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Allergy Apr 2024The efficacy and safety of preventive allergen immunotherapy (pAIT) in children are currently under investigation. Here, we provide an overview of pAIT with respiratory... (Review)
Review
The efficacy and safety of preventive allergen immunotherapy (pAIT) in children are currently under investigation. Here, we provide an overview of pAIT with respiratory allergens concerning the prevention of new sensitizations, allergic disease onset and progression as well as further immunomodulatory effects. Three databases were searched for clinical pAIT studies in children. Selected publications were reviewed for preventive outcomes according to prevention level (primary, secondary, and tertiary), allergen type, administration route, dose, and treatment duration. The primary prevention approach appears safe but showed no allergen-specific effect on new sensitizations. Secondary prevention seems feasible and may induce regulatory T cell-mediated immunotolerance. The number of studies at these prevention levels is limited. Tertiary prevention with grass and/or tree pollen-based pAIT has shown efficacy in preventing disease progression from allergic rhinitis/conjunctivitis to asthma. Data on tertiary pAIT with house dust mites and other allergen types are inconclusive. Subcutaneous and sublingual routes appear similarly effective, but head-to-head comparative paediatric studies are scarce. Additionally, there are fewer placebo-controlled studies. Nevertheless, immunomodulatory outcomes of pAIT are encouraging. Currently, limited but favourably suggestive evidence is available for preventing respiratory allergic diseases in children by pAIT. Primary and secondary prevention have potential and warrant further investigation through well-designed studies.
PubMed: 38588176
DOI: 10.1111/all.16115 -
Journal of Public Health Research Apr 2024Traditional eye medicine (TEM) is becoming more widely used across the world. Depending on the drugs used, TEM usage can be considered harmful or innocuous. The therapy...
BACKGROUND
Traditional eye medicine (TEM) is becoming more widely used across the world. Depending on the drugs used, TEM usage can be considered harmful or innocuous. The therapy may induce infection or irreparable blindness in the already injured eye.The aim of the study was to determine the proportion of traditional eye medicine practices and associated factors among adult ophthalmic patients attending ophthalmic clinics in the governmental hospitals in the West Bank.
DESIGN AND METHODS
A cross-sectional study conducted on 300 patients. The data was collected using a structured, self-administered questionnaire.
RESULTS
The results of the study revealed that 65.7% of people use TEM. The most common symptoms that necessitated the use of traditional eye practice were inflammatory symptoms of the eye (49.2%), blurred vision (15.7%), and allergic conjunctivitis (10.7%). The most common TEM used was tea (34.0%), followed by herbal products (25.4%) and vegetable slices (potato, cucumber, and onion) (14.7%). The most traditional eye treatment was the topical route (92.9%). The majority of prescribers of traditional eye practice were traditional healers (48.7%). Furthermore, the current study found that occupation and the income were predictors of using traditional eye practice among ophthalmic patients attending ophthalmic clinics in selected West Bank hospitals.
CONCLUSION
The proportion of traditional eye medicine practice was high among ophthalmic patients in the West Bank. The predictors of using traditional eye treatment were occupation and the income. The most common TEM used was tea, followed by herbal products and vegetable slices (potato, cucumber, and onion).
PubMed: 38577243
DOI: 10.1177/22799036241243267 -
Indian Journal of Otolaryngology and... Apr 2024Allergic rhinitis affects approximately 40% of children. This study aimed at determining the prevalence, sociodemographic features, comorbid illnesses, complications and...
