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Alternative Therapies in Health and... Feb 2024This study aims to assess the correlation between allergic conjunctivitis (AC) and allergic rhinitis (AR).
OBJECTIVE
This study aims to assess the correlation between allergic conjunctivitis (AC) and allergic rhinitis (AR).
METHODS
A total of 462 patients diagnosed with either allergic conjunctivitis or allergic rhinitis and treated at our hospital from January 2018 to December 2020 were included. Patients were categorized into two groups, the AC group and the AR group, based on their initial department of consultation. The AC group comprised 232 patients diagnosed with allergic conjunctivitis in the ophthalmology department, while the AR group consisted of 230 patients diagnosed with allergic rhinitis in the ENT department. Allergen analysis was conducted on patients presenting with both AC and AR and conjunctival and nasal mucosal scrapings were performed to examine eosinophil presence. The study analyzed the association between allergic AC and AR.
RESULTS
In the AC group, 174 patients (75.00%) had concurrent AR, while in the AR group, 169 patients (73.48%) had concurrent AC. Inhalant allergen testing among patients with concurrent AC and AR revealed that the primary inhalant allergens were dust mites, house dust, and fungi, with specific immunoglobulin E (IgE) positivity of 91.23%. Testing for food allergens identified fish, shrimp, and crab as ingestive allergens, with a specific IgE positivity of 58.58%. Eosinophil presence was assessed through conjunctival and nasal mucosal scrapings in patients with concurrent AC and AR. Eosinophils were detected in 188 cases (54.81%) through conjunctival scraping and 197 cases (57.43%) through nasal mucosal scraping, with no significant differences observed (P > .05).
CONCLUSIONS
AC and AR share a common pathophysiological process and allergen profile, with the conjunctiva and nasal mucosa serving as sites of allergic reactions. This study suggests the integration of AC prevention and treatment into AR prevention strategies.
Topics: Animals; Humans; Conjunctivitis, Allergic; Rhinitis, Allergic; Allergens; Immunoglobulin E
PubMed: 37971456
DOI: No ID Found -
Journal of Global Health Nov 2023Various epidemiological studies have focused on the adverse health outcomes of meteorological factors. However, there has been little research on the impact of humidex...
BACKGROUND
Various epidemiological studies have focused on the adverse health outcomes of meteorological factors. However, there has been little research on the impact of humidex on allergic conjunctivitis, especially in child and adolescent populations. We aimed to explore the impact of humidex, a comprehensive index of relative humidity and temperature, on child and adolescent allergic conjunctivitis admissions.
METHODS
Outpatient visit data for allergic conjunctivitis, meteorological factors and air pollutants in Shanghai for the 2017-2022 period were retrieved. For the purpose of analysing the nonlinear connection and lag impact between humidex and admissions for paediatric and adolescent allergic conjunctivitis, the distributed lag nonlinear model (DLNM) was fitted.
RESULTS
A total of 147 090 cases were included in our cohort. We found a significantly nonlinear effect on humidex and allergic conjunctivitis. In the single-day lag pattern, the relative risks (RR) of allergic conjunctivitis were significant at lag 0 (RR = 1.08, 95% confidence interval (CI) = 1.05-1.11) to lag 2 (RR = 1.01, 95% CI = 1.00-1.01), lag 5 (RR = 1.01, 95% CI = 1.00-1.01) to lag 9 (RR = 1.01, 95% CI = 1.00-1.01), and lag 14 (RR = 1.02, 95% CI: 1.01-1.03). In the cumulative-lag day pattern, the RR of allergic conjunctivitis were significant at lag 0-0 (RR = 1.08, 95% CI = 1.05-1.11) to lag 0-14 (RR = 1.21, 95% CI = 1.13-1.28). We found that boys, children aged 7-17 years, and children in the warm season were more vulnerable to humidex. In addition, the highest attributable fraction (AF) and attributable number (AN) of humidex are at lag 0-14 (AF = 0.17, AN = 25 026).
CONCLUSIONS
Humidex exposure markedly increased the risk of allergic conjunctivitis, especially in highly high humidex. Appropriate public health management is needed for disease management and early intervention.
Topics: Male; Child; Humans; Adolescent; Conjunctivitis, Allergic; Outpatients; Time Factors; China; Temperature
PubMed: 37921044
DOI: 10.7189/jogh.13.04132 -
Annals of Allergy, Asthma & Immunology... Mar 2024A lower adherence rate existed in patients receiving allergen-specific immunotherapy due to its lengthy period and adverse effects even though it is the only curative... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
A lower adherence rate existed in patients receiving allergen-specific immunotherapy due to its lengthy period and adverse effects even though it is the only curative treatment for IgE-mediated allergies. Therefore, exploring innovative allergen-specific immunotherapy routes is necessary.
