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Cells Oct 2023Nitric oxide (NO) is a short-lived gas molecule which has been studied for its role as a signaling molecule in the vasculature and later, in a broader view, as a... (Review)
Review
Nitric oxide (NO) is a short-lived gas molecule which has been studied for its role as a signaling molecule in the vasculature and later, in a broader view, as a cellular messenger in many other biological processes such as immunity and inflammation, cell survival, apoptosis, and aging. Fractional exhaled nitric oxide (FeNO) is a convenient, easy-to-obtain, and non-invasive method for assessing active, mainly Th2-driven, airway inflammation, which is sensitive to treatment with standard anti-inflammatory therapy. Consequently, FeNO serves as a valued tool to aid the diagnosis and monitoring of several asthma phenotypes. More recently, FeNO has been evaluated in several other respiratory and/or immunological conditions, including allergic rhinitis, chronic rhinosinusitis with/without nasal polyps, atopic dermatitis, eosinophilic esophagitis, and food allergy. In this review, we aim to provide an extensive overview of the current state of knowledge about FeNO as a biomarker in type 2 inflammation, outlining past and recent data on the application of its measurement in patients affected by a broad variety of atopic/allergic disorders.
Topics: Humans; Nitric Oxide; Asthma; Inflammation; Rhinitis, Allergic; Biomarkers
PubMed: 37947596
DOI: 10.3390/cells12212518 -
Current Opinion in Allergy and Clinical... Aug 2023This review aimed to introduce the pharmacotherapy of allergic rhinitis according to the 2022 updated Chinese guidelines. (Review)
Review
PURPOSE OF REVIEW
This review aimed to introduce the pharmacotherapy of allergic rhinitis according to the 2022 updated Chinese guidelines.
RECENT FINDINGS
Despite recent advances in basic and clinical research worldwide, pharmacotherapy remains a mainstream in allergic rhinitis treatment. Usually, the first-line drugs, involving intranasal corticosteroids, second-generation oral and intranasal H1-antihistamines, or leukotriene receptor antagonists, can achieve acceptable outcomes in the treatment of allergic rhinitis. The second-line drugs, such as oral corticosteroids, intranasal decongestants and intranasal anticholinergics, can assist in controlling severe symptoms, like nasal congestion/blockage and watery rhinorrhea. For those with moderate-to-severe allergic rhinitis, evidence-based stepwise strategies are suitable, in which the types and dosages of drugs are de-escalated or upgraded according to their therapeutic efficacy. Meanwhile, omalizumab, a novel biological agent, has burgeoned to satisfy the need of patients.
SUMMARY
This review highlights the staples in Chinese guidelines about the pharmacotherapy for allergic rhinitis to better understand the guidelines and promote the clinical practice.
Topics: Humans; Rhinitis, Allergic, Perennial; Rhinitis, Allergic; Omalizumab; Adrenal Cortex Hormones; Leukotriene Antagonists; Histamine H1 Antagonists
PubMed: 37357787
DOI: 10.1097/ACI.0000000000000921 -
Otolaryngologic Clinics of North America Apr 2024Allergic rhinitis affects up to 78% of people with asthma, and asthma occurs in 38% of people with allergic rhinitis. Asthma has a prevalence of 8.7% among adults and... (Review)
Review
Allergic rhinitis affects up to 78% of people with asthma, and asthma occurs in 38% of people with allergic rhinitis. Asthma has a prevalence of 8.7% among adults and 6.2% among children and accounts for $50 billion in medical costs and $32 billion in indirect and mortality costs in the United States, respectively. Allergic rhinitis occurs in 5% to 15% of people in the United States. Allergic rhinitis also accounts for a significant health care cost burden, predominantly in terms of indirect costs related to reduced quality of life and presenteeism.
