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The American Journal of Clinical... Mar 2019During the Pregnancy and Birth to 24 Months Project, the USDA and Department of Health and Human Services initiated a review of evidence on diet and health in these...
BACKGROUND
During the Pregnancy and Birth to 24 Months Project, the USDA and Department of Health and Human Services initiated a review of evidence on diet and health in these populations.
OBJECTIVES
The aim of these systematic reviews was to examine the relation of 1) never versus ever feeding human milk, 2) shorter versus longer durations of any human milk feeding, 3) shorter versus longer durations of exclusive human milk feeding prior to infant formula introduction, 4) feeding a lower versus higher intensity of human milk to mixed-fed infants, and 5) feeding a higher intensity of human milk by bottle versus breast with food allergies, allergic rhinitis, atopic dermatitis, and asthma.
METHODS
The Nutrition Evidence Systematic Review team conducted systematic reviews with external experts. We searched CINAHL, Cochrane, Embase, and PubMed for articles published between January 1980 and March 2016, dual-screened the results according to predetermined criteria, extracted data from and assessed the risk of bias for each included study, qualitatively synthesized the evidence, developed conclusion statements, and graded the strength of the evidence.
RESULTS
The systematic reviews numbered 1-5 above included 44, 35, 1, 0, and 0 articles, respectively. Moderate, mostly observational, evidence suggests that 1) never versus ever being fed human milk is associated with higher risk of childhood asthma, and 2) among children and adolescents who were fed human milk as infants, shorter versus longer durations of any human milk feeding are associated with higher risk of asthma. Limited evidence does not suggest associations between 1) never versus ever being fed human milk and atopic dermatitis in childhood or 2) the duration of any human milk feeding and allergic rhinitis and atopic dermatitis in childhood.
CONCLUSIONS
Moderate evidence suggests that feeding human milk for short durations or not at all is associated with higher childhood asthma risk. Evidence on food allergies, allergic rhinitis, and atopic dermatitis is limited.
Topics: Adolescent; Asthma; Breast Feeding; Child; Dermatitis, Atopic; Diet; Feeding Behavior; Food Hypersensitivity; Humans; Infant; Infant Formula; Infant Nutritional Physiological Phenomena; Infant, Newborn; Milk, Human; Rhinitis, Allergic
PubMed: 30982870
DOI: 10.1093/ajcn/nqy283 -
Primary Care Sep 2016Among the atopic disorders, allergic rhinitis is the most prevalent. Patients who suffer from allergic rhinitis sustain significant morbidity and loss of productivity.... (Review)
Review
Among the atopic disorders, allergic rhinitis is the most prevalent. Patients who suffer from allergic rhinitis sustain significant morbidity and loss of productivity. Cardinal symptoms include nasal congestion, rhinorrhea, sneezing, and nasal itching, although multiple related symptoms may occur. Causes should be ruled out with a thorough history and physical examination, with particular attention to red flag or atypical symptoms. Skin testing or serum sampling can confirm diagnosis and also guide therapy. Therapy is multimodal, tailored to a particular patient's symptom burden and quality of life.
Topics: Administration, Inhalation; Adrenal Cortex Hormones; Desensitization, Immunologic; Diagnosis, Differential; Histamine Antagonists; Humans; Immunoglobulin E; Leukotriene Antagonists; Prevalence; Primary Health Care; Rhinitis, Allergic; Rhinitis, Allergic, Seasonal; Skin Tests
PubMed: 27545735
DOI: 10.1016/j.pop.2016.04.009 -
Clinical and Experimental Allergy :... Jul 2017This is an updated guideline for the diagnosis and management of allergic and non-allergic rhinitis, first published in 2007. It was produced by the Standards of Care...