OBJECTIVE
To explore the efficacy and safety of the intratonsillar injection of house dust mite (HDM) extract in patients with HDM-induced allergic rhinitis (AR).
METHODS
A randomized, double-blind, placebo-controlled clinical trial was conducted. A total of 80 patients with HDM-induced AR were randomized to receive 6 intratonsillar injections with HDM extract or placebo in 3 months. The total nasal symptom score (TNSS), visual analogue scale of nasal symptoms, combined symptom and medication score, mini rhinoconjunctivitis quality of life questionnaire, and serum allergen-specific IgG4 to Dermatophagoides pteronyssinus were all monitored at baseline and 3 months, 6 months, and 12 months after the treatment was finished. The intent-to-treat and per-protocol set (PPS) are both analyzed.
RESULTS
The primary end points TNSS and ΔTNSS were improved significantly at 3 months after the patients with AR finished a 3-month 6-injection intratonsillar immunotherapy compared with those in the placebo treatment in both intent-to-treat and PPS. Results of visual analogue scale, combined symptom and medication score, and mini rhinoconjunctivitis quality of life questionnaire were also improved significantly at 3 months after the treatment in PPS. However, the improvement effect of intratonsillar immunotherapy at 6 and 12 months was limited and uncertain based on the data. The increase of serum Der p IgG4 in the active group was significantly higher than that in the placebo group at 3, 6, and 12 months after the treatment was finished. Adverse events were monitored, and no systemic adverse reactions were observed.
CONCLUSION
The clinical trial revealed that intratonsillar injection with HDM extract was safe and effective in patients with AR. Optimizing the protocol and allergen formulations is expected to increase and maintain the efficacy of this novel approach.
TRIAL REGISTRATION
https://www.chictr.org.cn/index.html, identifier: ChiCTR-TRC-13003600.
Topics: Animals; Humans; Quality of Life; Pyroglyphidae; Sublingual Immunotherapy; Treatment Outcome; Antigens, Dermatophagoides; Rhinitis, Allergic; Allergens; Rhinitis, Allergic, Perennial; Double-Blind Method; Conjunctivitis; Immunoglobulin G
PubMed: 37913839
DOI: 10.1016/j.anai.2023.10.029 -
Immunity, Inflammation and Disease Oct 2023Maintenance doses for allergen immunotherapy (AIT) have been recommended for at least 3 years but little data on long-term efficacy is available depending on AIT...
BACKGROUND
Maintenance doses for allergen immunotherapy (AIT) have been recommended for at least 3 years but little data on long-term efficacy is available depending on AIT duration. To show sustained efficacy 10 years after completion of treatment with depigmented-polymerized house dust mite (dpg-pol HDM) allergen extract in adults with asthma and/or rhinoconjunctivitis.
METHODS
Patients included in a double-blind placebo-controlled AIT study with dpg-pol HDM allergen extract were reviewed at completion of the perennial treatment and 10-year follow-up (10y-FU). Change in symptom and rescue medication score was the primary objective. Visual analog scale (VAS), asthma control test (ACT), and degree of disease control were the secondary objectives. A comparative analysis between patients who underwent AIT treatment for <3 years and ≥3 years was performed.
RESULTS
Data from 31 patients (mean age 38 years) were available at 10y-FU. All had asthma and 29 had rhinoconjunctivitis at baseline. Twenty-three patients were treated ≥3 years and 8 for <3 years. Seventeen (55%) patients were asymptomatic at completion of AIT, with significant differences for nasal, conjunctival, and bronchial symptoms (p < .0001) compared with baseline only in those patients treated ≥3 years. Nine (52.9%) patients remained completely asymptomatic at 10y-FU, all were treated for ≥3 years. Moreover, significant reduction in the number of patients with rhinitis (p = .0117), conjunctivitis (p < .0001), and bronchial (p = .0005) symptoms was observed at 10y-FU compared with baseline only in the ≥3 years treated. Ten (32.3%) patients did not require any rescue medication at 10y-FU, all had been treated for ≥3 years. ACT at 10y-FU showed a good control of asthma (median 23.5; 95% IC[22.0, 25.0]). No significant differences were observed between VAS at end of treatment compared with VAS at 10y-FU.
CONCLUSIONS
Sustained clinical efficacy is achieved 10 years after completion of depigmented-polymerized HDM, however, these findings were observed only if patients are treated for at least 3 years.
