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Otolaryngologic Clinics of North America Apr 2024Allergic rhinitis (AR) is associated with increased sleep disturbances in adults and children. Pathogenesis is multifactorial, with nasal obstruction playing a large... (Review)
Review
Allergic rhinitis (AR) is associated with increased sleep disturbances in adults and children. Pathogenesis is multifactorial, with nasal obstruction playing a large role. Intranasal corticosteroids, antihistamines, leukotriene inhibitors, and allergen immunotherapy have been demonstrated to relieve self-reported symptoms of sleep impairment. Given the high prevalence of sleep impairment in AR, providers should consider evaluating any patient with AR for sleep disturbances and sleep-disordered breathing.
Topics: Child; Adult; Humans; Rhinitis, Allergic, Perennial; Rhinitis, Allergic; Sleep; Histamine Antagonists; Sleep Apnea Syndromes; Sleep Wake Disorders
PubMed: 37867109
DOI: 10.1016/j.otc.2023.09.003 -
PLoS Pathogens Sep 2023The worldwide prevalence of asthma and allergic disorders (allergic rhinitis, atopic dermatitis, food allergy) has been steadily rising in recent decades. It is now... (Review)
Review
The worldwide prevalence of asthma and allergic disorders (allergic rhinitis, atopic dermatitis, food allergy) has been steadily rising in recent decades. It is now estimated that up to 20% of the global population is afflicted by an allergic disease, with increasing incidence rates in both high- and low-income countries. The World Allergy Organization estimates that the total economic burden of asthma and allergic rhinitis alone is approximately $21 billion per year. While allergic stimuli are a complex and heterogenous class of inputs including parasites, pollens, food antigens, drugs, and metals, it has become clear that fungi are major drivers of allergic disease, with estimates that fungal sensitization occurs in 20-30% of atopic individuals and up to 80% of asthma patients. Fungi are eukaryotic microorganisms that can be found throughout the world in high abundance in both indoor and outdoor environments. Understanding how and why fungi act as triggers of allergic type 2 inflammation will be crucial for combating this important health problem. In recent years, there have been significant advances in our understanding of fungi-induced type 2 immunity, however there is still much we don't understand, including why fungi have a tendency to induce allergic reactions in the first place. Here, we will discuss how fungi trigger type 2 immune responses and posit why this response has been evolutionarily selected for induction during fungal encounter.
Topics: Humans; Inflammation; Rhinitis, Allergic; Asthma; Eukaryota
PubMed: 37703276
DOI: 10.1371/journal.ppat.1011623 -
Cells Dec 2022Periostin, identified as a matricellular protein and an ECM protein, plays a central role in non-neoplastic diseases. Periostin and its variants have been considered to... (Review)
Review
Periostin, identified as a matricellular protein and an ECM protein, plays a central role in non-neoplastic diseases. Periostin and its variants have been considered to be normally involved in the progression of most non-neoplastic diseases, including brain injury, ocular diseases, chronic rhinosinusitis, allergic rhinitis, dental diseases, atopic dermatitis, scleroderma, eosinophilic esophagitis, asthma, cardiovascular diseases, lung diseases, liver diseases, chronic kidney diseases, inflammatory bowel disease, and osteoarthrosis. Periostin interacts with protein receptors and transduces signals primarily through the PI3K/Akt and FAK two channels as well as other pathways to elicit tissue remodeling, fibrosis, inflammation, wound healing, repair, angiogenesis, tissue regeneration, bone formation, barrier, and vascular calcification. This review comprehensively integrates the multiple roles of periostin and its variants in non-neoplastic diseases, proposes the utility of periostin as a biological biomarker, and provides potential drug-developing strategies for targeting periostin.
Topics: Humans; Asthma; Dermatitis, Atopic; Inflammation; Phosphatidylinositol 3-Kinases; Rhinitis, Allergic
PubMed: 36611844
DOI: 10.3390/cells12010050 -
American Family Physician May 2023Allergic rhinitis, the fifth most common chronic disease in the United States, is an immunoglobulin E-mediated process. A family history of allergic rhinitis, asthma, or...
