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Otolaryngologic Clinics of North America Apr 2024This review article highlights air pollution as a critical global health concern with emphasis on its effects and role in the development and exacerbation of upper... (Review)
Review
This review article highlights air pollution as a critical global health concern with emphasis on its effects and role in the development and exacerbation of upper airway and lower airway disease with a focus on allergic rhinitis and asthma. This review underscores the World Health Organization's recognition of air pollution as the biggest environmental threat to human health. It discusses the various components and categories of air pollutants and the evidence-based effects they have on asthma and allergic rhinitis, ranging from pathogenesis to exacerbation of these conditions across various age groups in different geographic locations.
Topics: Humans; Air Pollution; Asthma; Rhinitis, Allergic; Air Pollutants; Nose
PubMed: 37985273
DOI: 10.1016/j.otc.2023.10.005 -
Frontiers in Immunology 2023To systematically compare the efficacy and safety of subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) in children with allergic rhinitis (AR). (Meta-Analysis)
Meta-Analysis
AIM
To systematically compare the efficacy and safety of subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) in children with allergic rhinitis (AR).
METHODS
PubMed, Embase, Cochrane Library, and Web of Science were searched from inception to March 2, 2023. Outcomes included symptom scores (SSs), medication scores (MSs), symptom and medication scores (SMSs), new sensitizations, development of asthma, improvement, and treatment-related adverse events (TRAEs). The quality of the included studies was assessed by the modified Jadad scale and Newcastle-Ottawa scale (NOS). Meta-regression was carried out to explore the source of heterogeneity. Subgroup analysis was further conducted in terms of study design [randomized controlled trials (RCTs), cohort studies], allergen [house dust mites (HDMs), grass pollen], treatment duration (≥ 24, 12-23 or < 12 months), allergen immunotherapy (AIT) modality (drops or tablets), and AIT protocol [continuous, pre-seasonal, co-seasonal, or after the grass pollen season (GPS)]. Sensitivity analysis was conducted for all outcomes. A Bayesian framework and a Monte Carlo Markov Chain (MCMC) model were developed for indirect comparison.
RESULTS
Totally 50 studies with 10813 AR children were included, with 4122 treated with SLIT, 1852 treated with SCIT, and 4839 treated with non-SLIT or non-SCIT therapy. For direct comparison, the SLIT group had a similar SS to the SCIT group [pooled standardized mean difference (SMD): 0.41, 95% confidence interval (CI): -0.46, 1.28, = 0.353]. Comparable MSs were observed in the SLIT and SCIT groups (pooled SMD: 0.82, 95%CI: -0.88, 2.53, = 0.344). For indirect comparison, no significant differences were found in SSs (pooled SMD: 1.20, 95% credibility interval (CrI): -1.70, 4.10), MSs (pooled SMD: 0.57, 95%CrI: -1.20, 2.30), SMSs (pooled SMD: 1.80, 95%CrI: -0.005, 3.60), new sensitizations [pooled relative risk (RR): 0.34, 95%CrI: 0.03, 3.58], and development of asthma (pooled RR: 0.68, 95%CrI: 0.01, 26.33) between the SLIT and SCIT groups; the SLIT group illustrated a significantly lower incidence of TRAEs than the SCIT group (pooled RR: 0.17, 95%CrI: 0.11, 0.26).
CONCLUSION
Considering both efficacy and safety, SLIT might be a more favorable AIT than SCIT in the treatment of pediatric AR, which may serve as a decision-making reference for clinicians.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO (CRD42023460693).
Topics: Child; Humans; Allergens; Asthma; Desensitization, Immunologic; Pollen; Rhinitis, Allergic; Immunotherapy; Sublingual Immunotherapy
PubMed: 38162647
DOI: 10.3389/fimmu.2023.1274241 -
The Journal of Allergy and Clinical... Nov 2023Global warming has direct and indirect effects, as well as short- and long-term impacts on the respiratory and skin barriers. Extreme temperature directly affects the... (Review)
Review
Global warming has direct and indirect effects, as well as short- and long-term impacts on the respiratory and skin barriers. Extreme temperature directly affects the airway epithelial barrier by disrupting the structural proteins and by triggering airway inflammation and hyperreactivity. It enhances tidal volume and respiratory rate by affecting the thermoregulatory system, causing specific airway resistance and reflex bronchoconstriction via activation of bronchopulmonary vagal C fibers and upregulation of transient receptor potential vanilloid (TRPV) 1 and TRPV4. Heat shock proteins are activated under heat stress and contribute to both epithelial barrier dysfunction and airway inflammation. Accordingly, the frequency and severity of allergic rhinitis and asthma have been increasing. Heat activates TRPV3 in keratinocytes, causing the secretion of inflammatory mediators and eventually pruritus. Exposure to air pollutants alters the expression of genes that control skin barrier integrity and triggers an immune response, increasing the incidence and prevalence of atopic dermatitis. There is evidence that extreme temperature, heavy rains and floods, air pollution, and wildfires increase atopic dermatitis flares. In this narrative review, focused on the last 3 years of literature, we explore the effects of global warming on respiratory and skin barrier and their clinical consequences.