Topics: Adult; Animals; Humans; Allergens; Asthma; Dermatophagoides pteronyssinus; Desensitization, Immunologic; Follow-Up Studies; Pyroglyphidae; Rhinitis, Allergic; Double-Blind Method
PubMed: 37904678
DOI: 10.1002/iid3.1004 -
Biomolecules Sep 2023The aim of the study was to compare the distribution of corneal and conjunctival epithelial dendritic cells (DCs) in vernal keratoconjunctivitis (VKC), allergic...
The aim of the study was to compare the distribution of corneal and conjunctival epithelial dendritic cells (DCs) in vernal keratoconjunctivitis (VKC), allergic conjunctivitis (AC), and non-allergic controls to examine if the allergy type causes differences in immune cell activation. The prospective study included 60 participants: 20 with VKC, 20 with AC, and 20 non-allergic controls. In vivo confocal microscopy was performed on the right eye. The locations scanned included the corneal centre, inferior whorl, corneal periphery, corneal limbus, and bulbar conjunctiva. The DCs were counted manually, and their morphology was assessed for the largest cell body size, the presence of dendrites, and the presence of long and thick dendrites. The DC density was higher in VKC and AC compared to non-allergic group at all locations ( ≤ 0.01) except at the inferior whorl. The DC density in VKC participants was significantly higher than in AC at the limbus ( < 0.001) but not at other locations. Both the AC and the VKC group had larger DC bodies at the corneal periphery and limbus compared to the non-allergic group ( ≤ 0.03). The study found a higher proportion of participants with DCs exhibiting long dendrites at both the corneal periphery in AC ( = 0.01) and at the corneal centre, periphery, and limbus in VKC, compared to the non-allergic group ( ≤ 0.001). In conclusion, a higher DC density at the limbus may be a marker of more severe VKC. DCs with larger cell bodies and a greater proportion of participants with DCs displaying long dendrites can be potential markers to differentiate allergy from non-allergy, and more severe forms of allergy from milder forms.
Topics: Humans; Conjunctivitis, Allergic; Prospective Studies; Conjunctiva; Cornea; Dendritic Cells
PubMed: 37892151
DOI: 10.3390/biom13101469 -
Survey of Ophthalmology 2024Vernal keratoconjunctivitis (VKC) is a chronic, progressive, and potentially sight-threatening form of ocular inflammatory disease that primarily affects children and... (Review)
Review
Vernal keratoconjunctivitis (VKC) is a chronic, progressive, and potentially sight-threatening form of ocular inflammatory disease that primarily affects children and young adults. Prevalence varies by region, ranging from <2 per 10,000 in the United States to as high as 1,100 per 10,000 in parts of Africa. The rarity of VKC in developed countries can make differential diagnosis challenging, and treatment is often delayed until the disease is advanced, and symptoms are significantly impacting patients' quality of life. Although once viewed primarily as an immunoglobulin E-mediated condition, approximately 50% of patients with VKC do not exhibit allergic sensitization. It is now recognized that the immunopathology of VKC involves multiple inflammatory pathways that lead to the signs, symptoms, and conjunctival eosinophilic and fibroproliferative lesions that are a hallmark of the disease. We examine the evolution of our understanding of the immunopathology of VKC, the expanding VKC treatment armamentarium, the clinical implications of emerging treatment approaches, and future directions for VKC research and practice.
Topics: Child; Humans; Conjunctivitis, Allergic; Cyclosporine; Quality of Life; Conjunctiva; Ophthalmic Solutions
PubMed: 37890678
DOI: 10.1016/j.survophthal.2023.10.008 -
Romanian Journal of Ophthalmology 2023The most common disorders of the ocular surface are dry eye disease (DED) and ocular allergy (OA). These conditions are frequently coexisting with or without a clinical...
