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Bürgler A, Luyten A, Glick S, Kwiatkowski M, Gehrig R, Beigi M, Hartmann K, Eeftens M. Association between short-term pollen exposure and blood pressure in adults: A repeated-measures study. ENVIRONMENTAL RESEARCH 2024; 256:119224. [PMID: 38797464 DOI: 10.1016/j.envres.2024.119224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 05/16/2024] [Accepted: 05/23/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Recent studies have related high pollen concentrations to increased cardiovascular morbidity and mortality, yet very little research concerns pre-clinical cardiovascular health, including effects on blood pressure (BP). The EPOCHAL panel study investigated the exposure-response relationship between ambient pollen exposure and systolic and diastolic BP in adults. METHODS BP was measured in 302 adults with and in 94 without pollen allergy during the pollen season, on approximately 16 days per person (6253 observations). Average individually-relevant pollen exposure in the 96 h prior to each BP measurement was calculated by summing up the averages of all ambient pollen concentrations to which the individual was found to be sensitized in a skin prick test, and which originated from seven highly allergenic pollen types (hazel, alder, birch, ash, grasses, mugwort and ragweed). Generalized additive mixed models were used to study the association between mean individually-relevant pollen exposure in the last 96 h and BP, adjusting for individual and environmental time-varying covariates. Effect modification by pollen allergy status, sex and BMI was evaluated. RESULTS Positive non-linear associations between individually-relevant pollen exposure and both systolic and diastolic BP were found in the allergic but not in the non-allergic group. BP increased sharply for exposures from zero to 60/80 pollen/m3 (diastolic/systolic BP), followed by a tempered further increase at higher concentrations. Increases of 2.00 mmHg [95% confidence interval (CI): 0.80-3.19] in systolic and 1.51 mmHg [95% CI: 0.58-2.45] in diastolic BP were associated with 96-h average pollen exposure of 400 pollen/m3, compared to no exposure. Obesity and female sex were associated with larger BP increases. CONCLUSIONS The finding that short-term pollen concentration is associated with increased systolic and diastolic BP in persons with pollen allergy strengthens the evidence that pollen may cause systemic health effects and trigger cardiovascular events.
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Affiliation(s)
- Alexandra Bürgler
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Axel Luyten
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Sarah Glick
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Marek Kwiatkowski
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Regula Gehrig
- Federal Office of Meteorology and Climatology MeteoSwiss, Switzerland
| | - Minaya Beigi
- Division of Allergy, Department of Dermatology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Karin Hartmann
- Division of Allergy, Department of Dermatology, University Hospital Basel and University of Basel, Basel, Switzerland; Department of Biomedicine, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Marloes Eeftens
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland.
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Wang S, Qi L, Wei H, Jiang F, Yan A. Smoking behavior might affect allergic rhinitis and vasomotor rhinitis differently: A mendelian randomization appraisal. World Allergy Organ J 2022; 15:100630. [PMID: 35228855 PMCID: PMC8844647 DOI: 10.1016/j.waojou.2022.100630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 01/10/2022] [Accepted: 01/18/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Allergic rhinitis and vasomotor rhinitis are harassing numerous patients and their risk factors have not been well investigated. Here, we try to identify their risk factors and distinguish these 2 diseases. METHODS A two-sample Mendelian randomization (MR) study was implemented to discover the risk factors of allergic and vasomotor rhinitis. Based on previous studies, we selected 15 potential risk factors and the genome-wide summary statistics were extracted from the non-FinnGen consortium. The genome-wide summary statistics of rhinitis were obtained from the FinnGen consortium. Both univariable MR and multivariable MR analyses were performed to identify the causal risk factors. The Cochrane's Q value was calculated to appraise the heterogeneity. MR-Egger intercept and MR-RPESSO were utilized to appraise the pleiotropy. RESULTS In the univariable model, the number of cigarettes per day can decrease the risk of allergic rhinitis (IVW OR = 0.29[0.18, 0.47], p-value = 2.70 × 10-7) while increasing the risk of vasomotor rhinitis (IVW OR = 1.30[1.04, 1.62], p-value = 0.022). Besides, no other risk factors could affect the risk of either allergic or vasomotor rhinitis. After adjusting for age of smoking initiation and alcohol intake, the cigarettes per day could still decrease the risk of allergic rhinitis (IVW OR = 4.66 × 10-3 [1.99 × 10-4, 0.11], p-value = 0.003) while not affecting the risk of vasomotor rhinitis (IVW OR = 0.92[0.44, 1.96], p-value = 0.834). CONCLUSION Smoking can affect the risk of allergic and vasomotor rhinitis differently where it decreases the risk of allergic rhinitis and increases the risk of vasomotor rhinitis.
