosinusitis (CRS) were selected as examples of nasal disorders and atopic dermatitis and urticaria as examples of allergic skin disorders and the individual entities of both localizations were evaluated and compared in relation to their prevalence and coincidence, underlying pathophysiological mechanisms, genetic data and shared therapy options. RECENT FINDINGS The inter-relationships between atopic dermatitis and allergic rhinitis are the best studied, but even for the other comorbidities it was possible to demonstrate comparable pathomechanisms in addition to a high prevalence and coincidence, particularly in the case of atopically assisted forms. In this context, the interactions of IgE, mast cells and eosinophils play a special role, but genetic issues, the significance of epithelial barrier defects and colonization with Staphylococcus aureus are also important sharing issues. SUMMARY Allergic skin disorders such as atopic dermatitis and urticaria are frequently associated with comorbidities of the nose as well as allergic rhinitis and CRS. By contrast, different manifestations of these diseases involve the nose and the skin. These are not separate diseases but are linked by complex and currently unclear/insufficiently defined inter-relationships.
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Affiliation(s)
- Heidi Olze
- Department of Otorhinolaryngology, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany.
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Scala E, Alessandri C, Palazzo P, Pomponi D, Liso M, Bernardi ML, Ferrara R, Zennaro D, Santoro M, Rasi C, Mari A. IgE recognition patterns of profilin, PR-10, and tropomyosin panallergens tested in 3,113 allergic patients by allergen microarray-based technology. PLoS One 2011; 6:e24912. [PMID: 21949785 PMCID: PMC3174236 DOI: 10.1371/journal.pone.0024912] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2011] [Accepted: 08/22/2011] [Indexed: 01/01/2023] Open
Abstract
Background IgE recognition of panallergens having highly conserved sequence regions, structure, and function and shared by inhalant and food allergen sources is often observed. Methods We evaluated the IgE recognition profile of profilins (Bet v 2, Cyn d 12, Hel a 2, Hev b 8, Mer a 1, Ole e 2, Par j 3, Phl p 12, Pho d 2), PR-10 proteins (Aln g 1, Api g 1, Bet v 1.0101, Bet v 1.0401, Cor a 1, Dau c 1 and Mal d 1.0108) and tropomyosins (Ani s 3, Der p 10, Hel as 1, Pen i 1, Pen m 1, Per a 7) using the Immuno-Solid phase Allergen Chip (ISAC) microarray system. The three panallergen groups were well represented among the allergenic molecules immobilized on the ISAC. Moreover, they are distributed in several taxonomical allergenic sources, either close or distant, and have a route of exposure being either inhalation or ingestion. Results 3,113 individuals (49.9% female) were selected on the basis of their reactivity to profilins, PR-10 or tropomyosins. 1,521 (48.8%) patients were reactive to profilins (77.6% Mer a 1 IgE+), 1,420 (45.6%) to PR-10 (92.5% Bet v 1 IgE+) and 632 (20.3%) to tropomyosins (68% Der p 10 IgE+). A significant direct relationship between different representative molecules within each group of panallergens was found. 2,688 patients (86.4%) recognized only one out of the three distinct groups of molecules as confirmed also by hierarchical clustering analysis. Conclusions Unless exposed to most of the allergens in the same or related allergenic sources, a preferential IgE response to distinct panallergens has been recorded. Allergen microarray IgE testing increases our knowledge of the IgE immune response and related epidemiological features within and between homologous molecules better describing the patients' immunological phenotypes.