The most common disorders of the ocular surface are dry eye disease (DED) and ocular allergy (OA). These conditions are frequently coexisting with or without a clinical overlap and can cause a severe impact on the patient's quality of life. Therefore, it can sometimes be hard to distinguish between DED and OA because similar changes and manifestations may be present. Atopic patients can also develop DED, which can aggravate their manifestations. Moreover, patients with DED can develop ocular allergies, so these two pathological entities of the ocular surface can be considered as mutual conditions that share the same background. Nowadays, by using different techniques to collect tissue from ocular surfaces, the changes in molecular homeostasis can be detected and this can lead to a precise diagnosis. The article provides an up-to-date review of the various ocular surface biomarkers that have been identified in DED, OA, or both conditions. DED = dry eye disease, OA = ocular allergy, SS = Sjogren syndrome, TBUT = tear break up time, TFO = tear film osmolarity, AKC = Atopic keratoconjunctivitis, ANXA1 = Annexin 1, ANXA11 = Annexin 11, CALT = Conjunctival associated lymphoid tissue, CCL2/MIP-1 = Chemokine (C-C motif) ligand2/Monocyte chemoattractant protein 1, CCL3/MIP-1α = Chemokine (C-C motif) ligand 3/Macrophage inflammatory protein 1 alpha, CCL4/MIP-1β = Chemokine (C-C motif) ligand 4/Macrophage inflammatory protein 1 beta, CCL5/RANTES = Chemokine (C-C motif) ligand 5 /Regulated on Activation, Normal T cell Expressed and Secreted, CCR2 = Chemokine (C-C motif) receptor 2, CCR5 = Chemokine (C-C motif) receptor 5, CD3+ = Cluster of differentiation 3 positive, CD4+ = Cluster of differentiation 4 positive, CD8+ = Cluster of differentiation 8 positive, CGRP = Calcitonin-gene-related peptide, CX3CL1 C-X3 = C motif -chemokine ligand 1 /Fractalkine, CXCL8 = Chemokine (C-X-C motif) ligand 8, CXCL9 = Chemokine (C-X-C motif) ligand 9, CXCL10 = Chemokine (C-X-C motif) ligand 10, CXCL11 = Chemokine (C-X-C motif) ligand 11, CXCL12 = Chemokine (C-X-C motif) ligand 12, CXCR4 = Chemokine (C-X-C motif) receptor 4, EGF = Epidermal growth factor, HLA-DR = Human leukocyte antigen-D-related, ICAM-1 = Intercellular adhesion molecule 1, IFN-γ = Interferon-gamma, IgG = Immunoglobulin G, IgE = Immunoglobulin E, IL-1 = Interleukin-1, IL-1α = Interleukin-1 alpha, IL-1β = Interleukin-1 beta, CGRP = Calcitonin-Gene-Related Peptide, IL-3 = Interleukin-3, IL-4 = Interleukin-4, IL-6 = Interleukin-6, IL-8 = Interleukin-8, IL-10 = Interleukin-10, IL-17 = Interleukin-17, IL-17A = Interleukin-17A, LPRR3 = Lacrimal proline-rich protein 3, LPRR4 = Lacrimal proline-rich protein 4, MUC5AC = Mucin 5 subtype AC, oligomeric mucus/gel-forming, MUC16 = Mucin 16, OCT = Optical coherence tomography, OGVHD = Ocular graft versus host disease, PAX6 = Paired-box protein 6, VKC = Vernal keratoconjunctivitis, TGF-β = Transforming growth factor β, S100 = proteins Calcium activated signaling proteins, Th1 = T helper 1 cell, Th17 = T helper 17 cell, MGD = Meibomian gland dysfunction, TFOS = Tear film and ocular surface society, SS-KCS = Keratoconjunctivitis Sicca, MMP-9 = Matrix metalloproteinase 9, MMP-1 = Matrix metalloproteinase 1, ZAG = Zinc alpha glycoprotein, CBA = Cytometric bead array, MALDI TOF-MS = matrix assisted laser desorption ionization-time of flight, SELDI TOF-MS = surface-enhanced laser desorption ionization-time of flight, IVCM = in vivo confocal microscopy, AS-OCT = anterior segment optical coherence tomography, iTRAQ = Isobaric tags for relative and absolute quantitation, LC-MS = Liquid chromatography-mass spectrometry, LCN-1 = lipocalin 1, PIP = prolactin induced protein, NGF = Nerve growth factor, PRR4 = proline rich protein 4, VIP = Vasoactive intestinal peptide, ELISA = enzyme linked immunoassay, TNF-α = tumor necrosis factor alpha, PAC = perennial allergic conjunctivitis, SAC = seasonal allergic conjunctivitis, IC = impression cytology, RT-PCR = reverse transcription polymerase chain reaction, PCR = polymerase chain reaction, APCs = antigen-presenting cells, NK cells = natural killer cells, HEL = hexanoyl-lysine, 4-HNE = 4-hydroxy-2-nonenal, MDA = malondialdehyde.
Topics: Humans; Cytokines; Calcitonin; Conjunctivitis, Allergic; Ligands; Calcitonin Gene-Related Peptide; Quality of Life; Dry Eye Syndromes; Chemokines; Tumor Necrosis Factor-alpha; Biomarkers; Annexins; Proline
PubMed: 37876509
DOI: 10.22336/rjo.2023.42 -
Scientific Reports Oct 2023Ophthalmic preparations that contain ketorolac tromethamine (KET) and olopatadine HCl (OLO) are used to relieve seasonal allergies and allergic conjunctivitis....