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Affiliation(s)
- Sai Wang
- Department of Otorhinolaryngology, The First Hospital of China Medical University, China
| | - Li Qi
- Department of Otorhinolaryngology, The First Hospital of China Medical University, China
| | - Hongquan Wei
- Department of Otorhinolaryngology, The First Hospital of China Medical University, China
| | - Feifei Jiang
- Department of Otorhinolaryngology, The First Hospital of China Medical University, China
| | - Aihui Yan
- Department of Otorhinolaryngology, The First Hospital of China Medical University, China
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Bürgler A, Glick S, Hartmann K, Eeftens M. Rationale and Design of a Panel Study Investigating Six Health Effects of Airborne Pollen: The EPOCHAL Study. Front Public Health 2021; 9:689248. [PMID: 34222186 PMCID: PMC8249754 DOI: 10.3389/fpubh.2021.689248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 05/20/2021] [Indexed: 11/16/2022] Open
Abstract
Background: While airborne pollen is widely recognized as a seasonal cause of sneezing and itchy eyes, its effects on pulmonary function, cardiovascular health, sleep quality, and cognitive performance are less well-established. It is likely that the public health impact of pollen may increase in the future due to a higher population prevalence of pollen sensitization as well as earlier, longer, and more intense pollen seasons, trends attributed to climate change. The effects of pollen on health outcomes have previously been studied through cross-sectional design or at two time points, namely preceding and within the period of pollen exposure. We are not aware of any observational study in adults that has analyzed the dose-response relationship between daily ambient pollen concentration and cardiovascular, pulmonary, cognitive, sleep, or quality of life outcomes. Many studies have relied on self-reported pollen allergy status rather than objectively confirming pollen sensitization. In addition, many studies lacked statistical power due to small sample sizes or were highly restrictive with their inclusion criteria, making the findings less transferable to the "real world." Methods: The EPOCHAL study is an observational panel study which aims to relate ambient pollen concentration to six specific health domains: (1) pulmonary function and inflammation; (2) cardiovascular outcomes (blood pressure and heart rate variability); (3) cognitive performance; (4) sleep; (5) health-related quality of life (HRQoL); and (6) allergic rhinitis symptom severity. Our goal is to enroll 400 individuals with diverse allergen sensitization profiles. The six health domains will be assessed while ambient exposure to pollen of different plants naturally varies. Health data will be collected through six home nurse visits (at approximately weekly intervals) as well as 10 days of independent tracking of blood pressure, sleep, cognitive performance, HRQoL, and symptom severity by participants. Through repeated health assessments, we aim to uncover and characterize dose-response relationships between exposure to different species of pollen and numerous acute health effects, considering (non-)linearity, thresholds, plateaus and slopes. Conclusion: A gain of knowledge in pollen-health outcome relationships is critical to inform future public health policies and will ultimately lead toward better symptom forecasts and improved personalized prevention and treatment.
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Affiliation(s)
- Alexandra Bürgler
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Sarah Glick
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Karin Hartmann
- Division of Allergy, Department of Dermatology, University Hospital Basel, University of Basel, Basel, Switzerland
- Department of Biomedicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Marloes Eeftens
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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Vonderheid EC, Hamilton RG, Kadin ME. Mycosis Fungoides and Its Relationship to Atopy, Serum Total IgE, and Eosinophil Counts. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2020; 21:279-288.e7. [PMID: 33342729 DOI: 10.1016/j.clml.2020.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 11/03/2020] [Accepted: 11/07/2020] [Indexed: 01/18/2023]
Abstract
INTRODUCTION A recent serologic study and reports of increased serum total IgE (IgE-t) and eosinophil counts have suggested that the prevalence of atopy is more common in patients with mycosis fungoides (MF) than previously recognized. PATIENTS AND METHODS Patients with clinicopathologic features that were diagnostic and/or consistent with MF and/or the presence or absence of an atopic disorder (eg, allergic rhinitis, asthma, eczematous dermatitis), which was determined by patient history, eosinophil counts, and serum IgE-t obtained at evaluation, were selected from a patient registry. The MF population was divided into those with atypical and typical clinical presentations. We performed matching of controls using age, sex, and race from the 2005 to 2006 National Health Education Survey. RESULTS A history of allergic rhinitis was recorded for 186 of 728 patients (25.5%) with typical MF and 71 of 229 patients (31%) with atypical MF. However, the prevalence of asthma and eczema was low. The IgE-t and eosinophil counts were higher for patients with typical MF than for controls and for patients with atopic diathesis than for patients without atopy. The IgE-t and eosinophil counts were higher for the patients with advanced-stage MF compared with those for the patients with less-advanced disease for both atopic and nonatopic cohorts. In the Cox model with age and clinical stage as covariates, a history of atopy, increased IgE-t, and blood eosinophilia (> 500 cells/mm3) did not correlate with overall survival. CONCLUSION The findings from the present study did not reveal a significant association of atopy in patients with MF. However, atopy is a factor in the increased IgE-t and eosinophil counts observed in MF. Another factor is related to the disease stage, including possibly the influence of cytokines secreted by T-helper type 2-polarized neoplastic cells.