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Affiliation(s)
- Enrico Scala
- Center for Molecular Allergology, IDI-IRCCS, Rome, Italy
| | | | - Paola Palazzo
- Center for Molecular Allergology, IDI-IRCCS, Rome, Italy
| | - Debora Pomponi
- Center for Molecular Allergology, IDI-IRCCS, Rome, Italy
| | - Marina Liso
- Center for Molecular Allergology, IDI-IRCCS, Rome, Italy
| | | | | | - Danila Zennaro
- Center for Molecular Allergology, IDI-IRCCS, Rome, Italy
| | - Mario Santoro
- Center for Molecular Allergology, IDI-IRCCS, Rome, Italy
| | - Chiara Rasi
- Center for Molecular Allergology, IDI-IRCCS, Rome, Italy
| | - Adriano Mari
- Center for Molecular Allergology, IDI-IRCCS, Rome, Italy
- * E-mail:
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Kalra D, Fernando B. Approaches to enhancing the validity of coded data in electronic medical records. PRIMARY CARE RESPIRATORY JOURNAL : JOURNAL OF THE GENERAL PRACTICE AIRWAYS GROUP 2011; 20:4-5. [PMID: 21060979 DOI: 10.4104/pcrj.2010.00078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Hammersley V, Flint R, Pinnock H, Sheikh A. Developing and testing search strategies to identify patients with active seasonal allergic rhinitis in general practice. PRIMARY CARE RESPIRATORY JOURNAL : JOURNAL OF THE GENERAL PRACTICE AIRWAYS GROUP 2011; 20:71-4. [PMID: 21190011 DOI: 10.4104/pcrj.2010.00086] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
AIM We sought to assess the accuracy of different search terms to identify individuals with active seasonal allergic rhinitis (SAR) in general practice. METHODS A reference search strategy was developed to identify patients with active SAR. This was applied through inspection of electronic health records of patients aged 15-45 years in a 10% random sample of a general practice database. Searches used Read codes and medication relating to SAR. Sensitivity, specificity, and positive and negative predictive values were calculated. RESULTS Using the reference search strategy, 54/1092 (4.9%) of 15-45 year-old patients had current SAR. Searching for drugs used in nasal allergy had the highest sensitivity (85%) and good specificity (86%). Searching for a recorded history of SAR (H170) in the last two years was more specific (100%) but this approach only had limited sensitivity (17%). CONCLUSIONS Electronic searches can be used to identify patients with current SAR, but the accuracy varies widely. Larger numbers of sufferers can be identified using broader search parameters, but with increasing numbers of false positives. In contrast, more focused search strategies give a smaller yield needing less cleaning of data to identify true positives, but there is an associated increase in the number of false negatives.
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Affiliation(s)
- Vicky Hammersley
- Allergy and Respiratory Research Group, Centre for Population Health Sciences: GP Section, The University of Edinburgh, Edinburgh, Scotland, United Kingdom.
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DunnGalvin A, Daly D, Cullinane C, Stenke E, Keeton D, Erlewyn-Lajeunesse M, Roberts GC, Lucas J, Hourihane JO. Highly accurate prediction of food challenge outcome using routinely available clinical data. J Allergy Clin Immunol 2011; 127:633-9.e1-3. [PMID: 21377032 DOI: 10.1016/j.jaci.2010.12.004] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2010] [Revised: 11/26/2010] [Accepted: 12/02/2010] [Indexed: 10/18/2022]
Abstract
BACKGROUND Serum specific IgE or skin prick tests are less useful at levels below accepted decision points. OBJECTIVES We sought to develop and validate a model to predict food challenge outcome by using routinely collected data in a diverse sample of children considered suitable for food challenge. METHODS The proto-algorithm was generated by using a limited data set from 1 service (phase 1). We retrospectively applied, evaluated, and modified the initial model by using an extended data set in another center (phase 2). Finally, we prospectively validated the model in a blind study in a further group of children undergoing food challenge for peanut, milk, or egg in the second center (phase 3). Allergen-specific models were developed for peanut, egg, and milk. RESULTS Phase 1 (N = 429) identified 5 clinical factors associated with diagnosis of food allergy by food challenge. In phase 2 (N = 289), we examined the predictive ability of 6 clinical factors: skin prick test, serum specific IgE, total IgE minus serum specific IgE, symptoms, sex, and age. In phase 3 (N = 70), 97% of cases were accurately predicted as positive and 94% as negative. Our model showed an advantage in clinical prediction compared with serum specific IgE only, skin prick test only, and serum specific IgE and skin prick test (92% accuracy vs 57%, and 81%, respectively). CONCLUSION Our findings have implications for the improved delivery of food allergy-related health care, enhanced food allergy-related quality of life, and economized use of health service resources by decreasing the number of food challenges performed.
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Affiliation(s)
- Audrey DunnGalvin
- Paediatrics and Child Health, University College Cork, Cork, Ireland.
