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Medicina (Kaunas, Lithuania) Dec 2023The atopic march encompasses a sequence of allergic conditions, including atopic dermatitis, food allergy, allergic rhinitis, and asthma, that frequently develop in a... (Review)
Review
The atopic march encompasses a sequence of allergic conditions, including atopic dermatitis, food allergy, allergic rhinitis, and asthma, that frequently develop in a sequential pattern within the same individual. It was introduced as a conceptual framework aimed at elucidating the developmental trajectory of allergic conditions during childhood. Following the introduction of this concept, it was initially believed that the atopic march represented the sole and definitive trajectory of the development of allergic diseases. However, this perspective evolved with the emergence of new longitudinal studies, which revealed that the evolution of allergic diseases is far more intricate. It involves numerous immunological pathological mechanisms and may not align entirely with the traditional concept of the atopic march. The objective of our review is to portray the atopic march alongside other patterns in the development of childhood allergic diseases, with a specific emphasis on the potential for a personalized approach to the prevention, diagnosis, and treatment of atopic conditions.
Topics: Humans; Multimorbidity; Dermatitis, Atopic; Asthma; Rhinitis, Allergic
PubMed: 38256282
DOI: 10.3390/medicina60010021 -
The Journal of Dermatology Jul 2022The prevalence of atopic dermatitis (AD) has been steadily increasing in recent decades, reaching a steady plateau at the end of the 20th century. However, most of them...
The prevalence of atopic dermatitis (AD) has been steadily increasing in recent decades, reaching a steady plateau at the end of the 20th century. However, most of them were surveys of children, and the current prevalence and severity of AD in adults are unknown. A longitudinal survey including 40 649 freshmen attending Hiroshima University between 2002 and 2019 was conducted, with the aim to determine changes in AD prevalence in young adults over the age of 18 years. All data were longitudinally collected at a fixed time of the year. The AD diagnosis and severity assessment were made by dermatologists based on the diagnostic criteria in the Japanese Guidelines for AD. History or comorbidities of asthma and allergic rhinitis/conjunctivitis, current AD management, and use of topical corticosteroids (TCS) were also surveyed using a questionnaire. The prevalence of AD in university freshmen is slightly increasing from 9.1% in 2002 to 12.0% in 2010, remaining steady at around 10-11% until 2019, with poorly controlled AD present in nearly 10%. History or comorbidities of asthma and allergic rhinitis/conjunctivitis slightly increased from 2006 to 2019 in both the students with and without AD. Facial eczema was common among those with severe and most severe AD, whereas approximately 50% of the students with moderate AD and approximately 20% of those with mild AD exhibited facial eczema. The percentage of students treating AD at medical institutions and those self-managing was almost the same. This survey also revealed the presence of substantial anxiety regarding TCS use for AD and the necessity of promoting more effective explanation and education on AD by medical professionals.
Topics: Adult; Asthma; Child; Conjunctivitis, Allergic; Dermatitis, Atopic; Dermatologic Agents; Eczema; Humans; Middle Aged; Prevalence; Rhinitis, Allergic; Universities
PubMed: 35315120
DOI: 10.1111/1346-8138.16366 -
Nature Reviews. Disease Primers Dec 2020
Topics: Adrenal Cortex Hormones; Histamine Antagonists; Humans; Immunoglobulin E; Immunotherapy; Rhinitis, Allergic
PubMed: 33273472
DOI: 10.1038/s41572-020-00237-y -
Annals of Allergy, Asthma & Immunology... Jul 2021Atopic dermatitis (AD) and rhinitis are common atopic diseases that may co-occur owing to an overlap in pathophysiology. Although most cases of both diseases are mild... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Atopic dermatitis (AD) and rhinitis are common atopic diseases that may co-occur owing to an overlap in pathophysiology. Although most cases of both diseases are mild and managed with topical anti-inflammatory medicaments, the advent of new systemic and biologic treatments targeting type 2 inflammation in both diseases warrants further insight in the exact overlap of AD and rhinitis.
OBJECTIVE
To determine the association between AD and rhinitis.
METHODS
A systematic review and meta-analysis of the databases PubMed, Embase, and CNKI were performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Pooled prevalence and pooled odds ratios (ORs) with 95% confidence intervals (95% CIs) were calculated.
RESULTS
The search resulted in 10,422 citations, and 341 and 302 articles were included in the qualitative and quantitative analyses, respectively. The pooled prevalence of rhinitis was 40.5% (95% CI 39.0-42.0) in patients with AD and 18.0% (95% CI 16.7-19.2) in the reference individuals without AD. The pooled prevalence of having both rhinitis and asthma was 14.2% (95% CI 13.0-15.5) in patients with AD. There was an association between AD and rhinitis (OR 3.00, 95% CI 2.83-3.18), allergic rhinitis (OR 3.25, 95% CI 2.26-4.66), and nonallergic rhinitis (OR 1.99, 95% CI 1.39-2.86), respectively.
CONCLUSION
Rhinitis, both allergic and nonallergic forms, is very common in patients with AD. Future investigations should clarify how medications targeting both diseases should be indicated in these patients.
