-
Irish Journal of Medical Science Jun 2023Allergen immunotherapy (AIT) is a safe, effective and disease-modifying treatment for allergic rhinitis. It is indicated for children with moderate to severe disease...
BACKGROUND
Allergen immunotherapy (AIT) is a safe, effective and disease-modifying treatment for allergic rhinitis. It is indicated for children with moderate to severe disease whose symptoms persist despite conventional therapy. There is a high prevalence of allergic rhinitis amongst Irish children; however, levels of AIT prescribing in Ireland are lower than neighbouring countries.
AIMS
The aims of this study are to describe current patterns of AIT prescribing and referrals amongst Irish paediatricians and to identify barriers to accessing AIT in Ireland.
METHODS
An electronic questionnaire was distributed to all paediatricians and paediatric trainees caring for children with allergic rhinitis.
RESULTS
A lack of knowledge of AIT clinical criteria was the most frequently reported barrier with 50.5% (50/99) of general paediatricians unaware of the indications for referral compared to 27.3% (3/11) of respiratory physicians and 0% (0/8) of allergists. Accessibility is the next most cited barrier with 31.4% (37/118) of respondents unsure where to refer and 19.5% (23/118) reporting a lack of local services. Cost was reported to be a barrier by 12.7% (15/118). Paediatricians with an allergy or respiratory subspecialisation reported seeing significantly higher numbers of children with allergic rhinitis and were more likely to prescribe or refer a child for AIT.
CONCLUSIONS
This study demonstrated positive attitudes towards AIT amongst all grades and specialities of paediatricians in Ireland. The main barriers to more widespread use are difficulties with the identification of suitable candidates by general paediatricians and a lack of local AIT services and referral pathways.
Topics: Humans; Child; Allergens; Rhinitis, Allergic; Desensitization, Immunologic; Pediatricians; Pediatrics
PubMed: 35804261
DOI: 10.1007/s11845-022-03067-x -
The Medical Journal of Malaysia Nov 2023Coronavirus disease 2019 (COVID-19) has high morbidity and mortality especially in preexisting risk groups. In atopic diseases the IgE and eosinophils are commonly...
INTRODUCTION
Coronavirus disease 2019 (COVID-19) has high morbidity and mortality especially in preexisting risk groups. In atopic diseases the IgE and eosinophils are commonly elevated. This study aims to determine the potential association between COVID-19 and atopic diseases in Iraqi patients.
MATERIALS AND METHODS
A cross-sectional study done in Baghdad on 112 patients who attended Al-Zahraa Allergic Center. Their demographic characteristics, total IgE, eosinophil counts and PCR result for COVID-19 were determined.
RESULTS
The means for IgE and eosinophils were 245.7±260.1IU/ml and 444.5±117.1cells/microliter sequentially. Around 32.1% had high IgE level (i.e., atopic) and 11.6% had COVID-19. Among the atopic patients, 33.3%, 30.5% and 36.2% had atopic dermatitis, allergic rhinitis and asthma respectively. More than half (58.3%) of them were male, 55.5% aged <45 years, 36.2% were retired or had no job, 69.5% were graduated from secondary school or more and 88.8% lived in urban areas. There is no significant association in IgE level between those with and without COVID-19, which means that exposure to SARS Cov2 virus could not be a trigger or exacerbation for atopic diseases. Also, there was no association between atopic patients with COVID-19 and those without it regarding type of atopy, age, sex, occupation, education, type of living area.
CONCLUSIONS
Atopy is not a risk factor for COVID-19.
Topics: Humans; Male; Female; Iraq; Immunoglobulin E; Cross-Sectional Studies; COVID-19; Eosinophils; Rhinitis, Allergic
PubMed: 38031212
DOI: No ID Found -
Medicine Dec 2023Previous studies have suggested a potential association between allergic rhinitis (AR) and hypertension, but the genetic basis remains unclear. In this study, we aimed...
