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International Archives of Allergy and... 2020In recent decades, the worldwide prevalence of allergic disease has increased considerably. The atopic march is a model aimed at explaining the apparent progression of... (Review)
Review
In recent decades, the worldwide prevalence of allergic disease has increased considerably. The atopic march is a model aimed at explaining the apparent progression of allergic diseases from atopic dermatitis (AD) to allergic asthma (AA) and to allergic rhinitis (AR). It hypothesizes that allergic disease begins, typically in children, with the development of AD, then AA, and finally progresses to AR. This theory has been widely studied in cross-sectional and long-term longitudinal studies and it has been found that as prevalence of AD declines, prevalence of AA increases. A similar relationship is reported between AA and AR. The legitimacy of the atopic march model is, however, currently debated. Epidemiological evidence and criticism of longitudinal studies point to an overstatement of the atopic march's prevalence and incorrect mechanisms, opening a discussion for alternative models to better explain the pathophysiological and epidemiological processes that promote this progression of allergic diseases. Albeit, risk factors for the development and progression of allergic disease, particularly AD, are critical in identifying disease progression. Investigating the role of age, severity, family history, phenotype, and genetic traits may give a better indication into the progression of allergic diseases. In addition, studies following patients from infancy into adulthood and a general increase in longitudinal studies would help broaden the knowledge of allergic disease progression and the atopic march.
Topics: Adult; Allergy and Immunology; Animals; Asthma; Child; Dermatitis, Atopic; Disease Progression; Evidence-Based Medicine; Humans; Models, Immunological; Prevalence; Rhinitis, Allergic
PubMed: 31593946
DOI: 10.1159/000502958 -
The Journal of Allergy and Clinical... Nov 2023Global warming has direct and indirect effects, as well as short- and long-term impacts on the respiratory and skin barriers. Extreme temperature directly affects the... (Review)
Review
Global warming has direct and indirect effects, as well as short- and long-term impacts on the respiratory and skin barriers. Extreme temperature directly affects the airway epithelial barrier by disrupting the structural proteins and by triggering airway inflammation and hyperreactivity. It enhances tidal volume and respiratory rate by affecting the thermoregulatory system, causing specific airway resistance and reflex bronchoconstriction via activation of bronchopulmonary vagal C fibers and upregulation of transient receptor potential vanilloid (TRPV) 1 and TRPV4. Heat shock proteins are activated under heat stress and contribute to both epithelial barrier dysfunction and airway inflammation. Accordingly, the frequency and severity of allergic rhinitis and asthma have been increasing. Heat activates TRPV3 in keratinocytes, causing the secretion of inflammatory mediators and eventually pruritus. Exposure to air pollutants alters the expression of genes that control skin barrier integrity and triggers an immune response, increasing the incidence and prevalence of atopic dermatitis. There is evidence that extreme temperature, heavy rains and floods, air pollution, and wildfires increase atopic dermatitis flares. In this narrative review, focused on the last 3 years of literature, we explore the effects of global warming on respiratory and skin barrier and their clinical consequences.
Topics: Humans; Dermatitis, Atopic; Global Warming; Respiratory Rate; Rhinitis, Allergic; Inflammation
PubMed: 37689250
DOI: 10.1016/j.jaci.2023.09.001 -
The Turkish Journal of Pediatrics 2020Local allergic rhinitis (LAR) is a differentiated rhinitis phenotype defined by perennial or seasonal rhinitis symptoms without systemic atopy. The diagnosis can be made... (Review)
Review
Local allergic rhinitis (LAR) is a differentiated rhinitis phenotype defined by perennial or seasonal rhinitis symptoms without systemic atopy. The diagnosis can be made by a positive response to the nasal allergen challenge (NAC) (the gold standard for diagnosis) in the absence of skin prick test and/or serum allergenspecific immunoglobulin E. Clinical and epidemiological studies have demonstrated that LAR affects individuals from different countries, races, and age ranges. Several studies have shown that the onset of nasal symptoms occurs during childhood in a significant proportion of LAR individuals. Evidence of LAR has been growing, especially in pediatric and Asian populations. A review of the literature reveals that most LAR studies of pediatric populations have appeared in the last three years. The prevalence of LAR in children ranges from 3.7% to 66.6%, and similar to what has been observed in adults, prevalence is higher in Western countries. Publications have shown that LAR in children can be either seasonal or perennial, and diagnosis of LAR confirmed by NAC have been reported with numerous allergens (house dust mites, pollens, molds, and dander). These findings illustrate that LAR is an important differential diagnosis in children with presumed non-allergic rhinitis, and a through review of the very recent literature can contribute to the clinical identification and diagnosis of LAR in children with no evidence of systemic atopy, as well as update readers` knowledge of the topic.