Topics: Asthma; Comorbidity; Dermatitis, Atopic; Humans; Odds Ratio; Prevalence; Rhinitis; Rhinitis, Allergic; Risk Assessment; Risk Factors
PubMed: 33684526
DOI: 10.1016/j.anai.2021.02.026 -
Frontiers in Immunology 2022Over the past decades, atopic diseases, including allergic rhinitis, asthma, atopic dermatitis, and food allergy, increased strongly worldwide, reaching up to 50% in... (Review)
Review
Over the past decades, atopic diseases, including allergic rhinitis, asthma, atopic dermatitis, and food allergy, increased strongly worldwide, reaching up to 50% in industrialized countries. These diseases are characterized by a dominating type 2 immune response and reduced numbers of allergen-specific regulatory T (Treg) cells. Conventional allergen-specific immunotherapy is able to tip the balance towards immunoregulation. However, in mouse models of allergy adaptive transfer of Treg cells did not always lead to convincing beneficial results, partially because of limited stability of their regulatory phenotype activity. Besides genetic predisposition, it has become evident that environmental factors like a westernized lifestyle linked to modern sanitized living, the early use of antibiotics, and the consumption of unhealthy foods leads to epithelial barrier defects and dysbiotic microbiota, thereby preventing immune tolerance and favoring the development of allergic diseases. Epigenetic modification of Treg cells has been described as one important mechanism in this context. In this review, we summarize how environmental factors affect the number and function of Treg cells in allergic inflammation and how this knowledge can be exploited in future allergy prevention strategies as well as novel therapeutic approaches.
Topics: Allergens; Animals; Desensitization, Immunologic; Inflammation; Mice; Rhinitis, Allergic; T-Lymphocytes, Regulatory
PubMed: 35720406
DOI: 10.3389/fimmu.2022.912529 -
The Journal of Allergy and Clinical... Feb 2024Allergic and immunologic conditions, including asthma, food allergy, atopic dermatitis, and allergic rhinitis, are among the most common chronic conditions in children... (Review)
Review
Allergic and immunologic conditions, including asthma, food allergy, atopic dermatitis, and allergic rhinitis, are among the most common chronic conditions in children and adolescents that often last into adulthood. Although rare, inborn errors of immunity are life-altering and potentially fatal if unrecognized or untreated. Thus, allergic and immunologic conditions are both medical and public health issues that are profoundly affected by socioeconomic factors. Recently, studies have highlighted societal issues to evaluate factors at multiple levels that contribute to health inequities and the potential steps toward closing those gaps. Socioeconomic disparities can influence all aspects of care, including health care access and quality, diagnosis, management, education, and disease prevalence and outcomes. Ongoing research, engagement, and deliberate investment of resources by relevant stakeholders and advocacy approaches are needed to identify and address the impact of socioeconomics on health care disparities and outcomes among patients with allergic and immunologic diseases.
Topics: Humans; Child; Adolescent; Dermatitis, Atopic; Asthma; Rhinitis, Allergic; Food Hypersensitivity; Socioeconomic Factors
PubMed: 37967769
DOI: 10.1016/j.jaci.2023.10.025 -
Immunology and Allergy Clinics of North... Nov 2022Outdoor air pollution is associated with exacerbations of allergic diseases, including asthma, allergic rhinitis, and other atopic conditions. The increased allergic... (Review)
Review
Outdoor air pollution is associated with exacerbations of allergic diseases, including asthma, allergic rhinitis, and other atopic conditions. The increased allergic disease prevalence has been linked to this urbanization, industrialization, and economic growth globally. Air pollutants are well-known to disrupt the epithelium leading to specific diseases in any organ system that has epithelial linings. This review provides an overview of the health effects of air pollution on allergic disorders and specifically addresses how it may impact the epithelial barrier in the upper and lower respiratory tracts to facilitate the health effects associated with these exposures.
Topics: Humans; Air Pollution; Asthma; Air Pollutants; Rhinitis, Allergic; Prevalence
PubMed: 36265977
DOI: 10.1016/j.iac.2022.06.004 -
Allergology International : Official... Jan 2023The Practical Guideline for the Management of Allergic Rhinitis, the fist guideline for allergic rhinitis in Japan, was prepared after a symposium held by the Japanese... (Review)
Review
The Practical Guideline for the Management of Allergic Rhinitis, the fist guideline for allergic rhinitis in Japan, was prepared after a symposium held by the Japanese Society of Allergology in 1993. The current 9th edition was published in 2020 and is widely used today. The most recent collection of evidence from the literature was supplemented to the revised guideline to incorporate evidence-based medicine. The revised guideline includes updated epidemiology of allergic rhinitis in Japan, a figure representing the mechanisms of allergic rhinitis in both the onset and sensitization phases with the introduction of regulatory T cells and type 2 innate lymphoid cells, practical assessment for diagnosis, new pharmacotherapy agents such as anti-IgE mAb and a new drug delivery system for antihistamines, sublingual immunotherapy for children, dual sublingual immunotherapy for house dust mites and Japanese cedar pollen extract, new classification for surgery for allergic rhinitis, and treatment and prescriptions for older adults. An evidence-based step-by-step strategy for treatment is also described.
Topics: Child; Animals; Humans; Aged; Immunity, Innate; Lymphocytes; Rhinitis, Allergic; Allergens; Pyroglyphidae
PubMed: 36509676
DOI: 10.1016/j.alit.2022.11.003 -
American Journal of Rhinology & Allergy Sep 2019
Topics: Chronic Disease; Humans; Hypersensitivity; Otolaryngology; Rhinitis, Allergic; Sinusitis
PubMed: 31482735
DOI: 10.1177/1945892419870617 -
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