Allergic rhinitis affects approximately 40% of children. This study aimed at determining the prevalence, sociodemographic features, comorbid illnesses, complications and quality of life in children referred to the outpatient clinic of "Allergic Rhinitis" in Penteli Children Hospital, Athens, Greece. We analyzed 590 pediatric patients referred to the outpatient clinic of "Allergic Rhinitis" in Penteli Children Hospital, Athens, Greece from 26/01/2012 to 20/11/2022. Allergic rhinitis was recorded as the one and only allergic disease in 59% of the children diagnosed with allergic rhinitis, concomitant asthma in 16% of them, atopic dermatitis in 8% and allergic conjunctivitis in 5%. 54% of asthmatic children was diagnosed allergic rhinitis, while 16% of allergic rhinitis children was diagnosed asthma. Skin tests were important diagnostic tools, not being necessary the measurement of total IgE in plasma. Eosinophils from nasal secretions were increased in 19% of the children with non-diagnostic cases and the diagnosis was local allergic rhinitis (LAR). Clinical presentations of allergic rhinitis were mainly nasal blockage, runny nose, recurrent sneezing and nasal itching. The most common complication was acute or chronic sinusitis 35%. Major associated comorbid illnesses among were tonsils hypertrophy, adenoid hypertrophy and inferior turbinate hypertrophy. Allergic rhinitis was reported in 78% of studied children and was frequently characterized by significant morbidity. Allergic rhinitis affected all paediatric age group and was peaked at age group 11-14 years and 5-7 years. There were associated epidemiological features, clinical manifestations, comorbid illnesses, complications and affectation of the quality of life in children.
PubMed: 38566743
DOI: 10.1007/s12070-023-04402-z -
Life (Basel, Switzerland) Mar 2024Allergic conjunctivitis is one of the common immune hypersensitivity disorders that affect the ocular system. The clinical manifestations of this condition exhibit... (Review)
Review
Allergic conjunctivitis is one of the common immune hypersensitivity disorders that affect the ocular system. The clinical manifestations of this condition exhibit variability contingent upon environmental factors, seasonal dynamics, and genetic predisposition. While our comprehension of the pathophysiological engagement of immune and nonimmune cells in the conjunctiva has progressed, the same cannot be asserted for the cytokines mediating this inflammatory cascade. In this review, we proffer a comprehensive description of interleukins 4 (IL-4), IL-5, IL-6, IL-9, IL-13, IL-25, IL-31, and IL-33, as well as thymic stromal lymphopoietin (TSLP), elucidating their pathophysiological roles in mediating the allergic immune responses on the ocular surface. Delving into the nuanced functions of these cytokines holds promise for the exploration of innovative therapeutic modalities aimed at managing allergic conjunctivitis.
PubMed: 38541674
DOI: 10.3390/life14030350 -
Frontiers in Allergy 2024Combined exposures to allergens and air pollutants emerged as a topic of concern in scientific circles by the 1980's, when it became clear that parallel increases in... (Review)
Review
Combined exposures to allergens and air pollutants emerged as a topic of concern in scientific circles by the 1980's, when it became clear that parallel increases in respiratory allergies and traffic-related air pollution had been occurring during the 20th century. Although historically there has been a tendency to treat exposure-related symptoms as allergic or toxicologic in nature, cross-interactions have since been established between the two modalities. For example, exposure to selected air pollutants in concert with a given allergen can increase the likelihood that an individual will become sensitized to that allergen, strongly suggesting that the pollutant acted as an . Although not a review of underlying mechanisms, the purpose of this mini-review is to highlight the potential significance of co-exposure to adjuvant chemicals in predicting allergic sensitization in the respiratory tract. The current discussion emphasizes the upper airway as a model for respiratory challenge studies, the results of which may be applicable-not only to allergic rhinitis-but also to conjunctivitis and asthma.
PubMed: 38533354
DOI: 10.3389/falgy.2024.1374771 -
Oman Journal of Ophthalmology 2024A 32-year-old male, with juvenile open-angle glaucoma on chronic antiglaucoma therapy and recently introduced brimonidine eye drops to the treatment regimen, developed...
A 32-year-old male, with juvenile open-angle glaucoma on chronic antiglaucoma therapy and recently introduced brimonidine eye drops to the treatment regimen, developed bilateral follicular conjunctivitis with subepithelial infiltrates (SEIs) initially resembling common infectious keratoconjunctivitis entities. The persistent nature of the conjunctivitis, the lack of positive conjunctival cultures, the absence of systemic symptoms, the full resolution of the condition upon discontinuation of antiglaucoma drops, and the commencement of topical steroids, along with the reappearance of SEIs upon reintroducing brimonidine; suggested an immune-mediated drug reaction secondary to a Benzalkonium chloride (BAK) preserved brimonidine tartrate 0.2% formulation. The interval between the initiation of brimonidine and the onset of the drug reaction was 13 months and shortened to 1 week upon re-exposure to the drug. The condition fully resolved without further sequelae off brimonidine. Brimonidine is notoriously known for causing ocular allergic reactions, the most common being follicular conjunctivitis, but very few reports exist describing its adverse effects on the cornea. This case highlights that brimonidine may directly or indirectly induce an immune reaction affecting the cornea in the form of SEIs. Brimonidine is, thus, capable of mimicking more commonly recognized infectious disease entities causing keratoconjunctivitis. This is the second report of a similar manifestation linked to its use.
