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Clinical, Cosmetic and Investigational... 2024To assess the correlations between Immunoglobulin E (IgE) levels, pruritus, and lesion severity in patients with eczema, atopic dermatitis, or urticaria.
A Comprehensive Analysis of Immunoglobulin E Levels, Allergen-Specific Sensitivities, and Clinical Manifestations in Allergic Dermatological Conditions: A Multicenter Retrospective Study in China.
OBJECTIVE
To assess the correlations between Immunoglobulin E (IgE) levels, pruritus, and lesion severity in patients with eczema, atopic dermatitis, or urticaria.
METHODS
A retrospective study was conducted and data of 814 patients who visited the dermatology or allergy clinics of multiple hospitals, from December 2019 to December 2021, were collected. Patients were divided into children group (<18 years, 325 cases), adult group (18-60 years, 435 cases), and older population group (>60 years, 54 cases) based on the age. Baseline information, pruritus severity, severity of skin lesions, total IgE level, and specific IgE level were recorded to analyze the complex relationship between them.
RESULTS
The prevalence of allergic conjunctivitis and allergic rhinitis in the children group was significantly higher than that in the adult and older population group (P < 0.01 or P < 0.05). The positive rate of specific IgE in children group was significantly higher than that in the adult and older population group (P < 0.01). The IgE levels in children with moderate pruritus were significantly lower than those of severe pruritus (63.39vs 114.42 IU/mL, P < 0.05). The IgE levels in children with mild and moderate skin lesions were significantly lower than those in children with severe skin lesions (58.95 vs 72.88 vs 169.15 IU/mL, P < 0.001 or P < 0.01, respectively).
CONCLUSION
Relationships among age, severity of skin pruritus and lesions, and allergen-specific IgE response are complex and subtle, displaying dynamic patterns.
PubMed: 38444403
DOI: 10.2147/CCID.S451117 -
Ophthalmology and Therapy May 2024Vernal keratoconjunctivitis (VKC) is a rare yet severe form of allergic conjunctivitis predominantly affecting children, mainly boys, with a global prevalence and a...
Vernal keratoconjunctivitis (VKC) is a rare yet severe form of allergic conjunctivitis predominantly affecting children, mainly boys, with a global prevalence and a higher incidence in certain geographical regions. The disease is characterized by seasonal exacerbations. VKC presents with ocular surface inflammation leading to various distressing symptoms such as itching, redness, mucous discharge, and pain. The disease primarily manifests bilaterally, though it may initially appear unilaterally. If left untreated, VKC can result in corneal complications, including shield ulcers and vision impairment, affecting daily activities and psychosocial well-being, especially in children. The diagnosis of VKC involves identifying key clinical findings on the ocular surface such as Tranta dots, giant papillae, or shield ulcers. Management follows a stepwise approach, including anti-allergic eye drops, steroid eye drops, and topical medications like cyclosporine, which may take up to 3 months to show efficacy. Allergic sensitization, often to inhaled allergens like pollen and house dust mites, is associated with VKC in half of the cases. Understanding and managing these allergies through measures such as avoidance, sensitization control, and co-treatment of associated conditions like asthma and rhinoconjunctivitis are essential in VKC management. Atopic keratoconjunctivitis (AKC), a related condition associated with atopic dermatitis and asthma, shares similarities with VKC but typically affects young adults. However, there is an observed spectrum between the two diseases, indicating similar treatment strategies for both. VKC treatment requires a patient-centered approach, involving informed and supported parents, considering economic factors due to costly eye drops, and ensuring accessibility and practicality of treatment, especially in children. A multidisciplinary team collaboration, including ophthalmologists, pediatricians, and dermatologists, optimizes patient care. The rewarding aspect of VKC treatment lies in witnessing children regain their quality of life, overcome vision challenges, and thrive in their daily activities. In conclusion, understanding VKC, its associated allergies, and employing a comprehensive, patient-centered approach are crucial in managing this challenging condition, particularly in children, to enhance their vision and overall well-being.