This is an updated guideline for the diagnosis and management of allergic and non-allergic rhinitis, first published in 2007. It was produced by the Standards of Care Committee of the British Society of Allergy and Clinical Immunology, using accredited methods. Allergic rhinitis is common and affects 10-15% of children and 26% of adults in the UK, it affects quality of life, school and work attendance, and is a risk factor for development of asthma. Allergic rhinitis is diagnosed by history and examination, supported by specific allergy tests. Topical nasal corticosteroids are the treatment of choice for moderate to severe disease. Combination therapy with intranasal corticosteroid plus intranasal antihistamine is more effective than either alone and provides second line treatment for those with rhinitis poorly controlled on monotherapy. Immunotherapy is highly effective when the specific allergen is the responsible driver for the symptoms. Treatment of rhinitis is associated with benefits for asthma. Non-allergic rhinitis also is a risk factor for the development of asthma and may be eosinophilic and steroid-responsive or neurogenic and non- inflammatory. Non-allergic rhinitis may be a presenting complaint for systemic disorders such as granulomatous or eosinophilic polyangiitis, and sarcoidoisis. Infective rhinitis can be caused by viruses, and less commonly by bacteria, fungi and protozoa.
Topics: Disease Management; Humans; Rhinitis; Rhinitis, Allergic
PubMed: 30239057
DOI: 10.1111/cea.12953 -
The Journal of Allergy and Clinical... Aug 2023Allergic rhinitis (AR) is associated with significant clinical and socioeconomic burdens. It is a frequent risk factor for other atopic diseases, such as asthma. Thus, a... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Allergic rhinitis (AR) is associated with significant clinical and socioeconomic burdens. It is a frequent risk factor for other atopic diseases, such as asthma. Thus, a comprehensive updated description of the epidemiology of AR in the pediatric population is needed to understand its implications better.
OBJECTIVE
To determine the incidence, prevalence, and epidemiology of AR among children over the past 10 years.
METHODS
We conducted a systematic review and meta-analysis using a protocol registered and published with the International Prospective Register of Systematic Reviews (Register No. CRD42022332667). We searched databases, registers, and Web sites for cohort or cross-sectional studies published between 2012 and 2022, evaluating the epidemiology (incidence or prevalence) of AR in the pediatric population. We assessed study quality of and risk for bias using items derived from the Strengthening the Reporting of Observational Studies in Epidemiology statement.
RESULTS
Twenty-two studies were included in the analysis. The overall prevalence of physician-diagnosed AR was 10.48%, the overall prevalence of self-reported current (past 12 months) AR was 18.12%, and the overall prevalence of self-reported lifetime AR was 19.93%. The incidence could not be determined. The analysis of prevalence of AR over time showed a rising trend in physician-diagnosed AR over the years (8.39% in 2012 to 2015 vs 19.87% in 2016 to 2022).
CONCLUSIONS
Allergic rhinitis has significant impacts on the pediatric population, with an increasing trend for diagnosed AR over the years. Further investigations concerning the incidence, comorbidities, diagnosis, and treatment are needed to provide a complete overview of the disease as well as its burden and management.
Topics: Humans; Child; Cross-Sectional Studies; Rhinitis, Allergic; Asthma; Comorbidity; Risk Factors; Prevalence
PubMed: 37236349
DOI: 10.1016/j.jaip.2023.05.016 -
Acta Bio-medica : Atenei Parmensis Sep 2020Allergic rhinitis (AR) is induced by an IgE-mediated immune reaction after allergen exposure. The typical symptoms are itching, nasal discharge, sneezing and nasal...
Allergic rhinitis (AR) is induced by an IgE-mediated immune reaction after allergen exposure. The typical symptoms are itching, nasal discharge, sneezing and nasal obstruction. The diagnosis is based on the concordance between allergic symptoms and diagnostic tests. The skin prick test (SPT) is recommended as the "gold standard" method. First generation H1-antihistamines are widely used for treatment of AR. Intranasal glucocorticosteroids are well tolerated and can be used also in paediatric age. Allergic rhinitis cannot be considered as an isolated pathology. Other atopic diseases (allergic conjunctivitis, atopic eczema, asthma) are commonly associated.
Topics: Asthma; Child; Conjunctivitis, Allergic; Humans; Rhinitis, Allergic; Skin Tests
PubMed: 33004777
DOI: 10.23750/abm.v91i11-S.10310 -
Asian Pacific Journal of Allergy and... Dec 2020Asthma and allergic rhinitis (AR) are chronic inflammatory diseases of airway and affect the disease severity each other. (Clinical Trial)
Clinical Trial Randomized Controlled Trial
BACKGROUND
Asthma and allergic rhinitis (AR) are chronic inflammatory diseases of airway and affect the disease severity each other.
