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Sample records for allergic rhinitis asthma

  1. Allergic rhinitis and asthma in the athlete.

    PubMed

    Randolph, Christopher C

    2006-01-01

    The pathogenesis, epidemiology, presentation, diagnosis, and management of allergic rhinitis and asthma in the recreational and elite athlete are discussed in this study. There is an increased prevalence of allergic rhinitis and asthma in the elite athlete related to the enhanced ventilation with entrainment of inhalants including allergens as well as irritants such as pollutants in the urban athlete, chlorine in the swimmer, and cold air in the hockey player in the training environment. The history as well as objective exercise challenge and skin-prick tests to inhalants or in vitro allergen testing are essential in conjunction with a comprehensive physical exam to diagnosis of allergic rhinitis and/or asthma in the athlete. This is particularly necessary for the elite or competitive athlete who often has poor insight into the symptoms. Management is with appropriate inhaled steroids and/or leukotriene antagonists for the upper (nasal) and lower airways with avoidance of inhaled allergens and/or appropriate immunotherapy where relevant. The optimal management of the athlete results in minimum medication with minimum adverse side effects and optimal outcome. Proper adherence to antidoping regulations and application for use exemption in competitive athletes is recommended. The athlete should be encouraged to pursue the selected sports activity without limitations. PMID:16724626

  2. Asthma, Allergic Rhinitis, and Sleep Problems in Urban Children

    PubMed Central

    Koinis-Mitchell, Daphne; Kopel, Sheryl J.; Boergers, Julie; Ramos, Kara; LeBourgeois, Monique; McQuaid, Elizabeth L.; Esteban, Cynthia A.; Seifer, Ronald; Fritz, Gregory K.; Klein, Robert B.

    2015-01-01

    Objectives: In this study, we examine the association of asthma (asthma symptoms, asthma control, lung function) and sleep problems in a group of urban children. The role of allergic rhinitis (AR), a comorbid condition of asthma, on children's sleep problems is also examined. Finally, we investigate whether sleep hygiene moderates the association between asthma and sleep problems, and whether there are differences in these associations based on ethnic background. Methods: Non-Latino White, Latino, and African American urban children with asthma (n = 195) ages 7–9 (47% female) and their primary caregivers participated in a baseline visit involving interview-based questionnaires on demographics, asthma and rhinitis control, and caregiver report of children's sleep problems and sleep hygiene. Children and their caregivers participated in a clinical evaluation of asthma and AR, followed by a month monitoring period of children's asthma using objective and subjective methods. Results: Total sleep problem scores were higher in children of the sample who were from African American and Latino backgrounds, compared to non-Latino white children. Poor asthma control was predictive of higher levels of sleep problems in the entire sample. Poorer AR control also was related to more sleep problems, over and above children's asthma in the sample. This association was more robust in non-Latino white children. Poor sleep hygiene heightened the association between poor asthma control and sleep problems in the entire sample and in African American children. Conclusions: Multidisciplinary interventions integrating the co-management of asthma, AR, and the effects of both illnesses on children's sleep, need to be developed and tailored to children and their families' ethnic background. Citation: Koinis-Mitchell D, Kopel SJ, Boergers J, Ramos K, LeBourgeois M, McQuaid EL, Esteban CA, Seifer R, Fritz GK, Klein RB. Asthma, allergic rhinitis, and sleep problems in urban children. J Clin

  3. Allergic rhinitis

    PubMed Central

    2011-01-01

    Allergic rhinitis is a common disorder that is strongly linked to asthma and conjunctivitis. It is usually a long-standing condition that often goes undetected in the primary-care setting. The classic symptoms of the disorder are nasal congestion, nasal itch, rhinorrhea and sneezing. A thorough history, physical examination and allergen skin testing are important for establishing the diagnosis of allergic rhinitis. Second-generation oral antihistamines and intranasal corticosteroids are the mainstay of treatment. Allergen immunotherapy is an effective immune-modulating treatment that should be recommended if pharmacologic therapy for allergic rhinitis is not effective or is not tolerated. This article provides an overview of the pathophysiology, diagnosis, and appropriate management of this disorder. PMID:22166009

  4. Allergic rhinitis

    MedlinePlus

    ... allergic to, such as dust, animal dander, or pollen. Symptoms can also occur when you eat a ... article focuses on allergic rhinitis due to plant pollens. This type of allergic rhinitis is commonly called ...

  5. The united allergic airway: Connections between allergic rhinitis, asthma, and chronic sinusitis

    PubMed Central

    Miller, Michaela D.; Simon, Ronald A.

    2012-01-01

    Background: The united allergic airway is a theory that connects allergic rhinitis (AR), chronic rhinosinusitis, and asthma, in which seemingly disparate diseases, instead of being thought of separately, are instead viewed as arising from a common atopic entity. Objective: This article describes patients with such diseases; explores ideas suggesting a unified pathogenesis; elucidates the various treatment modalities available, emphasizing nasal corticosteroids and antihistamines; and provides an update of the literature. Methods: A literature review was conducted. Conclusion: The aggregation of research suggests that AR, asthma, and chronic rhinosinusitis are linked by the united allergic airway, a notion that encompasses commonalities in pathophysiology, epidemiology, and treatment. PMID:22643942

  6. Safety of Grass Pollen Sublingual Immunotherapy for Allergic Rhinitis in Concomitant Asthma.

    PubMed

    Sahadevan, A; Cusack, R; Lane, S J

    2015-01-01

    Seasonal allergic rhinitis (AR) occurs predominantly as a result of grass pollen allergy. Grass pollen sublingual immunotherapy (SLIT) has been proven effective in treating AR1. SLIT is currently licensed for use in AR with concomitant stable mild asthma. There is evidence that SLIT improves asthma control when primarily used to treat AR2. The aim was to assess the safety of SLIT in patients with severe seasonal allergic rhinitis who have co-existing stable mild asthma. The secondary aim was to determine whether asthma control improved post SLIT. There was no deterioration in asthma control after 6-36 months of SLIT. 27/30 (90%) patients' asthma control remained stable or indeed improved (p < 0.021). Of this 15 (50%) patients' asthma improved. There was no statistically significant change in their asthma pharmacotherapy after SLIT (p = 0.059). In conclusion, grass pollen SLIT is safe and can potentially treat dual allergic rhinitis- mild asthmatic patients. PMID:26817287

  7. Allergic sensitization to ornamental plants in patients with allergic rhinitis and asthma.

    PubMed

    Aydin, Ömür; Erkekol, Ferda Öner; Misirloigil, Zeynep; Demirel, Yavuz Selim; Mungan, Dilşad

    2014-01-01

    Ornamental plants (OPs) can lead to immediate-type sensitization and even asthma and rhinitis symptoms in some cases. This study aimed to evaluate sensitization to OPs in patients with asthma and/or allergic rhinitis and to determine the factors affecting the rate of sensitization to OPs. A total of 150 patients with asthma and/or allergic rhinitis and 20 healthy controls were enrolled in the study. Demographics and disease characteristics were recorded. Skin-prick tests were performed with a standardized inhalant allergen panel. Skin tests by "prick-to-prick" method with the leaves of 15 Ops, which are known to lead to allergenic sensitization, were performed. Skin tests with OPs were positive in 80 patients (47.1%). There was no significant difference between OP sensitized and nonsensitized patients in terms of gender, age, number of exposed OPs, and duration of exposure. Skin test positivity rate for OPs was significantly high in atopic subjects, patients with allergic rhinitis, food sensitivity, and indoor OP exposure, but not in patients with pollen and latex allergy. Most sensitizing OPs were Yucca elephantipes (52.5%), Dieffenbachia picta (50.8%), and Euphorbia pulcherrima (47.5%). There was significant correlation between having Saintpaulia ionantha, Croton, Pelargonium, Y. elephantipes, and positive skin test to these plants. Sensitivity to OPs was significantly higher in atopic subjects and patients with allergic rhinitis, food allergy, and indoor OP exposure. Furthermore, atopy and food sensitivity were found as risk factors for developing sensitization to indoor plants. Additional trials on the relationship between sensitization to OPs and allergic symptoms are needed. PMID:24717779

  8. Allergic rhinitis.

    PubMed

    Mygind, Niels

    2014-01-01

    Allergic rhinitis is a very frequent disease with a prevalence of 15-20%. Symptoms are most pronounced in young people while, for some unknown reason, the elderly become clinically hyposensitized. Pollen is the cause of seasonal allergic rhinitis, and house dust mite and animals are the main causes of perennial allergic rhinitis. Histamine is the main cause of sneezing and hypersecretion, while other mediators probably also play a role in nasal blockage. In polyposis, a local denervation is an important cause of vascular leakage, edema and polyp formation. Antihistamines have a positive effect on sneezing and hypersecretion, but not on blockage. As they have a quick onset of action they are useful in patients with mild and occasional symptoms. A nasal steroid is preferable in patients with persistent symptoms, since it is more effective on all nasal symptoms. Short-term use of a systemic steroid can be a valuable adjunct to topical treatment, especially in nasal polyposis, when there is a temporary failure of topical treatment in a blocked nose. A nasal vasoconstrictor can be added for short-term treatment, and an ipratropium spray can be beneficial in perennial non-allergic rhinitis, when watery secretion is the dominant symptom. Immunotherapy can be added in allergic rhinitis, when pharmacotherapy is insufficient. This chapter is based on the author's personal experience with allergic rhinitis, as a patient, a doctor and a researcher. Therefore, it is not a balanced review and the references will be highly selected as they largely consist of the author's own publications. As the text is mainly based on personal research, steroids are described in detail, while, with regard to immunotherapy, the reader is referred to another chapter. In addition to allergic rhinitis, nasal polyposis will be described. It was formerly believed to be an allergic disease, but we now know that it is not. However, with regard to histopathology and drug responsiveness this disease is

  9. Allergic rhinitis

    MedlinePlus

    ... your symptoms. Skin testing is the most common method of allergy testing. If your doctor determines you ... Others cause little or no sleepiness. Antihistamine nasal sprays work well for treating allergic rhinitis. Ask your ...

  10. Management of Allergic Rhinitis

    PubMed Central

    Sausen, Verra O.; Marks, Katherine E.; Sausen, Kenneth P.; Self, Timothy H.

    2005-01-01

    Allergic rhinitis is the most common chronic childhood disease. Reduced quality of life is frequently caused by this IgE-mediated disease, including sleep disturbance with subsequent decreased school performance. Asthma and exercise-induced bronchospasm are commonly seen concurrently with allergic rhinitis, and poorly controlled allergic rhinitis negatively affects asthma outcomes. Nonsedating antihistamines or intranasal azelastine are effective agents to manage allergic rhinitis, often in combination with oral decongestants. For moderate to severe persistent disease, intranasal corticosteroids are the most effiective agents. Some patients require concomitant intranasal corticosteroids and nonsedating antihistamines for optimal management. Other available agents include leukotriene receptor antagonists, intranasal cromolyn, intranasal ipratropium, specific immunotherapy, and anti-IgE therapy. PMID:23118635

  11. Hormetic Effect of Chronic Hypergravity in a Mouse Model of Allergic Asthma and Rhinitis

    NASA Astrophysics Data System (ADS)

    Jang, Tae Young; Jung, Ah-Yeoun; Kim, Young Hyo

    2016-06-01

    We aimed to evaluate the effect of chronic hypergravity in a mouse model of allergic asthma and rhinitis. Forty BALB/c mice were divided as: group A (n = 10, control) sensitized and challenged with saline, group B (n = 10, asthma) challenged by intraperitoneal and intranasal ovalbumin (OVA) to induce allergic asthma and rhinitis, and groups C (n = 10, asthma/rotatory control) and D (n = 10, asthma/hypergravity) exposed to 4 weeks of rotation with normogravity (1G) or hypergravity (5G) during induction of asthma/rhinitis. Group D showed significantly decreased eosinophils, neutrophils, and lymphocytes in their BAL fluid compared with groups B and C (p < 0.05). In real-time polymerase chain reaction using lung homogenate, the expression of IL-1β was significantly upregulated (p < 0.001) and IL-4 and IL-10 significantly downregulated (p < 0.05) in group D. Infiltration of inflammatory cells into lung parenchyma and turbinate, and the thickness of respiratory epithelium was significantly reduced in group D (p < 0.05). The expression of Bcl-2 and heme oxygenase-1 were significantly downregulated, Bax and extracellular dismutase significantly upregulated in Group D. Therefore, chronic hypergravity could have a hormetic effect for allergic asthma and rhinitis via regulation of genes involved in antioxidative and proapoptotic pathways. It is possible that we could use hypergravity machinery for treating allergic respiratory disorders.

  12. Hormetic Effect of Chronic Hypergravity in a Mouse Model of Allergic Asthma and Rhinitis

    PubMed Central

    Jang, Tae Young; Jung, Ah-Yeoun; Kim, Young Hyo

    2016-01-01

    We aimed to evaluate the effect of chronic hypergravity in a mouse model of allergic asthma and rhinitis. Forty BALB/c mice were divided as: group A (n = 10, control) sensitized and challenged with saline, group B (n = 10, asthma) challenged by intraperitoneal and intranasal ovalbumin (OVA) to induce allergic asthma and rhinitis, and groups C (n = 10, asthma/rotatory control) and D (n = 10, asthma/hypergravity) exposed to 4 weeks of rotation with normogravity (1G) or hypergravity (5G) during induction of asthma/rhinitis. Group D showed significantly decreased eosinophils, neutrophils, and lymphocytes in their BAL fluid compared with groups B and C (p < 0.05). In real-time polymerase chain reaction using lung homogenate, the expression of IL-1β was significantly upregulated (p < 0.001) and IL-4 and IL-10 significantly downregulated (p < 0.05) in group D. Infiltration of inflammatory cells into lung parenchyma and turbinate, and the thickness of respiratory epithelium was significantly reduced in group D (p < 0.05). The expression of Bcl-2 and heme oxygenase-1 were significantly downregulated, Bax and extracellular dismutase significantly upregulated in Group D. Therefore, chronic hypergravity could have a hormetic effect for allergic asthma and rhinitis via regulation of genes involved in antioxidative and proapoptotic pathways. It is possible that we could use hypergravity machinery for treating allergic respiratory disorders. PMID:27251783

  13. Hormetic Effect of Chronic Hypergravity in a Mouse Model of Allergic Asthma and Rhinitis.

    PubMed

    Jang, Tae Young; Jung, Ah-Yeoun; Kim, Young Hyo

    2016-01-01

    We aimed to evaluate the effect of chronic hypergravity in a mouse model of allergic asthma and rhinitis. Forty BALB/c mice were divided as: group A (n = 10, control) sensitized and challenged with saline, group B (n = 10, asthma) challenged by intraperitoneal and intranasal ovalbumin (OVA) to induce allergic asthma and rhinitis, and groups C (n = 10, asthma/rotatory control) and D (n = 10, asthma/hypergravity) exposed to 4 weeks of rotation with normogravity (1G) or hypergravity (5G) during induction of asthma/rhinitis. Group D showed significantly decreased eosinophils, neutrophils, and lymphocytes in their BAL fluid compared with groups B and C (p < 0.05). In real-time polymerase chain reaction using lung homogenate, the expression of IL-1β was significantly upregulated (p < 0.001) and IL-4 and IL-10 significantly downregulated (p < 0.05) in group D. Infiltration of inflammatory cells into lung parenchyma and turbinate, and the thickness of respiratory epithelium was significantly reduced in group D (p < 0.05). The expression of Bcl-2 and heme oxygenase-1 were significantly downregulated, Bax and extracellular dismutase significantly upregulated in Group D. Therefore, chronic hypergravity could have a hormetic effect for allergic asthma and rhinitis via regulation of genes involved in antioxidative and proapoptotic pathways. It is possible that we could use hypergravity machinery for treating allergic respiratory disorders. PMID:27251783

  14. Allergic Rhinitis.

    PubMed

    Kakli, Hasan A; Riley, Timothy D

    2016-09-01

    Among the atopic disorders, allergic rhinitis is the most prevalent. Patients who suffer from allergic rhinitis sustain significant morbidity and loss of productivity. Cardinal symptoms include nasal congestion, rhinorrhea, sneezing, and nasal itching, although multiple related symptoms may occur. Causes should be ruled out with a thorough history and physical examination, with particular attention to red flag or atypical symptoms. Skin testing or serum sampling can confirm diagnosis and also guide therapy. Therapy is multimodal, tailored to a particular patient's symptom burden and quality of life. PMID:27545735

  15. Prevalence of self-reported smoking experimentation in adolescents with asthma or allergic rhinitis

    PubMed Central

    Fernandes, Silvia de Sousa Campos; de Andrade, Cláudia Ribeiro; Caminhas, Alessandra Pinheiro; Camargos, Paulo Augusto Moreira; Ibiapina, Cássio da Cunha

    2016-01-01

    Objective: To determine the prevalence of smoking experimentation among adolescents with asthma or allergic rhinitis. Methods: This was a cross-sectional study involving adolescent students (13-14 years of age) in the city of Belo Horizonte, Brazil. The participants completed the Centers for Disease Control and Prevention and International Study of Asthma and Allergies in Childhood questionnaires, both of which have been validated for use in Brazil. We calculated the prevalence of smoking experimentation in the sample as a whole, among the students with asthma symptoms, and among the students with allergic rhinitis symptoms, as well as in subgroups according to gender and age at smoking experimentation. Results: The sample comprised 3,325 adolescent students. No statistically significant differences were found regarding gender or age. In the sample as a whole, the prevalence of smoking experimentation was 9.6%. The mean age for smoking experimentation for the first time was 11.1 years of age (range, 5-14 years). Among the adolescents with asthma symptoms and among those with allergic rhinitis symptoms, the prevalence of self-reported smoking experimentation was 13.5% and 10.6%, respectively. Conclusions: The proportion of adolescents with symptoms of asthma or allergic rhinitis who reported smoking experimentation is a cause for concern, because there is strong evidence that active smoking is a risk factor for the occurrence and increased severity of allergic diseases. PMID:27167427

  16. Local Allergic Rhinitis.

    PubMed

    Campo, Paloma; Salas, María; Blanca-López, Natalia; Rondón, Carmen

    2016-05-01

    This review focuses on local allergic rhinitis, a new phenotype of allergic rhinitis, commonly misdiagnosed as nonallergic rhinitis. It has gained attention over last decade and can affect patients from all countries, ethnic groups and ages, impairing their quality of life, and is frequently associated with conjunctivitis and asthma. Diagnosis is based on clinical history, the demonstration of a positive response to nasal allergen provocation test and/or the detection of nasal sIgE. A positive basophil activation test may support the diagnosis. Recent studies have demonstrated that allergen immunotherapy is an effective immune-modifying treatment, highlighting the importance of early diagnosis. PMID:27083105

  17. Traffic exposure associated with allergic asthma and allergic rhinitis in adults. A cross-sectional study in southern Sweden

    PubMed Central

    Lindgren, Anna; Stroh, Emilie; Nihlén, Ulf; Montnémery, Peter; Axmon, Anna; Jakobsson, Kristina

    2009-01-01

    Background There is conflicting evidence that traffic-related air pollution is a risk factor for allergic conditions. Few studies have investigated this in adults. In adults, a high proportion of asthma, rhinitis and eczema is triggered by non-allergic factors. We investigated traffic as a risk factor for allergic versus non-allergic asthma and rhinitis, and eczema, in adults. A questionnaire from 2000 (n = 9319, 18–77 years) provided individual data about disease outcome and self-reported traffic exposure. Additional exposure assessments were obtained using Geographical Informations Systems (GIS). Residential addresses were linked to the national Swedish Road Database and to a pollutant database with modelled annual means of NOx (Nitrogen Oxids). Results Living within 100 m from a road with a traffic intensity of >10 cars/min (24 hour mean) was associated with prevalence of current asthma reported to be triggered by allergic factors (OR = 1.83, 95% CI = 1.23–2.72) and with allergic rhinitis (OR = 1.30, 95%CI = (1.05–1.61). No relation was seen with asthma or rhinitis triggered by other factors. Living within 100 m of a road with >10 cars/min was also associated with hand-eczema during the last 12 months (OR = 1.63, 95% CI = 1.19–2.23), but not with allergic eczema or diagnosed hand-eczema. Consistent results were seen using self-reported traffic, but the associations with NOx were less consistent. Conclusion Exposure to traffic was associated with a higher prevalence of allergic asthma and allergic rhinitis, but not with asthma or rhinitis triggered by non-allergic factors. This difference was suggested by the overall pattern, but only clear using GIS-measured traffic intensity as a proxy for traffic exposure. An association was also found with hand-eczema during the last 12 months. We suggest that asthma and rhinitis should not be treated as homogenous groups when estimating effects from traffic in adults. PMID:19419561