PubMed: 38436902
DOI: 10.1007/s40123-024-00909-y -
Cureus Jan 2024Background This study aimed to examine the association of suspended particulate matter (SPM) with outpatient attendance for allergic conjunctivitis. Methodology The...
Background This study aimed to examine the association of suspended particulate matter (SPM) with outpatient attendance for allergic conjunctivitis. Methodology The information on air pollution, encompassing total hydrocarbons, non-methane hydrocarbons, methane, carbon monoxide, nitrogen oxide, nitric oxide, oxidants, and SPM alongside data concerning daily weather conditions such as temperature, wind speed, and humidity, was gathered. Subsequently, the weekly mean values for outpatient visits, air pollution, and weather parameters were computed. Results The number of outpatient visits for allergic conjunctivitis was significantly associated with SPM levels (r = 0.70, p = 0.0037), oxidant levels (r = 0.70, p = 0.0038), wind speed (r = 0.48, p = 0.0472), and humidity (r = 0.77, p = 0.0009) from January to March, as well as SPM levels (r = 0.53, p = 0.0309) and carbon monoxide (r = 0.56, p = 0.0230) from April to June. Multivariate analysis showed that SPM (odds ratio = 1.37, p = 0.0161) and wind velocity (odds ratio = 1.52, p = 0.0038) were significant predictors of the number of outpatient visits from January to December. Conclusions SPM levels were the only independent predictor of outpatient visits for allergic conjunctivitis, suggesting that SPM contributes to the pathophysiology of this condition.
PubMed: 38435920
DOI: 10.7759/cureus.53292 -
Cureus Feb 2024Background A child's learning ability depends on vision, and visual impairment negatively affects neurological, intellectual, and emotional development by limiting...
Background A child's learning ability depends on vision, and visual impairment negatively affects neurological, intellectual, and emotional development by limiting children's exposure to a range of experiences and information. This study aims to determine the prevalence and pattern of ocular morbidity among primary schoolchildren in Abakaliki and provide evidence that can be used in planning a school eye health program for the state. Methodology A school-based, cross-sectional study was conducted within the Abakaliki metropolis between January and April 2018 to determine the ocular health status of schoolchildren recruited using stratified random sampling. Data were analyzed using SPSS version 22 (IBM Corp., Armonk, NY, USA) and presented using descriptive statistics. Univariate analysis was performed to determine the association between dependent and independent variables, with the level of significance determined by a p-value <0.05 (95% confidence interval (CI)). Results A total of 553 schoolchildren aged 6-16 years were examined. The prevalence of eye disorders was 23.5%. Common disorders included refractive error (12.7%) and allergic eye disease (7.1%). Other findings included glaucoma suspect (15, 2.7%), infective conjunctivitis (1, 0.2%), amblyopia (3, 0.5%), cataract (1, 0.2%), and squint (1, 0.2%). The prevalence of visual impairment was 3.1%. Univariate analysis showed a significant association between ocular morbidity and attending private schools (95% CI = 6.5-11.1, p = 0.003). Conclusions Eye disorders such as uncorrected refractive error and allergic conjunctivitis were common among schoolchildren. School eye health programs can ensure that eye screening is done periodically, allowing for early detection, referral, and prompt treatment of eye diseases that can potentially cause visual impairment.
PubMed: 38435209
DOI: 10.7759/cureus.53385 -
Graefe's Archive For Clinical and... Mar 2024To evaluate the long-term efficacy and safety of ripasudil-brimonidine fixed-dose combination (RBFC), a new intraocular pressure (IOP)-lowering medication for glaucoma...
Long-term intraocular pressure-lowering efficacy and safety of ripasudil-brimonidine fixed-dose combination for glaucoma and ocular hypertension: a multicentre, open-label, phase 3 study.
PURPOSE
To evaluate the long-term efficacy and safety of ripasudil-brimonidine fixed-dose combination (RBFC), a new intraocular pressure (IOP)-lowering medication for glaucoma and ocular hypertension (OHT).