Topics: Humans; Dermatitis, Atopic; Global Warming; Respiratory Rate; Rhinitis, Allergic; Inflammation
PubMed: 37689250
DOI: 10.1016/j.jaci.2023.09.001 -
Trends and hotspots of acupuncture for allergic rhinitis: A bibliometric analysis from 2002 to 2022.Complementary Therapies in Medicine Nov 2023The study aims to investigate and visualize the hotspots of acupuncture for Allergic rhinitis (AR) over the past two decades and pinpoint future trends in this field.
OBJECTIVE
The study aims to investigate and visualize the hotspots of acupuncture for Allergic rhinitis (AR) over the past two decades and pinpoint future trends in this field.
METHOD
We conducted a systematic search of English-language articles or reviews on acupuncture for AR in the Web of Science Core Collection from 2002 to 2022. Using Citespace, VOSviewer, and Bibliometrix, we analyzed and visualized the publications, countries, institutions, authors, journals, and keywords from various angles.
RESULT
The study identified 197 documents, 80 journals, 458 keywords, and 928 authors associated with acupuncture for AR. Although article publication fluctuated over the past 20 years, an overall upward trend emerged, with rapid growth during the second decade. China contributed the most to acupuncture research on AR and had the closest collaborations with the United States and Germany. China Medical University was the most prolific institution, and Benno Brinkhaus was the most productive and influential author. The most published journal was Medicine, while the Journal of Allergy and Clinical Immunology was the most frequently cited journal. The highest frequency keywords included acupuncture, allergic rhinitis, and asthma. Randomized controlled trials and alternative & complementary medicine remained significant research hotspots, while rhinoconjunctivitis is expected to be the emerging focus of future investigations.
CONCLUSION
acupuncture has experienced robust development for the treatment of allergic rhinitis over the last two decades, with rhinoconjunctivitis and clinical research being the anticipated trends and frontiers of future research.
Topics: Humans; Acupuncture Therapy; Rhinitis, Allergic; Bibliometrics; Asthma; China
PubMed: 37696311
DOI: 10.1016/j.ctim.2023.102984 -
The Journal of Allergy and Clinical... Jan 2024Allergen immunotherapy is a disease-modifying treatment for IgE-mediated allergies reducing disease burden and symptoms in patients with allergic rhinitis, with or...
Allergen immunotherapy is a disease-modifying treatment for IgE-mediated allergies reducing disease burden and symptoms in patients with allergic rhinitis, with or without asthma. The growing evidence that allergen immunotherapy also has the potential to facilitate achieving asthma control in patients with allergic asthma resulted in its acknowledgment by international bodies (Global Initiative for Asthma and European Academy of Allergy and Clinical Immunology) as add-on treatment for mild/moderate asthma. Although there have been promising developments in biomarkers for patient selection and for allergen immunotherapy efficacy evaluation in patients with asthma, a lot more data are still required.
Topics: Humans; Asthma; Desensitization, Immunologic; Rhinitis, Allergic; Hypersensitivity, Immediate; Biomarkers; Allergens; Sublingual Immunotherapy
PubMed: 38013158
DOI: 10.1016/j.jaip.2023.11.031 -
American Family Physician Aug 2023In the United States, approximately 2% to 3% of adults and 8% of children have a food allergy. Allergic reactions range from minor pruritus to life-threatening...
In the United States, approximately 2% to 3% of adults and 8% of children have a food allergy. Allergic reactions range from minor pruritus to life-threatening anaphylaxis. These allergies often lead to significant anxiety and costs for patients and caregivers. Common food allergies include peanuts, cow's milk, shellfish, tree nuts, egg, fish, soy, and wheat. Peanut allergy, the most common, is the leading cause of life-threatening anaphylaxis. Children with asthma, allergic rhinitis, atopic dermatitis, or an allergy to insect venom, medications, or latex are at an increased risk of developing food allergies. Diagnosis of food allergy starts with a detailed, allergy-focused history. Serum immunoglobulin E and skin prick testing provide reliable information regarding food allergy diagnoses. Primary treatment involves elimination of the offending food from the diet. Prevention strategies proven to decrease the risk of developing a food allergy include restricting exposure to cow's milk in the first three days of life and early sequential exposure to allergenic foods starting between four and six months of age. Exclusive breastfeeding for three to four months reduces the likelihood of developing eczema and asthma but does not reduce development of food allergies. Most children eventually outgrow allergies to cow's milk, egg, soy, and wheat. However, allergies to tree nuts, peanuts, and shellfish are more likely to be lifelong.