Previous studies have suggested a potential association between allergic rhinitis (AR) and hypertension, but the genetic basis remains unclear. In this study, we aimed to explore the genetic correlation and potential causal association between AR and hypertension. Using a large-scale genome-wide association study (GWAS) public database, we conducted meticulous screening to acquire the most up-to-date GWAS data on single nucleotide polymorphisms (SNPs) relevant to AR and hypertension, with a significance threshold of P < 5 × 10-8. Then, we investigated the causal association between AR and hypertension through mendelian randomization (MR) analysis. We also performed reverse MR analysis to assess the possibility of reverse causality. Sensitivity analyses encompassed various factors, including horizontal pleiotropy, heterogeneity testing, and stepwise exclusion sensitivity checks. To investigate the causal relationship between AR and hypertension, we utilize the odds ratio (OR) and 95% confidence interval (CI) as our evaluative metric. This study leveraged a database comprising 112583 samples for AR and 461880 samples for hypertension. After meticulous screening, we identified 32 SNPs as instrumental variables. By employing the aforementioned 2-sample Mendelian randomization approaches, the estimated causal effects showed striking concordance. A discernible causal association between AR and hypertension was found using the IVW method (OR = 0.91, 95% CI: 0.86-0.98, P = .008), with horizontal pleiotropy and heterogeneity tests supporting the validity of our MR study. MR-Egger regression findings provided reassurance against bias stemming from genetic pleiotropy (intercept = -0.0006802, P = .6947). Interestingly, "leave-one-out" analysis yielded no evidence of nonspecific SNP influences, further consolidating our findings. Moreover, our reverse MR analysis yielded no indication of reverse causality from hypertension to AR, effectively discounting any influence from the latter on the former. Our study found evidence of a causal association between AR and hypertension in individuals of European ancestry. It demonstrated that AR reduced the risk of hypertension, suggesting a protective effect on hypertension due to the negative correlation with AR.
Topics: Humans; Genome-Wide Association Study; Mendelian Randomization Analysis; Rhinitis, Allergic; Databases, Factual; Hypertension
PubMed: 38115257
DOI: 10.1097/MD.0000000000036700 -
International Journal of Medical... 2024Cross-sectional evidence has suggested a high prevalence of atopic diseases in patients with hidradenitis suppurativa (HS). However, there is a lack of evidence based...
Cross-sectional evidence has suggested a high prevalence of atopic diseases in patients with hidradenitis suppurativa (HS). However, there is a lack of evidence based on longitudinal studies. This study aimed to assess the risk of different atopic diseases, including asthma, atopic dermatitis, and allergic rhinitis, in patients with HS. In this retrospective cohort study, data from the TriNetX research network were obtained. Patients with HS were enrolled, and a 1:1 propensity score matching was performed to select a non-HS control group. Matching covariates included age, sex, race, comorbidities, comedications, socioeconomic status, lab data, and medical utilization status. Hazard ratios (HR) for atopic diseases were assessed. Over a 15-year follow-up period, patients with HS were found to be at a higher risk for atopic dermatitis (HR = 1.65; 95% CI, 1.44-1.90), asthma (HR = 1.41; 95% CI, 1.33-1.49), and allergic rhinitis (HR = 1.08; 95% CI, 1.03-1.13). A similar trend was observed in shorter follow-up periods. The association between HS, atopic dermatitis, and asthma was consistent across different age and sex subgroups. Atopic diseases including atopic dermatitis, asthma and allergic rhinitis are associated with HS. Further investigation is needed to assess the necessity of early screening for atopic diseases in patients with HS.
Topics: Humans; Dermatitis, Atopic; Cohort Studies; Hidradenitis Suppurativa; Retrospective Studies; Cross-Sectional Studies; Propensity Score; Asthma; Rhinitis, Allergic
PubMed: 38169580
DOI: 10.7150/ijms.90086 -
International Journal of Molecular... Aug 2019Atopic dermatitis (AD) is the most common inflammatory skin disease worldwide. It is a chronic, relapsing and pruritic skin disorder which results from epidermal barrier... (Review)
Review
Atopic dermatitis (AD) is the most common inflammatory skin disease worldwide. It is a chronic, relapsing and pruritic skin disorder which results from epidermal barrier abnormalities and immune dysregulation, both modulated by environmental factors. AD is strongly associated with asthma and allergic rhinitis in the so-called 'atopic march.' Xenobiotic receptors and their mates are ligand-activated transcription factors expressed in the skin where they control cellular detoxification pathways. Moreover, they regulate the expression of genes in pathways involved in AD in epithelial cells and immune cells. Activation or overexpression of xenobiotic receptors in the skin can be deleterious or beneficial, depending on context, ligand and activation duration. Moreover, their impact on skin might be amplified by crosstalk among xenobiotic receptors and their mates. Because they are activated by a broad range of endogenous molecules, drugs and pollutants owing to their promiscuous ligand affinity, they have recently crystalized the attention of researchers, including in dermatology and especially in the AD field. This review examines the putative roles of these receptors in AD by critically evaluating the conditions under which the proteins and their ligands have been studied. This information should provide new insights into AD pathogenesis and ways to develop new therapeutic interventions.