METHODS
This prospective, multicentre (23 sites in Japan), open-label study enrolled patients with primary open-angle glaucoma (POAG), OHT or exfoliative glaucoma and assigned them to one of four combination therapy cohorts, based on previous treatment(s) received: prostaglandin (PG) analogue (Cohort 1); PG analogue and beta-adrenoceptor blocker (β-blocker) (Cohort 2); PG analogue, β-blocker and carbonic anhydrase inhibitor (Cohort 3); or other/no treatment (Cohort 4). After a ≥ 4-week screening period, eligible patients received twice-daily RBFC for 52 weeks in addition to the treatments they were already receiving. Efficacy was assessed by change in IOP from baseline through week 52. Adverse events and adverse drug reactions (ADRs) were monitored throughout.
RESULTS
In total, 179 patients from Cohort 1 (n = 48), Cohort 2 (n = 44), Cohort 3 (n = 41) and Cohort 4 (n = 46) entered the RBFC treatment period. For all cohorts, mean IOP was significantly reduced at 11:00 (2 h after instillation of RBFC) through week 52 with the changes from baseline at week 52 of - 2.7 to - 4.1 mmHg across cohorts; all p < 0.001. Common ADRs were conjunctival hyperaemia (58%), allergic conjunctivitis (18%) and blepharitis (17%), most of which were mild in severity.
CONCLUSION
These data demonstrated the long-term efficacy and safety of RBFC, both alone and in combination with other anti-glaucoma agents. RBFC may offer a new treatment option for the long-term management of glaucoma and OHT.
TRIAL REGISTRATION
Japan Registry of Clinical Trials Identifier: jRCT2080225063.
DATE OF REGISTRATION
17 February 2020.
PubMed: 38430227
DOI: 10.1007/s00417-024-06388-y -
Scientific Reports Feb 2024Allergens from domestic cats (Felis catus) cause allergy-related health problems worldwide. Fel d 1 is a major allergen that causes severe allergic reactions in humans,...
Allergens from domestic cats (Felis catus) cause allergy-related health problems worldwide. Fel d 1 is a major allergen that causes severe allergic reactions in humans, including rhinitis, conjunctivitis, and life-threatening asthma. Therefore, patients with cat allergies anticipate hypoallergenic cats. We successfully generated Fel d 1 chain 2 (CH2) genome-edited cats using the CRISPR-Cas9 system in this study. T7 endonuclease 1 assay and Sanger sequencing were used to confirm the mutation in CH2 genome-edited cats. Fel d 1 level in CH2 genome-edited cats were assessed by enzyme-linked immunosorbent assay (ELISA). Remarkably, ELISA showed that the level of Fel d 1 in the CH2 homozygous genome-edited cat (Name: Alsik) was extremely low compared with that in wild type domestic cats and could be hypoallergenic cats. Additionally, we successfully cloned the CH2 homozygous genome-edited cat using cytoplasm injection clone technology. The cloned CH2 homozygous genome-edited cat was verified using microsatellite analysis. Creating hypoallergenic cats using the CRISPR-Cas9 system is a significant step forward because these cats can safely approach allergic patients.
Topics: Cats; Animals; Humans; CRISPR-Cas Systems; Hypersensitivity; Allergens; Asthma; Enzyme-Linked Immunosorbent Assay
PubMed: 38424152
DOI: 10.1038/s41598-024-55464-0 -
Journal of the Science of Food and... Aug 2024Allergic conjunctivitis is one of the most common eye disorders. Different drugs are used for its treatment. Hesperidin is an active substance isolated from Citrus...
BACKGROUND
Allergic conjunctivitis is one of the most common eye disorders. Different drugs are used for its treatment. Hesperidin is an active substance isolated from Citrus sinensis L. (Rutaceae) fruit peels, with known anti-inflammatory activity but low solubility. It was complexed with cyclodextrin and encapsulated in situ gel to extend its duration in the eye.