  18. Allergic Rhinitis and its Impact on Asthma (ARIA): achievements in 10 years and future needs.

    PubMed

    Bousquet, J; Schünemann, H J; Samolinski, B; Demoly, P; Baena-Cagnani, C E; Bachert, C; Bonini, S; Boulet, L P; Bousquet, P J; Brozek, J L; Canonica, G W; Casale, T B; Cruz, A A; Fokkens, W J; Fonseca, J A; van Wijk, R Gerth; Grouse, L; Haahtela, T; Khaltaev, N; Kuna, P; Lockey, R F; Lodrup Carlsen, K C; Mullol, J; Naclerio, R; O'Hehir, R E; Ohta, K; Palkonen, S; Papadopoulos, N G; Passalacqua, G; Pawankar, R; Price, D; Ryan, D; Simons, F E R; Togias, A; Williams, D; Yorgancioglu, A; Yusuf, O M; Aberer, W; Adachi, M; Agache, I; Aït-Khaled, N; Akdis, C A; Andrianarisoa, A; Annesi-Maesano, I; Ansotegui, I J; Baiardini, I; Bateman, E D; Bedbrook, A; Beghé, B; Beji, M; Bel, E H; Ben Kheder, A; Bennoor, K S; Bergmann, K C; Berrissoul, F; Bieber, T; Bindslev Jensen, C; Blaiss, M S; Boner, A L; Bouchard, J; Braido, F; Brightling, C E; Bush, A; Caballero, F; Calderon, M A; Calvo, M A; Camargos, P A M; Caraballo, L R; Carlsen, K H; Carr, W; Cepeda, A M; Cesario, A; Chavannes, N H; Chen, Y Z; Chiriac, A M; Chivato Pérez, T; Chkhartishvili, E; Ciprandi, G; Costa, D J; Cox, L; Custovic, A; Dahl, R; Darsow, U; De Blay, F; Deleanu, D; Denburg, J A; Devillier, P; Didi, T; Dokic, D; Dolen, W K; Douagui, H; Dubakiene, R; Durham, S R; Dykewicz, M S; El-Gamal, Y; El-Meziane, A; Emuzyte, R; Fiocchi, A; Fletcher, M; Fukuda, T; Gamkrelidze, A; Gereda, J E; González Diaz, S; Gotua, M; Guzmán, M A; Hellings, P W; Hellquist-Dahl, B; Horak, F; Hourihane, J O'B; Howarth, P; Humbert, M; Ivancevich, J C; Jackson, C; Just, J; Kalayci, O; Kaliner, M A; Kalyoncu, A F; Keil, T; Keith, P K; Khayat, G; Kim, Y Y; Koffi N'goran, B; Koppelman, G H; Kowalski, M L; Kull, I; Kvedariene, V; Larenas-Linnemann, D; Le, L T; Lemière, C; Li, J; Lieberman, P; Lipworth, B; Mahboub, B; Makela, M J; Martin, F; Marshall, G D; Martinez, F D; Masjedi, M R; Maurer, M; Mavale-Manuel, S; Mazon, A; Melen, E; Meltzer, E O; Mendez, N H; Merk, H; Mihaltan, F; Mohammad, Y; Morais-Almeida, M; Muraro, A; Nafti, S; Namazova-Baranova, L; Nekam, K; Neou, A; Niggemann, B; Nizankowska-Mogilnicka, E; Nyembue, T D; Okamoto, Y; Okubo, K; Orru, M P; Ouedraogo, S; Ozdemir, C; Panzner, P; Pali-Schöll, I; Park, H S; Pigearias, B; Pohl, W; Popov, T A; Postma, D S; Potter, P; Rabe, K F; Ratomaharo, J; Reitamo, S; Ring, J; Roberts, R; Rogala, B; Romano, A; Roman Rodriguez, M; Rosado-Pinto, J; Rosenwasser, L; Rottem, M; Sanchez-Borges, M; Scadding, G K; Schmid-Grendelmeier, P; Sheikh, A; Sisul, J C; Solé, D; Sooronbaev, T; Spicak, V; Spranger, O; Stein, R T; Stoloff, S W; Sunyer, J; Szczeklik, A; Todo-Bom, A; Toskala, E; Tremblay, Y; Valenta, R; Valero, A L; Valeyre, D; Valiulis, A; Valovirta, E; Van Cauwenberge, P; Vandenplas, O; van Weel, C; Vichyanond, P; Viegi, G; Wang, D Y; Wickman, M; Wöhrl, S; Wright, J; Yawn, B P; Yiallouros, P K; Zar, H J; Zernotti, M E; Zhong, N; Zidarn, M; Zuberbier, T; Burney, P G; Johnston, S L; Warner, J O

    2012-11-01

    Allergic rhinitis (AR) and asthma represent global health problems for all age groups. Asthma and rhinitis frequently coexist in the same subjects. Allergic Rhinitis and its Impact on Asthma (ARIA) was initiated during a World Health Organization workshop in 1999 (published in 2001). ARIA has reclassified AR as mild/moderate-severe and intermittent/persistent. This classification closely reflects patients' needs and underlines the close relationship between rhinitis and asthma. Patients, clinicians, and other health care professionals are confronted with various treatment choices for the management of AR. This contributes to considerable variation in clinical practice, and worldwide, patients, clinicians, and other health care professionals are faced with uncertainty about the relative merits and downsides of the various treatment options. In its 2010 Revision, ARIA developed clinical practice guidelines for the management of AR and asthma comorbidities based on the Grading of Recommendation, Assessment, Development and Evaluation (GRADE) system. ARIA is disseminated and implemented in more than 50 countries of the world. Ten years after the publication of the ARIA World Health Organization workshop report, it is important to make a summary of its achievements and identify the still unmet clinical, research, and implementation needs to strengthen the 2011 European Union Priority on allergy and asthma in children. PMID:23040884

  19. Allergic rhinitis and asthma: inflammation in a one-airway condition

    PubMed Central

    Jeffery, Peter K; Haahtela, Tari

    2006-01-01

    Background Allergic rhinitis and asthma are conditions of airway inflammation that often coexist. Discussion In susceptible individuals, exposure of the nose and lungs to allergen elicits early phase and late phase responses. Contact with antigen by mast cells results in their degranulation, the release of selected mediators, and the subsequent recruitment of other inflammatory cell phenotypes. Additional proinflammatory mediators are released, including histamine, prostaglandins, cysteinyl leukotrienes, proteases, and a variety of cytokines, chemokines, and growth factors. Nasal biopsies in allergic rhinitis demonstrate accumulations of mast cells, eosinophils, and basophils in the epithelium and accumulations of eosinophils in the deeper subepithelium (that is, lamina propria). Examination of bronchial tissue, even in mild asthma, shows lymphocytic inflammation enriched by eosinophils. In severe asthma, the predominant pattern of inflammation changes, with increases in the numbers of neutrophils and, in many, an extension of the changes to involve smaller airways (that is, bronchioli). Structural alterations (that is, remodeling) of bronchi in mild asthma include epithelial fragility and thickening of its reticular basement membrane. With increasing severity of asthma there may be increases in airway smooth muscle mass, vascularity, interstitial collagen, and mucus-secreting glands. Remodeling in the nose is less extensive than that of the lower airways, but the epithelial reticular basement membrane may be slightly but significantly thickened. Conclusion Inflammation is a key feature of both allergic rhinitis and asthma. There are therefore potential benefits for application of anti-inflammatory strategies that target both these anatomic sites. PMID:17140423

  20. Allergic Rhinitis and Asthma in Southern Croatia: Impact of Sensitization to Ambrosia elatior

    PubMed Central

    Cvitanović, Slavica; Znaor, Ljubo; Kanceljak-Macan, Božica; Macan, Jelena; Gudelj, Ivan; Grbić, Dragica

    2007-01-01

    Aim To identify pollen types in southern Croatia and investigate the impact of sensitization to Ambrosia elatior (A. elatior) on symptoms and treatment of patients with seasonal allergic rhinitis and/or asthma. Methods The study recruited 120 patients from Split-Dalmatian County with seasonal rhinitis and asthma symptoms and positive skin prick test to one or more common inhaled allergens. Patients with positive skin prick test and increased specific IgE to A. elatior (n = 56) were included in the follow-up study during the A. elatior pollen season. Rhinitis and asthma symptoms were scored and drug treatment recorded using standardized questionnaires. Also, forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), and eosinophil count in peripheral blood were measured. Type and pollen concentration of A. elatior in the air over the nine-week pollen season were determined on the glass slides using the gravimetric method. The results were expressed as the proportion of A. elatior pollen in the total pollen. Results Fifty-six of 120 patients (46.7%) were sensitized to A. elatior. Its proportion in total pollen peaked to 12% in the first week of September. Forty-one patients who completed the follow-up study showed a significantly higher score of symptoms during this peak period than in the beginning of the pollen season for seasonal allergic rhinitis (median±interquartile range, 50 ± 11 vs 7 ± 4; P<0.001) and for seasonal allergic asthma (median±interquartile range, 12 ± 2 vs 0 ± 0; P<0.001). Conclusion A. elatior is an important cause of seasonal allergic rhinitis and asthma and must be included in the routine diagnostic procedures in southern Croatia. PMID:17309141

  1. Analysis of the quality of life of patients with asthma and allergic rhinitis after immunotherapy

    PubMed Central

    Szynkiewicz, Ewa; Cegła, Bernadeta; Bartuzi, Zbigniew

    2016-01-01

    Aim To assess the quality of life of Polish patients with asthma and/or allergic rhinitis before the implementation and after 30–36 months of immunotherapy. Material and methods Two hundred patients have been involved in the study: 101 with allergic asthma and 99 with pollinosis. In order to collect research material, the Polish versions of AQLQ (Asthma Quality of Life) and RQLQ (Rhinoconjunctivitis Quality of Life) questionnaires have been used. The self-administered questionnaires concerned such data as age, sex and the patients’ subjective evaluation of their quality of life. Results The average increase in quality of life of patients with asthma was 0.84 and of patients with allergic rhinitis – 1.50. A hypothesis was made that changes of quality of life in each examined group differed significantly. A test for two fractions showed that for patients with asthma it was 7.74 and for patients with allergic rhinitis – 10.38. A statistical analysis showed no such relation in the group of patients with asthma (coefficient of correlation = 0.08) and a slight correlation in the group of patients with allergic rhinitis (coefficient of correlation = 0.20). Applied tests did not show any significant differences, which means that an average increase in quality of life does not depend on sex and age of both examined groups. Conclusions On the basis of the research conducted among patients before and after a 3-year period of immunotherapy, the following conclusions have been drawn: 1) immunotherapy significantly improves the objective quality of life in both groups; 2) a slight correlation has been identified between the objective and subjective dimension of quality of life amongst patients with asthma, what contributes to a better quality of life; 3) in both study groups, no significant relationship between gender or age and improvement in quality of life has been noted; 4) immunotherapy, from the point of view of the improvement of quality of life, is a valuable

  2. Nasal irrigation for chronic sinus symptoms in patients with allergic rhinitis, asthma and nasal polyposis: a hypothesis generating study

    PubMed Central

    Rabago, David P.; Guerard, Emily; Bukstein, Don

    2009-01-01

    Background Rhinosinusitis is a common, expensive disorder with a significant impact on patients' quality-of-life. Chronic sinus symptoms are associated with allergic rhinitis, asthma, and nasal polyposis. Saline nasal irrigation is an adjunctive therapy for rhinosinusitis and sinus symptoms. Prior studies suggest that HSNI may be effective for symptoms associated with allergy, asthma and nasal polyposis. Objective To assess the degree to which subjects using nasal irrigation for chronic sinus symptoms also reported improvements in symptoms related to allergy, asthma or nasal polyposis. Design Qualitative study using in-depth long interviews. Participants 28 participants in a prior qualitative nasal irrigation study. Intervention Daily nasal irrigation. Outcome Qualitative transcripts Results Transcripts of interviews were systematically examined. Twelve of 21 subjects with allergic rhinitis spontaneously reported that HSNI improved symptoms. Two of seven subjects with asthma and one of two subjects with nasal polyposis reported a positive association between HSNI use and asthma or nasal polyposis symptoms. Transcript content was organized into themes which included: 1) HSNI resulted in improvement of allergic rhinitis and asthma symptoms, and 2) HSNI should be used for symptoms of allergic rhinitis. Conclusions This hypothesis generating study offers suggestive qualitative evidence that in patients with frequent rhinosinusitis and daily sinus symptoms, symptoms of concomitant allergic rhinitis, asthma or polyposis may also improve with HSNI. The parent studies offer strong evidence that HSNI is an effective adjunctive treatment for symptoms of chronic rhinosinusitis. Larger prospective studies are needed in patients with these diagnoses. PMID:18593081

  3. Allergic Rhinitis and Its Impact on Asthma in Asia Pacific and the ARIA Update 2008

    PubMed Central

    Bunnag, Chaweewan; Khaltaev, Nikolai; Bousquet, Jean

    2012-01-01

    Abstract: The prevalence of allergic diseases such as allergic rhinitis (AR) and asthma are markedly increasing to epidemic proportions worldwide as societies adopt Western lifestyles. An estimated 300 million persons worldwide have asthma, about 50% of whom live in developing countries, and about 400 million people suffer from AR. AR has a marked impact on quality of life, socially, at school, and in the workplace and is a huge socioeconomic burden. Thus, there was clearly a need for a global evidence-based guideline not only for managing AR but also highlighting the interactions between the upper and lower airways including diagnosis, epidemiology, common risk factors, management, and prevention. The Allergic Rhinitis and its Impact on Asthma (ARIA) document was first published in 2001 as a state-of-the-art document for the specialist, the general practitioner, and other health care professionals. Subsequent research and increasing knowledge have resulted in the ARIA 2008 update. The present review summarizes the ARIA update with particular emphasis on the current status of AR and asthma in Asia Pacific. PMID:23268481

  4. Systemic and local eosinophil inflammation during the birch pollen season in allergic patients with predominant rhinitis or asthma

    PubMed Central

    Kämpe, Mary; Stålenheim, Gunnemar; Janson, Christer; Stolt, Ingrid; Carlson, Marie

    2007-01-01

    Background The aim of the study was to investigate inflammation during the birch pollen season in patients with rhinitis or asthma. Methods Subjects with birch pollen asthma (n = 7) or rhinitis (n = 9) and controls (n = 5) were studied before and during pollen seasons. Eosinophils (Eos), eosinophil cationic protein (ECP) and human neutrophil lipocalin were analysed. Results Allergic asthmatics had a larger decline in FEV1 after inhaling hypertonic saline than patients with rhinitis (median) (-7.0 vs.-0.4%, p = 0.02). The asthmatics had a lower sesonal PEFR than the rhinitis group. The seasonal increase in B-Eos was higher among patients with asthma (+0.17 × 109/L) and rhinitis (+0.27 × 109/L) than among controls (+0.01 × 109/L, p = 0.01). Allergic asthmatics and patients with rhinitis had a larger increase in sputum ECP (+2180 and +310 μg/L) than the controls (-146 μg/L, p = 0.02). No significant differences in inflammatory parameters were found between the two groups of allergic patients. Conclusion Patients with allergic asthma and rhinitis have the same degree of eosinophil inflammation. Despite this, only the asthmatic group experienced an impairment in lung function during the pollen season. PMID:17967188

  5. Control of Allergic Rhinitis and Asthma Test (CARAT): dissemination and applications in primary care.

    PubMed

    Azevedo, Pedro; Correia de Sousa, Jaime; Bousquet, Jean; Bugalho-Almeida, António; Del Giacco, Stefano R; Demoly, Pascal; Haahtela, Tari; Jacinto, Tiago; Garcia-Larsen, Vanessa; van der Molen, Thys; Morais-Almeida, Mário; Nogueira-Silva, Luis; Pereira, Ana M; Rodríguez, Miguel Román; Silva, Bárbara G; Tsiligianni, Ioanna G; Yaman, Hakan; Yawn, Barbara; Fonseca, João A

    2013-03-01

    Asthma frequently occurs in association with allergic rhinitis and a combined management approach has been suggested. The Control of Allergic Rhinitis and Asthma Test (CARAT) is the first questionnaire to assess control of both diseases concurrently. However, to have an impact on healthcare it needs to be disseminated and adopted. In this paper we discuss the dissemination of CARAT in different countries and its possible applications in primary care. At present, the adaptation of CARAT for use in different languages and cultures is being led by volunteer researchers and clinicians in 15 countries. Website and smartphone applications have been developed, and a free open model of distribution was adopted to contribute to the dissemination of CARAT. Examples of dissemination activities include distribution of leaflets and posters, educational sessions on the use of the questionnaire in the follow-up of patients, development of clinical studies, collaborations with professional organisations and health authorities, and the inclusion of CARAT in clinical guidelines. The adoption of innovations is an important challenge in healthcare today, and research on the degree of success of dissemination strategies using suitable methods and metrics is much needed. We propose that CARAT can be used in a range of settings and circumstances in primary care for clinical, research and audit purposes, within the overall aim of increasing awareness of the level of disease control and strengthening the partnership between patients and doctors in the management of asthma and rhinitis. PMID:23412110

  6. The impact of Vitamin D deficiency on asthma, allergic rhinitis and wheezing in children: An emerging public health problem

    PubMed Central

    Bener, Abdulbari; Ehlayel, Mohammad S.; Bener, Hale Z.; Hamid, Qutayba

    2014-01-01

    Background: Vitamin D deficiency has been declared a public health problem for both adults and children worldwide. Asthma and related allergic diseases are the leading causes of morbidity in children. The objective of this study was to investigate the potential role of Vitamin D deficiency in childhood asthma and other allergic diseases such as allergic rhinitis and wheezing. Materials and Methods: This cross-sectional study was conducted in Primary Health Care Centers (PHCs), from March 2012 to October 2013. A total of 2350 Qatari children below the age of 16 were selected from PHCs, and 1833 agreed to participate in this study giving a response rate of (78%). Face-to-face interviews with parents of all the children were based on a questionnaire that included variables such as socio-demographic information, assessment of nondietary covariates, Vitamin D intake, type of feeding, and laboratory investigations. Their health status was assessed by serum Vitamin D (25-hydoxyvitamin D), family history and body mass index. Results: Most of the children who had asthma (38.5%), allergic rhinitis (34.8%) and wheezing (35.7%) were below 5 years. Consanguinity was significantly higher in parents of children with allergic rhinitis (48.6%), followed by those with asthma (46.4%) and wheezing (40.8%) than in healthy children (35.9%) (P < 0.001). The proportion of severe Vitamin D deficiency was significantly higher in children with wheezing (23.4%), allergic rhinitis (18.5%), and asthma (17%) than in healthy children (10.5%). Exposure to the sun was significantly less in Vitamin D deficient children with asthma (60.3%), allergic rhinitis (62.5%) and wheezing (64.4%) than in controls (47.1%) (P = 0.008). It was found that Vitamin D deficiency was a significant correlate for asthma (odds ratio [OR] =2.31; P < 0.001), allergic rhinitis (OR = 1.59; P < 0.001) and wheezing (relative risk = 1.29; P = 0.05). Conclusion: The study findings revealed a high prevalence of Vitamin D

  7. Atopic Manifestations: Dermatitis, Allergic Rhinitis and Asthma in Patients With Hypogammaglobulinemia

    PubMed Central

    Dadkhah, Minoo; Aghamohammadi, Asghar; Movahedi, Masoud; Gharagozlou, Mohammad

    2015-01-01

    Background: Most of the hypogammaglobulinemic patients have a clinical history in favor of allergic respiratory disease. Nevertheless, in these patients the importance and prevalence of atopic disorders have not been completely explained. Objectives: This study was aimed to evaluate atopic manifestations (dermatitis, allergic rhinitis and asthma) and pulmonary function in patients with hypogammaglobulinemia. Patients and Methods: We used the international study of asthma and allergies in childhood (ISAAC) questionnaire in forty-five patients diagnosed with hypogammaglobulinemia and spirometry was done in 41 patients older than 5 years. Results: Spirometry results were normal in 21 (51%), and showed obstructive in 15 (37%) and restrictive pattern in 5 (12%) of the 41 patients who were evaluated. By the end of the study, asthma was diagnosed in nine (20%) patients and other atopies (rhinitis and dermatitis) identified in 10 (22%), and four (9%), respectively. Conclusions: Atopic conditions should be investigated in the hypogammaglobulinemic patients and the prevalence in these patients may be higher than in normal population. Also, it is recommended to perform a pulmonary function test as a routine procedure in patients with hypogammaglobulinemia and atopy should be assessed in these patients. PMID:26495093

  8. Diagnosing Allergic Rhinitis.

    PubMed

    Scadding, Glenis K; Scadding, Guy W

    2016-05-01

    Allergic rhinitis (AR) is the most common immunologic disease in industrialized societies and has a significant impact on quality of life. Most asthmatics also have rhinitis. AR may present with comorbidities, including chronic otitis media with effusion, cough, and pollen-food cross-reactivity. AR may occur in isolation or be part of a mixed rhinitis. PMID:27083100

  9. New therapies for allergic rhinitis.

    PubMed

    Braido, Fulvio; Sclifò, Francesca; Ferrando, Matteo; Canonica, Giorgio Walter

    2014-04-01

    Because of its burden on patient's lives and its impact on asthma, allergic rhinitis must be treated properly with more effective and safer treatments. According to guidelines by Allergic Rhinitis and Its Impact on Asthma (ARIA), the classification, pathogenesis, and treatment of allergic rhinitis are well defined. Currently, second-generation antihistamines and inhaled steroids are considered the cornerstone of first-line therapy. However, new formulations of available drugs (e.g., loratadine and rupatadine oral solution, ebastine fast-dissolving tablets, and the combination of intranasal fluticasone propionate and azelastine hydrochloride), recently discovered molecules (e.g., ciclesonide, bilastine, and phosphodiesterase-4 inhibitors), immunologic targets (e.g., omalizumab), and unconventional treatments (e.g., homeopathic treatments) are currently under investigation and represent a new frontier in modern medicine and in allergic rhinitis management. The aim of this review is to provide an update on allergic rhinitis treatment, paying particular attention to clinical trials published within the past 20 months that assessed the efficacy and safety of new formulations of available drugs or new molecules. PMID:24504526

  10. Complete right lung agenesis presenting with bronchial asthma and allergic rhinitis.

    PubMed

    Kushwaha, Ram Avadh Singh; Ranganath, T G; Garg, Rajiv; Anand, Shipra

    2012-01-01

    A 26 year-old lady presented with episodic breathlessness, chest tightness, recurrent nasal obstruction and excessive sneezing, mainly during change of season along with opacity of the right hemithorax on chest x-ray. Further detailed work-up including spirometry, high-resolution CT scan of the thorax and fibre-optic bronchoscopy confirmed complete right lung agenesis in patients with bronchial asthma and allergic rhinitis. Complete control of symptoms was achieved with formeterol 6 μg and mometasone 200 μg (via dry powder inhaler) and intranasal fluticasone 50 μg (nasal spray) 2 puffs twice daily and oral montelukast 10 mg with levocetirizine 5 mg once daily. PMID:23001088

  11. Differences in allergen-induced T cell activation between allergic asthma and rhinitis: Role of CD28, ICOS and CTLA-4

    PubMed Central

    2011-01-01

    Background Th2 cell activation and T regulatory cell (Treg) deficiency are key features of allergy. This applies for asthma and rhinitis. However with a same atopic background, some patients will develop rhinitis and asthma, whereas others will display rhinitis only. Co-receptors are pivotal in determining the type of T cell activation, but their role in allergic asthma and rhinitis has not been explored. Our objective was to assess whether allergen-induced T cell activation differs from allergic rhinitis to allergic rhinitis with asthma, and explore the role of ICOS, CD28 and CTLA-4. Methods T cell co-receptor and cytokine expressions were assessed by flow cytometry in PBMC from 18 house dust mite (HDM) allergic rhinitics (R), 18 HDM allergic rhinitics and asthmatics (AR), 13 non allergic asthmatics (A) and 20 controls, with or without anti-co-receptors antibodies. Results In asthmatics (A+AR), a constitutive decrease of CTLA-4+ and of CD4+CD25+Foxp3+ cells was found, with an increase of IFN-γ+ cells. In allergic subjects (R + AR), allergen stimulation induced CD28 together with IL-4 and IL-13, and decreased the proportion of CTLA-4+, IL-10+ and CD4+CD25+Foxp3+ cells. Anti-ICOS and anti-CD28 antibodies blocked allergen-induced IL-4 and IL-13. IL-13 production also involved CTLA-4. Conclusions T cell activation differs between allergic rhinitis and asthma. In asthma, a constitutive, co-receptor independent, Th1 activation and Treg deficiency is found. In allergic rhinitis, an allergen-induced Treg cell deficiency is seen, as well as an ICOS-, CD28- and CTLA-4-dependent Th2 activation. Allergic asthmatics display both characteristics. PMID:21356099

  12. Consumption of Artificially-Sweetened Soft Drinks in Pregnancy and Risk of Child Asthma and Allergic Rhinitis

    PubMed Central

    Maslova, Ekaterina; Strøm, Marin; Olsen, Sjurdur F.; Halldorsson, Thorhallur I.