Topics: Allergens; Child; Humans; Immunoglobulin E; Nasal Provocation Tests; Rhinitis, Allergic; Skin Tests
PubMed: 33108072
DOI: 10.24953/turkjped.2020.05.001 -
International Journal of Molecular... Mar 2023Allergic diseases are accompanied by a variety of symptoms such as pruritus, coughing, sneezing, and watery eyes, which can result in severe physiological and even... (Review)
Review
Allergic diseases are accompanied by a variety of symptoms such as pruritus, coughing, sneezing, and watery eyes, which can result in severe physiological and even psychological impairments. The exact mechanisms of these conditions are not yet completely understood. However, recent studies demonstrated a high relevance of neurotrophins in allergic inflammation, as they induce cytokine release, mediate interaction between immune cells and neurons, and exhibit different expression levels in health and disease. In this review, we aim to give an overview of the current state of knowledge concerning the role of neurotrophins in atopic disorders such as atopic dermatitis, allergic asthma, and allergic rhinitis.
Topics: Humans; Nerve Growth Factors; Neuroimmunomodulation; Dermatitis, Atopic; Asthma; Rhinitis, Allergic
PubMed: 37047077
DOI: 10.3390/ijms24076105 -
International Archives of Allergy and... 2023Local allergic rhinitis (LAR) is, to date, a debated and complex entity, still orphan of global consideration and a multicentric approach. LAR does not seem to find a... (Review)
Review
Local allergic rhinitis (LAR) is, to date, a debated and complex entity, still orphan of global consideration and a multicentric approach. LAR does not seem to find a proper positioning in the classic classifications and phenotypes of chronic rhinitis, and its pathophysiology relies specifically on the presence of local IgE. These patients in fact have a suggestive clinical history of allergic rhinitis in the presence of negative skin prick tests and serum IgE tests for the suspect allergen. Nasal allergen challenge, assessment of local IgE, basophil activation test (BAT), and nasal cytology are, at the moment, the most used tests in the diagnostic approach to the disease, despite their limitations. Considering that the correct interpretation of diagnostic tests and their clinical relevance is fundamental in the assessment of the right diagnosis and the subsequent therapy, we propose a new diagnostic approach that encompasses all of these methodologies and suggest that several pragmatic randomized control trials as well as prospective, multicentric studies directed at the long-term follow-up of LAR be carried out to further investigate this debated entity.
Topics: Humans; Prospective Studies; Immunoglobulin E; Rhinitis, Allergic; Allergens; Rhinitis; Skin Tests; Nasal Provocation Tests
PubMed: 36223735
DOI: 10.1159/000526604 -
Minerva Pediatrica Oct 2020The rising incidence of allergic disease requires more specific, effective and safe therapeutic strategies. In this regard, several kinds of biologically active... (Review)
Review
The rising incidence of allergic disease requires more specific, effective and safe therapeutic strategies. In this regard, several kinds of biologically active substances, commonly known as immunostimulants, have been introduced for the prevention and treatment of allergic diseases in pediatric population. Among the heterogeneous group of biologically active molecules to date available, pidotimod (Axil, Valeas S.p.A, Milan) is proved to be able to ameliorate both innate and adaptive immunity and enhances the immune system properties often impaired in patients with allergic disorders.
Topics: Adaptive Immunity; Adjuvants, Immunologic; Adolescent; Asthma; Child; Child, Preschool; Chronic Urticaria; Dermatitis, Atopic; Desensitization, Immunologic; Food Hypersensitivity; Humans; Hypersensitivity; Immunity, Innate; Immunologic Factors; Pyrrolidonecarboxylic Acid; Rhinitis, Allergic; Thiazolidines
PubMed: 32731733
DOI: 10.23736/S0026-4946.20.05967-8 -
Medicine Oct 2021This study aimed to evaluate the correlation between fractional exhaled nitric oxide (FeNO) and nasal nitric oxide (nNO) in allergic rhinitis (AR) and patients with or...