OBJECTIVE
We performed this study to examine whether nasal saline irrigation (NSI) improves bronchial hyperresponsiveness and clinical parameters in children with asthma and allergic rhinitis (AR).
METHODS
We enrolled 20 children with AR and asthma aged between 6-18 years. Patients were randomized into two groups: irrigation group (8 boys and 2 girls) and control group (8 boys and 2 girls). The irrigation group performed daily NSI. All patients received 12-week treatment with montelukast, levocetirizine, and inhaled glucocorticoids. Provocative concentrations of methacholine causing a 20% decrease in FEV1 (PC20), Asthma Control Test (ACT), the Questionnaire for Quality-of-Life Specific to Allergic Rhinitis in Korean Children (QQOL-ARK) and exhaled nitric oxide (FENO) were compared before and after the study.
RESULTS
The PC20 at week 12 was higher than baseline measurements in the irrigation group (P = 0.017), while there was no difference in PC20 before and after treatment in the control group (P = 0.333). ACT score increased after 12 weeks of NSI (P = 0.007), while QQOL-ARK score decreased compared to baseline scores (P = 0.028) in the irrigation group. No differences in ACT and QQOL-ARK were found between weeks 0 and 12 in the control group. No differences were found in the median value of changes in PC20, ACT, QQOL-ARK and FENO between the irrigation and control groups.
CONCLUSIONS
Our results suggest that NSI is beneficial for treatment of asthma and AR in children.
Topics: Adolescent; Allergens; Asthma; Biomarkers; Child; Disease Susceptibility; Female; Humans; Immunization; Male; Nasal Lavage; Quality of Life; Respiratory Function Tests; Rhinitis, Allergic; Saline Solution; Treatment Outcome
PubMed: 31012599
DOI: 10.12932/AP-070918-0403 -
Laryngo- Rhino- Otologie Jan 2018Allergic rhinitis (AR) affects ca. 20% of the population. Approximately one third of patients affected by AR are suffering from perennial rhinitis due to mite allergy....
Allergic rhinitis (AR) affects ca. 20% of the population. Approximately one third of patients affected by AR are suffering from perennial rhinitis due to mite allergy. Perennial rhinitis is the form of the disease that is most frequently associated with other allergy-related comorbidities such as asthma and atopic dermatitis, sleep disorders, chronic sinusitis, eustachian tube dysfunction and others.The often non-specific symptoms and the insidious course may lead to misinterpretations in diagnosing the disease.Therapeutic options include allergen avoidance with regard to environmental measures, encasings and personal actions. Drug therapy in mite-AR consists mainly in the administration of mast cell stabilizers, H1-antihistamines, glucocorticosteroids (GCS), leukotriene receptor antagonists and decongestants. It is particularly important to ensure a good antiinflammatory activity. Thus, a combination of H1-antihistamine and topical nasal GCS seems to be a rational approach. The only causal treatment form besides allergen avoidance is allergen-specific immunotherapy 1.
Topics: Asthma; Chronic Disease; Comorbidity; Humans; Rhinitis, Allergic; Sinusitis
PubMed: 29301162
DOI: 10.1055/s-0043-121086 -
Current Allergy and Asthma Reports May 2020Local allergic rhinitis (LAR) represents a diagnostic and therapeutic challenge for clinicians. Even though it affects a considerable number of chronic rhinitis patients... (Review)
Review
PURPOSE OF REVIEW
Local allergic rhinitis (LAR) represents a diagnostic and therapeutic challenge for clinicians. Even though it affects a considerable number of chronic rhinitis patients and a significant number of articles regarding prevalence, evolution, diagnosis, and treatment have been published, the condition remains still largely unrecognized and therefore misdiagnosed and mistreated.
RECENT FINDINGS
LAR is a unique form of chronic rhinitis; it is neither classical allergic rhinitis (AR) nor non-allergic rhinitis (NAR). The symptoms, duration, severity, and complications of LAR are similar to those of AR and can affect adults and children. Thus, a portion of patients diagnosed with NAR or chronic rhinitis of unknown etiology may have LAR. The relationship between LAR inflammation and systemic allergic inflammation is unclear. Patients are frequently misdiagnosed with idiopathic NAR, and distinguishing between both entities is difficult without specific diagnostic tests. Underdiagnosis of LAR has implications on the management of these patients, as they are deprived of allergen immunotherapy (AIT) that has been demonstrated to modulate the immune mechanisms underlying allergic diseases. This review aims to comprehensively summarize the current knowledge on LAR and address unmet needs in the areas of disease diagnosis and treatment.