    2013-01-01

    Background Past evidence has suggested a role of artificial sweeteners in allergic disease; yet, the evidence has been inconsistent and unclear. Objective To examine relation of intake of artificially-sweetened beverages during pregnancy with child asthma and allergic rhinitis at 18 months and 7 years. Methods We analyzed data from 60,466 women enrolled during pregnancy in the prospective longitudinal Danish National Birth Cohort between 1996 and 2003. At the 25th week of gestation we administered a validated Food Frequency Questionnaire which asked in detail about intake of artificially-sweetened soft drinks. At 18 months, we evaluated child asthma using interview data. We also assessed asthma and allergic rhinitis through a questionnaire at age 7 and by using national registries. Current asthma was defined as self-reported asthma diagnosis and wheeze in the past 12 months. We examined the relation between intake of artificially-sweetened soft drinks and child allergic disease outcomes and present here odds ratios with 95% CI comparing daily vs. no intake. Results At 18 months, we found that mothers who consumed more artificially-sweetened non-carbonated soft drinks were 1.23 (95% CI: 1.13, 1.33) times more likely to report a child asthma diagnosis compared to non-consumers. Similar results were found for child wheeze. Consumers of artificially-sweetened carbonated drinks were more likely to have a child asthma diagnosis in the patient (1.30, 95% CI: 1.01, 1.66) and medication (1.13, 95% CI: 0.98, 1.29) registry, as well as self-reported allergic rhinitis (1.31, 95% CI: 0.98, 1.74) during the first 7 years of follow-up. We found no associations for sugar-sweetened soft drinks. Conclusion Carbonated artificially-sweetened soft drinks were associated with registry-based asthma and self-reported allergic rhinitis, while early childhood outcomes were related to non-carbonated soft drinks. These results suggest that consumption of artificially-sweetened soft drinks

  13. Atopic dermatitis, asthma and allergic rhinitis in general practice and the open population: a systematic review

    PubMed Central

    Pols, D. H. J.; Wartna, J. B.; Moed, H.; van Alphen, E. I.; Bohnen, A. M.; Bindels, P. J. E.

    2016-01-01

    Objective To examine whether significant differences exist between the self-reported prevalence of atopic disorders in the open population compared with physician diagnosed prevalence of atopic disorders in general practice. Methods Medline (OvidSP), PubMed Publisher, EMBASE, Google Scholar and the Cochrane Controlled Clinical Trials Register databases were systematically reviewed for articles providing data on the prevalence of asthma, allergic rhinitis and eczema in a GP setting. Studies were only included when they had a cross-sectional or cohort design and included more than 100 children (aged 0-18 years) in a general practice setting. All ISAAC studies (i.e. the open population) that geographically matched a study selected from the first search, were also included. A quality assessment was conducted. The primary outcome measures were prevalence of eczema, asthma and allergic rhinitis in children aged 0-18 years. Results The overall quality of the included studies was good. The annual and lifetime prevalences of the atopic disorders varied greatly in both general practice and the open population. On average, the prevalence of atopic disorders was higher in the open population. Conclusion There are significant differences between the self-reported prevalence of atopic disorders in the open population compared with physician diagnosed prevalence of atopic disorders in general practice. Data obtained in the open population cannot simply be extrapolated to the general practice setting. This should be taken into account when considering a research topic or requirements for policy development. GPs should be aware of the possible misclassification of allergic disorders in their practice. Key PointsEpidemiological data on atopic disorders in children can be obtained from various sources, each having its own advantages and limitations.On average, the prevalence of atopic disorders is higher in the open population.GPs should take into account the possible

  14. [Definition and clinic of the allergic rhinitis].

    PubMed

    Spielhaupter, Magdalena

    2016-03-01

    The allergic rhinitis is the most common immune disorder with a lifetime prevalence of 24% and one of the most common chronic diseases at all--with tendency to rise. It occurs in childhood and influences the patients' social life, school performance and labour productivity. Furthermore the allergic rhinitis is accompanied by a lot of comorbidities, including conjunctivitis, asthma bronchiale, food allergy, neurodermatitis and sinusitis. For example the risk for asthma is 3.2-fold higher for adults with allergic rhinitis than for healthy people. PMID:27120868

  15. Allergic rhinitis during pregnancy.

    PubMed

    2016-04-01

    During pregnancy, the first-choice drugs for allergic rhinitis are nasal or oral "non-sedating" antihistamines without antimuscarinic activity, in particular cetirizine, or loratadine after the first trimester. PMID:27186624

  16. Allergic Rhinitis: Antihistamines

    MedlinePlus

    MENU Return to Web version Allergic Rhinitis | Antihistamines What are antihistamines? Antihistamines are medicines that help stop allergy symptoms, such as itchy eyes, sneezing and a runny nose. Sometimes, an antihistamine ...

  17. The Prevalence of Serum Specific IgE to Superantigens in Asthma and Allergic Rhinitis Patients.

    PubMed

    Liu, Jing Nan; Shin, Yoo Seob; Yoo, Hye-Soo; Nam, Young Hee; Jin, Hyun Jung; Ye, Young-Min; Nahm, Dong-Ho; Park, Hae-Sim

    2014-05-01

    Staphylococcus aureus is the most common bacterium present in upper respiratory tract, and the toxins it produced are involved in allergic inflammation pathogenesis. In this study, we investigated the clinical significance of IgE in association with staphylococcal superantigens in allergic asthma with rhinitis (BAwAR) and allergic rhinitis alone (AR). We recruited 100 patients with BAwAR (group I), 100 patients with AR (group II), and 88 healthy controls (group III). Patients were clinically diagnosed by physicians, and were sensitized to house dust mites. Specific IgE antibodies to staphylococcal superantigen A (SEA), B (SEB), and toxic shock syndrome toxin-1 (TSST-1) were measured using the ImmunoCAP system. Other clinical parameters were retrospectively analyzed. All specific IgE antibodies to SEA, SEB, and TSST-1 were detected most frequently in group I (22%, 21%, and 27%), followed by group II (11%, 14%, and 21%) and group III (4.5%, 3.4%, and 2.3%). Absolute values of serum specific IgE to SEA, SEB, and TSST-1 were also significantly higher in group I (0.300±1.533 kU/L, 0.663±2.933 kU/L, and 0.581±1.931 kU/L) and group II (0.502±2.011 kU/L, 0.695±3.337 kU/L, and 1.067±4.688 kU/L) compared to those in group III (0.03±0.133 kU/L, 0.03±0.14 kU/L, and 0.028±0.112 kU/L). The prevalence of serum specific IgE to SEA was significantly higher in group I compared to group II (P=0.025). Blood eosinophil counts were significantly higher in patients with specific IgE to SEA or SEB, and higher serum levels of specific IgE to house dust mites were noted in patients with specific IgE to TSST-1. In conclusion, the present study suggested that IgE responses to staphylococcal superantigens are prevalent in the sera of both BAwAR and AR patients. This may contribute to an augmented IgE response to indoor allergens and eosinophilic inflammation. PMID:24843803

  18. [Antihistamines in allergic rhinitis].

    PubMed

    Kruszewski, Jerzy

    2007-01-01

    Antihistamines are the first line of pharmacotherapy in allergic diseases, especially in allergic rhinitis. The article also presents the interesting 2005-2007 publications on the use of antihistamine in practical point of view, especially the newly introduced ones (desloratadine, fexofenadine, levocetirizine) and those which are to be introduced soon (rupatadine). The efficacy in skin histamine provocation model and various clinical model were discussed. PMID:18260244

  19. [Therapy of allergic rhinitis].

    PubMed

    Klimek, Ludger; Sperl, Annette

    2016-03-01

    If the avoidance of the provoking allergen is insufficient or not possible, medical treatment can be tried. Therapeutics of the first choice for the treatment of the seasonal and persistent allergic rhinitis are antihistamines and topical glucocorticoids. Chromones are less effective so they should only be used for adults with a special indication, for example during pregnancy. Beside the avoidance of the allergen the immunotherapy is the only causal treatment of allergic diseases. PMID:27120870

  20. [Recent advances in allergic rhinitis].

    PubMed

    Liang, Meijun; Xu, Rui; Xu, Geng

    2015-02-01

    Allergic rhinitis (AR) clinically expressed by sneezing, rhinorrhea, nasal itching and congestion is an allergen-driven mucosal inflammatory disease which is modulated by immunoglobulin E. Epidemiological studies have indicated that prevalence of AR continues to increase, and it has been a worldwide health problem that places a significant healthcare burden on individuals and society. Given the evolving understanding of the process by which an allergen is recognized and the roles of mediators which account for AR progress, the pathogenesis of AR has become clearer. Current studies have demonstrated local allergic rhinitis (LAR) that patients with both sug- gestive symptoms of AR and a negative diagnostic test for atopy may have local allergic inflammation is a prevalent entity in patients evaluated with rhinitis, but further research remains needed. Management of AR includes aller- gen avoidance, pharmacological treatment and allergen-specific immunotherapy. Recently montelukast has exhibited previously undocumented anti-inflammatory properties, leukotriene receptor antagonists therefore may serve a more important role in the treatment of AR. Not only has immunotherapy proved its efficacy, but also been able to alter disease course and thereby mitigate progression to asthma. Thus immunotherapy can be initiated while receiving pharmacotherapy, especially in children with AR. As clinical guidelines, the ARIA (Allergic Rhinitis and its Impact on Asthma) provides basic principles of effective treatment of AR. Besides, choosing an appropriate treatment strategy should be based on the severity and chronicity of patient's symptom. The aim of this review was to provide an update mainly on the pathophysiology, epidemiology, and management of AR. PMID:26012287

  1. High-Fat and Low-Carbohydrate Diets Are Associated with Allergic Rhinitis But Not Asthma or Atopic Dermatitis in Children

    PubMed Central

    Kim, So Young; Sim, Songyong; Park, Bumjung; Kim, Jin-Hwan; Choi, Hyo Geun

    2016-01-01

    Background Numerous studies have suggested that nutritional intake is related to allergic diseases. Although conflicting results exist, fat intake is often associated with allergic diseases. We investigated the relationship between allergic diseases and nutritional intake after adjusting for various demographic and socioeconomic factors in a large, representative sample of Korean children. Methods A total of 3,040 participants, aged 4 to 13 years old, were enrolled in the present study from the Korean National Health and Nutrition Examination Survey (KNHANES), 2010–2012. Nutritional intake data, including total calories, protein, fat, carbohydrate, vitamin A, vitamin C, thiamine, riboflavin, and niacin, were retrieved from the survey using the complete 24-hour recall method. The associations between each nutritional factor and allergic rhinitis/asthma/atopic dermatitis were analyzed using simple and multiple logistic regression analyses with complex sampling. Age, sex, body mass index (BMI), number of household members, income level, and region of residence were adjusted for as covariates. Results Of the participants, 22.1%, 6.0%, and 15.5% suffered from allergic rhinitis, asthma, and atopic dermatitis, respectively. Allergic rhinitis was significantly correlated with high-fat and low-carbohydrate diets. The adjusted odds ratio (AOR) was 1.25 (95% CIs = 1.06–1.46, P = 0.007) for fat intake, denoting a 10% increase. Carbohydrate intake (10% increase) was negatively related to allergic rhinitis with an AOR of 0.84 (95% CIs = 0.74–0.95, P = 0.004). No other significant relationships were found between the retrieved nutritional factors and either asthma or atopic dermatitis. Conclusion Allergic rhinitis was related to high-fat and low-carbohydrate diets. Although the underlying mechanisms and causal relationships remain elusive, the present study provides reliable evidence regarding the associations between nutritional factors and allergic rhinitis by considering

  2. Urban Tree Canopy and Asthma, Wheeze, Rhinitis, and Allergic Sensitization to Tree Pollen in a New York City Birth Cohort

    PubMed Central

    Lovasi, Gina S.; O’Neil-Dunne, Jarlath P.M.; Lu, Jacqueline W.T.; Sheehan, Daniel; Perzanowski, Matthew S.; MacFaden, Sean W.; King, Kristen L.; Matte, Thomas; Miller, Rachel L.; Hoepner, Lori A.; Perera, Frederica P.

    2013-01-01

    Background: Urban landscape elements, particularly trees, have the potential to affect airflow, air quality, and production of aeroallergens. Several large-scale urban tree planting projects have sought to promote respiratory health, yet evidence linking tree cover to human health is limited. Objectives: We sought to investigate the association of tree canopy cover with subsequent development of childhood asthma, wheeze, rhinitis, and allergic sensitization. Methods: Birth cohort study data were linked to detailed geographic information systems data characterizing 2001 tree canopy coverage based on LiDAR (light detection and ranging) and multispectral imagery within 0.25 km of the prenatal address. A total of 549 Dominican or African-American children born in 1998–2006 had outcome data assessed by validated questionnaire or based on IgE antibody response to specific allergens, including a tree pollen mix. Results: Tree canopy coverage did not significantly predict outcomes at 5 years of age, but was positively associated with asthma and allergic sensitization at 7 years. Adjusted risk ratios (RRs) per standard deviation of tree canopy coverage were 1.17 for asthma (95% CI: 1.02, 1.33), 1.20 for any specific allergic sensitization (95% CI: 1.05, 1.37), and 1.43 for tree pollen allergic sensitization (95% CI: 1.19, 1.72). Conclusions: Results did not support the hypothesized protective association of urban tree canopy coverage with asthma or allergy-related outcomes. Tree canopy cover near the prenatal address was associated with higher prevalence of allergic sensitization to tree pollen. Information was not available on sensitization to specific tree species or individual pollen exposures, and results may not be generalizable to other populations or geographic areas. PMID:23322788

  3. Allergic rhinitis - self-care

    MedlinePlus

    ... in something you are allergic to, such as dust mites, animal dander, or pollen. Allergic rhinitis is ... your or your child's exposure to them. Reduce dust and dust mites in the home. Control molds ...

  4. Optimal management of allergic rhinitis.

    PubMed

    Scadding, Glenis K

    2015-06-01

    Allergic rhinitis (AR), the most common chronic disease in childhood is often ignored, misdiagnosed and/or mistreated. Undertreated AR impairs quality of life, exacerbates asthma and is a major factor in asthma development. It can involve the nose itself, as well as the organs connected with the nose manifesting a variety of symptoms. Evidence-based guidelines for AR therapy improve disease control. Recently, paediatric AR guidelines have been published by the European Academy of Allergy and Clinical Immunology and are available online, as are a patient care pathway for children with AR and asthma from the Royal College of Paediatrics and Child Health. Management involves diagnosis, followed by avoidance of relevant allergens, with additional pharmacotherapy needed for most sufferers. This ranges, according to severity, from saline sprays, through non-sedating antihistamines, oral or topical, with minimally bioavailable intranasal corticosteroids for moderate/severe disease, possibly plus additional antihistamine or antileukotriene. The concept of rhinitis control is emerging, but there is no universally accepted definition. Where pharmacotherapy fails, allergen-specific immunotherapy, which is uniquely able to alter long-term disease outcomes, should be considered. The subcutaneous form (subcutaneous immunotherapy) in children has been underused because of concerns regarding safety and acceptability of injections. Sublingual immunotherapy is both efficacious and safe for grass pollen allergy. Further studies on other allergens in children are needed. Patient, carer and practitioner education into AR and its treatment are a vital part of management. PMID:25838332

  5. Association of allergic rhinitis or asthma with pollen and chemical pollutants in Szeged, Hungary, 1999-2007

    NASA Astrophysics Data System (ADS)

    Makra, László; Matyasovszky, István; Bálint, Beatrix; Csépe, Zoltán

    2014-07-01

    The effect of biological (pollen) and chemical air pollutants on respiratory hospital admissions for the Szeged region in Southern Hungary is analysed. A 9-year (1999-2007) database includes—besides daily number of respiratory hospital admissions—daily mean concentrations of CO, PM10, NO, NO2, O3 and SO2. Two pollen variables ( Ambrosia and total pollen excluding Ambrosia) are also included. The analysis was performed for patients with chronic respiratory complaints (allergic rhinitis or asthma bronchiale) for two age categories (adults and the elderly) of males and females. Factor analysis was performed to clarify the relative importance of the pollutant variables affecting respiratory complaints. Using selected low and high quantiles corresponding to probability distributions of respiratory hospital admissions, averages of two data sets of each air pollutant variable were evaluated. Elements of these data sets were chosen according to whether actual daily patient numbers were below or above their quantile value. A nonparametric regression technique was applied to discriminate between extreme and non-extreme numbers of respiratory admissions using pollen and chemical pollutants as explanatory variables. The strongest correlations between extreme patient numbers and pollutants can be observed during the pollen season of Ambrosia, while the pollen-free period exhibits the weakest relationships. The elderly group with asthma bronchiale is characterised by lower correlations between extreme patient numbers and pollutants compared to adults and allergic rhinitis, respectively. The ratio of the number of correct decisions on the exceedance of a quantile resulted in similar conclusions as those obtained by using multiple correlations.

  6. Association of allergic rhinitis or asthma with pollen and chemical pollutants in Szeged, Hungary, 1999-2007.

    PubMed

    Makra, László; Matyasovszky, István; Bálint, Beatrix; Csépe, Zoltán

    2014-07-01

    The effect of biological (pollen) and chemical air pollutants on respiratory hospital admissions for the Szeged region in Southern Hungary is analysed. A 9-year (1999-2007) database includes--besides daily number of respiratory hospital admissions--daily mean concentrations of CO, PM10, NO, NO2, O3 and SO2. Two pollen variables (Ambrosia and total pollen excluding Ambrosia) are also included. The analysis was performed for patients with chronic respiratory complaints (allergic rhinitis or asthma bronchiale) for two age categories (adults and the elderly) of males and females. Factor analysis was performed to clarify the relative importance of the pollutant variables affecting respiratory complaints. Using selected low and high quantiles corresponding to probability distributions of respiratory hospital admissions, averages of two data sets of each air pollutant variable were evaluated. Elements of these data sets were chosen according to whether actual daily patient numbers were below or above their quantile value. A nonparametric regression technique was applied to discriminate between extreme and non-extreme numbers of respiratory admissions using pollen and chemical pollutants as explanatory variables. The strongest correlations between extreme patient numbers and pollutants can be observed during the pollen season of Ambrosia, while the pollen-free period exhibits the weakest relationships. The elderly group with asthma bronchiale is characterised by lower correlations between extreme patient numbers and pollutants compared to adults and allergic rhinitis, respectively. The ratio of the number of correct decisions on the exceedance of a quantile resulted in similar conclusions as those obtained by using multiple correlations. PMID:23558448

  7. Impact of Atopy on Asthma and Allergic Rhinitis in the Cohort for Reality and Evolution of Adult Asthma in Korea

    PubMed Central

    Jang, An-Soo; Kim, Sang-Heon; Kim, Tae-Bum; Park, Heung-Woo; Kim, Sae-Hoon; Chang, Yoon-Seok; Lee, Jae Hyun; Cho, You Sook; Park, Jung Won; Nahm, Dong-Ho; Cho, Young-Joo; Cho, Sang-Heon; Yoon, Ho Joo; Choi, Byoung-Whui; Moon, Hee-Bom

    2013-01-01

    Purpose Atopy is an important cause of asthma. Few data on the prevalence of atopy or comparisons with clinical characteristics of asthma in Korean patients have been published. We evaluated the effects of atopy on clinical profiles and airway inflammation in Korean asthmatics. Methods We retrospectively enrolled 1,492 asthmatics from the Cohort for Reality and Evolution of Adult Asthma in Korea (COREA) cohort who had undergone skin prick tests for aeroallergens. The patients' clinical characteristics, lung function, PC20, and sputum and blood inflammatory cell counts were compared based on the presence or absence of atopy. Atopy was defined as one or more positive reactions (A/H ratio >1) on a skin prick test. Results Among 11 aeroallergens, house dust mites (Dermatophagoides farinae and Dermatophagoides pteronyssinus) were the most prevalent cause of a positive skin prick test. As compared with non-atopic asthmatics, atopic asthmatics showed early onset of the disease. Atopic patients with asthma had a higher FEV1, FVC, and FEV1/FVC as compared with non-atopic patients with asthma. In addition, asthmatics without atopy had more uncontrolled asthma (P=0.001) and severe rhinitis (P<0.05) as compared with atopic asthmatics. Smoking, as measured in pack years, was higher in the non-atopic asthmatics than in the atopic asthmatics. The erythrocyte sedimentation rate was higher in non-atopic asthmatics than in the atopic asthmatics and patients with non-atopic asthma had a higher sputum neutrophil count than did those with atopic asthma. Conclusions Our data indicate that atopic asthmatics had an early onset of disease and high IgE levels, while the non-atopic asthmatics had decreased lung function and a high sputum neutrophil count, suggesting that a different approach is needed to treat atopic asthma. PMID:23638312

  8. Allergic rhinitis - what to ask your doctor - child

    MedlinePlus

    ... How do I find out when smog or pollution is worse in our area? What does my ... More Allergen Allergic rhinitis Allergies - overview Allergy testing - skin Asthma and allergy - resources Common cold Sneezing Patient ...