This study aimed to evaluate the correlation between fractional exhaled nitric oxide (FeNO) and nasal nitric oxide (nNO) in allergic rhinitis (AR) and patients with or without bronchial asthma (BA).A total of 90 patients who were diagnosed with persistent AR (AR group, n = 30), BA (BA group, n = 30), or allergic rhinitis with bronchial asthma (AR-BA) (AR-BA group, n = 30), were enrolled in this study, along with 30 healthy adult volunteers (control group, n = 30). The participants were further divided into 2 groups based on the results of a skin-prick test (SPT): a highly atopic group (SPT = 3+ and above) and a moderately atopic group (SPT = 2+ and below). All participants underwent FeNO and nNO measurement, an absolute blood eosinophil count, total serum immunoglobulin measurement, and horizontal baseline lung capacity determination.The results showed that the FeNO levels in the 3 observation groups were significantly higher than those in the control group (P < .01), and in the BA group they were significantly higher than in the AR-BA group (P < .01). The levels of nNO in both the AR group and the AR-BA group were higher than those in the control group and the BA group (P < .01), but there was no significant difference between the AR group and the AR-BA group (P > .05). The levels of nNO in the BA group were also significantly different from those in the control group (P < .01).FeNO and nNO are positively correlated with the degree of AR in patients with BA; therefore, nNO levels can be used as an inflammatory marker of AR in patients with BA. FeNO can also be used as an inflammatory marker of AR in patients complicated with BA as a warning indicator of asthma.
Topics: Adolescent; Adult; Aged; Asthma; Eosinophils; Exhalation; Female; Humans; Immunoglobulin E; Male; Middle Aged; Nitric Oxide; Nose; Respiratory Function Tests; Rhinitis, Allergic; Young Adult
PubMed: 34596130
DOI: 10.1097/MD.0000000000027314 -
Allergology International : Official... Mar 2011Like asthma and atopic dermatitis, allergic rhinitis is an allergic disease, but of the three, it is the only type I allergic disease. Allergic rhinitis includes... (Review)
Review
Like asthma and atopic dermatitis, allergic rhinitis is an allergic disease, but of the three, it is the only type I allergic disease. Allergic rhinitis includes pollinosis, which is intractable and reduces quality of life (QOL) when it becomes severe. A guideline is needed to understand allergic rhinitis and to use this knowledge to develop a treatment plan. In Japan, the first guideline was prepared after a symposium held by the Japanese Society of Allergology in 1993. The current 6th edition was published in 2009, and is widely used today. To incorporate evidence based medicine (EBM) introduced from abroad, the most recent collection of evidence/literature was supplemented to the Practical Guideline for the Management of Allergic Rhinitis in Japan 2009. The revised guideline includes assessment of diagnosis/treatment and prescriptions for children and pregnant women, for broad clinical applications. An evidence-based step-by-step strategy for treatment is also described. In addition, the QOL concept and cost benefit analyses are also addressed. Along with Allergic Rhinitis and its Impact of Asthma (ARIA), this guideline is widely used for various clinical purposes, such as measures for patients with sinusitis, childhood allergic rhinitis, oral allergy syndrome, and anaphylaxis and for pregnant women.
Topics: Female; Humans; Japan; Pregnancy; Quality of Life; Rhinitis, Allergic, Perennial; Rhinitis, Allergic, Seasonal; Risk Factors
PubMed: 21636965
DOI: 10.2332/allergolint.11-rai-0334 -
International Journal of Molecular... Jun 2022Immune cells and immune-derived molecules, endocrine glands and hormones, the nervous system and neuro molecules form the combined tridirectional neuroimmune network,... (Review)
Review
Immune cells and immune-derived molecules, endocrine glands and hormones, the nervous system and neuro molecules form the combined tridirectional neuroimmune network, which plays a significant role in the communication pathways and regulation at the level of the whole organism and local levels, in both healthy persons and patients with allergic rhinitis based on an allergic inflammatory process. This review focuses on a new research paradigm devoted to neuronal-immune cell units, which are involved in allergic inflammation in the nose and neuroimmune control of the nasal mucociliary immunologically active epithelial barrier. The categorization, cellular sources of neurotransmitters and neuropeptides, and their prevalent profiles in constituting allergen tolerance maintenance or its breakdown are discussed. Novel data on the functional structure of the nasal epithelium based on a transcriptomic technology, single-cell RNA-sequencing results, are considered in terms of neuroimmune regulation. Notably, the research of pathogenesis and therapy for atopic allergic diseases, including recently identified local forms, from the viewpoint of the tridirectional interaction of the neuroimmune network and discrete neuronal-immune cell units is at the cutting-edge.
Topics: Allergens; Humans; Inflammation; Nasal Mucosa; Nervous System; Rhinitis, Allergic
PubMed: 35805946
DOI: 10.3390/ijms23136938 -
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