Topics: Child; Adult; Humans; United States; Quality of Life; Cost of Illness; Rhinitis, Allergic; Health Care Costs; Asthma
PubMed: 37833101
DOI: 10.1016/j.otc.2023.09.007 -
Nutrients Aug 2023Obesity is a global problem. It affects every age group and is associated with many negative health effects. As an example, there is a relationship between obesity and... (Review)
Review
Obesity is a global problem. It affects every age group and is associated with many negative health effects. As an example, there is a relationship between obesity and allergic and immunological diseases, such as asthma, psoriasis, food allergies, allergic rhinitis and atopic dermatitis. Obesity undeniably affects their development. In addition, it causes adverse changes in the course and response to therapy in relation to patients without excessive body weight. The treatment of diseases associated with obesity is difficult; drugs are less effective and must be used in higher doses, and their use in patients with obesity is often associated with higher risks. The main form of treatment of all obesity-related diseases is a change in eating habits and increased physical activity, which leads to a decrease in body fat mass. The positive effect of reducing BMI has been confirmed in many independent studies. This paper reviews various types of research documents published since 2019. It aims to systematize the latest knowledge and highlight the need for further research for effective and sustainable treatment options for obesity, its complications and obesity-related diseases.
Topics: Humans; Obesity; Body Weight; Asthma; Rhinitis, Allergic; Weight Gain
PubMed: 37686844
DOI: 10.3390/nu15173813 -
The Journal of Allergy and Clinical... Nov 2023Coronavirus disease 2019 (COVID-19) is a highly contagious viral disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It has various effects...
Coronavirus disease 2019 (COVID-19) is a highly contagious viral disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It has various effects on asthma, allergic rhinitis, atopic dermatitis, and urticaria and may change the course of the disease depending on the severity of the infection and control status of the disease. Conversely, these diseases may also impact the course of COVID-19. Patients with chronic urticaria and atopic dermatitis may have COVID-19-induced disease exacerbations and biological treatments reduce the risk of exacerbations. Poor asthma control is linked to severe COVID-19 while allergic asthma is associated with lower risk of death and a lower rate of hospitalization due to COVID-19 compared with nonallergic asthma. The use of intranasal corticosteroids is associated with lower rates of hospitalization due to COVID-19 in patients with allergic rhinitis, whereas the effect of inhaled corticosteroids is confounded by asthma severity. These observations reinforce the importance of keeping allergic diseases under control during pandemics. The use of biologicals during COVID-19 is generally regarded as safe, but more evidence is needed. The pandemic substantially changed the management of allergic disorders such as home implementation of various biologicals, allergen immunotherapy, food introduction, and increased use of telemedicine and even home management of anaphylaxis to reduce emergency department burden and reduce risk of infection. Physicians need to be aware of the potential impact of COVID-19 on allergic diseases and educate their patients on the importance of continuing prescribed medications and adhering to their treatment plans to maintain optimal control of their disease.
Topics: Humans; Dermatitis, Atopic; COVID-19; SARS-CoV-2; Asthma; Rhinitis, Allergic; Adrenal Cortex Hormones
PubMed: 37660731
DOI: 10.1016/j.jaip.2023.08.038 -
Allergy and Asthma Proceedings Nov 2023Rhinitis, allergic rhinitis in particular, and urticaria are both common diseases globally. However, there is controversy with regard to the correlation between... (Meta-Analysis)
Meta-Analysis
Rhinitis, allergic rhinitis in particular, and urticaria are both common diseases globally. However, there is controversy with regard to the correlation between rhinitis and urticaria. To examine the accurate association between rhinitis and urticaria. Three medical literature data bases were searched from data base inception until January 11, 2022. The prevalence and association between rhinitis and urticaria were estimated by meta-analysis. Quality assessment was performed by using the Newcastle-Ottawa Scale. Pooled odds ratios (OR) with 95% confidence intervals (CI) and pooled prevalence were calculated by using random-effects models. Urticaria prevalence in patients with rhinitis was 17.6% (95% CI, 13.2%-21.9%). The pooled prevalence of rhinitis was 31.3% (95% CI, 24.2%-38.4%) in patients with urticaria, and rhinitis prevalence in patients with acute urticaria and chronic urticaria was 31.6% (95% CI, 7.4%-55.8%) and 28.7% (95% CI, 20.4%-36.9%), respectively. Rhinitis occurrence was significantly associated with urticaria (OR 2.67 [95% CI, 2.625-2.715]). Urticaria and rhinitis were diagnosed based on different criteria, possibly resulting in a potential error of misclassification. Rhinitis and urticaria were significantly correlated. Physicians should be cognizant with regard to this relationship and address nasal or skin symptoms in patients.