  9. Allergic rhinitis - what to ask your doctor - adult

    MedlinePlus

    ... How do I find out when smog or pollution is worse in my area? Am I taking ... More Allergen Allergic rhinitis Allergies - overview Allergy testing - skin Asthma and allergy - resources Common cold Sneezing Patient ...

  10. Characteristics and predictors of allergic rhinitis undertreatment in primary care.

    PubMed

    Spinozzi, F; Murgia, N; Baldacci, S; Maio, S; Pala, A P; Casciari, C; dell'Omo, M; Viegi, G

    2016-03-01

    Although allergic rhinitis is considered a raising medical problem in many countries it is often undertreated. The reasons for this phenomenon are not completely clear.The aim of this study is to evaluate factors associated with allergic rhinitis under-/no treatment.A sample of 518 allergic rhinitis patients recruited by their primary care physicians, as a part of the ARGA study, were invited to fill in a specific questionnaire regarding rhinitis symptoms, treatment, and rhinitis-related work/social disability. Chi-square test and logistic regression were performed to assess risk factors for allergic rhinitis under-/no treatment.Over one out of four patients had no treatment despite the symptoms and 13.5% were inadequately treated. Participants with asthma (OR 0.47, 95% CI 0.30-0.75) and conjunctivitis (0.44, 95% CI 0.27-0.71) were at lower risk of allergic rhinitis under-/no treatment: in asthmatics this reduction was related mainly to the concomitant asthma treatment (OR 0.19, 95% CI 0.10-0.37).Asthmatics with under-/not treated rhinitis had the highest prevalence of rhinitis-related quality of life impairment.Under-/no treatment for allergic rhinitis is still rather frequent despite the relevance of this disease. The simultaneous presence of asthma and an anti-asthmatic therapy are able to influence positively the treatment. Targeted interventions toward a better characterization and a tight follow-up of rhinitis patient without asthma are needed. PMID:26680255

  11. The burden of allergic rhinitis.

    PubMed

    Nathan, Robert A

    2007-01-01

    Although formerly regarded as a nuisance disease, allergic rhinitis (AR) has a considerable effect on quality of life and can have significant consequences if left untreated. The total burden of this disease lies not only in impaired physical and social functioning but also in a financial burden made greater when considering evidence that AR is a possible causal factor in comorbid diseases such as asthma or sinusitis. Compared with matched controls, patients with AR have an approximate twofold increase in medication costs and 1.8-fold the number of visits to health practitioners. Hidden direct costs include the treatment of comorbid asthma, chronic sinusitis, otitis media, upper respiratory infection, and nasal polyposis. Nasal congestion, the most prominent symptom in AR, is associated with sleep-disordered breathing, a condition that can have a profound effect on mental health, including increased psychiatric disorders, depression, anxiety, and alcohol abuse. Furthermore, sleep-disordered breathing in childhood and adolescence is associated with increased disorders of learning performance, behavior, and attention. In the United States, AR results in 3.5 million lost workdays and 2 million lost schooldays annually. Patients struggle to alleviate their misery, frequently self-adjusting their treatment regimen of over-the-counter and prescription medications because of lack of efficacy, deterioration of efficacy, lack of 24-hour relief, and bothersome side effects. Ironically, health care providers overestimate patient satisfaction with therapy. Therefore, improvement in patient-practitioner communication may enhance patient adherence with prescribed regimens. PMID:17390749

  12. Nasal hyperreactivity and inflammation in allergic rhinitis

    PubMed Central

    Veld, C. de Graaf-in't; Wijk, R. Gerth van; Zijlstra, F. J.

    1996-01-01

    The history of allergic disease goes back to 1819, when Bostock described his own ‘periodical affection of the eyes and chest’, which he called ‘summer catarrh’. Since they thought it was produced by the effluvium of new hay, this condition was also called hay fever. Later, in 1873, Blackley established that pollen played an important role in the causation of hay fever. Nowadays, the definition of allergy is ‘An untoward physiologic event mediated by a variety of different immunologic reactions’. In this review, the term allergy will be restricted to the IgE-dependent reactions. The most important clinical manifestations of IgE-dependent reactions are allergic conjunctivitis, allergic rhinitis, allergic asthma and atopic dermatitis. However, this review will be restricted to allergic rhinitis. The histopathological features of allergic inflammation involve an increase in blood flow and vascular permeability, leading to plasma exudation and the formation of oedema. In addition, a cascade of events occurs which involves a variety of inflammatory cells. These inflammatory cells migrate under the influence of chemotactic agents to the site of injury and induce the process of repair. Several types of inflammatory cells have been implicated in the pathogenesis of allergic rhinitis. After specific or nonspecific stimuli, inflammatory mediators are generated from cells normally found in the nose, such as mast cells, antigen-presenting cells and epithelial cells (primary effector cells) and from cells recruited into the nose, such as basophils, eosinophils, lymphocytes, platelets and neutrophils (secondary effector cells). This review describes the identification of each of the inflammatory cells and their mediators which play a role in the perennial allergic processes in the nose of rhinitis patients. PMID:18475703

  13. [Comparative characterization of the microflora of the upper respiratory tract mucous membranes in bronchial asthma and allergic persistent rhinitis].

    PubMed

    Romanenko, E E; Baturo, A P; Ulisko, I N

    2005-01-01

    A total of 250 patients with diagnosed bronchial asthma (BA) were examined by microbiological methods. Among them--188 children and 62 adults. In 87 patients the microflora of nasal mucosa was studied, in 40--of pharynx only and in 123 patients--both the nasal and the pharynx. For comparative analysis earlier data obtained in 69 patients with persistent allergic rhinitis (PAR) were used. The cultures isolated from the nasal mucosa of BA patients were shown to number 18 genera and 42 species, while among those isolated from pharynx mucosa 20 genera and 40 species. Monocultures were isolated from the nasal mucosa only in 23% of the examined patients and from the pharynx mucosa--only in 1.42%. Associations with different numbers of components were isolated from nasal and pharynx mucosa (2 to 6, 2 to 8 respectively). Staphylococcus aureus was regarded as the main species of nasal biocenosis in BA and PAR, as well as pharynx biocenosis in BA. Besides, in BA other Staphylococcus species (schleiferi, caprae, capitis, hominis, etc.), reversely related to the main species, could be isolated from both mucous membranes. Similarities and differences in microflora of biocenoses in both nosological forms, confirming links between PAR and BA, are considered. PMID:15881942

  14. Alteration of circulating type 2 follicular helper T cells and regulatory B cells underlies the comorbid association of allergic rhinitis with bronchial asthma.

    PubMed

    Kamekura, Ryuta; Shigehara, Katsunori; Miyajima, Satsuki; Jitsukawa, Sumito; Kawata, Koji; Yamashita, Keiji; Nagaya, Tomonori; Kumagai, Ayako; Sato, Akinori; Matsumiya, Hiroshi; Ogasawara, Noriko; Seki, Nobuhiko; Takano, Kenichi; Kokai, Yasuo; Takahashi, Hiroki; Himi, Tetsuo; Ichimiya, Shingo

    2015-06-01

    Allergic rhinitis (AR), the most common allergic disorder of the airway, is often accompanied by bronchial asthma. However, little is known about the mechanism by which AR advances to AR comorbid with bronchial asthma (AR+Asthma). To determine the pathophysiologic features of AR and AR+Asthma, we examined subsets of follicular helper T (Tfh) cells and regulatory B (Breg) cells in peripheral blood from AR and AR+Asthma patients. The results showed polarization of Tfh2 cells within Tfh cell subsets in both AR and AR+Asthma cases. Interestingly, the %Breg cells in total B cells were decreased in AR cases and, more extensively, in AR+Asthma cases. Moreover, we found significant correlations of fractional exhaled nitric oxide and blood eosinophil levels with the index %Tfh2 cells per %Breg cells. Our findings indicate that relative decrease in Breg cells under the condition of Tfh2 cell skewing is a putative exaggerating factor of AR to bronchial asthma. PMID:25829231

  15. Imbalance of Peripheral Th17 and Regulatory T Cells in Children with Allergic Rhinitis and Bronchial Asthma.

    PubMed

    Tao, Baohong; Ruan, Guiying; Wang, Dongguo; Li, Yong; Wang, Zhuping; Yin, Genquan

    2015-06-01

    The purpose of the present study is to investigate the prevalence of Th17 and regulatory T (Treg) cells in children with allergic rhinitis (AR) accompanying with bronchial asthma (BA). 24 children with AR, 22 children with BA, 18 children with AR accompanying with BA, and 20 healthy controls were recruited. The prevalence of peripheral blood Th17 and Treg cells were determined by flow cytometry. mRNA expression of retinoid-acid receptor-related orphan receptor (ROR)-γt and forkhead box P3 (Foxp3) were determined by realtime polymerase chain reaction. Cytokine expressions in plasma were determined by enzyme linked immunosorbent assay. The frequency of Th17 cells, ROR-γt mRNA expression, and the plasma levels of IL-17 were significantly higher, while Treg cells and Transforming growth factor (TGF)-β1 were significantly lower in children with AR accompanying with BA compared with those in children with AR or BA alone or control subjects. In children with allergic airway disease, total IgE levels were positively correlated to the frequency of Th17 cells (r=0.607, p<0.01), plasma IL-17 levels, and negatively correlated to the frequency of Treg cells (r=-0.429, p<0.01) and TGF-β1 levels (r=-0.224, p<0.01). While Forced expiratory volume in one second (FEV1) (% predicted) was negatively correlated to the frequency of Th17 cells (r=-0.602, p<0.01), plasma IL-17 levels (r=-0.577, p<0.01), and positively correlated to the frequency of Treg cells r=0.504, p<0.01) and TGF-β1 levels (r=0.231, p<0.05). Our results demonstrate that the imbalance of peripheral Th17/Treg cells plays an important role in the pathogenesis of AR accompanying with BA. PMID:26546895

  16. Rupatadine in allergic rhinitis and chronic urticaria.

    PubMed

    Mullol, J; Bousquet, J; Bachert, C; Canonica, W G; Gimenez-Arnau, A; Kowalski, M L; Martí-Guadaño, E; Maurer, M; Picado, C; Scadding, G; Van Cauwenberge, P

    2008-04-01

    Histamine is the primary mediator involved the pathophysiology of allergic rhinitis and chronic urticaria, and this explains the prominent role that histamine H(1)-receptor antagonists have in the treatment of these disorders. However, histamine is clearly not the only mediator involved in the inflammatory cascade. There is an emerging view that drugs which can inhibit a broader range of inflammatory processes may prove to be more effective in providing symptomatic relief in both allergic rhinitis and chronic urticaria. This is an important consideration of the Allergic Rhinitis and its Impact on Asthma (ARIA) initiative which provides a scientific basis for defining what are the desirable properties of an 'ideal' antihistamine. In this review of rupatadine, a newer dual inhibitor of histamine H(1)- and PAF-receptors, we evaluate the evidence for a mechanism of action which includes anti-inflammatory effects in addition to a powerful inhibition of H(1)- and PAF-receptors. We assess this in relation to the clinical efficacy (particularly the speed of onset of action) and safety of rupatadine, and importantly its longer term utility in everyday life. In clinical trials, rupatadine has been shown to be an effective and well-tolerated treatment for allergic rhinitis and chronic idiopathic urticaria (CIU). It has a fast onset of action, producing rapid symptomatic relief, and it also has an extended duration of clinical activity which allows once-daily administration. In comparative clinical trials rupatadine was shown to be at least as effective as drugs such as loratadine, cetirizine, desloratadine and ebastine in reducing allergic symptoms in adult/adolescent patients with seasonal, perennial or persistent allergic rhinitis. Importantly, rupatadine demonstrated no adverse cardiovascular effects in preclinical or extensive clinical testing, nor negative significant effects on cognition or psychomotor performance (including a practical driving study). It improved the

  17. Complementary Therapies in Allergic Rhinitis

    PubMed Central

    Sayin, Ibrahim; Cingi, Cemal; Baykal, Bahadir

    2013-01-01

    Objective. To determine the prevalence of herbal treatment of allergic rhinitis. Methods. In this prospective study, patients who were diagnosed with perennial allergic rhinitis were questioned about their use of natural products/herbal therapies for their symptoms. Results. In total, 230 patients were enrolled. Overall, 37.3% of the patients stated that they had used natural products/herbal therapies at least once. Women were more likely than men to use herbal supplements (38.3% versus 32.4%). Ten different types of herbal supplements were identified, with stinging nettle (Urtica dioicath), black elderberry (Sambucus nigra), and Spirulina being the most common (12.6%, 6.1%, and 5.7%, resp.). Conclusion. This study found a high prevalence of herbal treatment usage for the relief of allergic rhinitis symptoms in Turkey. The herbal products identified in this study and in the literature are discussed. PMID:24324897

  18. Valuing the Economic Costs of Allergic Rhinitis, Acute Bronchitis, and Asthma from Exposure to Indoor Dampness and Mold in the US.

    PubMed

    Mudarri, David H

    2016-01-01

    Two foundational methods for estimating the total economic burden of disease are cost of illness (COI) and willingness to pay (WTP). WTP measures the full cost to society, but WTP estimates are difficult to compute and rarely available. COI methods are more often used but less likely to reflect full costs. This paper attempts to estimate the full economic cost (2014$) of illnesses resulting from exposure to dampness and mold using COI methods and WTP where the data is available. A limited sensitivity analysis of alternative methods and assumptions demonstrates a wide potential range of estimates. In the final estimates, the total annual cost to society attributable to dampness and mold is estimated to be $3.7 (2.3-4.7) billion for allergic rhinitis, $1.9 (1.1-2.3) billion for acute bronchitis, $15.1 (9.4-20.6) billion for asthma morbidity, and $1.7 (0.4-4.5) billion for asthma mortality. The corresponding costs from all causes, not limited to dampness and mold, using the same approach would be $24.8 billion for allergic rhinitis, $13.5 billion for acute bronchitis, $94.5 billion for asthma morbidity, and $10.8 billion for asthma mortality. PMID:27313630

  19. Valuing the Economic Costs of Allergic Rhinitis, Acute Bronchitis, and Asthma from Exposure to Indoor Dampness and Mold in the US

    PubMed Central

    2016-01-01

    Two foundational methods for estimating the total economic burden of disease are cost of illness (COI) and willingness to pay (WTP). WTP measures the full cost to society, but WTP estimates are difficult to compute and rarely available. COI methods are more often used but less likely to reflect full costs. This paper attempts to estimate the full economic cost (2014$) of illnesses resulting from exposure to dampness and mold using COI methods and WTP where the data is available. A limited sensitivity analysis of alternative methods and assumptions demonstrates a wide potential range of estimates. In the final estimates, the total annual cost to society attributable to dampness and mold is estimated to be $3.7 (2.3–4.7) billion for allergic rhinitis, $1.9 (1.1–2.3) billion for acute bronchitis, $15.1 (9.4–20.6) billion for asthma morbidity, and $1.7 (0.4–4.5) billion for asthma mortality. The corresponding costs from all causes, not limited to dampness and mold, using the same approach would be $24.8 billion for allergic rhinitis, $13.5 billion for acute bronchitis, $94.5 billion for asthma morbidity, and $10.8 billion for asthma mortality. PMID:27313630

  20. Allergic Rhinitis: Mechanisms and Treatment.

    PubMed

    Bernstein, David I; Schwartz, Gene; Bernstein, Jonathan A

    2016-05-01

    The prevalence of allergic rhinitis (AR) has been estimated at 10% to 40%, and its economic burden is substantial. AR patients develop specific immunoglobulin E (IgE) antibody responses to indoor and outdoor environmental allergens with exposure over time. These specific IgE antibodies bind to high-affinity IgE receptors on mast cells and basophils. Key outcome measures of therapeutic interventions include rhinitis symptom control, rescue medication requirements, and quality-of-life measures. A comprehensive multiple modality treatment plan customized to the individual patient can optimize outcomes. PMID:27083101

  1. Role of Cysteinyl Leukotrienes in Allergic Rhinitis.

    PubMed

    Shirasaki, Hideaki; Himi, Tetsuo

    2016-01-01

    Cysteinyl leukotrienes (CysLTs) are lipid mediators that have been implicated in the pathogenesis of allergic rhinitis. Pharmacological studies using CysLTs indicate that two classes of receptor exist: CysLT1 receptor (CysLT1R) and CysLT2 receptor (CysLT2R). The CysLT1R is a high-affinity leukotriene D4 receptor with lower affinity for leukotriene C4 that is sensitive to the CysLT1R antagonist currently used to treat asthma and allergic rhinitis. Our previous immunohistochemical and autoradiographic studies have demonstrated the presence of anti-CysLT1R antibodies labeled in eosinophils, mast cells, macrophages, neutrophils and vascular endothelial cells in human nasal mucosa. Furthermore, we have revealed that the novel radioactive CysLT1R antagonist [3H]-pranlukast bound specifically to CysLT1R in human inferior turbinates and its binding sites were localized to vascular endothelium and the interstitial cells. These data suggest that the major targets of CysLT1R antagonists in allergic rhinitis are the vascular bed and infiltrated leukocytes such as mast cells, eosinophils and macrophages. Clinical trials have demonstrated that CysLT1R antagonists are as effective as antihistamines for the treatment of allergic rhinitis; however, they are less effective than intranasal steroids. The use of CysLT1R antagonists in combination with antihistamines has generally resulted in greater efficacy than when these agents were used alone. PMID:27115997

  2. Allergic Rhinitis Quiz

    MedlinePlus

    ... allergic conjunctivitis (eye allergy). Is it true that mold spores can trigger eye allergy symptoms? True False ... allergy) are seasonal allergens such as pollen and mold spores. Indoor allergens such as dust mites and ...

  3. A Systematic and Narrative Review of Acupuncture Point Application Therapies in the Treatment of Allergic Rhinitis and Asthma during Dog Days

    PubMed Central

    Wen, Cai-Yu-Zhu; Liu, Ya-Fei; Zhou, Li; Zhang, Hong-Xing; Tu, Sheng-Hao

    2015-01-01

    Acupuncture point application therapies, including San-Fu-Tie and San-Fu-Jiu, have been widely employed to treat diseases with attacks in winter during dog days in China. The therapies combine Chinese herbal medicine and acupuncture points with the nature. However, the previous studies were reported to be unsystematic and incomplete. To develop a more comprehensive understanding of the effects of acupuncture point application therapies on allergic rhinitis and asthma, a systematic review of the literature up to 2015 was conducted. After filtering, eighteen randomized controlled trials (RCTs) involving 1,785 subjects were included. This systematic and narrative review shows that acupuncture point application therapies have been extensively applied in the treatment of allergic rhinitis and asthma with advantages of favorable treatment effect, convenient operation, receiving patients' good acceptability and compliance, and few side effects. Meanwhile, the study elaborated the operating process of San-Fu-Tie and San-Fu-Jiu in detail. The review may provide a reference for clinical application in future. However, the efficacy, safety, and mechanisms of San-Fu-Tie and San-Fu-Jiu in treating the above diseases need to be validated by more well-designed and fully powered RCTs in a larger population of patients. PMID:26543488

  4. Upper and lower airway pathology in young children with allergic- and non-allergic rhinitis.

    PubMed

    Chawes, Bo L K

    2011-05-01

    Allergic- and non-allergic rhinitis are very common diseases in childhood in industrialized countries. Although these conditions are widely trivialized by both parents and physicians they induce a major impact on quality of life for the affected children and a substantial drainage of health care resources. Unfortunately, diagnostic specificity is hampered by nonspecific symptom history and lack of reliable diagnostic tests which may explain why the pathology behind such diagnoses is poorly understood. Improved understanding of the pathophysiology of allergic- and non-allergic rhinitis in young children may contribute to the discovery of new mechanisms involved in pathogenesis and help direct future research to develop correctly timed preventive measures as well as adequate monitoring and treatment of children with rhinitis. Asthma is a common comorbidity in subjects with allergic rhinitis and epidemiological surveys have suggested a close connection between upper and lower airway diseases expressed as the "united airways concept". Furthermore, an association between upper and lower airway diseases also seems to exist in non-atopic individuals. Nevertheless, the nature of this association is poorly understood and there is a paucity of data objectivizing this association in young children. The aim of this thesis was to describe pathology in the upper and lower airways in young children from the COPSAC birth cohort with investigator-diagnosed allergic- and non-allergic rhinitis. Nasal congestion is a key symptom in both allergic- and non-allergic rhinitis, and eosinophilic inflammation is a hallmark of the allergic diseases. In paper I, we studied nasal eosinophilia and nasal airway patency assessed by acoustic rhinometry in children with allergic rhinitis, non-allergic rhinitis and healthy controls. Allergic rhinitis was significantly associated with nasal eosinophilia and irreversible nasal airway obstruction suggesting chronic inflammation and structural remodeling

  5. Comparison of allergen-induced changes in bronchial hyperresponsiveness and airway inflammation between mildly allergic asthma patients and allergic rhinitis patients.