PubMed: 38524330
DOI: 10.4103/ojo.ojo_99_23 -
International Ophthalmology Mar 2024This meta-analysis aimed to review the safety and efficacy of topical cyclosporine A (CsA) and topical tacrolimus in allergic eye disease. (Review)
Review Meta-Analysis
PURPOSE
This meta-analysis aimed to review the safety and efficacy of topical cyclosporine A (CsA) and topical tacrolimus in allergic eye disease.
METHODS
A systematic search identified thirteen studies and a total of 445 patients for inclusion, making this the largest meta-analysis published on the subject. The current review was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).
RESULTS
Thirteen randomized control trials were included in the meta-analysis. Eleven studies used CsA as the treatment, and two used Tacrolimus. In total, 445 participants were included, of whom 76.6% were male. The mean age of participants across the included studies was 14 years. All studies reported clinical signs as evaluated by an examining clinician. Signs were usually assessed by anatomical region, with the most common regions being the conjunctiva and the cornea, and the most common signs assessed were hyperemia and papillae. Three studies accounted for more than 50% of the meta-analysis's weight. Effect size (d) ranged from - 2.37 to - 0.03, negative values favoring immunomodulators. Fixed Effect Meta-Analysis returned an SMD of - 0.81 (95% CI [- 0.98, - 0.65]). However, there was significant heterogeneity (I = 61%, Q = 30.76) in the outcome measure (P = 0.0021); therefore, a random-effect meta-analysis was also completed in which the pooled SMD was - 0.98 (95% CI [- 1.26, - 0.69], τ = 0.16).
CONCLUSIONS
This study affirms the current scientific community's stance that immunomodulators effectively treat clinical signs, including blepharitis, conjunctival hyperemia, edema, papillae, and corneal damage in severe ocular allergic disease.
Topics: Humans; Male; Adolescent; Female; Conjunctivitis, Allergic; Hyperemia; Tacrolimus; Immunologic Factors; Keratoconjunctivitis; Conjunctiva; Cyclosporine
PubMed: 38522059
DOI: 10.1007/s10792-024-03097-7 -
Scientific Reports Mar 2024Globally, there has been a dramatic increase in the geriatric population. Sadly, this populace is highly prone to develop various ocular morbidities putting pressure on...
Globally, there has been a dramatic increase in the geriatric population. Sadly, this populace is highly prone to develop various ocular morbidities putting pressure on the strained eye care delivery system especially in low-income countries. Hence, the aim of this study was to determine the distribution of ocular morbidities among elderly. The study was a retrospective cross-sectional study conducted at Mzuzu Central Hospital in Malawi. We retrieved data from the hospital's Ophthalmology out-patient registry from January 2021 to December 2021. We recruited all 970 elderly patients who visited the clinic during the period of study. Data entry and analysis was done employing SPSS (v.26). More males than females had ocular morbidities. Cataract 400 (41.2%) was the most prevalent ocular morbidity followed by glaucoma 189 (19.5%), pinguecula 48 (4.9%) and allergic conjunctivitis 43 (4.4%). Anterior segment eye diseases were common 714 (73.6%). The prevalence of cataract, glaucoma, refractive error and allergic conjunctivitis was significantly associated with sex (p < 0.05). Age association was found with the prevalence of cataract, glaucoma, pinguecula, allergic conjunctivitis and corneal scar (p < 0.05). The pattern of eye diseases is endemic to the country. More resources should be targeting cataract and glaucoma among the age group.
Topics: Male; Female; Humans; Aged; Conjunctivitis, Allergic; Tertiary Care Centers; Cross-Sectional Studies; Retrospective Studies; Malawi; Pinguecula; Eye Diseases; Glaucoma; Cataract; Prevalence; Outpatients
PubMed: 38509142
DOI: 10.1038/s41598-024-55538-z -
International Journal of Pediatric... Apr 2024Previous studies have reported an increasing prevalence of childhood allergic rhinitis in developing countries. There is still a lack of the recent epidemiology of...