Allergic rhinitis, the fifth most common chronic disease in the United States, is an immunoglobulin E-mediated process. A family history of allergic rhinitis, asthma, or atopic dermatitis increases a patient's risk of being diagnosed with allergic rhinitis. People in the United States are commonly sensitized to grass, dust mites, and ragweed allergens. Dust mite-proof mattress covers do not prevent allergic rhinitis in children two years and younger. Diagnosis is clinical and based on history, physical examination, and at least one symptom of nasal congestion, runny or itchy nose, or sneezing. History should include whether the symptoms are seasonal or perennial, symptom triggers, and severity. Common examination findings are clear rhinorrhea, pale nasal mucosa, swollen nasal turbinates, watery eye discharge, conjunctival swelling, and allergic shiners (i.e., dark circles under the eyes). Serum or skin testing for specific allergens should be performed when there is inadequate response to empiric treatment, if diagnosis is uncertain, or to guide initiation or titration of therapy. Intranasal corticosteroids are first-line treatment for allergic rhinitis. Second-line therapies include antihistamines and leukotriene receptor antagonists and neither shows superiority. If allergy testing is performed, trigger-directed immunotherapy can be effectively delivered subcutaneously or sublingually. High-efficiency particulate air (HEPA) filters are not effective at decreasing allergy symptoms. Approximately 1 in 10 patients with allergic rhinitis will develop asthma.
Topics: Child; Humans; Rhinitis, Allergic; Histamine Antagonists; Asthma; Allergens; Dermatitis, Atopic
PubMed: 37192071
DOI: No ID Found -
Primary Care Sep 2021Allergy is a broad topic encompassing common clinical allergic diseases, asthma, and complex immunodeficiencies. In this article, the authors discuss the most common... (Review)
Review
Allergy is a broad topic encompassing common clinical allergic diseases, asthma, and complex immunodeficiencies. In this article, the authors discuss the most common allergic diseases and anaphylaxis and briefly review the current knowledge and management of food allergies, allergic rhinitis, otitis media, sinusitis, chronic cough, atopic dermatitis, urticarial and angioedema, contact dermatitis, allergic ophthalmopathy, drug allergy, latex allergy, and insect sting. Because the prevalence of allergic disorders continues to increase, it is increasingly important for physicians to stay up to date on most recent evidence-based diagnosis and management of allergic disorders.
Topics: Anaphylaxis; Asthma; Child; Dermatitis, Atopic; Food Hypersensitivity; Humans; Rhinitis, Allergic
PubMed: 34311855
DOI: 10.1016/j.pop.2021.04.006 -
The Journal of Allergy and Clinical... Jun 2024Chronic allergic and nonallergic rhinitis are common phenotypes of a highly prevalent disorder of the upper airways, often associated with asthma. Clinical data,... (Review)
Review
Chronic allergic and nonallergic rhinitis are common phenotypes of a highly prevalent disorder of the upper airways, often associated with asthma. Clinical data, epidemiologic studies, and mHealth-based and genomic approaches indicate the existence of 2 distinct diseases: rhinitis alone and rhinitis + asthma, which may be allergic or less often nonallergic. Both disease phenotypes need to be further characterized, because allergic conjunctivitis, food allergy, and atopic dermatitis, often present in patients with allergic rhinitis, may be considered as independent multimorbidities. Thus, the concept "multimorbid allergic disease" is more appropriate than "one-airway-one-disease." In a meta-analysis, atopic dermatitis was strongly associated with allergic and nonallergic rhinitis, but not with rhinitis and asthma. Asthma alone may also be associated with non-type 2 mechanisms. The distinction between rhinitis alone and rhinitis and asthma was found in all the 12 countries studied using an mHealth app (MASK-air) in Europe and Latin America. These data indicate that the distinction between the 2 diseases is independent of allergen exposure..
Topics: Humans; Phenotype; Asthma; Rhinitis; Multimorbidity; Rhinitis, Allergic; Dermatitis, Atopic
PubMed: 38641129
DOI: 10.1016/j.jaip.2024.04.013 -
International Forum of Allergy &... Sep 2014Allergic rhinitis (AR) is the archetypal allergic disease otolaryngologists encounter. Epidemiologic studies inform providers of the association of rhinitis symptoms and... (Review)
Review
BACKGROUND
Allergic rhinitis (AR) is the archetypal allergic disease otolaryngologists encounter. Epidemiologic studies inform providers of the association of rhinitis symptoms and allergy test results in the broader population. Understanding the epidemiological characteristics of AR is important for interpreting both rhinitis symptoms and allergy tests.
METHODS
Articles were selected based on literature review through PubMed and personal knowledge of the author. The largest and highest-quality studies were included. The search selection was not standardized.
RESULTS
Epidemiological studies demonstrate marked variability globally in the prevalence of both rhinitis symptoms and allergy tests. Self-reported seasonal or perennial rhinitis symptoms significantly overestimate the prevalence of AR defined by a positive history and positive allergy tests. Positive allergy tests are also common in those without self-reported rhinitis symptoms.
CONCLUSION
Interpreting rhinitis symptoms and allergy testing is enhanced by an understanding of the epidemiology of AR.