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Campbell KL, Cohn JR, Fischman DL, Walinsky P, Mallya R, Jaffrani W, Savage MP. Management of clopidogrel hypersensitivity without drug interruption. Am J Cardiol 2011; 107:812-6. [PMID: 21247516 DOI: 10.1016/j.amjcard.2010.11.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2010] [Revised: 11/03/2010] [Accepted: 11/03/2010] [Indexed: 11/27/2022]
Abstract
Clopidogrel hypersensitivity affects up to 6% of treated patients, often leading to discontinuation of the drug. Conventional desensitization protocols incorporate a washout period off medication that may be problematic after percutaneous coronary intervention because premature discontinuation of dual antiplatelet therapy is a major risk factor for stent thrombosis. The purpose of this study was to evaluate a strategy for treating clopidogrel hypersensitivity without drug interruption using corticosteroids and antihistamines to facilitate development of physiologic tolerance. The study population consisted of 25 consecutive patients who developed clopidogrel hypersensitivity after percutaneous coronary intervention and were managed with suppressive therapy using corticosteroids and antihistamines. Treatment success (resolution of hypersensitivity symptoms without interrupting clopidogrel) was assessed, in addition to duration of clopidogrel therapy and adverse cardiac events during late follow-up (mean 670 ± 630 days). The cohort included 19 men and 6 women with a mean age of 62 ± 9 years. Drug-eluting stents were used in 16 patients (64%). Clopidogrel hypersensitivity occurred 6 ± 2 days after drug initiation. Treatment included corticosteroids (5 patients), antihistamines (5 patients), or corticosteroids and antihistamines (15 patients). Patients treated with corticosteroids received tapering courses for a mean of 10 ± 8 days. Treatment was successful with sustained symptom resolution in 22 of 25 patients (88%). Clopidogrel therapy was continued in successfully desensitized patients for 417 ± 369 days and in patients with drug-eluting stents for 529 ± 376 days. There were no deaths, myocardial infarctions, or stent thrombosis during extended follow-up. In conclusion, clopidogrel hypersensitivity can be successfully treated using short-course corticosteroids and antihistamines without interrupting drug therapy. This technique enables long-term continuation of clopidogrel and confers a low risk of adverse cardiac events.
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Kotz D, Simpson CR, Sheikh A. Incidence, prevalence, and trends of general practitioner-recorded diagnosis of peanut allergy in England, 2001 to 2005. J Allergy Clin Immunol 2011; 127:623-30.e1. [PMID: 21236479 DOI: 10.1016/j.jaci.2010.11.021] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2010] [Revised: 09/20/2010] [Accepted: 11/05/2010] [Indexed: 11/25/2022]
Abstract
BACKGROUND Previous descriptions of the epidemiology of peanut allergy have mainly been derived from small cross-sectional studies. OBJECTIVE To interrogate a large national research database to provide estimates for the incidence, prevalence, and trends of general practitioner (GP)-recorded diagnosis of peanut allergy in the English population. METHODS Version 10 of the QRESEARCH database was used with data from 2,958,366 patients who were registered with 422 United Kingdom general practices in the years 2001 to 2005. The primary outcome was a recording of clinician-diagnosed peanut allergy. RESULTS The age-sex standardized incidence rate of peanut allergy in 2005 was 0.08 per 1000 person-years (95% CI, 0.07-0.08), and the prevalence rate was 0.51 per 1000 patients (95% CI, 0.49-0.54). This translated into an estimated 4000 incident cases (95% CI, 3500-4600) and 25,700 prevalent cases (95% CI, 24,400-27,100) of GP-recorded diagnosis of peanut allergy in England in 2005. During the study period, the incidence rate of peanut allergy remained fairly stable, whereas the prevalence rate doubled. In those under 18 years of age, the crude lifetime prevalence rate was higher in males than females. A significant inverse relationship between prevalence and socioeconomic status was found. CONCLUSION These data on GP-recorded diagnosis of peanut allergy from a large general practice database suggest a much lower prevalence in peanut allergy than has hitherto been found. This difference may in part be explained by underrecording of peanut allergy in general practice. Further research is needed to assess the true frequency of peanut allergy in the population and whether there has been a true increase in recent years.