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Affiliation(s)
- Eric C Vonderheid
- Sydney Kimmel Cancer Center, Johns Hopkins Medical Institutions, Tucson, AZ
| | - Robert G Hamilton
- Asthma and Allergy Center, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Marshall E Kadin
- Department of Dermatology, Boston University and Roger Williams Medical Center; Department of Pathology and Laboratory Medicine, Brown University Alpert Medical School, Providence RI.
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Yao A, Wilson JA, Ball SL. Autonomic nervous system dysfunction and sinonasal symptoms. ALLERGY & RHINOLOGY 2018; 9:2152656718764233. [PMID: 29977656 PMCID: PMC6028164 DOI: 10.1177/2152656718764233] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background The autonomic nervous system (ANS) richly innervates the nose and paranasal sinuses, and has a significant role in lower airway diseases, e.g., asthma. Nonetheless, its contribution to sinonasal symptoms is poorly understood. This review aimed to explore the complex relationship between the ANS and sinonasal symptoms, with reference to systemic diseases and triggers of ANS dysfunction. Methods A review of articles published in English was conducted by searching medical literature databases with the key words “autonomic nervous system” and (“sinusitis” or “nose” or “otolaryngology”). All identified abstracts were reviewed, and, from these, relevant published whole articles were selected. Results The ANS has a significant role in the pathophysiologic mechanisms that produce sinonasal symptoms. There was limited evidence that describes the relationship of the ANS in sinonasal disease with systemic conditions, e.g. hypertension. There was some evidence to support mechanisms related to physical and psychological stressors in this relationship. Conclusion The role of ANS dysfunction in sinonasal disease is highly complex. The ANS sits within a web of multiple factors, including personality and psychological distress, that contribute to sinonasal symptoms. Further research will help to clarify the etiology of ANS dysfunction and its contribution to common systemic conditions.
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Affiliation(s)
- Alexander Yao
- ENT Department, Stepping Hill National Health Service (NHS) Foundation Trust, Stockport, United Kingdom
| | - Janet A Wilson
- ENT Department, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom
| | - Stephen L Ball
- Institute of Health and Society, Newcastle University, Newcastle Upon Tyne, United Kingdom No external funding sources reported
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Association Between Hay Fever and High Myopia in United States Adolescents and Adults. Eye Contact Lens 2017; 43:186-191. [PMID: 26974535 DOI: 10.1097/icl.0000000000000251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To investigate the relationship between hay fever and refractive error in a representative sample of adolescents and adults in the United States. METHODS This cross-sectional study included 5,744 participants aged ≥12 years from the 2005 to 2006 National Health and Nutrition Examination Survey who participated in the allergy questionnaire, completed objective refraction and keratometry in both eyes, and had immunoglobulin E (IgE) serology. The primary predictor variable, refractive error, was classified as emmetropia (-0.99 to +0.99 diopters [D]), low myopia (-1.00 to -2.99 D), moderate myopia (-3.00 to -5.99 D), high myopia (≥-6.00 D), or hyperopia (≥1.00 D). Covariates included age, gender, race, asthma, eczema, total serum IgE ≥120 kU/L, corneal steepness, and corneal astigmatism. The primary outcome was hay fever. RESULTS The study population's mean age was 41.7 years; 48.8% of subjects were men and 51.2% were women. The prevalence of hay fever was 12.1% overall. High myopes had 2.7 times higher odds of hay fever compared to emmetropes (OR 2.67, CI, 1.57-4.51, P=0.001), which was independent of demographics, atopic conditions, IgE serology, and keratometry measurements. CONCLUSIONS The association between hay fever and high myopia identified in this large cross-sectional study remains speculative and was not mediated through corneal steepness or corneal astigmatism. Further prospective studies may help elucidate the directionality of the association between hay fever and high myopia.
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Shunsheng Han C. A specific hygiene hypothesis. Med Hypotheses 2016; 93:146-9. [PMID: 27372876 DOI: 10.1016/j.mehy.2016.05.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 05/24/2016] [Indexed: 10/21/2022]
Abstract
Allergic diseases have reached epidemic proportions in Western populations in the last several decades. The hygiene hypothesis proposed more than twenty years ago has helped us to understand the epidemic and has been verified with numerous studies. However, translational measures deduced from these studies to prevent allergic diseases have not proven effective. Recent studies on immigrants' allergies and any potential association between oral infection and allergic diseases prompt me to propose a specific hygiene hypothesis to explain how oral hygiene practices might have contributed to the uprising of hay fever, the most common allergic disease. The historic oral hygiene level in US is closely associated with the emerging allergic epidemic. Future studies to test the hypothesis are needed and verification of the hypothesis can potentially yield highly effective measures to prevent allergic diseases.