Topics: Humans; Animals; Cattle; Female; Anaphylaxis; Food Hypersensitivity; Asthma; Peanut Hypersensitivity; Rhinitis, Allergic; Arachis
PubMed: 37590855
DOI: No ID Found -
Journal of Investigational Allergology... Apr 2024The allergic march comprises the sequential appearance of a series of allergic comorbidities. However, variability in the onset and progression of allergic diseases... (Review)
Review
The allergic march comprises the sequential appearance of a series of allergic comorbidities. However, variability in the onset and progression of allergic diseases generates a heterogeneous scenario that does not follow a linear and single trajectory. Almost half of the pediatric population presents at least 1 allergy symptom. However, only 4%-6% present multimorbidity, with several allergic diseases co-occurring. It has recently been shown that although they share etiological mechanisms and risk factors, allergic diseases arise independently. In most cases, progression is not consecutive, or at least not the same in all patients. TH2-mediated inflammation, epithelial barrier dysfunction, and genetic predisposition play a fundamental role in the etiology of allergic diseases, on which the interaction with the exposome acts decisively. Therefore, studying diseases from an omics point of view is essential when attempting to describe the various trajectories of allergic progression and to propose effective interventions to prevent multimorbidity. In this narrative review, we provide an overview of the current perception of the allergic march, including clinical observations, omics data, risk factors, and measures aimed at modifying its course or even preventing its onset.
Topics: Child; Humans; Dermatitis, Atopic; Asthma; Rhinitis, Allergic; Comorbidity; Risk Factors
PubMed: 38113128
DOI: 10.18176/jiaci.0983 -
The Journal of Allergy and Clinical... Jun 2024Evidence is mounting that climate change is having a significant impact on exacerbations of rhinitis. Concomitantly, the prevalence of allergic rhinitis is increasing at... (Review)
Review
Evidence is mounting that climate change is having a significant impact on exacerbations of rhinitis. Concomitantly, the prevalence of allergic rhinitis is increasing at an accelerated rate. We herein explore the impact of carbon dioxide, barometric pressure and humidity changes, and anthropogenic pollutants on aeroallergens and rhinitis hypersensitivity. Important immune mechanisms underlying the climate-driven effects on rhinitis are discussed. Also, climate change is shifting ecological zones and seasons, increasing weather extremes, and altering regional atmospheric and environmental conditions. The direct impact of these factors on promoting allergic and nonallergic rhinitis is reviewed.
Topics: Humans; Climate Change; Rhinitis; Allergens; Humidity; Carbon Dioxide; Rhinitis, Allergic; Animals; Atmospheric Pressure
PubMed: 38636591
DOI: 10.1016/j.jaip.2024.04.012 -
BMJ Open Nov 2023Intranasal antihistamines and corticosteroids are some of the most frequently used drug classes in the treatment of allergic rhinitis. However, there is uncertainty as...
INTRODUCTION
Intranasal antihistamines and corticosteroids are some of the most frequently used drug classes in the treatment of allergic rhinitis. However, there is uncertainty as to whether effectiveness differences may exist among different intranasal specific medications. This systematic review aims to analyse and synthesise all evidence from randomised controlled trials (RCTs) on the effectiveness of intranasal antihistamines and corticosteroids in rhinitis nasal and ocular symptoms and in rhinoconjunctivitis-related quality-of-life.
METHODS AND ANALYSIS
We will search four electronic bibliographic databases and three clinical trials databases for RCTs (1) assessing patients ≥12 years old with seasonal or perennial allergic rhinitis and (2) comparing the use of intranasal antihistamines or corticosteroids versus placebo. Assessed outcomes will include the Total Nasal Symptom Score (TNSS), the Total Ocular Symptom Score (TOSS) and the Rhinoconjunctivitis Quality-of-Life Questionnaire (RQLQ). We will assess the methodological quality of included primary studies by using the Cochrane risk-of-bias tool. Certainty in the body of evidence for the analysed outcomes will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. We will perform a random-effects meta-analysis for each assessed medication and outcome, presenting results as pooled mean differences and standardised mean differences. Heterogeneity will be explored by sensitivity and subgroup analyses, considering (1) the risk of bias, (2) the follow-up period and (3) the drug dose.
ETHICS AND DISSEMINATION
Ethical considerations will not be required. Results will be disseminated in a peer-review journal.
PROSPERO REGISTRATION NUMBER
CRD42023416573.
Topics: Humans; Child; Systematic Reviews as Topic; Meta-Analysis as Topic; Rhinitis, Allergic; Histamine Antagonists; Administration, Intranasal; Adrenal Cortex Hormones
PubMed: 37918935
DOI: 10.1136/bmjopen-2023-076614 -
Allergologia Et Immunopathologia 2023
Topics: Humans; Dental Caries; Rhinitis, Allergic
PubMed: 37695224
DOI: 10.15586/aei.v51i5.868