Topics: Cost of Illness; Humans; Immunologic Tests; Prevalence; Rhinitis, Allergic
PubMed: 25182349
DOI: 10.1002/alr.21385 -
Pediatric Allergy and Immunology :... Jul 2023Following the "hygiene hypothesis" and the increase in the prevalence of atopic diseases such as allergic rhinitis, a plethora of studies have investigated the role of... (Meta-Analysis)
Meta-Analysis Review
Following the "hygiene hypothesis" and the increase in the prevalence of atopic diseases such as allergic rhinitis, a plethora of studies have investigated the role of sibship composition as a protective factor, but findings are conflicting. The aim of this study was to synthesize the global literature linking birth order and sibship size (number of siblings) to the risk of allergic rhinitis. Fifteen databases were systematically searched, with no restrictions on publication date or language. Observational studies with defined sibship composition (birth order or sibship size) as exposure and allergic rhinitis or allergic rhinoconjunctivitis (self-reported or clinically diagnosed) as outcome were eligible. Study selection, data extraction, and quality assessment were performed independently in pairs. Relevant data were summarized in tables. Comparable numerical data were analyzed using meta-analysis with robust variance estimation (RVE). Seventy-six reports with >2 million subjects were identified. Being second- or later-born child was associated with protection against both current (pooled risk ratio [RR] 0.79, 95% CI 0.73-0.86) and ever (RR 0.77, 95% CI 0.68-0.88) allergic rhinitis. Having siblings, regardless of birth order, was associated with a decreased risk of current allergic rhinitis (RR 0.89, 95% CI 0.83-0.95) and allergic rhinoconjunctivitis (RR 0.92, 95% CI 0.86-0.98). These effects were unchanged across age, time period, and geographical regions. Our findings thus indicate that primarily, a higher birth order, and to a lesser extent the number of siblings, is associated with a lower risk of developing allergic rhinitis.
Topics: Child; Humans; Siblings; Rhinitis, Allergic; Conjunctivitis
PubMed: 37492922
DOI: 10.1111/pai.13991 -
Current Allergy and Asthma Reports Aug 2022Allergen immunotherapy (AIT) has been shown to be safe and effective in children and is a unique treatment strategy that has disease-modifying and preventative effects... (Review)
Review
PURPOSE OF REVIEW
Allergen immunotherapy (AIT) has been shown to be safe and effective in children and is a unique treatment strategy that has disease-modifying and preventative effects that are not shared with other treatment options for allergic diseases. This article reviews the present knowledge and relevant updates on AIT in children.
RECENT FINDINGS
Although there is no definite lower age limit for starting AIT, clear indications for AIT are established and each case should be considered individually by weighing risks and benefits. Documented short- and long-term benefits of AIT in children with allergic disease include significant improvement of symptoms and quality of life, and decreased use of medications as well as preventing the development of new allergen sensitizations and the progression of allergic rhinitis to asthma. This review provides a comprehensive overview of the present knowledge and key updates on AIT in the pediatric population.
Topics: Allergens; Asthma; Child; Child, Preschool; Desensitization, Immunologic; Humans; Quality of Life; Rhinitis, Allergic
PubMed: 35467180
DOI: 10.1007/s11882-022-01035-0 -
Current Allergy and Asthma Reports May 2020Local respiratory allergy (LRA) is an eosinophilic phenotype of chronic airway disease. Three entities have been described within the LRA spectrum: local allergic... (Review)
Review
PURPOSE OF REVIESW
Local respiratory allergy (LRA) is an eosinophilic phenotype of chronic airway disease. Three entities have been described within the LRA spectrum: local allergic rhinitis (LAR) and local allergic asthma (LAA) in non-atopic patients, and dual allergic rhinitis (DAR) in atopic patients (coexistence of LAR and allergic rhinitis). In this article, we aim to review the current evidence on the therapeutic options for LRA.
RECENT FINDINGS
No controlled study has assessed the effect of standard therapy (oral antihistamines, intranasal or inhaled corticosteroids, bronchodilators) in LRA subjects. Three randomized clinical trials and one observational study demonstrated that allergen immunotherapy (AIT) is able to control nasal and ocular symptoms, decrease the need for rescue medication, and improve quality of life in LAR individuals. Nasal or inhaled steroids can be expected to improve eosinophilic inflammation in LRA patients but cannot change the natural course of the disease. Moreover, the long-term and disease-modifying effects of AIT in LRA subjects need to be investigated.
Topics: Desensitization, Immunologic; Humans; Quality of Life; Rhinitis, Allergic
PubMed: 32430550
DOI: 10.1007/s11882-020-00920-w