RESULTS
The optimized formulation comprised 1% hesperidin, 1.5% hydroxyethyl cellulose, and 16% poloxamer 407. The viscosity at 25 °C was 492 ± 82 cP, and at 35 °C it was 8875 ± 248 cP, the pH was 7.01 ± 0.03, gelation temperature was 34 ± 1.3 °C, and gelation time was 33 ± 1.2 s. There was a 66% in vitro release in the initial 2 h, with a burst effect. A lipoxygenase (LOX) inhibition test determined that hesperidin was active at high doses on leukotyrens seen in the body in allergic diseases. In cell-culture studies, the hesperidin cyclodextrin complex loaded in situ gel, BRN9-CD (poloxamer 16%, hydroxy ethyl cellulose (HEC) 1.5%), enhanced cell viability in comparison with the hesperidin solution. It was determined that BRN9-CD did not cause any irritation in the ocular tissues in the Draize test.
CONCLUSION
The findings of this study demonstrate the potential of the in situ gel formulation of hesperidin in terms of ease of application and residence time on the ocular surface. Due to its notable LOX inhibition activity and positive outcomes in the in vivo Draize test, it appears promising for incorporation into pharmaceutical formulations. © 2024 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.
Topics: Hesperidin; Drug Delivery Systems; Gels; Animals; Humans; Citrus sinensis; Conjunctivitis, Allergic; Drug Compounding; Viscosity; Mice; Plant Extracts; Cell Survival; Chemistry, Pharmaceutical
PubMed: 38385802
DOI: 10.1002/jsfa.13407 -
The Journal of Allergy and Clinical... Jun 2024The most common symptoms of pollen allergy are rhinitis and conjunctivitis. However, in real-world clinical practice, we sometimes encounter patients with pollen allergy...
BACKGROUND
The most common symptoms of pollen allergy are rhinitis and conjunctivitis. However, in real-world clinical practice, we sometimes encounter patients with pollen allergy suffering from severe extrarespiratory symptoms including skin, gastrointestinal, or flu-like symptoms in relation to exposure to sensitized pollen.
OBJECTIVE
To elucidate the extrarespiratory symptoms in patients with pollen allergy.
METHODS
We performed a non-drug-focused prospective study of patients with pollen allergy (n = 384). During the 1-year observational period, they were asked to complete a weekly electronic diary consisting of visual analog scale (VAS) scores to assess all symptoms experienced in various organs over the past week. An association between seasonal pollen levels and seasonal increase in VAS scores was evaluated using a mixed-effects model for repeated measures. A k-means cluster analysis was performed to identify a group of patients experiencing stronger extrarespiratory symptoms.
RESULTS
In patients sensitized to grass or birch pollen, higher seasonal levels of these pollen grains were associated with higher VAS scores for headache, gastrointestinal symptoms, skin symptoms, and fatigue. A cluster analysis identified a group of severe pollen-allergic patients with higher extrarespiratory symptoms (n = 42). This group was characterized by a higher frequency of comorbid food allergy/atopic dermatitis, higher rate of IgE sensitization to pollens, and higher impaired activity and work productivity.
CONCLUSIONS
This 1-year survey identified a small but nonnegligible group of patients with pollen-related extrarespiratory symptoms. More attention should be paid to this patient group considering their impaired activity and work productivity.
Topics: Humans; Rhinitis, Allergic, Seasonal; Japan; Male; Female; Adult; Pollen; Middle Aged; Prospective Studies; Allergens; Surveys and Questionnaires; Seasons; Young Adult; Dermatitis, Atopic; Food Hypersensitivity
PubMed: 38382879
DOI: 10.1016/j.jaip.2024.02.011 -
Clinical Ophthalmology (Auckland, N.Z.) 2024To compare clinical outcomes and patient preference for the dexamethasone intracanalicular insert (DEX) versus topical loteprednol (LOT) or olopatadine (OLO) for the... (Clinical Trial)
Clinical Trial
PURPOSE
To compare clinical outcomes and patient preference for the dexamethasone intracanalicular insert (DEX) versus topical loteprednol (LOT) or olopatadine (OLO) for the treatment of allergic conjunctivitis in a real-world model of allergen exposure.