    PubMed

    Alvarez, M J; Olaguibel, J M; Garcia, B E; Tabar, A I; Urbiola, E

    2000-06-01

    Bronchial eosinophilic inflammation and bronchial hyperresponsiveness (BHR) are the main features of allergic asthma (AA), but they have also been demonstrated in allergic rhinitis (AR), suggesting a continuity between both diseases. In spite of not fully reproducing natural allergenic exposure, the allergen bronchial provocation test (A-BPT) has provided important knowledge of the pathophysiology of AA. Our aim was to verify the existence of a behavior of AA and AR airways different from the allergen bronchial challenge-induced airway eosinophilic inflammation and BHR changes. We studied a group of 31 mild and short-evolution AA and 15 AR patients, sensitized to Dermatophagoides pteronyssinus. The A-BPT was performed with a partially biologically standardized D. pteronyssinus extract, and known quantities of Der p 1 were inhaled. Peripheral blood (eosinophils and ECP) and induced sputum (percentage cell counts, ECP, albumin, tryptase, and interleukin [IL]-5) were analyzed, before and 24 h after A-BPT. Methacholine BHR, assessed before and 32 h after the A-BPT, was defined by M-PD20 values and, when possible, by maximal response plateau (MRP). The A-BPT was well tolerated by all the patients. AA presented a lower Der p 1 PD20 and a higher occurrence of late-phase responses (LPR). M-PD20 values decreased in AA, but not in AR, patients. MRP values increased in both groups. Eosinophils numbers and ECP levels increased in blood and sputum from both AA and AR, but only the absolute increment of sputum ECP levels was higher in AA than AR patients (P = 0.025). The A-BPT induced no change in sputum albumin, tryptase, or IL-5 values. We conclude as follows: 1) In spite of presenting a lower degree of bronchial sensitivity to allergen, AR patients responded to allergen inhalation with an eosinophilic inflammation enhancement very similar to that observed among AA. 2) MRP levels increased in both AA and AR patients after allergen challenge; however, M-PD20 values

  6. [Allergic inflamation of the lower airways in patients with allergic rhinitis].

    PubMed

    Stefanović, Lj; Balaban, J; Stosović, R; Mitrović, N; Djurasinović, M; Tanurdzić, S

    1994-01-01

    Reporting two of our cases we wanted to point to a great dilemma related to the final diagnosis. Recently, such cases have been more frewuently seen, since in all patients with allergic rhinitis conditions of the lower airways is examined before the administration of the specific immunotherapy. Therefore, we may see patients who are still free of pulmonary sings, despite of positive specific and/or non specific bronchoprovocative tests. The presented cases with evidenced allergic rhinitis are probably in the phase of development of allergic bronchial asthma, the phase of "allergic inflammation" of the lower airways, not clinically manifested yet. PMID:18173213

  7. Update on local allergic rhinitis.

    PubMed

    Altıntoprak, Niyazi; Kar, Murat; Bayar Muluk, Nuray; Oktemer, Tugba; Ipci, Kagan; Birdane, Leman; Aricigil, Mitat; Senturk, Mehmet; Bafaqeeh, Sameer Ali; Cingi, Cemal

    2016-08-01

    We here provide an update on the literature regarding local allergic rhinitis (LAR). In reviewing LAR, we have included an updated definition, classifications, mechanisms, comorbidities, and recommendations for diagnosis and treatment for LAR, as well as the defined research areas for future evidence-based studies. LAR is a localised nasal allergic response in the absence of systemic atopy characterised by local production of specific IgE (sIgE) antibodies, a TH2 pattern of mucosal cell infiltration during natural exposure to aeroallergens, and a positive nasal allergen provocation test response, with the release of inflammatory mediators. The localised allergic response of LAR is an important topic for the study of allergies. This review provides an update on the current knowledge of LAR. PMID:27368453

  8. Current and future biomarkers in allergic asthma.

    PubMed

    Zissler, U M; Esser-von Bieren, J; Jakwerth, C A; Chaker, A M; Schmidt-Weber, C B

    2016-04-01

    Diagnosis early in life, sensitization, asthma endotypes, monitoring of disease and treatment progression are key motivations for the exploration of biomarkers for allergic rhinitis and allergic asthma. The number of genes related to allergic rhinitis and allergic asthma increases steadily; however, prognostic genes have not yet entered clinical application. We hypothesize that the combination of multiple genes may generate biomarkers with prognostic potential. The current review attempts to group more than 161 different potential biomarkers involved in respiratory inflammation to pave the way for future classifiers. The potential biomarkers are categorized into either epithelial or infiltrate-derived or mixed origin, epithelial biomarkers. Furthermore, surface markers were grouped into cell-type-specific categories. The current literature provides multiple biomarkers for potential asthma endotypes that are related to T-cell phenotypes such as Th1, Th2, Th9, Th17, Th22 and Tregs and their lead cytokines. Eosinophilic and neutrophilic asthma endotypes are also classified by epithelium-derived CCL-26 and osteopontin, respectively. There are currently about 20 epithelium-derived biomarkers exclusively derived from epithelium, which are likely to innovate biomarker panels as they are easy to sample. This article systematically reviews and categorizes genes and collects current evidence that may promote these biomarkers to become part of allergic rhinitis or allergic asthma classifiers with high prognostic value. PMID:26706728

  9. Assessment of Allergic Rhinitis Websites in Korea

    PubMed Central

    Chang, Moon Young; Han, Doo Hee; Moon, Il Joon; Kim, Seung-Tae; Kim, Dong-Young; Lee, Chul Hee; Min, Yang-Gi

    2010-01-01

    Objectives The internet has become an important source of medical information and a great amount of information related to allergic rhinitis (AR) is available on the internet. However, the quality of this information is still a matter of debate. Therefore, this study was conducted to assess the AR-related information on Korean websites. Methods The key word "allergic rhinitis" was entered into 4 popular search engines, and this led to identifying 40 websites. After being categorized according to authorship, the informational value of these websites was evaluated using 4 different assessment tools such as the Journal of the American Medical Association (JAMA) benchmarks, the DISCERN questionnaire, the Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 Update and the Health On the Net (HON) code. Results The 40 websites containing AR-related information were categorized according to their authorship as Western physician: 20, Oriental physician: 14, commercial: 1, and others: 5. The mean citation frequencies of the JAMA benchmarks and the ARIA 2008 Update concepts was 1.23 out of 4 and 4.33 out of 8, respectively, while the mean DISCERN score was 1.92 out of 5. When the websites were evaluated based on the type of authorship, the mean citation frequencies of the ARIA 2008 Update concepts were Western physician: 5.35, Oriental physician: 2.64. Additionally, three websites authored by Western physicians and 13 authored by Oriental physicians contained unreliable information. Among these 16 websites, only 3 websites met the requirements for the HON code "Justification". Conclusion AR-related information available on Korean websites is of variable quality and not all of the information provided is justifiable. Thus, performing surveillance of the medical information on these websites is necessary. Furthermore, common criteria that can be used to evaluate the websites created by both Western and Oriental physicians are also needed. PMID:20379400

  10. Sublingual immunotherapy for pediatric allergic rhinitis: The clinical evidence

    PubMed Central

    Poddighe, Dimitri; Licari, Amelia; Caimmi, Silvia; Marseglia, Gian Luigi

    2016-01-01

    Allergic rhinitis is estimated to affect 10%-20% of pediatric population and it is caused by the IgE-sensitization to environmental allergens, most importantly grass pollens and house dust mites. Allergic rhinitis can influence patient’s daily activity severely and may precede the development of asthma, especially if it is not diagnosed and treated correctly. In addition to subcutaneous immunotherapy, sublingual immunotherapy (SLIT) represents the only treatment being potentially able to cure allergic respiratory diseases, by modulating the immune system activity. This review clearly summarizes and analyzes the available randomized, double-blinded, placebo-controlled trials, which aimed at evaluating the effectiveness and the safety of grass pollen and house dust mite SLIT for the specific treatment of pediatric allergic rhinitis. Our analysis demonstrates the good evidence supporting the efficacy of SLIT for allergic rhinitis to grass pollens in children, whereas trials regarding pediatric allergic rhinitis to house dust mites present lower quality, although several studies supported its usefulness. PMID:26862501

  11. Sublingual immunotherapy for pediatric allergic rhinitis: The clinical evidence.

    PubMed

    Poddighe, Dimitri; Licari, Amelia; Caimmi, Silvia; Marseglia, Gian Luigi

    2016-02-01

    Allergic rhinitis is estimated to affect 10%-20% of pediatric population and it is caused by the IgE-sensitization to environmental allergens, most importantly grass pollens and house dust mites. Allergic rhinitis can influence patient's daily activity severely and may precede the development of asthma, especially if it is not diagnosed and treated correctly. In addition to subcutaneous immunotherapy, sublingual immunotherapy (SLIT) represents the only treatment being potentially able to cure allergic respiratory diseases, by modulating the immune system activity. This review clearly summarizes and analyzes the available randomized, double-blinded, placebo-controlled trials, which aimed at evaluating the effectiveness and the safety of grass pollen and house dust mite SLIT for the specific treatment of pediatric allergic rhinitis. Our analysis demonstrates the good evidence supporting the efficacy of SLIT for allergic rhinitis to grass pollens in children, whereas trials regarding pediatric allergic rhinitis to house dust mites present lower quality, although several studies supported its usefulness. PMID:26862501

  12. Interaction between rhinitis and asthma: state of the art.

    PubMed

    Frieri, Marianne

    2003-01-01

    Rhinitis and asthma are very prevalent allergic disorders with comorbid features, similar risk factors, and environmental triggers. Pathophysiological processes are linked via tissue histopathology, immunologic pathway, and inflammatory mediators. Allergen challenge of the upper airway can increase lower-airway responsiveness and allergen challenge of the lower airway can lead to upper-airway inflammation. Both allergic rhinitis and asthma exert a high social and economic burden in significant loss of work and school days as well as impairment for children and adults. PMID:14763239

  13. Management of Rhinitis: Allergic and Non-Allergic

    PubMed Central

    Tran, Nguyen P; Vickery, John

    2011-01-01

    Rhinitis is a global problem and is defined as the presence of at least one of the following: congestion, rhinorrhea, sneezing, nasal itching, and nasal obstruction. The two major classifications are allergic and nonallergic rhinitis (NAR). Allergic rhinitis occurs when an allergen is the trigger for the nasal symptoms. NAR is when obstruction and rhinorrhea occurs in relation to nonallergic, noninfectious triggers such as change in the weather, exposure to caustic odors or cigarette smoke, barometric pressure differences, etc. There is a lack of concomitant allergic disease, determined by negative skin prick test for relevant allergens and/or negative allergen-specific antibody tests. Both are highly prevalent diseases that have a significant economic burden on society and negative impact on patient quality of life. Treatment of allergic rhinitis includes allergen avoidance, antihistamines (oral and intranasal), intranasal corticosteroids, intranasal cromones, leukotriene receptor antagonists, and immunotherapy. Occasional systemic corticosteroids and decongestants (oral and topical) are also used. NAR has 8 major subtypes which includes nonallergic rhinopathy (previously known as vasomotor rhinitis), nonallergic rhinitis with eosinophilia, atrophic rhinitis, senile rhinitis, gustatory rhinitis, drug-induced rhinitis, hormonal-induced rhinitis, and cerebral spinal fluid leak. The mainstay of treatment for NAR are intranasal corticosteroids. Topical antihistamines have also been found to be efficacious. Topical anticholinergics such as ipratropium bromide (0.03%) nasal spray are effective in treating rhinorrhea symptoms. Adjunct therapy includes decongestants and nasal saline. Investigational therapies in the treatment of NAR discussed include capsaicin, silver nitrate, and acupuncture. PMID:21738880

  14. Investigational drugs for allergic rhinitis.

    PubMed

    Passalacqua, Giovanni; Compalati, Enrico; Canonica, Giorgio Walter

    2010-01-01

    Allergic rhinitis (AR) is a high-prevalence disease, triggered by an IgE-mediated reaction, and sustained by a complex inflammatory network of cells, mediators, and cytokines. When the exposure to allergens persists, the inflammatory process becomes chronic. The current therapeutic strategy is based on allergen avoidance when possible, drugs and allergen immunotherapy. The main drugs are oral and topical antihistamines and nasal steroids. They are overall effective in controlling symptoms, but do not modify the immune background that leads to allergic inflammation. In addition, safety concerns may be present, especially for prolonged treatments. Thus, efforts are currently made to improve the existing molecules and to develop new drugs, in order to achieve greater clinical efficacy with a better tolerability. Also, attempts are made to selectively block relevant signal pathways of the allergic reaction by means of specific anti-mediators. Specific immunotherapy, in addition to the clinical effect, is capable of modifying the Th2-biased immune response. Thus, an intense research activity is presently ongoing with the aim of improving the characteristics and modes of action of this treatment. PMID:20001557

  15. Assessment of disease control in allergic rhinitis.

    PubMed

    Demoly, Pascal; Calderon, Moises A; Casale, Thomas; Scadding, Glenis; Annesi-Maesano, Isabella; Braun, Jean-Jacques; Delaisi, Bertrand; Haddad, Thierry; Malard, Olivier; Trébuchon, Florence; Serrano, Elie

    2013-01-01

    The Allergic Rhinitis and its Impact on Asthma (ARIA) initiative has had a significant impact, by raising awareness of allergic rhinitis (AR) and improving the diagnosis and treatment of AR sufferers. ARIA classifies the severity of AR as "mild" or "moderate/severe" on the basis of "yes"/"no" answers to four questions. This two-point classification has been criticized as providing little guidance on patient management; patients with "mild" AR are unlikely to consult a physician, whereas the group of patients with "moderate/severe" seen by specialists is heterogeneous. These perceived shortcomings have prompted attempts to improve the ARIA classification or, by analogy with the Global Initiative for Asthma (GINA), adopt approaches based on "disease control" in AR. Even though "disease severity", "disease control" and "responsiveness to treatment" are different (albeit related) metrics, they are not mutually exclusive. Currently, there is no single, accepted definition, but we propose that "disease control" in AR can combine (i) measurements of the severity and/or frequency of daily or nocturnal symptoms, (ii) impairments in social, physical, professional and educational activities, (iii) respiratory function monitoring and (iv) exacerbations (e.g. unscheduled medical consultations and rescue medication use). Although control-based classifications have a number of limitations (e.g. their dependence on treatment compliance and the patient's psychological status), these instruments could be used as an adjunct to the ARIA severity classification and regional practice parameters. Here, we assess the strengths and weaknesses of the current two-level ARIA classification, analyze published proposals for its modification and review the literature on instruments that measure AR control. We conclude that there is a need for research in which severity is compared with control in terms of their effects on patient management. PMID:23419058

  16. Common aeroallergens in patients with asthma and allergic rhinitis living in southwestern part of Iran: based on skin prick test reactivity.

    PubMed

    Farrokhi, Shokrollah; Gheybi, Mohammad Kazzem; Movahed, Ali; Tahmasebi, Rahim; Iranpour, Dariush; Fatemi, Atena; Etemadan, Razieh; Gooya, Mostafa; Zandi, Sahar; Ashourinejad, Hamid; Alavizadeh, Sara; Khoddami, Shaghayegh

    2015-04-01

    Aeroallergens continue to have a key role in the pathogenesis of asthma and allergic diseases and have recently received increased attention in medical research throughout the world. The prevalence of aeroallergens vary in different regions, depending on the type of climate. The aim of the present study was to determine prevalence of the sensitivity to aeroallergens among patients with asthma and allergic rhinitis (AR), based on skin prick test (SPT) reactivity in the province of Bushehr, Iran. In this cross-sectional study, 743 patients were enrolled. The participants had asthma and AR and reacted to at least one allergen with SPT. Skin prick test with standard extracts including house dust mites (HDMs), animal dander, molds and pollens were performed on patients according to the herbal geography of the area. The male to female ratio and mean age of the patients were 1.03 and 27.6± 15.4 year, respectively. Out of 567 patients with AR, the common aeroallergens were HDMs (88.5%), molds (82.9%), animal dander (79.5%), weeds (77.6%), trees (75.5%) and grass pollen (71.5%). Moreover, among 176 patients with asthma, the prevalence of aeroallergens were HDMs (90.5 %), molds (80.7%), animal dander (77.5%), weeds (73.3%), trees (73.3%) and grass pollen (67.9%). The sensitivity to animal dander, Chenopodium album and Russian thistle pollens were significantly associated with the severity of AR. Moreover, sensitivity to animal dander such as cat and feather of birds, cockroach, Bermuda grass and Chenopodium album pollens were significantly associated with the severity of asthma. The results of this study revealed that HDM was the most common sensitizing aeroallergen in patients with asthma and AR. Molds and animal dander as indoor allergens were also common aeroallergens. We suggest that the hot weather and ambient humidity in the region may be the main cause of the change in the pattern of SPT reactivity. PMID:25780879

  17. MACVIA-ARIA Sentinel NetworK for allergic rhinitis (MASK-rhinitis): the new generation guideline implementation.

    PubMed

    Bousquet, J; Schunemann, H J; Fonseca, J; Samolinski, B; Bachert, C; Canonica, G W; Casale, T; Cruz, A A; Demoly, P; Hellings, P; Valiulis, A; Wickman, M; Zuberbier, T; Bosnic-Anticevitch, S; Bedbrook, A; Bergmann, K C; Caimmi, D; Dahl, R; Fokkens, W J; Grisle, I; Lodrup Carlsen, K; Mullol, J; Muraro, A; Palkonen, S; Papadopoulos, N; Passalacqua, G; Ryan, D; Valovirta, E; Yorgancioglu, A; Aberer, W; Agache, I; Adachi, M; Akdis, C A; Akdis, M; Annesi-Maesano, I; Ansotegui, I J; Anto, J M; Arnavielhe, S; Arshad, H; Baiardini, I; Baigenzhin, A K; Barbara, C; Bateman, E D; Beghé, B; Bel, E H; Ben Kheder, A; Bennoor, K S; Benson, M; Bewick, M; Bieber, T; Bindslev-Jensen, C; Bjermer, L; Blain, H; Boner, A L; Boulet, L P; Bonini, M; Bonini, S; Bosse, I; Bourret, R; Bousquet, P J; Braido, F; Briggs, A H; Brightling, C E; Brozek, J; Buhl, R; Burney, P G; Bush, A; Caballero-Fonseca, F; Calderon, M A; Camargos, P A M; Camuzat, T; Carlsen, K H; Carr, W; Cepeda Sarabia, A M; Chavannes, N H; Chatzi, L; Chen, Y Z; Chiron, R; Chkhartishvili, E; Chuchalin, A G; Ciprandi, G; Cirule, I; Correia de Sousa, J; Cox, L; Crooks, G; Costa, D J; Custovic, A; Dahlen, S E; Darsow, U; De Carlo, G; De Blay, F; Dedeu, T; Deleanu, D; Denburg, J A; Devillier, P; Didier, A; Dinh-Xuan, A T; Dokic, D; Douagui, H; Dray, G; Dubakiene, R; Durham, S R; Dykewicz, M S; El-Gamal, Y; Emuzyte, R; Fink Wagner, A; Fletcher, M; Fiocchi, A; Forastiere, F; Gamkrelidze, A; Gemicioğlu, B; Gereda, J E; González Diaz, S; Gotua, M; Grouse, L; Guzmán, M A; Haahtela, T; Hellquist-Dahl, B; Heinrich, J; Horak, F; Hourihane, J O 'b; Howarth, P; Humbert, M; Hyland, M E; Ivancevich, J C; Jares, E J; Johnston, S L; Joos, G; Jonquet, O; Jung, K S; Just, J; Kaidashev, I; Kalayci, O; Kalyoncu, A F; Keil, T; Keith, P K; Khaltaev, N; Klimek, L; Koffi N'Goran, B; Kolek, V; Koppelman, G H; Kowalski, M L; Kull, I; Kuna, P; Kvedariene, V; Lambrecht, B; Lau, S; Larenas-Linnemann, D; Laune, D; Le, L T T; Lieberman, P; Lipworth, B; Li, J; Louis, R; Magard, Y; Magnan, A; Mahboub, B; Majer, I; Makela, M J; Manning, P; De Manuel Keenoy, E; Marshall, G D; Masjedi, M R; Maurer, M; Mavale-Manuel, S; Melén, E; Melo-Gomes, E; Meltzer, E O; Merk, H; Miculinic, N; Mihaltan, F; Milenkovic, B; Mohammad, Y; Molimard, M; Momas, I; Montilla-Santana, A; Morais-Almeida, M; Mösges, R; Namazova-Baranova, L; Naclerio, R; Neou, A; Neffen, H; Nekam, K; Niggemann, B; Nyembue, T D; O'Hehir, R E; Ohta, K; Okamoto, Y; Okubo, K; Ouedraogo, S; Paggiaro, P; Pali-Schöll, I; Palmer, S; Panzner, P; Papi, A; Park, H S; Pavord, I; Pawankar, R; Pfaar, O; Picard, R; Pigearias, B; Pin, I; Plavec, D; Pohl, W; Popov, T A; Portejoie, F; Postma, D; Potter, P; Price, D; Rabe, K F; Raciborski, F; Radier Pontal, F; Repka-Ramirez, S; Robalo-Cordeiro, C; Rolland, C; Rosado-Pinto, J; Reitamo, S; Rodenas, F; Roman Rodriguez, M; Romano, A; Rosario, N; Rosenwasser, L; Rottem, M; Sanchez-Borges, M; Scadding, G K; Serrano, E; Schmid-Grendelmeier, P; Sheikh, A; Simons, F E R; Sisul, J C; Skrindo, I; Smit, H A; Solé, D; Sooronbaev, T; Spranger, O; Stelmach, R; Strandberg, T; Sunyer, J; Thijs, C; Todo-Bom, A; Triggiani, M; Valenta, R; Valero, A L; van Hage, M; Vandenplas, O; Vezzani, G; Vichyanond, P; Viegi, G; Wagenmann, M; Walker, S; Wang, D Y; Wahn, U; Williams, D M; Wright, J; Yawn, B P; Yiallouros, P K; Yusuf, O M; Zar, H J; Zernotti, M E; Zhang, L; Zhong, N; Zidarn, M; Mercier, J

    2015-11-01

    Several unmet needs have been identified in allergic rhinitis: identification of the time of onset of the pollen season, optimal control of rhinitis and comorbidities, patient stratification, multidisciplinary team for integrated care pathways, innovation in clinical trials and, above all, patient empowerment. MASK-rhinitis (MACVIA-ARIA Sentinel NetworK for allergic rhinitis) is a simple system centred around the patient which was devised to fill many of these gaps using Information and Communications Technology (ICT) tools and a clinical decision support system (CDSS) based on the most widely used guideline in allergic rhinitis and its asthma comorbidity (ARIA 2015 revision). It is one of the implementation systems of Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA). Three tools are used for the electronic monitoring of allergic diseases: a cell phone-based daily visual analogue scale (VAS) assessment of disease control, CARAT (Control of Allergic Rhinitis and Asthma Test) and e-Allergy screening (premedical system of early diagnosis of allergy and asthma based on online tools). These tools are combined with a clinical decision support system (CDSS) and are available in many languages. An e-CRF and an e-learning tool complete MASK. MASK is flexible and other tools can be added. It appears to be an advanced, global and integrated ICT answer for many unmet needs in allergic diseases which will improve policies and standards. PMID:26148220

  18. Intranasal administration of CpG oligodeoxynucleotides reduces lower airway inflammation in a murine model of combined allergic rhinitis and asthma syndrome.