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Affiliation(s)
- Daniel Kotz
- Department of General Practice, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Center, Maastricht, The Netherlands
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Worth A, Nurmatov U, Sheikh A. Key components of anaphylaxis management plans: consensus findings from a national electronic Delphi study. JRSM SHORT REPORTS 2010; 1:42. [PMID: 21103134 PMCID: PMC2984371 DOI: 10.1258/shorts.2010.010060] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objectives There is no international consensus on the components of anaphylaxis management plans and responsibility for their design and delivery is contested. We set out to establish consensus among relevant specialist and generalist clinicians on this issue to inform future randomized controlled trials. Design A two-round electronic Delphi study completed by a 25-person, multidisciplinary expert panel. Participants scored the importance of a range of statements on anaphylaxis management, identified from a systematic review of the literature, on a five-point scale ranging from ‘very important’ to ‘irrelevant’. Consensus was defined a priori as being achieved if 80% or more of panel members rated a statement as ‘important’ or ‘very important’ after Round 2. Setting Primary and secondary care and academic settings in the UK and Ireland. Participants Twenty-five medical, nursing and allied health professionals. Main outcome measures Consensus on the key components of anaphylaxis management plans. Results The response rate was 84% (n = 21) for Round 1 and 96% (n = 24) for Round 2. The key components of emergency care on which consensus was achieved included: awareness of trigger factors (100%); recognition and emergency management of reactions of different severity (100%); and clear information on adrenaline (epinephrine) use (100%). Consensus on longer-term management issues included: clear written guidelines on anaphylaxis management (96%); annual review of plans (87%); and plans that were tailored to individual needs (82%). Conclusions This national consensus-building exercise generated widespread agreement that emergency plans need to be simple, clear and generic, making them easy to implement in a crisis. In contrast, long-term plans need to be negotiated between patient/carers and professionals, and tailored to individual needs. The effectiveness of this expert-agreed long-term plan now needs to be evaluated rigorously.
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Affiliation(s)
- Allison Worth
- Allergy & Respiratory Research Group, Centre for Population Health Sciences: General Practice Section, The University of Edinburgh, Medical School , Teviot Place, Edinburgh EH8 9AG , UK
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Burton C, Irshad T, Sheikh A. Understanding the experiences of allergy testing: a qualitative study of people with perceived serious allergic disorders. Postgrad Med J 2010; 86:591-6. [PMID: 20702434 DOI: 10.1136/pgmj.2009.092395] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
PURPOSE To investigate the experience of patients with perceived severe allergic disorders in obtaining allergen testing. DESIGN In-depth interviews with 20 purposively sampled adults and parents of children with, or at perceived risk of, serious allergic problems. Data were analysed thematically, drawing on Frank's classification of narratives to help interpret patient/career accounts. RESULTS Accounts fell into four main groups: (i) children with anaphylaxis occurring 'out of the blue' (ii) children in whom the recognition of severe allergy by professionals was perceived as delayed; (iii) adults with anaphylaxis who adapted; and (iv) adults who remained in search of an answer. Whereas children had eventually been assessed and tested in a specialist clinic, adults had difficulty in obtaining testing, and most-including those for whom current guidelines would recommend testing-had not been tested. Participants incorporated their past experience of testing into narrative accounts, which included current ways of dealing with their allergy. They saw testing as only one component of appropriate allergy management which required interpretive expertise in professionals who ordered tests. Despite the limitations in NHS allergy testing provision, there was relatively little interest among patients/carers in using complementary and alternative providers of allergy testing. CONCLUSIONS Patients perceived major shortfalls in relation to NHS allergy testing provision, focusing on both the availability of testing and expertise in interpreting the results. Any increased provision of testing needs to be matched by access to specialist interpretation of these tests.
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Affiliation(s)
- Christopher Burton
- Allergy & Respiratory Research Group, School of Community Health Sciences: General Practice Section, University of Edinburgh, Edinburgh EH8 9DX, UK.
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Abstract
PURPOSE OF REVIEW To review recent developments on the inter-relationship between food allergy and atopic eczema, with a particular focus on understanding the role of filaggrin gene defects. RECENT FINDINGS Filaggrin gene defects have recently been identified as a major risk factor for the development of atopic eczema. These skin barrier defects increase the risk of early onset, severe and persistent forms of atopic eczema. They also increase the risk of allergic sensitization, and asthma and allergic rhinitis in those with co-existent eczema. These skin barrier defects are also likely to increase the risk of food allergy. SUMMARY Atopic dermatitis and food allergy are frequently herald conditions for other manifestations of 'the allergic march'. They commonly co-exist, particularly in those with early onset, severe and persistent atopic eczema. Filaggrin gene defects substantially increase the risk of atopic eczema. The increased skin permeability may increase the risk of sensitization to food and other allergens, this pointing to the possible role of cutaneous allergen avoidance in early life to prevent the onset of atopic eczema and food allergy. Emerging evidence also indicates that oral exposure to potentially allergenic foods may be important for inducing immunological tolerance.