Topics: Asthma; Dermatitis, Atopic; Eczema; Epidermis; Gene Expression Regulation; Ligands; Receptors, Cytoplasmic and Nuclear; Rhinitis, Allergic; Skin; Xenobiotics
PubMed: 31470652
DOI: 10.3390/ijms20174234 -
Nutrients Mar 2021Allergic diseases including allergic rhinitis and asthma are increasing in the developing world, related to a westernizing lifestyle, while the prevalence is stable and... (Review)
Review
Allergic diseases including allergic rhinitis and asthma are increasing in the developing world, related to a westernizing lifestyle, while the prevalence is stable and decreasing in the industrialized world. This paper aims to answer the question if prevention and/or treatment of allergic rhinitis and asthma can be achieved by administrating pro-, pre- and/or synbiotics that might contribute to stabilizing the disturbed microbiome that influences the immune system through the gut-lung axis. We searched for relevant English articles in PubMed and Google Scholar. Articles interesting for the topic were selected using subject heading and key words. Interesting references in included articles were also considered. While there is substantial evidence from animal studies in well controlled conditions that selected probiotic strains may offer benefits in the prevention of wheezing and asthma, outcomes from clinical studies in infants (including as well pre- and postnatal administration) are disappointing. The latter may be related to the multiple confounding factors such as environment, strain selection and dosage, moment of administration and genetic background. There is little evidence to recommend administration of pro, pre- or synbiotics in the prevention of asthma and allergic rhinitis in children.
Topics: Asthma; Child; Humans; Prebiotics; Probiotics; Rhinitis, Allergic; Synbiotics
PubMed: 33799367
DOI: 10.3390/nu13030934 -
Annals of the Academy of Medicine,... Nov 2020Allergic rhinitis (AR) is prevalent in Singapore, with a significant disease burden. Afflicting up to 13% of the population, AR impairs quality of life, leads to reduced... (Review)
Review
Allergic rhinitis (AR) is prevalent in Singapore, with a significant disease burden. Afflicting up to 13% of the population, AR impairs quality of life, leads to reduced work productivity and is an independent risk factor for asthma. In the last 2 decades, local studies have identified patient and physician behaviours leading to suboptimal control of the disease. Yet, there is an overall lack of attention to address this important health issue. Allergic Rhinitis and its Impact on Asthma (ARIA) is a European organisation aimed at implementing evidence-based management for AR worldwide. Recent focus in Europe has been directed towards empowering patients for self-management, exploring the complementary role of mobile health, and establishing healthcare system-based integrated care pathways. Consolidation of these ongoing efforts has led to the release of the 2019 ARIA care pathways. This review summarises the ARIA update with particular emphasis on the current status of adult AR in Singapore. In addition, we identify unmet needs and future opportunities for research and clinical care of AR in the local context.
Topics: Adult; Asthma; Humans; Quality of Life; Rhinitis, Allergic; Singapore; Telemedicine
PubMed: 33381782
DOI: 10.47102/annals-acadmedsg.202076 -
International Journal of Molecular... Feb 2021Currently, extracellular vesicles (EVs) have been implicated in the etiopathogenesis of many diseases, including lung disorders, with the possibility of diagnostic and... (Review)
Review
Currently, extracellular vesicles (EVs) have been implicated in the etiopathogenesis of many diseases, including lung disorders, with the possibility of diagnostic and therapeutic applications. The analysis of EV in respiratory tract diseases faces many obstacles, including material collection from airways, standardization of isolation techniques, detection methods, the analysis of their content, etc. This review focuses on the role of extracellular vesicles in the pathogenesis of atopic respiratory diseases, especially asthma, with a special focus on their clinical applicability as a diagnostic tool. We also summarize available laboratory techniques that enable the detection of EVs in various biological materials, with particular emphasis on flow cytometry. The opportunities and limitations of detecting EV in bronchoalveolar lavage fluid (BALF) were also described.
Topics: Asthma; Clinical Laboratory Techniques; Extracellular Vesicles; Flow Cytometry; Humans; Nanoparticles; Rhinitis, Allergic
PubMed: 33668821
DOI: 10.3390/ijms22052273 -
BMC Immunology Jul 2023Allergen-specific immunotherapy (AIT) is a causative treatment in allergic rhinitis (AR), comprising long-term allergen administration and over three years of treatment....