    PubMed

    Li, Hong-Tao; Zhang, Tian-Tuo; Chen, Zhuang-Gui; Ye, Jin; Liu, Hui; Zou, Xiao-Ling; Wang, Yan-Hong; Yang, Hai-Ling

    2015-09-01

    Given the relationship between allergic rhinitis (AR) and asthma, it can be hypothesized that reducing upper airway inflammation by targeting oligodeoxynucleotides with CpG motifs (CpG-ODN) specifically to the upper airway via intranasal administration in a small volume (10 μL) might improve lower airway (asthma) outcomes. The goal of this study was to investigate the therapeutic efficacy of 10 μL of intranasal versus intradermal administration of CpG-ODN in suppressing lower airway inflammation and methacholine-induced airway hyperreactivity (AHR) in mice subjected to ovalbumin (OVA)-induced combined allergic rhinitis and asthma syndrome (CARAS). OVA-sensitized BALB/c mice were subjected to upper-airway intranasal OVA exposure three times per week for 3 weeks. Then, CpG-ODN was administered to a subset of these mice 1h after intranasal OVA exposure, followed by five days of OVA aerosol challenges, thereby targeting OVA to the lower airways. Immunologic variables and nasal symptoms were evaluated. The results showed that the CARAS mice exhibited significant increases in bronchoalveolar lavage fluid (BALF) and splenocytes Th2-associated cytokine production, OVA-specific serum IgE, and AHR, as well as nose and lung pathologies. Intranasal administration of CpG-ODN significantly reduced Th2-associated cytokine production, the percentage of eosinophils in the BALF, the IL-4 and IL-5 concentrations in the supernatants of cultured OVA-challenged splenic lymphocytes, the serum OVA-specific IgE levels, the peribronchial inflammation score in the lungs, and the severity of nose pathology and nasal symptoms. However, intradermal administration of CpG-ODN did not significantly reduce the aforementioned parameters. In conclusion, intranasal treatment with CpG-ODN attenuated AR and significantly alleviated lower airway inflammation and AHR in the CARAS model. CpG-ODN therapy was more effective when administered intranasally than when administered intradermally. The current

  19. Genetics Home Reference: allergic asthma

    MedlinePlus

    ... Understand Genetics Home Health Conditions allergic asthma allergic asthma Enable Javascript to view the expand/collapse boxes. Download PDF Open All Close All Description Asthma is a breathing disorder characterized by inflammation of ...

  20. Rupatadine for the treatment of allergic rhinitis and urticaria.

    PubMed

    Metz, Martin; Maurer, Marcus

    2011-01-01

    Allergies are a widespread group of diseases of civilization and most patients are still undertreated. Since histamine is considered to be the most important mediator in allergies such as allergic rhinitis and urticaria, the most commonly used drugs to treat these disorders are antihistamines acting on the histamine 1 (H1) receptor. The currently available antihistamines, however, have significant differences in their effects and safety profiles. Furthermore, the Allergic Rhinitis and its Impact on Asthma initiative calls for additional desirable properties of antihistamines. Here, we review the profile of rupatadine, a new dual platelet-activating factor and H1-receptor antagonist that fulfils these criteria and therefore offers an excellent option for the treatment of allergic diseases. PMID:21162645

  1. Cardiac autonomic imbalance in children with allergic rhinitis.

    PubMed

    Tascilar, Emre; Yokusoglu, Mehmet; Dundaroz, Rusen; Baysan, Oben; Ozturk, Sami; Yozgat, Yilmaz; Kilic, Ayhan

    2009-11-01

    The involvement of autonomic imbalance has been reported in the pathogenesis of hypersensitivity reactions. Allergic diseases are more frequent in children and some of predisposing factors may be changed according to the increasing age, but the involvement of autonomic imbalance has not been investigated in pediatric population. In this cross-sectional, case-control study, we evaluated the autonomic system by measuring heart rate variability (HRV) in pediatric patients with allergic rhinitis. Thirty-five pediatric patients with allergic rhinitis and 36 healthy children (mean age 11 +/- 2.7, and 12 +/- 3 years, respectively) were enrolled in the study. Age and gender were not different between the groups. The diagnosis of allergic rhinitis was based on the history, symptoms, and skin prick tests. Participants with acute infection, nasal polyposis, bronchial asthma, and any other medical problems, assessed by history, physical examination and routine laboratory tests, were excluded. Twenty-four hour ambulatory electrocardiographic recordings were obtained, and the time domain and frequency domain indices of HRV were analyzed. We found significant increase in calculated HRV variables in children with allergic rhinitis compared to controls, which reflect parasympathetic tones, such as number of R-R intervals exceeding 50 ms, root mean square of successive differences between normal sinus R-R intervals, the percentage of difference between adjacent normal R-R intervals, and high frequency. These results indicate that HRV is increased, which implies sympathetic withdrawal and parasympathetic predominance. We propose that autonomic imbalance may be involved in the pathophysiology of allergic rhinitis in pediatric patients. PMID:19851046

  2. Treatment of Allergic Rhinitis with Probiotics: An Alternative Approach

    PubMed Central

    Yang, Gui; Liu, Zhi-Qiang; Yang, Ping-Chang

    2013-01-01

    Allergic rhinitis is a skewed immune reaction to common antigens in the nasal mucosa; current therapy is not satisfactory and can cause a variety of complications. In recent decades, the incidence of allergic rhinitis is increasing every year. Published studies indicate that probiotics are beneficial in treating allergic rhinitis. This review aims to help in understanding the role of probiotics in the treatment of allergic rhinitis. We referred to the PubMed database as data source. This review focuses on the following aspects: The types of probiotics using in the treatment of allergic rhinitis, approaches of administration, its safety, mechanisms of action, treating results, and the perspectives to improve effectiveness of probiotics in the treatment of allergic rhinitis. This review reports the recent findings regarding the role of probiotics in the treatment of allergic rhinitis. Probiotics are a useful therapeutic remedy in the treatment of allergic rhinitis, but its underlying mechanisms remain to be further investigated. PMID:24083221

  3. Treatment of allergic rhinitis with probiotics: an alternative approach.

    PubMed

    Yang, Gui; Liu, Zhi-Qiang; Yang, Ping-Chang

    2013-08-01

    Allergic rhinitis is a skewed immune reaction to common antigens in the nasal mucosa; current therapy is not satisfactory and can cause a variety of complications. In recent decades, the incidence of allergic rhinitis is increasing every year. Published studies indicate that probiotics are beneficial in treating allergic rhinitis. This review aims to help in understanding the role of probiotics in the treatment of allergic rhinitis. We referred to the PubMed database as data source. This review focuses on the following aspects: The types of probiotics using in the treatment of allergic rhinitis, approaches of administration, its safety, mechanisms of action, treating results, and the perspectives to improve effectiveness of probiotics in the treatment of allergic rhinitis. This review reports the recent findings regarding the role of probiotics in the treatment of allergic rhinitis. Probiotics are a useful therapeutic remedy in the treatment of allergic rhinitis, but its underlying mechanisms remain to be further investigated. PMID:24083221

  4. The Quality of Health Information on Allergic Rhinitis, Rhinitis, and Sinusitis Available on the Internet

    PubMed Central

    Chang, Mun Young; Kim, Jeong-Whun

    2015-01-01

    Purpose The internet has become one of the most important media outlets used to obtain health information. Therefore, the quality of health information available on the internet is very important. We evaluated the quality of internet-derived health information on allergic rhinitis, rhinitis and sinusitis and compared these results to those of previous studies performed five years ago. Methods The terms "allergic rhinitis (AR)", "rhinitis" and "sinusitis" were searched among the four most commonly used search engines in South Korea. These websites were evaluated according to the author, the Journal of the American Medical Association (JAMA) benchmarks, the DISCERN questionnaire and the Allergic rhinitis and its Impact on Asthma (ARIA) 2008 Update. Results A total of 120 websites were obtained and analyzed. For all diseases, "Oriental physician" had the largest portion (almost half of all websites), followed by "Western physician". Based on analyses using the JAMA benchmark, "Attribution" and "Disclosure" were ignored in almost all surveyed websites. According to the scores of the DISCERN question, the majority of websites did not supply appropriate references for their health information, and information on the negative aspects of treatment such as risks and uncertainty was not provided in several websites. In an analysis based on the ARIA 2008 Update concepts, 65% of websites pertaining to health information on AR contained unreliable information. Conclusions The quality of health information on the internet was not acceptable. Thus, governmental regulation or control to improve the quality of health information is required. PMID:25729621

  5. Overview on the pathomechanisms of allergic rhinitis

    PubMed Central

    Mori, Sachiko; Ozu, Chika; Kimura, Satoko

    2011-01-01

    Allergic rhinitis a chronic inflammatory disease of the upper airways that has a major impact on the quality of life of patients and is a socio-economic burden. Understanding the underlying immune mechanisms is central to developing better and more targeted therapies. The inflammatory response in the nasal mucosa includes an immediate IgE-mediated mast cell response as well as a latephase response characterized by recruitment of eosinophils, basophils, and T cells expressing Th2 cytokines including interleukin (IL)-4, a switch factor for IgE synthesis, and IL-5, an eosinophil growth factor and on-going allergic inflammation. Recent advances have suggested new pathways like local synthesis of IgE, the IgE-IgE receptor mast cell cascade in on-going allergic inflammation and the epithelial expression of cytokines that regulate Th2 cytokine responses (i.e., thymic stromal lymphopoietin, IL-25, and IL-33). In this review, we briefly review the conventional pathways in the pathophysiology of allergic rhinitis and then elaborate on the recent advances in the pathophysiology of allergic rhinitis. An improved understanding of the immune mechanisms of allergic rhinitis can provide a better insight on novel therapeutic targets. PMID:22053313

  6. Role of Predatory Mites in Persistent Nonoccupational Allergic Rhinitis

    PubMed Central

    Poza Guedes, Paloma; Sánchez Machín, Inmaculada; Matheu, Víctor; Iraola, Víctor

    2016-01-01

    Mites can sensitize and induce atopic disease in predisposed individuals and are an important deteriorating factor in patients with allergic rhinitis, asthma, and atopic dermatitis. Although Pyroglyphidae mites have been extensively studied, very scarce reports are available on Cheyletidae spp. especially regarding human respiratory pathology. The main objective of the present study is to investigate the clinical role of this predator mite (Cheyletus eruditus) as a respiratory antigen in a selected sensitized human population. Fifty-two adult patients were recruited from the outpatient allergy clinic to assess their eligibility for the study. The thirty-seven subjects with persistent allergic rhinitis (PAR) who fulfilled the ARIA criteria had a positive IgE response confirmed by skin prick test (SPT) to C. eruditus. Only those individuals (37/47) with a positive SPT to C. eruditus showed a positive nasal provocation test (NPT), while 10 patients with nonallergic mild-to-moderate persistent rhinitis, control group, had a negative NPT with C. eruditus. The present paper describes a new role for the predator mite Cheyletus eruditus as a respiratory allergen in a selected subset of patients in a subtropical environment afflicted with persistent nonoccupational allergic rhinitis. PMID:27445552

  7. Allergic Rhinitis: A neglected disease — A community based assessment among adults in Delhi

    PubMed Central

    Sinha, B; Vibha; Singla, R; Chowdhury, R

    2015-01-01

    Background and Objectives: Allergic Rhinitis is rather erroneously viewed as a trivial disease. It is important in that it can significantly affect quality of life. There is paucity of community based prevalence studies on the disease in India. This study was planned to assess the prevalence of allergic rhinitis in adults, the proportion of asthmatics among them, risk factors associated and treatment seeking behaviour among the patients. Materials and Methods: A community based cross sectional study was conducted in Mehrauli, South Delhi among 1200 adults, aged 30 years and over selected by systematic random sampling from two randomly selected wards. A pre-tested questionnaire was used to collect information regarding symptoms, risk factors and treatment seeking behaviour. Allergic Rhinitis was diagnosed as per ARIA guidelines. Spirometry was done to diagnose asthma among them. Multivariate logistic regression analysis was done to find the association of risk factors with disease. Results: The prevalence of Allergic Rhinitis was found to be 11% (132 subjects) and 33.3% (44 patients) among them also had asthma. Overcrowding (aOR = 6.4), absence of cross-ventilation (aOR = 2.5), occupational exposure to dust/smoke (aOR = 2.1), tobacco smoking (aOR = 2.1), family history of allergic diseases (aOR = 2.7) and clinical allergy (aOR = 10.2) were found to be independent risk factors associated with Rhinitis. More patients of Rhinitis with asthma (75%) took treatment, relative to those without asthma (40%) who, mostly relied on home remedies (42%) or, did not seek any treatment (18%) (P = 0.031). Interpretations and Conclusion: The burden of Allergic Rhinitis is high with a considerable overlap with asthma. These allergic diseases and emphasize the importance of early and regular treatment. PMID:26119436

  8. When perennial rhinitis worsens: rhinolith mimicking severe allergic rhinitis

    PubMed Central

    Heffler, Enrico; Machetta, Giacomo; Magnano, Mauro; Rolla, Giovanni

    2014-01-01

    Allergic rhinitis is one of the most common causes of nasal obstruction, but other diseases need to be considered particularly when the clinical course is getting worse. We present a patient with known mild persistent allergic rhinitis due to house dust mites who experienced progressive worsening of nasal obstruction with associated hyposmia and mucopurulent discharge. The lack of improvement of the patient’s symptoms prompted the re-evaluation of the case. Skin prick tests for airborne allergens confirmed sensitisation only to house dust mites. Nasal endoscopy and facial CT scan revealed a huge rhinolith occupying almost completely the right nasal cavity. The rhinolith was surgically removed with resolution of symptoms. Rhinoliths are rare and unusual calcified materials which grow around intranasal foreign body; they are often promoted by trauma, surgical operations and dental work. The patient underwent dental work about 30 months before the diagnosis of rhinolith, suggesting a possible aetiology. PMID:24526202

  9. Bilastine: in allergic rhinitis and urticaria.

    PubMed

    Carter, Natalie J

    2012-06-18

    Bilastine is an orally administered, second-generation antihistamine used in the symptomatic treatment of seasonal or perennial allergic rhinoconjunctivitis and urticaria. In two well designed phase III trials, 14 days' treatment with bilastine was associated with a significantly lower area under the effect curve (AUEC) for the reflective total symptom score (TSS) than placebo in patients with symptomatic seasonal allergic rhinitis. Additionally, reflective nasal symptom scores were significantly lower in bilastine than placebo recipients in patients with a history of seasonal allergic rhinitis who were challenged with grass pollen allergen in a single-centre, phase II study. Neither bilastine nor cetirizine was effective in the treatment of perennial allergic rhinitis with regard to the mean AUEC for reflective TSS in another well designed phase III trial. However, results may have been altered by differences in some baseline characteristics and placebo responses between study countries. In another well designed phase III trial, compared with placebo, bilastine was associated with a significantly greater change from baseline to day 28 in the mean reflective daily urticaria symptom score in patients with chronic urticaria. There were no significant differences in primary endpoint results between bilastine and any of the active comparators used in these trials (i.e. cetirizine, levocetirizine and desloratadine). Bilastine was generally well tolerated, with a tolerability profile that was generally similar to that of the other second-generation antihistamines included in phase III clinical trials. PMID:22686617

  10. Clinical and allergic sensitization characteristics of allergic rhinitis among the elderly population in Istanbul, Turkey.

    PubMed

    Ozturk, Ayse Bilge; Ozyigit, Leyla Pur; Olmez, Merve Ozata

    2015-04-01

    Prevalence of allergic rhinitis (AR) in elderly population in Turkey is not known. Studies on the prevalence and features of allergy in older adults are needed to identify safe and effective diagnostic/therapeutic methods for elderly AR patients. We aimed to identify the clinical and allergic characteristics of sensitization to aeroallergens among individuals aged ≥60 years with allergic rhinitis admitted to an allergy outpatient clinic in Istanbul. Of 109 patients, 33.9 % were atopic. Sixty-five percent of subjects were sensitized to Dermatophagoides pteronyssinus, 17 % to a grass-pollen mixture, 8 % to Aspergillus fumigatus, and 8 % to Blattella germanica. There was no difference between mono- and polysensitized patients in terms of the duration of rhinitis and symptom severity. No significant difference was observed between the two groups according to age, sex, smoking status, AR onset (<40 or ≥40 years), or duration/severity of disease. There was no significant difference between the two groups in the prevalence of asthma and conjunctivitis, (p = 0.256). Atopic dermatitis/eczema was more prevalent in those with AR (p = 0.046). Clinical characteristics of AR in the elderly could be different from those in non-allergic patients, and the prevalence of allergy may be higher than expected. PMID:25680346

  11. Obesity is a risk factor for allergic rhinitis in children of Wuhan (China)

    PubMed Central

    Yang, Huang; Zhen, Long

    2016-01-01

    Background The relationship between obesity and allergic diseases in children of China is unclear. Objective To analysis the relationship between obesity and overweight and the prevalence of allergic diseases and the impact of gender. Methods Questionnaire based on those used in National Study of Asthma and Allergies in Childhood in China. The study included 3,327 participants (23.7% aged 2–6 years, 65.8% aged 7–12 years, 10.5% aged 13–14 years) in Wuhan City. Allergic diseases were determined by physicians. Results Overweight was found in 35.68% of participants (8.96% of 2–6 years old, 32.83% of 7–12 years old, and 48.57% of 13–14 years old), obesity in 12.53% (4.18%, 12.01%, and 4.29%, respectively). Obesity (odds ratio [OR], 1.33) increased the prevalence of allergic rhinitis and atopic dermatitis. Obesity (OR, 1.48) affected the incidence of allergic rhinitis in girls. There was no relationship between body mass index (BMI) and asthma in child from Wuhan City. Obesity and overweight did not affect the frequency of asthma, food allergy, and drug allergy. Conclusion Obesity increased the prevalence of allergic rhinitis and atopic dermatitis in child. Higher BMI was no relationship with the prevalence of asthma, food allergy, and drug allergy. PMID:27141483

  12. Differential diagnosis of allergic rhinitis and sinusitis an expert system

    SciTech Connect

    Creider, R.D.; Sundar Singh, P.S.

    1996-12-31

    Nasal congestion is a common problem for many people. It is a symptom of chronic sinusitis and also a characteristic of allergic rhinitis. Individuals frequently confuse sinusitis and allergic rhinitis. The expert system described below will diagnose the problem to be either rhinitis or sinusitis. In this paper we describe the expert system, the need for such an expert system and the process of developing the system.