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Yilmaz AS, Nocon CC, Corey JP. Immunoglobulin E-mediated food allergies among adults with allergic rhinitis. Otolaryngol Head Neck Surg 2010; 143:379-85. [DOI: 10.1016/j.otohns.2010.04.271] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2010] [Revised: 04/15/2010] [Accepted: 04/29/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE: To compare the prevalence of food allergy for peanut, shrimp, and milk in adults with allergic rhinitis and to determine predictive values of these allergens and total immunoglobulin E (IgE) to detect food allergies. STUDY DESIGN: Cross-sectional study. SETTING: University of Chicago Medical Center, Chicago, Illinois. SUBJECTS AND METHODS: We retrospectively analyzed in vitro enzyme-linked immunosorbent assays of adults with rhinitis. Subjects were tested for nine inhalants and three foods (peanut, shrimp, milk) and total IgE. Subjects with food allergy history were tested with additional foods. The sensitivity (SE), specificity (SP), positive predictive value (PPV), and negative predictive value (NPV) of the allergens and total IgE to detect food allergies were calculated. RESULTS: A total of 283 subjects received in vitro tests. Fortyone percent tested negative and 59 percent tested positive for inhalants. The prevalence of subjects with a positive peanut or shrimp allergy in the inhalant-positive population was significantly greater than subjects with milk allergy (23.4% peanut [ P = 0.008], 22.2% shrimp [ P = 0.001], and 13.2% milk [ P = 0.008], P = 0.001). For subjects with food allergy history, peanut had the best SP (100.0%), SE (28.1%), PPV (100.0%), and NPV (64.6%) in detecting allergies to other foods. In patients positive for the initial panel (inhalants and peanut), the SP, SE, PPV, and NPV of elevated total IgE was 71.4, 72.4, 77.8, and 65.2 percent, respectively. CONCLUSION: Peanut and shrimp were the most common foods encountered in adults with allergic rhinitis. Peanut was best in predicting other food allergies. Total IgE levels with inhalants plus peanut provided the optimal combination of SE, SP, PPV, and NPV. In vitro testing may be important to identify and prevent anaphylaxis to foods in adults. © 2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.
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Affiliation(s)
- Asli Sahin Yilmaz
- From the Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Chicago, Chicago, IL
| | - Cheryl C. Nocon
- From the Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Chicago, Chicago, IL
| | - Jacquelynne P. Corey
- From the Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Chicago, Chicago, IL
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Sheikh A, Hurwitz B, Nurmatov U, van Schayck CP. House dust mite avoidance measures for perennial allergic rhinitis. Cochrane Database Syst Rev 2010; 2010:CD001563. [PMID: 20614426 PMCID: PMC7061254 DOI: 10.1002/14651858.cd001563.pub3] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND This is an update of a Cochrane Review first published in The Cochrane Library in Issue 4, 2001 and previously updated in 2003 and 2007.It is estimated that in developed countries approximately 30% of the general population suffer from one or more allergic disorders, of which allergic rhinitis is particularly common. Perennial rhinitis is most often due to allergy to the house dust mite. In such patients house dust mite avoidance is logical, but there is considerable uncertainty regarding the efficacy and effectiveness of interventions designed to reduce dust mite exposure. OBJECTIVES To assess the benefit (and harm) of measures designed to reduce house dust mite exposure in the management of house dust mite sensitive allergic rhinitis. SEARCH STRATEGY Our search included the Cochrane Ear, Nose and Throat Disorders Group Trials Register, the Cochrane Central Register of Controlled Trials Register (CENTRAL) (The Cochrane Library Issue 4, 2009), MEDLINE and EMBASE. The date of the last search was 31 December 2009. SELECTION CRITERIA Randomised controlled trials, with or without blinding, in which house dust mite control measures have been evaluated in comparison with placebo or other dust mite avoidance measures, in patients with clinician-diagnosed allergic rhinitis and confirmed allergy to dust mite. DATA COLLECTION AND ANALYSIS Two authors independently screened titles and abstracts, graded methodological quality using the Cochrane approach and extracted data. Meta-analysis was neither possible nor appropriate due to heterogeneity of the patient groups studied. MAIN RESULTS Nine trials involving 501 participants satisfied the inclusion criteria. Only two studies investigating the effectiveness of mite impermeable bedding covers were of good quality; the remaining seven studies were small and of poor quality. Two trials investigated the efficacy of acaricides, another two trials investigated the role of high-efficiency particulate air (HEPA) filters. One trial, using a factorial design, investigated the efficacy of both acaricide and house dust mite impermeable bedding covers in isolation and combination; the remaining four trials investigated the efficacy of bedroom environmental control programmes involving use of house dust mite impermeable bedding covers. Seven of the nine trials reported that, when compared with control, the interventions studied resulted in significant reductions in house dust mite load. Of the interventions studied to date, acaricides appear to be the most promising type of intervention, although the findings from these studies need to be interpreted with care because of their methodological limitations. House dust mite impermeable bedding as an isolated intervention is unlikely to offer clinical benefit. No serious adverse effects were reported from any of the interventions. AUTHORS' CONCLUSIONS Trials to date have on the whole been small and of poor methodological quality, making it difficult to offer any definitive recommendations on the role, if any, of house dust mite avoidance measures in the management of house dust mite sensitive perennial allergic rhinitis. The results of these studies suggest that use of acaricides and extensive bedroom-based environmental control programmes may be of some benefit in reducing rhinitis symptoms and, if considered appropriate, these should be the interventions of choice. Isolated use of house dust mite impermeable bedding is unlikely to prove effective.