BACKGROUND
Allergen-specific immunotherapy (AIT) is a causative treatment in allergic rhinitis (AR), comprising long-term allergen administration and over three years of treatment. This study is carried out for revealing the mechanisms and key genes of AIT in AR.
METHODS
The present study utilized online Gene Expression Omnibus (GEO) microarray expression profiling dataset GSE37157 and GSE29521 to analyze the hub genes changes related to AIT in AR. Based on limma package, differential expression analysis for the two groups (samples of allergic patients prior to AIT and samples of allergic patients undergoing AIT) was performed to obtain differentially expressed genes (DEGs). Gene Ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis of DEGs were conducted using DAVID database. A Protein-Protein Interaction network (PPI) was built and a significant network module was acquired by using Cytoscape software (Cytoscape, 3.7.2). Utilizing the miRWalk database, we identified potential gene biomarkers, constructed interaction networks of target genes and microRNAs (miRNAs) using Cytoscape software, and explore the cell type-specific expression patterns of these genes in peripheral blood using publicly available single-cell RNA sequencing data (GSE200107). Finally, we are using PCR to detect changes in the hub genes that are screened using the above method in peripheral blood before and after AIT treatment.
RESULTS
GSE37157 and GSE29521 included 28 and 13 samples, respectively. A total of 119 significantly co-upregulated DEGs and 33 co-downregulated DEGs were obtained from two datasets. The GO and KEGG analyses demonstrated that protein transport, positive regulation of apoptotic process, Natural killer cell mediated cytotoxicity, T cell receptor signaling pathway, TNF signaling pathway, B cell receptor signaling pathway and Apoptosis may be potential candidate therapeutic targets for AIT of AR. From the PPI network, 20 hub genes were obtained. Among them, the PPI sub-networks of CASP3, FOXO3, PIK3R1, PIK3R3, ATF4, and POLD3 screened out from our study have been identified as reliable predictors of AIT in AR, especially the PIK3R1.
CONCLUSION
Our analysis has identified novel gene signatures, thereby contributing to a more comprehensive understanding of the molecular mechanisms underlying AIT in the treatment of AR.
Topics: Humans; Rhinitis, Allergic; Transcription Factors; MicroRNAs; Allergens; Immunotherapy; Phosphatidylinositol 3-Kinases
PubMed: 37430199
DOI: 10.1186/s12865-023-00556-1 -
Environment International Sep 2023Prenatal exposure to metallic elements may adversely affect early childhood health. However, more evidence is needed as population-based cohort studies are currently...
BACKGROUND
Prenatal exposure to metallic elements may adversely affect early childhood health. However, more evidence is needed as population-based cohort studies are currently limited.
OBJECTIVES
We aimed to examine the associations between prenatal metallic (mercury, selenium, and manganese) exposure and the risk of allergic diseases in early childhood until three years of age.
METHODS
The data from 94,794 mother-infant pairs, who participated in the Japan Environment and Children's study, were used in this study. Prenatal metallic element exposure was measured in maternal blood collected during mid-pregnancy. The incidence of atopic dermatitis, food allergies, asthma, and allergic rhinitis during the first three years of life was prospectively investigated using self-reports of physician-diagnosed allergies. A multivariable modified Poisson regression model was used to estimate the cumulative incidence ratio and their 95% confidence intervals of allergic diseases associated with prenatal exposure to mercury, selenium, and manganese. We further evaluated the interaction between mercury and selenium exposures in this association.
RESULTS
We confirmed 26,238 cases of childhood allergic diseases: atopic dermatitis, food allergies, asthma, and allergic rhinitis in 9,715 (10.3%), 10,897 (11.5%), and 9,857 (10.4%), 4,630 (4.9%), respectively. No association was found between prenatal mercury or manganese exposure and the risk of allergic diseases. Prenatal selenium exposure was inversely associated with atopic dermatitis, food allergies, allergic rhinitis, and any allergic diseases, but not with asthma. These inverse associations were more pronounced for lower mercury exposures than for higher exposures.
CONCLUSIONS
Our findings suggest that prenatal exposure to selenium may be beneficial for reducing the risk of atopic dermatitis, food allergies, allergic rhinitis, and any allergic diseases in early childhood, especially with lower prenatal mercury exposure.
Topics: Infant; Female; Pregnancy; Child, Preschool; Child; Humans; Selenium; Manganese; Dermatitis, Atopic; Japan; Prenatal Exposure Delayed Effects; Rhinitis, Allergic; Asthma; Vitamins; Mercury; Mothers
PubMed: 37595534
DOI: 10.1016/j.envint.2023.108123