  13. Neurology of allergic inflammation and rhinitis.

    PubMed

    Canning, Brendan J

    2002-05-01

    Afferent nerves, derived from the trigeminal ganglion, and postganglionic autonomic nerves, derived from sympathetic and parasympathetic ganglia expressing many different neurotransmitters, innervate the nose. Reflexes that serve to optimize the air-conditioning function of the nose by altering sinus blood flow, or serve to protect the nasal mucosal surface by mucus secretion, vasodilatation, and sneezing, can be initiated by a variety of stimuli, including allergen, cold air, and chemical irritation. Activation of nasal afferent nerves can also have profound effects on respiration, heart rate, blood pressure, and airway caliber (the diving response). Dysregulation of the nerves in the nose plays an integral role in the pathogenesis of allergic rhinitis. Axon reflexes can precipitate inflammatory responses in the nose, resulting in plasma extravasation and inflammatory cell recruitment, while allergic inflammation can produce neuronal hyper-responsiveness. Targeting the neuronal dysregulation in the nose may be beneficial in treating upper airway disease. PMID:11918862

  14. Clinical features of allergic rhinitis in children of Shanghai, China.

    PubMed

    He, S; Li, Y J; Chen, J

    2016-01-01

    The aims of the current study were to assess the clinical features of allergic rhinitis (AR) in children in Shanghai. Serum-specific IgE (sIgE) tests were performed on samples from patients with AR symptoms from January 2011 to December 2014. A disease-related questionnaire was completed after AR diagnosis. The allergen profile and clinical features of AR were analyzed. In total, 2713 AR patients were enrolled in this study. Dermatophagoides pteronyssinus was found to be the most common offending allergen in the study population. With increasing age, the prevalence of sIgE against inhalant allergens was significantly increased; however, the opposite trend was observed for food allergens. Additionally, the proportion of children with high levels of sIgE against D. pteronyssinus increased with age. Of the AR cases, 8.6% were classified as intermittent mild, 4.2% as persistent mild, 40.5% as intermittent moderate-severe, and 46.7% as persistent moderate-severe. A family history of allergies and a patient history of allergies within 6 months of birth were significantly associated with the duration and severity of AR symptoms. The occurrence of co-morbidities, such as allergic conjunctivitis, cough, and asthma, gradually increased from intermittent mild, persistent mild, and intermittent moderate-severe to persistent moderate-severe. The most frequently used drugs were topical corticosteroids and oral antihistamines, which were used by 86.7 and 79.0% of patients, respectively. These results confirm the adequacy of the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines for classifying AR patients, and advance the understanding of clinical features of AR in children in Shanghai, China. PMID:27173334

  15. Allergen-specific immunotherapy in pediatric allergic asthma

    PubMed Central

    2016-01-01

    Allergen-specific immunotherapy (AIT) is the only curative way that can change the immunologic response to allergens and thus can modify the natural progression of allergic diseases. There are some important criteria which contributes significantly on efficacy of AIT, such as the allergen extract used for treatment, the dose and protocol, patient selection in addition to the severity and control of asthma. The initiation of AIT in allergic asthma should be considered in intermittent, mild and moderate cases which coexisting with other allergic diseases such as allergic rhinitis, and in case of unacceptable adverse effects of medications. Two important impact of AIT; steroid sparing effect and preventing from progression to asthma should be taken into account in pediatric asthma when making a decision on starting of AIT. Uncontrolled asthma remains a significant risk factor for adverse events and asthma should be controlled both before and during administration of AIT. The evidence concerning the efficacy of subcutaneous (SCIT) and sublingual immunotherapy (SLIT) for treatment of pediatric asthma suggested that SCIT decreases asthma symptoms and medication scores, whereas SLIT can ameliorate asthma symptoms. Although the effectiveness of SCIT has been shown for both seasonal and perennial allergens, the data for SLIT is less convincing for perennial allergies in pediatric asthma. PMID:27489785

  16. Allergen-specific immunotherapy in pediatric allergic asthma.

    PubMed

    Yukselen, Ayfer

    2016-07-01

    Allergen-specific immunotherapy (AIT) is the only curative way that can change the immunologic response to allergens and thus can modify the natural progression of allergic diseases. There are some important criteria which contributes significantly on efficacy of AIT, such as the allergen extract used for treatment, the dose and protocol, patient selection in addition to the severity and control of asthma. The initiation of AIT in allergic asthma should be considered in intermittent, mild and moderate cases which coexisting with other allergic diseases such as allergic rhinitis, and in case of unacceptable adverse effects of medications. Two important impact of AIT; steroid sparing effect and preventing from progression to asthma should be taken into account in pediatric asthma when making a decision on starting of AIT. Uncontrolled asthma remains a significant risk factor for adverse events and asthma should be controlled both before and during administration of AIT. The evidence concerning the efficacy of subcutaneous (SCIT) and sublingual immunotherapy (SLIT) for treatment of pediatric asthma suggested that SCIT decreases asthma symptoms and medication scores, whereas SLIT can ameliorate asthma symptoms. Although the effectiveness of SCIT has been shown for both seasonal and perennial allergens, the data for SLIT is less convincing for perennial allergies in pediatric asthma. PMID:27489785

  17. Rhinolith misdiagnosed as allergic rhinitis: case report

    PubMed Central

    Aljfout, Qais; Saraireh, Mohammad; Maita, Abdullah

    2016-01-01

    Foreign body neglected in the nasal cavity for many years leads to the formation of a rhinolith, which gradually increases in size. Nasal obstruction and persistent foul smelling nasal discharge usually are the main presenting symptoms, although some might be silent. This paper presents and discuss a case of 19-year-old female patient whose main complaint was nasal obstruction for many years and treated as allergic rhinitis. Diagnosis was confirmed with computed tomography scan, and it was removed endoscopically without complications. We think that proper examination, which includes endoscopic evaluation, should be done to reach the diagnosis. A computed tomography scan confirmed the diagnosis and helped in planning the best treatment option. PMID:27053994

  18. Treatment strategies designed to minimize medical complications of allergic rhinitis.

    PubMed

    Fireman, P

    1997-01-01

    Perennial and seasonal allergic rhinitis affect many million Americans and account for close to $2 billion annually in medical costs and lost productivity. The symptoms of allergic rhinitis, including sneezing, rhinorrhea, nasal congestion, and pruritus are, at best, very annoying and may be quite debilitating in some patients, causing irritability, insomnia, and fatigue. Moreover, allergic rhinitis is often not self-limiting and can contribute to serious medical complications such as sinusitis and otitis. Aggressive medical management of allergic rhinitis is important in the therapy for chronic sinusitis and otitis media and may prevent progression to more serious disease. Accurate diagnosis and initiation of environmental control measures to reduce exposure to causative factors should accompany initiation of pharmacotherapy. Antihistamines form the cornerstone of pharmacologic therapy, and use of the newer nonsedating antihistamines such as loratadine, terfenadine, and astemizole is not associated with the sedation produced by the classic antihistamines. Both loratadine and terfenadine are available in combination with a decongestant. Topical intranasal corticosteroids are another important component of pharmacologic management of allergic rhinitis. Allergen immunotherapy (hyposensitization) is used in those patients not adequately managed with pharmacotherapy. The relative safety and convenient dosing schedule of the newer medications should be accompanied by enhanced patient compliance and, hence, better control of allergic symptoms, halting progression of allergic rhinitis to serious medical complications. PMID:9129750

  19. Allergic rhinitis - what to ask your doctor - child

    MedlinePlus

    ... Below are some questions you may want to ask your child's health care provider to help you ... What to ask your doctor about allergic rhinitis - child; Hay fever - what to ask your doctor - child; Allergies - what to ask ...

  20. [The modern strategies for the treatment of allergic rhinitis].

    PubMed

    Nosulya, E V; Kim, I A

    2016-01-01

    The present literature review had the objective to analyze the published data concerning the effectiveness of intranasal administration of antihistamine preparations and intranasal glucocorticoids for the treatment of allergic rhinitis. Special emphasis is placed on the clinical significance and the further prospects for the application of a fixed combination of these medications including azelastineplusmometasonefuroateas the first choice therapy of moderately severe and severe manifestations of allergic rhinitis. PMID:27213663

  1. Characterization of Rhinitis According to the Asthma Status in Adults Using an Unsupervised Approach in the EGEA Study

    PubMed Central

    Burte, Emilie; Bousquet, Jean; Varraso, Raphaëlle; Gormand, Frédéric; Just, Jocelyne; Matran, Régis; Pin, Isabelle; Siroux, Valérie

    2015-01-01

    Background The classification of rhinitis in adults is missing in epidemiological studies. Objective To identify phenotypes of adult rhinitis using an unsupervised approach (data-driven) compared with a classical hypothesis-driven approach. Methods 983 adults of the French Epidemiological Study on the Genetics and Environment of Asthma (EGEA) were studied. Self-reported symptoms related to rhinitis such as nasal symptoms, hay fever, sinusitis, conjunctivitis, and sensitivities to different triggers (dust, animals, hay/flowers, cold air…) were used. Allergic sensitization was defined by at least one positive skin prick test to 12 aeroallergens. Mixture model was used to cluster participants, independently in those without (Asthma-, n = 582) and with asthma (Asthma+, n = 401). Results Three clusters were identified in both groups: 1) Cluster A (55% in Asthma-, and 22% in Asthma+) mainly characterized by the absence of nasal symptoms, 2) Cluster B (23% in Asthma-, 36% in Asthma+) mainly characterized by nasal symptoms all over the year, sinusitis and a low prevalence of positive skin prick tests, and 3) Cluster C (22% in Asthma-, 42% in Asthma+) mainly characterized by a peak of nasal symptoms during spring, a high prevalence of positive skin prick tests and a high report of hay fever, allergic rhinitis and conjunctivitis. The highest rate of polysensitization (80%) was found in participants with comorbid asthma and allergic rhinitis. Conclusion This cluster analysis highlighted three clusters of rhinitis with similar characteristics than those known by clinicians but differing according to allergic sensitization, and this whatever the asthma status. These clusters could be easily rebuilt using a small number of variables. PMID:26309034

  2. Prevalence and triggers of allergic rhinitis in the United Arab Emirates

    PubMed Central

    2014-01-01

    Background and objectives Allergic rhinitis is a morbid condition that is frequently overlooked by patients and physicians. This type of atopy has not been adequately investigated in the United Arab Emirates. Methods This cross-sectional, population-based observational study was conducted in the seven Emirates (Abu Dhabi, Dubai, Sharjah, Ajman, Umm Al-Quwain, Ras Al-Khaimah, and Fujairah). It used the European Community Respiratory Health Survey (ECRHS II) to screen for allergic rhinitis in people living in this region. Results Symptoms of allergic rhinitis were present in 85 (7%) of the 1,229 study population. Only 33 (39%) patients received treatment. Seventy-six (89%) patients had asthma. Thirty-seven (44%) patients were poly-sensitized. Symptoms were aggravated by dust (59%), grass/pollens (44%) and proximity to animals (21%). Winter was the peak season (37%), followed by spring (30%), autumn (18%) and summer (15%). Grass/pollen allergies were clustered in the winter, spring and summer (p ≤ 0.001). Dust was non-seasonal (p ≥ 0.121) and animal allergy was worse in the winter (p = 0.024) and spring (p = 0.044). Spring symptoms were less common in people living in the inner city (p = 0.003). Conclusions At least 7% of the studied population had allergic rhinitis. Most (71%) of these patients had environmental triggers and remained untreated. Allergic rhinitis awareness and measures to control allergens and dust are needed. The impact of preventing allergic rhinitis on other common atopies in the region deserves future studies. PMID:25097721

  3. [Non-allergic Rhinitis: Epidemiology, Diagnostic and Therapy].

    PubMed

    Lorenz, A; Küster, I; Beule, A G

    2015-12-01

    Non-allergic rhinitis is a heterogenous group of medical diseases without an IgE-mediated pathophysiology. In this review, typical subgroups are presented with data regarding their frequency, clinical symptoms and recommendations for an effective and efficient diagnostic and therapeutic approach are indicated. The most common subtype is the non-allergic rhinopathy, also known as idiopathic or vasomotoric rhinitis. Because medication induced rhinitis is still a frequent clinical problem, a step wise approach to wean the patient is presented. PMID:26669462

  4. Eosinophilic Inflammation in Allergic Asthma

    PubMed Central

    Possa, Samantha S.; Leick, Edna A.; Prado, Carla M.; Martins, Mílton A.; Tibério, Iolanda F. L. C.

    2013-01-01

    Eosinophils are circulating granulocytes involved in pathogenesis of asthma. A cascade of processes directed by Th2 cytokine producing T-cells influence the recruitment of eosinophils into the lungs. Furthermore, multiple elements including interleukin (IL)-5, IL-13, chemoattractants such as eotaxin, Clara cells, and CC chemokine receptor (CCR)3 are already directly involved in recruiting eosinophils to the lung during allergic inflammation. Once recruited, eosinophils participate in the modulation of immune response, induction of airway hyperresponsiveness and remodeling, characteristic features of asthma. Various types of promising treatments for reducing asthmatic response are related to reduction in eosinophil counts both in human and experimental models of pulmonary allergic inflammation, showing that the recruitment of these cells really plays an important role in the pathophysiology of allergic diseases such asthma. PMID:23616768

  5. Skin Testing for Allergic Rhinitis: A Health Technology Assessment

    PubMed Central

    2016-01-01

    Background Allergic rhinitis is the most common type of allergy worldwide. The accuracy of skin testing for allergic rhinitis is still debated. This health technology assessment had two objectives: to determine the diagnostic accuracy of skin-prick and intradermal testing in patients with suspected allergic rhinitis and to estimate the costs to the Ontario health system of skin testing for allergic rhinitis. Methods We searched All Ovid MEDLINE, Embase, and Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, CRD Health Technology Assessment Database, Cochrane Central Register of Controlled Trials, and NHS Economic Evaluation Database for studies that evaluated the diagnostic accuracy of skin-prick and intradermal testing for allergic rhinitis using nasal provocation as the reference standard. For the clinical evidence review, data extraction and quality assessment were performed using the QUADAS-2 tool. We used the bivariate random-effects model for meta-analysis. For the economic evidence review, we assessed studies using a modified checklist developed by the (United Kingdom) National Institute for Health and Care Excellence. We estimated the annual cost of skin testing for allergic rhinitis in Ontario for 2015 to 2017 using provincial data on testing volumes and costs. Results We meta-analyzed seven studies with a total of 430 patients that assessed the accuracy of skin-prick testing. The pooled pair of sensitivity and specificity for skin-prick testing was 85% and 77%, respectively. We did not perform a meta-analysis for the diagnostic accuracy of intradermal testing due to the small number of studies (n = 4). Of these, two evaluated the accuracy of intradermal testing in confirming negative skin-prick testing results, with sensitivity ranging from 27% to 50% and specificity ranging from 60% to 100%. The other two studies evaluated the accuracy of intradermal testing as a stand-alone tool for diagnosing allergic rhinitis, with

  6. Evidence-based practice: sublingual immunotherapy for allergic rhinitis.

    PubMed

    Wise, Sarah K; Schlosser, Rodney J

    2012-10-01

    In this article, the authors review the current evidence regarding the public health and economic impact of allergic rhinitis. Diagnostic methods for allergic disease are discussed as well as certain nuances of allergy skin testing protocols. In addition, the evidence supporting sublingual immunotherapy (SLIT) for allergic rhinitis is reviewed, with subsequent attention to certain subgroups, such as adults and children, seasonal versus perennial allergens, and SLIT efficacy for individual antigens. The authors consider the evidence supporting appropriate SLIT dosing as well as the existing data on SLIT safety. PMID:22980684

  7. Variation in Uteroglobin-Related Protein 1 (UGRP1) gene is associated with Allergic Rhinitis in Singapore Chinese

    PubMed Central

    2011-01-01

    Background Uteroglobin-Related Protein 1 (UGRP1) is a secretoglobulin protein which has been suggested to play a role in lung inflammation and allergic diseases. UGRP1 has also been shown to be an important pneumoprotein, with diagnostic potential as a biomarker of lung damage. Previous genetic studies evaluating the association between variations on UGRP1 and allergic phenotypes have yielded mixed results. The aim of this present study was to identify genetic polymorphisms in UGRP1 and investigate if they were associated with asthma and allergic rhinitis in the Singapore Chinese population. Methods Resequencing of the UGRP1 gene was conducted on 40 randomly selected individuals from Singapore of ethnic Chinese origin. The polymorphisms identified were then tagged and genotyped in a population of 1893 Singapore Chinese individuals. Genetic associations were evaluated in this population comparing 795 individuals with allergic rhinitis, 718 with asthma (of which 337 had both asthma and allergic rhinitis) and 717 healthy controls with no history of allergy or allergic diseases. Results By resequencing the UGRP1 gene within our population, we identified 11 novel and 16 known single nucleotide polymorphisms (SNPs). TagSNPs were then genotyped, revealing a significant association between rs7726552 and allergic rhinitis (Odds Ratio: 0.81, 95% Confidence Interval: 0.66-0.98, P = 0.039). This association remained statistically significant when it was analyzed genotypically or when stratified according to haplotypes. When variations on UGRP1 were evaluated against asthma, no association was observed. Conclusion This study documents the association between polymorphisms in UGRP1 and allergic rhinitis, suggesting a potential role in its pathogenesis. PMID:21410962

  8. Response to Nonallergenic Irritants in Children With Allergic and Nonallergic Rhinitis

    PubMed Central

    Baek, Ji Hyeon; Cho, Eunhae; Kim, Mi Ae; Lee, Seung Won; Kang, Yu Sun; Sheen, Youn Ho; Jee, Hye Mi; Jung, Young-Ho

    2016-01-01

    Purpose Nonallergenic irritants can aggravate the symptoms of rhinitis. We investigated the clinical responses of children with allergic rhinitis (AR) and nonallergic rhinitis (NAR) to nonallergenic irritants, and identified factors associated with these responses. Methods Children with chronic rhinitis (n=208) were classified as having AR or NAR based on the presence of aeroallergen-specific IgE. Healthy controls (n=24) were recruited for comparison. The Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines were used to classify patients, and their irritant score (0-21 points) and current symptom score (5-35 points) were measured. Subjects with irritant scores ≥3 and <3 were classified as having irritant and nonirritant rhinitis, respectively. Results The mean age of enrolled subjects was 6.8 years (range: 1.8-16.0 years). The AR and NAR groups had similar irritant scores (P=0.394) and proportions of subjects with irritant scores ≥3 (P=0.105). Irritant score correlated positively with symptom score (P=0.005), and the proportion of subjects with irritant scores ≥3 was greater in children with moderate-severe rhinitis than in those with mild rhinitis (P=0.046). Multiple logistic regression analysis indicated that the presence of atopic eczema increased the risk for sensitivity to a nonallergenic irritant (aOR=2.928, 95% CI 1.567-5.473, P=0.001). Conclusions Response to a nonallergenic irritant was useful for gauging the severity of rhinitis, but not for differentiating AR from NAR. AR and NAR patients with atopic eczema may increase nasal sensitivity to nonallergenic irritants. PMID:27126728

  9. Beclomethasone dipropionate aerosol in allergic rhinitis.

    PubMed

    Cockcroft, D W; MacCormack, D W; Newhouse, M T; Hargreave, F E

    1976-09-18

    Treatment with beclomethasone dipropionate aerosol (BDA), 50 mug four times daily in each nostril, was compared with placebo therapy in a double-blind non-crossover trial of 30 matched patients with allergic rhinitis induced by ragweed pollen. The trial was started at the beginning of the ragweed season and continued for 42 days. Response to treatment was assessed from information on daily diary cards, weekly objective measurements of nasal patency and measurement of total eosinophil count (TEC) before treatment and at week 4. Patients in the BDA group had significantly less (P less than 0.05) sneezing, rhinorrhea and nasal stuffiness at 36 days, cough at 10 days and antihistamine consumption at 17 days. There was no significant difference between the groups in eye symptoms, nasal airway inspiratory resistance, maximum inspiratory nasal flow or TEC. Overall comparison with previous pollen seasons by the patients indicated moderate to great improvement in 86% of the BDA group and in 13% of the placebo group (P less than 0.01). Minor side effects were noted by two patients in each group. PMID:782679

  10. Sublingual or subcutaneous immunotherapy for allergic rhinitis?

    PubMed

    Durham, Stephen R; Penagos, Martin

    2016-02-01

    Allergen immunotherapy is effective in patients with allergic rhinitis (AR) and, unlike antiallergic drugs, has been shown to modify the underlying cause of the disease, with proved long-term benefits. Subcutaneous immunotherapy (SCIT) has been the gold standard, whereas sublingual immunotherapy (SLIT) has emerged as an effective and safe alternative. Previous Cochrane systematic reviews and meta-analyses have confirmed that both SLIT and SCIT are effective in patients with seasonal AR, whereas evidence for their efficacy in patients with perennial disease has been less convincing. Recent large, adequately powered trials have demonstrated reductions in both symptoms and use of rescue medication in patients with seasonal and those with perennial AR. Here we appraise evidence for SCIT versus SLIT based on indirect evidence from Cochrane reviews and recent well-powered double-blind, randomized controlled trials versus placebo and the limited direct evidence available from randomized blind head-to-head comparisons. At present, based on an overall balance of efficacy and side effects, the patient is in equipoise. Pending definitive comparative trials, choice might be determined largely by the local availability of SCIT and SLIT products of proved value and personal (patient) preference. PMID:26853126

  11. Olfaction in allergic rhinitis: A systematic review.

    PubMed

    Stuck, Boris A; Hummel, Thomas

    2015-12-01

    Olfactory dysfunction is a key symptom in patients with allergic rhinitis (AR). Despite the implications for quality of life, relatively few articles have tested olfactory function in their investigations. The current systematic review aimed to investigate the following 2 questions: (1) What does AR do to human olfaction? (2) How effective is the treatment of AR in restoring the sense of smell? A comprehensive literature search was performed, and human studies of any design were included. A total of 420 articles were identified, and 36 articles were considered relevant. Data indicate that the frequency of olfactory dysfunction increases with the duration of the disorder, and most studies report a frequency in the range of 20% to 40%. Although olfactory dysfunction does not appear to be very severe in patients with AR, its presence seems to increase with the severity of the disease. There is very limited evidence that antihistamines improve olfactory function. In addition, there is limited evidence that topical steroids improve the sense of smell, especially in patients with seasonal AR. This is also the case for specific immunotherapy. However, many questions remain unanswered because randomized controlled trials are infrequent and only a few studies rely on quantitative measurement of olfactory function. PMID:26409662

  12. Local allergic rhinitis: A critical reappraisal from a paediatric perspective.

    PubMed

    Arasi, Stefania; Pajno, Giovanni Battista; Lau, Susanne; Matricardi, Paolo Maria

    2016-09-01

    The so-called local allergic rhinitis (LAR) has been proposed as a phenotype of rhinitis with Th2-driven prominent local allergic inflammation, nasal synthesis of specific IgE and a positive response to a nasal allergen provocation test, in the absence of 'systemic' atopy (negative skin prick test and serum allergen-specific IgE antibodies). To date, available data on LAR are mostly focused on adults. The purpose of this 'Rostrum' was to critically discuss data and implications of the 'LAR concept' in paediatrics. In the natural history of rhinitis due to IgE-mediated reactions triggered by exposure to allergens, a 'LAR' can be either the initial, transient stage of classical allergic rhinitis or a stable phenotype never evolving to 'systemic' IgE sensitization. Given the present difficulties in performing routinely nasal allergen provocation test in children, the development of sensitive and specific tests to detect IgE in the child's nasal secretions is a research priority. We suggest also the hypothetical role of allergen immunoprophylaxis or immunotherapy in LAR. Last, the term 'local allergic rhinitis' may be inappropriate, as rhinitis is always 'local', while IgE sensitization can be either 'local' or 'systemic'. PMID:27098888

  13. Asthma and Respiratory Allergic Disease

    EPA Science Inventory

    The pathogenesis of non-communicable diseases such as allergy is complex and poorly understood. The causes of chronic allergic diseases including asthma involve to a large extent, immunomodulation of the adaptive and particularly the innate immune systems and are markedly influen...