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Affiliation(s)
- Aziz Sheikh
- The University of EdinburghCentre for Population Health SciencesMedical SchoolDoorway 3, Teviot PlaceEdinburghUKEH8 9AG
| | - Brian Hurwitz
- King's College LondonDepartment of EnglishStrandLondonUKWC2R 2LS
| | - Ulugbek Nurmatov
- Centre for Population Health Sciences: GP Section, The University of EdinburghAllergy & Respiratory Research Group20 West Richmond StreetEdinburghUKEH8 9DX
| | - Constant Paul van Schayck
- Care and Public Health Research Institute (CAPHRI)Department of General PracticeMaastricht University Medical CenterP Debyeplein 1, PO Box 616MaastrichtNetherlands6200 MD
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Simpson CR, Hippisley-Cox J, Sheikh A. Trends in the epidemiology of chronic obstructive pulmonary disease in England: a national study of 51 804 patients. Br J Gen Pract 2010; 60:277-84. [PMID: 20594429 PMCID: PMC2894402 DOI: 10.3399/bjgp10x514729] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2009] [Revised: 12/09/2009] [Accepted: 01/07/2010] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Patients with chronic obstructive pulmonary disease (COPD) constitute a substantial burden to healthcare services. Analysis of national healthcare datasets offers the possibility to advance understanding about the changing epidemiology of COPD. AIM To investigate the epidemiology of physician-diagnosed COPD in general practice. DESIGN OF STUDY Cross-sectional study. SETTINGS A total of 422 general practices in England contributing to the QRESEARCH database. METHOD Data were extracted on 2.8 million patients, including age, sex, socioeconomic status, and geographical area. Trends over time for recorded physician diagnosis of COPD were analysed (2001-2005). RESULTS There was little change over time in the incidence rate of COPD (2005: 2.0 per 1000 patient-years, 95% confidence interval [CI] = 2.0 to 2.1), but a significant increase in lifetime prevalence rate (2001: 13.5 per 1000 patients [95% CI = 13.4 to 13.7]; 2005: 16.8 [95% CI = 16.7 to 17.0]; P<0.001). In 2005, 51 804 individuals or one in 59 people in England were recorded with physician-diagnosed COPD. The most deprived people (31.1 per 1000 patients; 95% CI = 30.6 to 31.7) and those living in the north east of England (29.2 per 1000 patients; 95% CI = 28.4 to 30.1) had the highest prevalence. The observed reduction in the rate of smoking by patients with COPD (overall decrease: 2.5%; P<0.001) varied according to socioeconomic group (most affluent: 6.5% decrease, most deprived: 1.3% decrease). CONCLUSION Given the peak in the incidence rate of COPD, we may be approaching the summit of COPD incidence and prevalence in England. However, the number of people affected remains high and poses a major challenge for health services, particularly those in the north east of the country and in the most deprived communities in England. The very limited decrease in smoking rates among the more deprived groups of patients with COPD is also a cause for concern.
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Affiliation(s)
- Colin R Simpson
- Allergy and Respiratory Research Group, Centre for Population Health Sciences, University of Edinburgh, Medical School (Doorway 3), Teviot Place, Edinburgh.
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