UV spectrophotometric methods for simultaneous determination of ketorolac tromethamine and olopatadine hydrochloride: Application of multiple standard addition for assay of ophthalmic solution.
Ophthalmic preparations that contain ketorolac tromethamine (KET) and olopatadine HCl (OLO) are used to relieve seasonal allergies and allergic conjunctivitis. Simultaneous quantification of KET and OLO was held by validated and simple spectrophotometric methods. KET was determined directly from the fundamental UV absorption spectra (at 323 nm), while OLO was determined after performing either dual wavelength or ratio derivative methods. The first method was based on measuring the absorbance difference (ΔA) between 243 and 291 nm, while the second depended on generating first derivative ratio spectra using 3.0 µg/mL KET as a divisor and measuring OLO responses at 234 nm (minima). Multiple standard addition method was applied to enable the determination of OLO which is considered as the weakly absorbing species as well as the minor component in a challenging dosage form ratio (4:1). The linearity ranges of the developed methods were 3-12 μg/mL and 4-40 μg/mL for KET and OLO, respectively. Simultaneous determination of both drugs was successfully implemented to lab prepared eye drops that contain KET, OLO and benzalkonium chloride as an inactive ingredient. Greenness assessment indicates minimal impact on environment. The developed methods determined the cited drugs with % recovery ± SD of 99.63 ± 0.01 for KET, 100.90 ± 0.02 and 100.31 ± 0.01 for OLO using dual wavelength and first derivative ratio methods, respectively. Using F-test and t-test at confidence level %95 to compare between the results of the presented methods and a reported method show no significant difference which allows precise, accurate, rapid, and simple quantification of quality control samples that contain KET and OLO.
Topics: Humans; Olopatadine Hydrochloride; Ketorolac Tromethamine; Ophthalmic Solutions; Conjunctivitis, Allergic; Spectrophotometry
PubMed: 37875539
DOI: 10.1038/s41598-023-45378-8 -
European Review For Medical and... Oct 2023This paper aims to review biologics in allergic rhinitis (AR). Biologic agents of Omalizumab, Dupilumab, Mepolizumab, Reslizumab, and Benralizumab are reviewed in... (Review)
Review
This paper aims to review biologics in allergic rhinitis (AR). Biologic agents of Omalizumab, Dupilumab, Mepolizumab, Reslizumab, and Benralizumab are reviewed in detail. The search is performed in "Pubmed," "Google," Google Scholar" and EBSCO Academic Search Ultimate (EKUAL) database of Kırıkkale University Library from 2021 to 2000, and randomized and/or placebo-controlled studies, review papers, meta-analysis, and reports are taken into consideration. The search was performed with the keywords of "allergic rhinitis," "biologics," "biologic agents," "Omalizumab," "Dupilumab," "Mepolizumab," "Reslizumab," "Benralizumab," "Anti IgE," "Anti-IL-4/IL-13", "Anti IL-5". Search is also performed in the "U.S. Food and Drug Administration" (FDA) and "European Medicines Agency" (EMA) web systems. Biological agents such as monoclonal antibodies (MAb) in treatment are called biological therapy or biotherapy. Omalizumab is a humanized Anti-IgE monoclonal antibody. Omalizumab treatment improved the Daily Nasal Rescue Medication Score (DNSSS) and decreased the use of antiallergic drugs in seasonal and perennial AR and rhino-conjunctivitis. Omalizumab is also used in specific immunotherapy patients with allergic rhinitis and reduced allergic reactions associated with allergen immunotherapy, such as anaphylaxis. Dupilumab is an Anti-IL-4/IL-13 biologic agent. Dupilumab treatment significantly improved sino-nasal Outcome Test (SNOT-22) total scores in perennial allergic rhinitis. Anti-IL-5 monoclonal antibodies of Mepolizumab, Reslizumab Benralizumab reduce the number of eosinophils in the blood and tissue, corticosteroid addiction and asthma attacks are reduced, and their use in the treatment of severe eosinophilic asthma has been approved. Biologics, especially Omalizumab, and Dupilumab, may be used more in allergic rhinitis.
Topics: Humans; Anti-Asthmatic Agents; Antibodies, Monoclonal; Asthma; Biological Products; Interleukin-13; Omalizumab; Rhinitis, Allergic
PubMed: 37869947
DOI: 10.26355/eurrev_202310_34069 -
Allergology International : Official... Jan 2024
Topics: Humans; Conjunctivitis, Allergic; Extracellular Traps; Keratoconjunctivitis; Conjunctiva
PubMed: 37866981
DOI: 10.1016/j.alit.2023.10.002