Topics: Humans; Rhinitis; Rhinitis, Allergic, Perennial; Prevalence; Urticaria; Rhinitis, Allergic
PubMed: 37919842
DOI: 10.2500/aap.2023.44.230063 -
The Journal of Allergy and Clinical... Nov 2023Allergen immunotherapy (AIT) is a well-established disease-modifying therapy for allergic rhinitis, yet the fundamental mechanisms underlying its clinical effect remain... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Allergen immunotherapy (AIT) is a well-established disease-modifying therapy for allergic rhinitis, yet the fundamental mechanisms underlying its clinical effect remain inadequately understood. Gauging Response in Allergic Rhinitis to Sublingual and Subcutaneous Immunotherapy was a randomized, double-blind, placebo-controlled trial of individuals allergic to timothy grass who received 2 years of placebo (n = 30), subcutaneous immunotherapy (SCIT) (n = 27), or sublingual immunotherapy (SLIT) (n = 27) and were then followed for 1 additional year.
OBJECTIVE
We used yearly biospecimens from the Gauging Response in Allergic Rhinitis to Sublingual and Subcutaneous Immunotherapy study to identify molecular mechanisms of response.
METHODS
We used longitudinal transcriptomic profiling of nasal brush and PBMC samples after allergen provocation to uncover airway and systemic expression pathways mediating responsiveness to AIT.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT01335139, EudraCT Number: 2010-023536-16.
RESULTS
SCIT and SLIT demonstrated similar changes in gene module expression over time. In nasal samples, alterations included downregulation of pathways of mucus hypersecretion, leukocyte migration/activation, and endoplasmic reticulum stress (log2 fold changes -0.133 to -0.640, false discovery rates [FDRs] <0.05). We observed upregulation of modules related to epithelial development, junction formation, and lipid metabolism (log2 fold changes 0.104 to 0.393, FDRs <0.05). In PBMCs, modules related to cellular stress response and type 2 cytokine signaling were reduced by immunotherapy (log2 fold changes -0.611 to -0.828, FDRs <0.05). Expression of these modules was also significantly associated with both Total Nasal Symptom Score and peak nasal inspiratory flow, indicating important links between treatment, module expression, and allergen response.
CONCLUSIONS
Our results identify specific molecular responses of the nasal airway impacting barrier function, leukocyte migration activation, and mucus secretion that are affected by both SCIT and SLIT, offering potential targets to guide novel strategies for AIT.
Topics: Humans; Transcriptome; Leukocytes, Mononuclear; Pollen; Allergens; Desensitization, Immunologic; Sublingual Immunotherapy; Phleum; Injections, Subcutaneous; Rhinitis, Allergic
PubMed: 37460024
DOI: 10.1016/j.jaci.2023.06.025 -
Scientific Reports Nov 2023Studies examining the association between type 1 diabetes (T1D) and atopic diseases, i.e., atopic dermatitis, allergic rhinitis and asthma have yielded conflicting...
Studies examining the association between type 1 diabetes (T1D) and atopic diseases, i.e., atopic dermatitis, allergic rhinitis and asthma have yielded conflicting results due to different algorithms for classification, sample size issues and risk of referral bias of exposed cohorts with frequent contact to health care professionals. Using Danish national registries and well-established disease algorithms, we examined the bidirectional association between T1D and atopic diseases in childhood and adolescence using Cox Proportional Hazard regression compared to two different unexposed cohorts from a population of 1.5 million Danish children born from 1997 to 2018. We found no associations between T1D and atopic dermatitis, allergic rhinitis, or asthma (defined after age five). However, in multivariable analysis we found an increased risk of persistent wheezing (defined as asthma medication before age five) after T1D with an adjusted hazard ratio (aHR) of 1.70 [1.17-2.45]. We also identified an increased risk of developing T1D after persistent wheezing with aHR of 1.24 [1.13-1.36]. This study highlights similar risks of atopic diseases in children with T1D and of T1D in children with atopic disease after age of five years versus healthy controls. However, more research is needed to understand the possible early immunological effects of the link between persistent wheezing and T1D.