METHODS
This was a prospective comparative trial. Adults with testing-confirmed bilateral allergic conjunctivitis received DEX in the more symptomatic eye and either LOT 2 times daily or OLO once daily for 30 days in the fellow eye. The primary outcome was patient preference for treatment. Clinical outcomes included ocular itching and hyperemia, lid swelling, and watering/tearing. Safety outcomes included intraocular pressure (IOP).
RESULTS
Thirty patients participated and completed the study. All received DEX in the eye with worse symptoms and 15 received LOT and the other 15 received OLO in the other eye. Patients preferred DEX (10/15; 66.7%) over LOT (4/15; 26.7%), with one patient having no preference (p = 0.0103). Patients had no preference between DEX (8/15; 53.3%) and OLO (6/15; 40%), with one patient having no preference (p = 0.1044). In the DEX/LOT cohort, ocular itching and hyperemia improved more with DEX than LOT (p ≤ 0.009), while in the DEX/OLO cohort, the DEX eyes showed greater improvement in conjunctival hyperemia (p < 0.0001) but not itching (p = 0.074). No between-group differences were seen in eyelid swelling or tearing/watering in either cohort. Mean change in IOP was similar between the DEX and LOT eyes (p = 0.4921), and mean IOP rose more in the DEX eyes than the OLO eyes (by <1 mmHg; p = 0.0403).
CONCLUSION
Overall, this real-world study demonstrated that the dexamethasone intracanalicular insert was as effective as a topical antihistamine/mast cell stabilizer and more effective than topical steroids in relieving the signs and symptoms of allergic conjunctivitis. This insert should be considered as an alternative to topical therapy for the treatment of allergic conjunctivitis.
PubMed: 38375441
DOI: 10.2147/OPTH.S440840 -
Die Ophthalmologie Mar 2024In severe and recurrent ocular allergies conventional ophthalmic drugs can reach their limits, especially in chronic forms. The first novel immunomodulators and... (Review)
Review
BACKGROUND
In severe and recurrent ocular allergies conventional ophthalmic drugs can reach their limits, especially in chronic forms. The first novel immunomodulators and biologicals are already in clinical use and could provide relief.
OBJECTIVE
Based on the immunopathophysiological mechanisms of ocular allergies, possible targets for innovative treatment approaches are presented. An overview of promising new and future immunomodulators and biologicals and their modes of action is also given.
MATERIAL AND METHODS
Current reviews on ocular allergies and the treatment of systemic allergic diseases were screened. Case reports on the treatment of ocular allergy using immunomodulators and biologicals were analyzed. The clinical relevance and possible applications are presented.
RESULTS
In chronic forms of ocular allergies, complex ocular surface inflammatory responses mediated via immunoglobulin E (IgE), mast cells, CD4-positive type 2 T‑helper cells and eosinophilic granulocytes are predominant. Cyclosporine A 0.1% eyedrops have been approved in Europe since 2018 for children aged 4 years and older with severe vernal keratoconjunctivitis (VKC). In addition, case reports present promising data on the systemic off-label use of biologicals, such as dupilumab or omalizumab, in refractory VKC or atopic keratoconjunctivitis (AKC).
CONCLUSION
A profound understanding of the immunopathophysiology of ocular allergies is necessary to detect further targets for future immunomodulators and biologicals. Currently, immunomodulatory therapy remains limited to cyclosporine A eyedrops. Other immunomodulatory agents, such as tacrolimus and biologicals can only be used off-label. Further studies on the controlled clinical use of these substances in the treatment of VKC or AKC are underway.
Topics: Child; Humans; Conjunctivitis, Allergic; Cyclosporine; Tacrolimus; Immunologic Factors; Adjuvants, Immunologic; Ophthalmic Solutions
PubMed: 38363381
DOI: 10.1007/s00347-024-01996-9