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Affiliation(s)
- Cliff Shunsheng Han
- Los Alamos National Laboratory, Bioscience Division and Quality Performance Assurance Division, MS, M888, Los Alamos, NM 87545, USA
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Magen E, Mishal J, Vardy D. Selective IgE deficiency and cardiovascular diseases. Allergy Asthma Proc 2015; 36:225-9. [PMID: 25976439 DOI: 10.2500/aap.2015.36.3825] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Selective immunoglobulin E (IgE) deficiency (IgED) is defined as serum levels of IgE more than or equal to 2 kIU/L and is associated with immune dysregulation and autoimmunity. This study aimed to investigate a prevalence of atherosclerotic cardiovascular disease (ASCVD) in population with IgED. Within the electronic patient record (EPR) database of Leumit Health Care Services (LHS) in Israel, data capture was performed using IBM Cognos 10.1.1 BI Report Studio software. The case samples were drawn from the full study population (n = 18,487), having any allergy-related symptoms and/or those requesting antiallergy medications and performed serum total IgE measurement during 2012 at LHS. All subjects aged more than or equal to 40 years old, with serum total IgE less than 2 kIU/L were included in case group. Control group was randomly sampled from the remained subjects, with a case-control ratio of 10 controls for each case (1:10). The comorbid cardiovascular diseases during less than or equal to 10 years before serum total IgE testing were identified and retrieved using specific International Classification of Diseases, 9th Revision, Clinical Modification diagnostic codes. There were 103 in case and 1030 subjects in control group. Compared with control group patients, the case group had significantly more arterial hypertension [34 (37.7%) versus 187 (18.2%), p < 0.001], ischemic heart disease (IHD) [26 (25.2%) versus 87 (8.4%), p < 0.001], carotid stenosis [5 (4.9%) versus 7 (0.7%), p = 0.003], cerebrovascular disease (CVD) [3 (2.9%) versus 5 (0.5%), p = 0.029], and peripheral vascular disease (PVD) [4 (3.9%) versus 9 (0.9%), p = 0.024]. IgED is associated with higher prevalence of arterial hypertension and ASCVD.
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Affiliation(s)
- Eli Magen
- Leumit Health Services, Barzilai Medical Center, Ben-Gurion University of Negev, Ashkelon, Israel
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Juhn YJ. Risks for infection in patients with asthma (or other atopic conditions): is asthma more than a chronic airway disease? J Allergy Clin Immunol 2014; 134:247-57; quiz 258-9. [PMID: 25087224 PMCID: PMC4122981 DOI: 10.1016/j.jaci.2014.04.024] [Citation(s) in RCA: 106] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 04/22/2014] [Accepted: 04/22/2014] [Indexed: 12/16/2022]
Abstract
Most of the research effort regarding asthma has been devoted to its causes, therapy, and prognosis. There is also evidence that the presence of asthma can influence patients' susceptibility to infections, yet research in this aspect of asthma has been limited. There is additional debate in this field, with current literature tending to view the increased risk of infection among atopic patients as caused by opportunistic infections secondary to airway inflammation, especially in patients with severe atopic diseases. However, other evidence suggests that such risk and its underlying immune dysfunction might be a phenotypic or clinical feature of atopic conditions. This review argues (1) that improved understanding of the effects of asthma or other atopic conditions on the risk of microbial infections will bring important and new perspectives to clinical practice, research, and public health concerning atopic conditions and (2) that research efforts into the causes and effects of asthma must be juxtaposed because they are likely to guide each other.
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MESH Headings
- Asthma/complications
- Asthma/immunology
- Asthma/pathology
- Bacterial Infections/complications
- Bacterial Infections/immunology
- Bacterial Infections/pathology
- Chronic Disease
- Dermatitis, Atopic/complications
- Dermatitis, Atopic/immunology
- Dermatitis, Atopic/pathology
- Disease Susceptibility
- Humans
- Immunity, Innate
- Mycoses/complications
- Mycoses/immunology
- Mycoses/pathology
- Rhinitis, Allergic, Perennial/complications
- Rhinitis, Allergic, Perennial/immunology
- Rhinitis, Allergic, Perennial/pathology
- Rhinitis, Allergic, Seasonal/complications
- Rhinitis, Allergic, Seasonal/immunology
- Rhinitis, Allergic, Seasonal/pathology
- Risk Factors
- Virus Diseases/complications
- Virus Diseases/immunology
- Virus Diseases/pathology
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Affiliation(s)
- Young J Juhn
- Department of Pediatric and Adolescent Medicine/Internal Medicine/Health Sciences Research, Mayo Clinic, Rochester, Minn.
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