Topics: Child; Adolescent; Humans; Child, Preschool; Dermatitis, Atopic; Diabetes Mellitus, Type 1; Cohort Studies; Respiratory Sounds; Asthma; Rhinitis, Allergic; Denmark
PubMed: 37968327
DOI: 10.1038/s41598-023-47292-5 -
Environmental Science and Pollution... Nov 2023Evidences showed the link between allergy and depression, while the relationships of depression with allergy-related outcomes is insufficient. The objective of this...
Evidences showed the link between allergy and depression, while the relationships of depression with allergy-related outcomes is insufficient. The objective of this study is to evaluate and compare the relationship of depression with allergy-related outcomes assessed using two different outcome indicators, in a population-based study. A cross-sectional study was performed of 1094 participants in the 2005-2006 National Health and Nutrition Examination Survey (NHANES). The self-reported allergic symptoms of allergic rhinitis (AR) status and immunoglobulin E (IgE) were used to evaluate the allergy-related outcomes. The depression disorder was defined as the ≥ 10 points on the Patient Health Questionnaire-9. Logistic and linear regression models were performed to illustrate the associations of depression and allergy-related outcomes. The prevalence of AR and depression was 34.2% and 6.8%, respectively. The odds of depression were 8.6% higher in participants with AR patients compared those without AR [odds ratio (OR) = 1.739, 95% confidence interval (CI): (1.034, 2.933)], while the odds of depression in participants with allergic sensitization and without allergic sensitization were not found significant difference. Allergy is positively associated with depression disorder, and patients with allergy-related outcomes, such as AR, may be at higher risk of depression, while the IgE level was not founded to be related with depression. In the treatment of AR patients with depression symptoms, early detection and management of mental problems are of importance.
Topics: Humans; Adult; Nutrition Surveys; Cross-Sectional Studies; Depression; Rhinitis, Allergic; Immunoglobulin E
PubMed: 37884722
DOI: 10.1007/s11356-023-30559-9 -
Current Pediatric Reviews 2024Allergic rhinitis is a prevalent condition among children, with its occurrence reaching up to 40% of the general population in some geographical areas. A type 2 immunity... (Review)
Review
Allergic rhinitis is a prevalent condition among children, with its occurrence reaching up to 40% of the general population in some geographical areas. A type 2 immunity sustains allergic rhinitis. Consequently, type 2 inflammation leads to eosinophilic infiltrate of the nasal mucosa. Allergic inflammation causes the symptom occurrence. Typical nasal symptoms include nasal itching, sneezing, watery rhinorrhea, and nasal congestion. Nasal congestion depends on vasodilation and increased mucus production. These conditions result in nasal obstruction. Nasal obstruction is closely associated with type 2 inflammation. Allergic rhinitis usually occurs in association with other allergic conditions, in particular allergic conjunctivitis and asthma. The effective management of allergic rhinitis involves avoiding triggering allergens and employing pharmacological treatments as per ARIA guidelines. These treatments may include intranasal/oral antihistamines or/and nasal corticosteroids. In particular, antihistamines are particularly indicated for symptoms consequent to mediators' release, mainly concerning histamine. These histamine-dependent symptoms include itching, sneezing, and rhinorrhea. Nasal obstruction, being associated with inflammation, is responsive to corticosteroids, administered mostly intranasally. The fixed combination of a topical antihistamine plus a topical corticosteroid is very effective, but is indicated for adolescents only. However, nasal lavage is safe, cheap, and adequate, thus its use is prevalent. Namely, nasal lavage allows to remove secretions, allergens, mediators. In addition, hypertonic solutions exert a decongestant activity. On the other hand, the allergen-specific immunotherapy is still the only causal treatment. Nutraceuticals have also been used to relieve symptoms. The objective of this review is to explore and compare the traditional and new therapeutic approaches for pollen-induced allergic rhinitis in children.
Topics: Child; Adolescent; Humans; Nasal Obstruction; Histamine; Sneezing; Rhinitis, Allergic; Histamine Antagonists; Adrenal Cortex Hormones; Allergens; Inflammation; Rhinorrhea; Pruritus
PubMed: 37702169
DOI: 10.2174/1573396320666230912103108