BACKGROUND
Previous studies have reported an increasing prevalence of childhood allergic rhinitis in developing countries. There is still a lack of the recent epidemiology of allergic rhinitis among Chinese preschool children. Therefore, this study explored the prevalence of rhinitis symptoms and identified their associations with potential risk factors among children at the age of 3-6 in Shanghai, China.
METHODS
Validated International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was adopted to collect information about rhinitis symptoms and potential risk factors. Univariate and multivariate logistic regression analyses were used to assess associations between risk factors and allergic rhinitis and rhinoconjunctivitis.
RESULTS
A total of 6183 questionnaires were included in our study. The prevalence of rhinitis ever, current rhinitis, and physician-diagnosed rhinitis were 32.6%, 29.2%, and 14.3%, respectively, while the prevalence of current rhinoconjunctivitis was 11.3%. The higher prevalence was observed in boys than in girls in terms of rhinitis ever, current rhinitis, current rhinoconjunctivitis and doctor-diagnosed rhinitis. Autumn had the highest prevalence among four seasons. In our multivariate logistic regression analyses, history of allergic diseases and paracetamol use in the last year showed positive associations with the increased risk of both current rhinitis and rhinoconjunctivitis, and antibiotic use was an independent significant risk factor only for current rhinitis. Genetic factors, including maternal and paternal rhinitis, asthma, and eczema, were significantly associated with the prevalence of current rhinitis. Similar associations were seen between these factors and current rhinoconjunctivitis, except for paternal eczema. Among environmental factors, smoking exposure at home, heavy truck traffic in home's street, floor heating system were independent risk factors for both current rhinitis and rhinoconjunctivitis in the adjusted model, while cleaning the house less than once a week was only associated with current rhinitis.
CONCLUSION
The prevalence of current rhinitis was 29.2% among children aged 3-6 in Shanghai, China. Sex differences and seasonal variations were observed in the prevalence of rhinitis symptoms. The identified risk factors would provide a basis for policy makers and medical experts to take intervention measures to prevent allergic rhinitis and rhinoconjunctivitis.
Topics: Humans; Female; Child, Preschool; Male; Conjunctivitis, Allergic; China; Rhinitis; Risk Factors; Eczema; Rhinitis, Allergic; Asthma; Surveys and Questionnaires; Prevalence
PubMed: 38492328
DOI: 10.1016/j.ijporl.2024.111906 -
Journal of Ocular Pharmacology and... Mar 2024Topical antihistamines, such as olopatadine hydrochloride, an H1 receptor antagonist, are commonly prescribed for treating allergic conjunctivitis. Drug delivery via...
Topical antihistamines, such as olopatadine hydrochloride, an H1 receptor antagonist, are commonly prescribed for treating allergic conjunctivitis. Drug delivery via eye drops has many deficiencies including a short residence time due to tear drainage via the nasolacrimal duct, which results in a low bioavailability and potential for side effects. These deficiencies could be mitigated by a drug-eluting contact lens such as the recently approved ACUVUE THERAVISION™ WITH KETOTIFEN which is a daily disposable etafilcon, a drug-eluting contact lens with ketotifen (19 μg per lens). Here, we investigate the feasibility of designing a drug-eluting lens with sustained release of olopatadine for treating allergies using an extended wear lens. Nanobarrier depots composed of vitamin-E (VE) are formed through direct entrapment by ethanol-driven swelling. The drug-loaded lenses are characterized for transparency and water content. release is measured under sink conditions and fitted to a diffusion control release model to determine diffusivity and partition coefficient. studies indicate that ACUVUE OASYS and ACUVUE TruEye™ lenses loaded with ∼0.3 g of VE/g of hydrogel effectively prolong olopatadine dynamics by 7-fold and 375-fold, respectively. Incorporation of VE into the lenses retains visible light transmission and other properties. The VE incorporation in commercial lenses significantly increases the release duration offering the possibility of antiallergy extended wear lenses.
Topics: Olopatadine Hydrochloride; Vitamin E; Ketotifen; Contact Lenses; Vitamins
PubMed: 38489059
DOI: 10.1089/jop.2023.0111