Topics: Adult; Humans; Rhinitis, Allergic
PubMed: 32430616
DOI: 10.1007/s11882-020-00925-5 -
American Journal of Respiratory and... Feb 2024Previous studies investigating the impact of comorbidities on the effectiveness of biologic agents have been relatively small and of short duration and have not...
Previous studies investigating the impact of comorbidities on the effectiveness of biologic agents have been relatively small and of short duration and have not compared classes of biologic agents. To determine the association between type 2-related comorbidities and biologic agent effectiveness in adults with severe asthma (SA). This cohort study used International Severe Asthma Registry data from 21 countries (2017-2022) to quantify changes in four outcomes before and after biologic therapy-annual asthma exacerbation rate, FEV% predicted, asthma control, and long-term oral corticosteroid daily dose-in patients with or without allergic rhinitis, chronic rhinosinusitis (CRS) with or without nasal polyps (NPs), NPs, or eczema/atopic dermatitis. Of 1,765 patients, 1,257, 421, and 87 initiated anti-IL-5/5 receptor, anti-IgE, and anti-IL-4/13 therapies, respectively. In general, pre- versus post-biologic therapy improvements were noted in all four asthma outcomes assessed, irrespective of comorbidity status. However, patients with comorbid CRS with or without NPs experienced 23% fewer exacerbations per year (95% CI, 10-35%; < 0.001) and had 59% higher odds of better post-biologic therapy asthma control (95% CI, 26-102%; < 0.001) than those without CRS with or without NPs. Similar estimates were noted for those with comorbid NPs: 22% fewer exacerbations and 56% higher odds of better post-biologic therapy control. Patients with SA and CRS with or without NPs had an additional FEV% predicted improvement of 3.2% (95% CI, 1.0-5.3; = 0.004), a trend that was also noted in those with comorbid NPs. The presence of allergic rhinitis or atopic dermatitis was not associated with post-biologic therapy effect for any outcome assessed. These findings highlight the importance of systematic comorbidity evaluation. The presence of CRS with or without NPs or NPs alone may be considered a predictor of the effectiveness of biologic agents in patients with SA.
Topics: Adult; Humans; Rhinitis; Cohort Studies; Asthma; Comorbidity; Chronic Disease; Sinusitis; Biological Products; Rhinitis, Allergic; Nasal Polyps
PubMed: 38016003
DOI: 10.1164/rccm.202305-0808OC -
Expert Review of Clinical Pharmacology 2023Allergic rhinitis (AR) is a widespread disease that can be associated with other conditions, including conjunctivitis, rhinosinusitis, asthma, food allergy, and atopic... (Review)
Review
INTRODUCTION
Allergic rhinitis (AR) is a widespread disease that can be associated with other conditions, including conjunctivitis, rhinosinusitis, asthma, food allergy, and atopic dermatitis. Diagnosis is based on the history and documentation of sensitization, such as the production of allergen-specific IgE, preferably using molecular diagnostics. Treatments are based on patient education, non-pharmacological and pharmacological remedies, allergen-specific immunotherapy (AIT), and surgery. Symptomatic treatments mainly concern intranasal/oral antihistamines and/or nasal corticosteroids.
AREAS COVERED
This review discusses current and emerging management strategies for AR, covering pharmacological and non-pharmacological remedies, AIT, and biologics in selected cases with associated severe asthma. However, AIT presently remains the unique causal treatment for AR.
EXPERT OPINION
The management of allergic rhinitis could include new strategies. In this regard, particular interest should be considered in the fixed association between intranasal antihistamines and corticosteroids, probiotics and other natural substances, and new formulations (tablets) of AIT.
Topics: Humans; Rhinitis, Allergic; Histamine Antagonists; Desensitization, Immunologic; Asthma; Adrenal Cortex Hormones; Allergens
PubMed: 37314373
DOI: 10.1080/17512433.2023.2225770