  14. A Nonsynonymous FCER1B SNP is Associated with Risk of Developing Allergic Rhinitis and with IgE Levels

    PubMed Central

    Amo, Gemma; García-Menaya, Jesús; Campo, Paloma; Cordobés, Concepción; Serón, M Carmen Plaza; Ayuso, Pedro; Esguevillas, Gara; Blanca, Miguel; Agúndez, Jose A.G.; García-Martín, Elena

    2016-01-01

    Allergic rhinitis is associated with elevated serum IgE levels. IgE response is mediated by the high-affinity IgE receptor (FcεRI), which is polymorphic. Studies analyzing the association between allergic rhinitis and FcεRI variants have been conducted with controversial results. The objective of this study is to analyze, in 1,041 individuals, the putative clinical association of allergic rhinitis with common polymorphisms in FcεRI subunits genes. These SNPs included FECR1A rs2494262, rs2427837 and rs2251746; FECR1B rs1441586, rs569108 and rs512555; FCER1G rs11587213, rs2070901 and rs11421. Statistically significant differences were observed for the FCER1B rs569108 and rs512555 polymorphisms frequencies when comparing patients with allergic rhinitis without asthma and controls. The OR (95% CI) value for the 237Gly allele (rs569108) is equal to 0.26 (0.08–0.86, P = 0.017) and for the G allele (rs512555) it is equal to 0.27 (0.08–0.88, P = 0.020). These two SNPs are linked (D’ = 1.0, LOD = 56.05). Also observed was a statistically significant trend towards lower IgE values among allergic rhinitis patients with variant alleles for both SNPs. In conclusion, in patients with allergic rhinitis without asthma, the FCER1B rs569108 and rs512555 polymorphisms are associated with increased risk of developing allergic rhinitis and with lower IgE levels. PMID:26792385

  15. PSYCHO-EMOTIONAL CHARACTERISTICS OF THE ADOLESCENTS WITH ALLERGIC RHINITIS.

    PubMed

    Adamia, N; Jorjoliani, L; Manjavidze, N; Ubiria, I; Saginadze, L

    2015-06-01

    Allergic rhinitis is a widespread allergic disease, with 35-40% prevalence in the world population. It is characterized with increasing frequency, particularly in children's population. Goal of the work - study of psycho-emotional profile in adolescents with allergic rhinitis of different severity. Single-stage research was conducted, in compliance with the ethical norms. Study included 86 children (41% girls and 45% boys) of age from 11 to 13 years with allergic rhinitis of different severity and 30 healthy children. For the purpose of study of the patients' psychological profile Esenek Personality Questionnaire (EPQ) intended for assessment of characterological and individual psychological features in children and adolescents (10-15 years) was used. Psycho-emotional sphere of the adolescents with allergic rhinitis was assessed also by Psychopathologic Symptom Checklist (Symptom Checklist-90-Revised-SCL-90-R). Clinical scale of self-assessment of psychical condition is widely applied in ambulatory and hospital practice. At the final stage of research the mathematical-statistical data processing was provided by means of SPSS/v12 software package. According to the research results, susceptibility to significant and mild introversion was identified in severe and average AR cases. Such patients are often locked into their inner world. These children are reserved, communicate with the parents and close friends only. They make decisions with due care, love order, control their emotions, are pessimistic and rarely aggressive. Results of neuroticism study by G. Esenek techniques are provided in Table. Neuroticism is associated with the lability of nervous system, characterizes emotional condition or emotional lability (emotional stability or instability). According to the research results, allergic rhinitis is characterized with emotional instability, anxiety, as manifested by unsatisfactory adaptation, instable nature, depression, low resistance to the stress situations

  16. Beclomethasone dipropionate hydrofluoroalkane for the treatment of allergic rhinitis.

    PubMed

    Ferrante, Giuliana; Montalbano, Laura; Cilluffo, Giovanna; Malizia, Velia; Marchese, Donatella; La Grutta, Stefania

    2016-01-01

    Allergic rhinitis (AR) is a common respiratory disease, and its prevalence is increasing all over the world, both in adults and in children. Patients experience symptoms that may negatively impact on physical, social and psychological well-being. Hence, if left untreated, allergic rhinitis may significantly affect quality of life. Under current guidelines, intranasal corticosteroids are considered the most effective drugs and they are recommended as first-line therapy. Among the several corticosteroid intranasal sprays available, beclomethasone dipropionate is one of the most prescribed. Recently, new intranasal hydrofluoroalkane-propelled formulations with little or no impact on the ozone layer have been developed for the treatment of AR. The use of these devices might improve patients' adherence to treatment, avoiding some of the most common side effects associated with aqueous formulations. This review provides the most recent evidence for the efficacy and safety of beclomethasone dipropionate hydrofluoroalkane nasal aerosol in the treatment of allergic rhinitis. PMID:26558604

  17. FEF(25-75) might be a predictive factor for bronchial inflammation and bronchial hyperreactivity in adolescents with allergic rhinitis.

    PubMed

    Ciprandi, G; Tosca, M A; Castellazzi, A M; Cairello, F; Salpietro, C; Arrigo, T; Miraglia Del Giudice, M

    2011-10-01

    Allergic rhinitis and asthma are closely associated. Bronchial hyperreactivity (BHR) is a pathophysiological characteristic of asthma. Allergic inflammation is characterized by eosinophilic infiltrate and may by indirectly assessed by exhaled nitric oxide (FeNO). Forced expiratory flow between 25 percent and 75 percent of vital capacity (FEF25-75) may predict BHR in adult patients with allergic rhinitis. The aim of this study was to evaluate the presence of BHR in a large group of adolescents with allergic rhinitis and whether FEF25-75 might be related with BHR and FeNO. Methods 150 adolescents with allergic rhinitis were enrolled. Clinical examination, skin prick test, spirometry, methacholine challenge, and FeNO were performed in all patients. Results Severe BHR is quite frequent in allergic adolescents. Impaired FEF25-75 values (such as less than 65 percent of predicted) constitute a relevant predictive factor for severe BHR (OR 4.4). FeNO levels were significantly related with BHR. Conclusion This study provides evidence that impaired FEF25-75 values might predict severe BHR and BHR is related with FeNO in adolescents. Therefore, BHR should be suspected in adolescents with low FEF25-75 values. PMID:22032781

  18. Allergic rhinitis: meaningful and less meaningful combination treatments including reminiscences.

    PubMed

    Szelenyi, I

    2014-06-01

    Allergic rhinitis (AR) results from a complex allergen-driven mucosal inflammation in the nasal cavity. Current guideline-based therapy for allergic rhinitis include oral and nasal antihistamines, topical and systemic glucocorticoids, decongestants, antimuscarinic agents, mast cell stabilizing drugs, leukotriene-receptor antagonists, and others. In spite of guideline recommendations, most patients are using multiple therapies in an attempt to achieve symptom control. Therefore, more effective therapies for the management of AR are clearly required. Recently, a novel fixed dose combination containing azelastine and fluticasone propionate has successfully been introduced. At present, it represents the only meaningful topical drug combination. Perhaps, it will be followed by others. PMID:24974572

  19. Moxibustion with Chinese herbal has good effect on allergic rhinitis

    PubMed Central

    Min, Cunyun; Peng, Congjian; Wei, Guojian; Huang, Xuhui; Fu, Tingting; Du, Yu; Wang, Changjun

    2015-01-01

    Allergic rhinitis (AR) is a chronic inflammatory disease of rhino-ocular mucosa, affecting up to 40% of population worldwide. Chinese herbal medicines and Acupuncture, adopted thousands of years in China, has good effect on allergic rhinitis. This study evaluates the effects of Moxibustion with Chinese herbal in treating patients with allergic rhinitis over a 1-year follow-up. A randomized controlled trial was conducted in a sample of 355 participants recruited from Guangdong general hospital of China. After baseline measurements, participants were randomly assigned to treatment-group or control group. Treatment group received Moxibustion with Chinese herbal. Control group received Loratadine. The main outcomes, including symptom severity and quality of life were measured using the Allergic Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ). Both moxibustion with Chinese herbal and Loratadine improve nose symptoms such as stuffy/blocked, sneezing, runny nose, itchy nose, sore nose and post-nasal drip in patients with AR. Symptoms fatigue, loss of taste, afraid of cold/wind and cold limb were improved significantly in moxibustion with Chinese herbal group. The mean quality of life scores decreased in both groups after treatment. Compare to control group, moxibustion with Chinese herbal is more effective than Loratadine in improving the quality of life in patients with AR. The results show moxibustion with Chinese herbal was effective to reduce symptoms and enhance quality of life in patients with allergic rhinitis. It is a simple, convenient and economic therapy for patients with AR. Further controlled trials of its effects in patients with allergic rhinitis are recommended. PMID:26629174

  20. Non-allergic rhinitis: a case report and review

    PubMed Central

    2010-01-01

    Rhinitis is characterized by rhinorrhea, sneezing, nasal congestion, nasal itch and/or postnasal drip. Often the first step in arriving at a diagnosis is to exclude or diagnose sensitivity to inhalant allergens. Non-allergic rhinitis (NAR) comprises multiple distinct conditions that may even co-exist with allergic rhinitis (AR). They may differ in their presentation and treatment. As well, the pathogenesis of NAR is not clearly elucidated and likely varied. There are many conditions that can have similar presentations to NAR or AR, including nasal polyps, anatomical/mechanical factors, autoimmune diseases, metabolic conditions, genetic conditions and immunodeficiency. Here we present a case of a rare condition initially diagnosed and treated as typical allergic rhinitis vs. vasomotor rhinitis, but found to be something much more serious. This case illustrates the importance of maintaining an appropriate differential diagnosis for a complaint routinely seen as mundane. The case presentation is followed by a review of the potential causes and pathogenesis of NAR. PMID:20181075

  1. Allergic rhinitis - what to ask your doctor - adult

    MedlinePlus

    Allergies to pollen, dust mites, and animal dander in the nose and nasal passages are also called allergic rhinitis. Hay fever is another word often used for this problem. Symptoms ... are questions you may want to ask your health care provider to ...

  2. Occupational rhinitis and occupational asthma; one airway two diseases?

    NASA Astrophysics Data System (ADS)

    Seed, M. J.; Gittins, M.; DeVocht, F.; Agius, R. M.

    2009-02-01

    The concept of 'one airway, one disease' refers to the frequent comorbidity of asthma and rhinitis. However, only limited research has been done on this association for the diverse range of occupational respiratory sensitisers. The relative frequency of rhinitis was determined for the 15 respiratory sensitisers reported to cause at least 10 cases of rhinitis or asthma to The Health and Occupation Reporting (THOR) network between 1997 and 2006. Of 1408 cases, 1190 were sole diagnoses of asthma, 138 sole diagnoses of rhinitis and in 80 cases asthma coexisted with rhinitis. The six sensitisers for which rhinitis featured in over 15% of cases were all particulates and known to cause release of mast cell mediators, either directly or through IgE antibodies. Four of the other nine sensitisers often exist as vapours and only two have been consistently associated with IgE-mediated disease mechanisms. Particle size did not appear to correlate with the relative frequency of rhinitis. Despite its limitations this study would support the hypothesis that there are at least two mechanistic categories of respiratory sensitisation with rhinitis being relatively more common where the mechanism is IgE-mediated. Particulate nature may be another important factor to consider in future studies.

  3. Investigation of the relationship between allergic rhinitis and personality traits using semeiometry.

    PubMed

    Gelis, N; Prokopakis, E; Helidonis, E; Velegrakis, G

    2007-07-01

    Mind-body interactions have been well recognized and are extendedly studied in the medical literature. There is evidence that the mind and body communicate with each other in a multidirectional flow of information by means of hormones, neurotransmitters/neuropeptides, cytokines, and semaphorines. There are consistent and convincing reports of links between stress and disease onset and progression, e.g. asthma. Growing evidence in the field of psychoneuroimmunology contributes to the understanding of the mechanisms by which stressful events affect physical health. The psychoneuroendocrine system can influence the immune response and thereby the capacity of the organism to cope with illness, and the immune system can have an impact on neuroendocrine function. Such cross-talk among systems is dependent upon feedback loops working to maintain homeostatic equilibrium. The immune system is capable of producing factors, which serve to integrate immune-neuroendocrine circuits with immunoregulatory and metabolic consequences for the organism. The interaction of the immune, nervous and endocrine system may drive an individual to a well recognized biological hypersensitivity and the creation of allergic symptoms (allergic rhinitis, asthma, atopic dermatitis, etc), followed by distinct behavioural patterns characterized as affective hypersensitivity. Semeiometry is a proper tool for large scale investigation of the psychological profile of patients with allergic rhinitis. Statistical analysis of semeiometry questionnaires processed by Greek adult patients in Crete island during 2005, showed that there is relation between occupation and allergy. Housewives, public services employees and private employees appear to be allergic in significantly higher percentage than others. With semeiometry we can find evidence of the bi-directional immunoendocrine--nervous system interactions in patients with allergic rhinitis. PMID:19582208

  4. Highly significant linkage to chromosome 3q13.31 for rhinitis and related allergic diseases

    PubMed Central

    Brasch‐Andersen, C; Haagerup, A; Børglum, A D; Vestbo, J; Kruse, T A

    2006-01-01

    Background Allergic diseases such as asthma and rhinitis have closely related phenotypes and often occur with atopy. They show strong familial and intra‐individual clustering, suggesting overlapping disease aetiology. Various loci and candidate genes have been suggested to underlie allergy. Many or all are still inconclusive. Following genome‐wide scans on multiple phenotypes, we previously suggested that chromosome 3q13.12–q21.2 harbours an allergy locus. Objective To identify candidate loci in the Danish population, two additional independent sets of sib‐pair families were fine‐scale mapped in candidate regions showing maximum likelihood scores (MLS) ⩾1.5 in the genome‐wide scans. Results Twenty eight microsatellite markers in a denser map on chromosome 3q were analysed in 236 allergy sib‐pair families including 125 sib pairs with rhinitis. We report significant evidence for linkage to chromosome 3q13.31 for rhinitis (MLS 5.55, identity by descent (IBD) 63.9%) and atopy (increased specific immunoglobulin E) (MLS 3.71, IBD 61.7%). We obtained an MLS of 5.1 (IBD 67.3%) at 3q13.31 when sib pairs with both rhinitis and atopy were analysed. Conclusion This study reports the first statistically significant evidence for a genetic susceptibility locus for rhinitis and to our knowledge shows the most significant evidence to date of linkage for any allergy phenotype. PMID:16525028

  5. [Epigenetics in allergic diseases and asthma].

    PubMed

    Castro-Rodríguez, José A; Krause, Bernardo J; Uauy, Ricardo; Casanello, Paola

    2016-01-01

    Allergic diseases and asthma are the result of complex interactions between genetic predisposition and environmental factors. Asthma is one of the most prevalent chronic disease among children. In this article we review some environmental factors like: allergen exposition, tobacco, bacteria, microbial components, diet, obesity and stress, which influences during intrauterine and infancy life in the epigenetic regulation of asthma and allergic diseases. The review has been done in three models: in-vitro, animal and human. PMID:27055949

  6. Pollen-induced antigen presentation by mesenchymal stem cells and T cells from allergic rhinitis.

    PubMed

    Desai, Mauli B; Gavrilova, Tatyana; Liu, Jianjun; Patel, Shyam A; Kartan, Saritha; Greco, Steven J; Capitle, Eugenio; Rameshwar, Pranela

    2013-10-01

    Mesenchymal stem cells (MSCs) are promising cellular suppressor of inflammation. This function of MSCs is partly due to their licensing by inflammatory mediators. In cases with reduced inflammation, MSCs could become immune-enhancer cells. MSCs can suppress the inflammatory response of antigen-challenged lymphocytes from allergic asthma. Although allergic rhinitis (AR) is also an inflammatory response, it is unclear if MSCs can exert similar suppression. This study investigated the immune effects (suppressor vs enhancer) of MSCs on allergen-stimulated lymphocytes from AR subjects (grass or weed allergy). In contrast to subjects with allergic asthma, MSCs caused a significant (P<0.05) increase in the proliferation of antigen-challenged lymphocytes from AR subjects. The increase in lymphocyte proliferation was caused by the MSCs presenting the allergens to CD4(+) T cells (antigen-presenting cells (APCs)). This correlated with increased production of inflammatory cytokines from T cells, and increased expressions of major histocompatibility complex (MHC)-II and CD86 on MSCs. The specificity of APC function was demonstrated in APC assay using MSCs that were knocked down for the master regulator of MHC-II transcription, CIITA. The difference in the effects of MSCs on allergic asthma and AR could not be explained by the sensitivity to the allergen, based on skin tests. Thus, we deduced that the contrasting immune effects of MSCs for antigen-challenged lymphocytes on AR and allergic asthma could be disease specific. It is possible that the enhanced inflammation from asthma might be required to license the MSCs to become suppressor cells. This study underscores the need for robust preclinical studies to effectively translate MSCs for any inflammatory disorder. PMID:25505949

  7. Effects of cetirizine versus terfenadine in seasonal allergic rhinitis.

    PubMed

    Lockey, R F; Findley, S; Mitchell, D Q; Woehler, T; Lieberman, P; Nicodemus, C F

    1993-04-01

    The purpose of this study was to compare the efficacy and safety of cetirizine, 10 mg, once daily in the morning to terfenadine, 60 mg, BID in the treatment of seasonal allergic rhinitis. The multicenter, single-blind, parallel study involved 160 patients, who were all included in the safety and efficacy analysis. The results of the study showed that both cetirizine, 10 mg, QD and terfenadine, 60 mg, BID used for 1 week are safe and effective in the management of allergic rhinitis. By repeated measures analysis, cetirizine improved symptoms more than terfenadine for the treatment period of days four to seven. Standard Cochran-Mantel-Haenszel statistics test showed the relative degree of patient satisfaction to be higher in the cetirizine group. PMID:8466096

  8. Subcutaneous Immunotherapy Improves the Symptomatology of Allergic Rhinitis.

    PubMed

    Lourenço, Edmir Américo; Caldeira, Eduardo José; Carvalho, César Alexandre Fabrega; Cunha, Marcelo Rodriques; Carvalho, Marcus Vinícius Henriques; Passos, Saulo Duarte

    2016-01-01

    Introduction The relevance of allergic rhinitis is unquestionable. This condition affects people's quality of life and its incidence has increased over the last years. Objective Thus, this study aims to analyze the effectiveness of subcutaneous injectable immunotherapy in cases of nasal itching, sneeze, rhinorrhea and nasal congestion in allergic rhinitis patients. Methods In the present study, the same researcher analyzed the records of 281 patients. Furthermore, the researchers identified allergens through puncture cutaneous tests using standardized extracts containing acari, fungi, pet hair, flower pollen, and feathers. Then, the patients underwent treatment with subcutaneous specific immunotherapy, using four vaccine vials for desensitization, associated with environmental hygiene. The authors analyzed conditions of nasal itching, sneeze, rhinorrhea, and nasal congestion throughout the treatment, and assigned them with a score ranging from zero (0), meaning absence of these symptoms to three (3), for severe cases. The symptoms were statistically compared in the beginning, during, and after treatment. Results In this study, authors analyzed the cases distribution according to age and the evolution of symptomatology according to the scores, comparing all phases of treatment. The average score for the entire population studied was 2.08 before treatment and 0.44 at the end. These results represent an overall improvement of ∼79% in symptomatology of allergic rhinitis in the studied population. Conclusion The subcutaneous immunotherapy as treatment of allergic rhinitis led to a reduction in all symptoms studied, improving the quality of life of patients, proving itself as an important therapeutic tool for these pathological conditions. PMID:26722338

  9. Allergen Challenge Chamber: an innovative solution in allergic rhinitis diagnosis

    PubMed Central

    Sowa, Jerzy; Wojas, Oksana; Piekarska, Barbara; Sybilski, Adam; Samoliński, Bolesław

    2015-01-01

    The Allergen Challenge Chamber (ACC) is definitely a serious challenge on the one hand and an innovative solution in allergic rhinitis diagnosis on the other. The gradual validation of the chamber (according to the test protocol) will allow for standardisation, which is a process undertaken by centres worldwide. The process of designing a consistent system that allows for creating conditions as those in the case of natural inhalation took into account all the aspects (technical specification) necessary to ensure appropriate inhalation. PMID:26755904

  10. Subcutaneous Immunotherapy Improves the Symptomatology of Allergic Rhinitis

    PubMed Central

    Lourenço, Edmir Américo; Caldeira, Eduardo José; Carvalho, César Alexandre Fabrega; Cunha, Marcelo Rodriques; Carvalho, Marcus Vinícius Henriques; Passos, Saulo Duarte

    2015-01-01

    Introduction The relevance of allergic rhinitis is unquestionable. This condition affects people's quality of life and its incidence has increased over the last years. Objective Thus, this study aims to analyze the effectiveness of subcutaneous injectable immunotherapy in cases of nasal itching, sneeze, rhinorrhea and nasal congestion in allergic rhinitis patients. Methods In the present study, the same researcher analyzed the records of 281 patients. Furthermore, the researchers identified allergens through puncture cutaneous tests using standardized extracts containing acari, fungi, pet hair, flower pollen, and feathers. Then, the patients underwent treatment with subcutaneous specific immunotherapy, using four vaccine vials for desensitization, associated with environmental hygiene. The authors analyzed conditions of nasal itching, sneeze, rhinorrhea, and nasal congestion throughout the treatment, and assigned them with a score ranging from zero (0), meaning absence of these symptoms to three (3), for severe cases. The symptoms were statistically compared in the beginning, during, and after treatment. Results In this study, authors analyzed the cases distribution according to age and the evolution of symptomatology according to the scores, comparing all phases of treatment. The average score for the entire population studied was 2.08 before treatment and 0.44 at the end. These results represent an overall improvement of ∼79% in symptomatology of allergic rhinitis in the studied population. Conclusion The subcutaneous immunotherapy as treatment of allergic rhinitis led to a reduction in all symptoms studied, improving the quality of life of patients, proving itself as an important therapeutic tool for these pathological conditions. PMID:26722338

  11. Aeroallergens, atopy and allergic rhinitis in the Middle East.

    PubMed

    Goronfolah, L

    2016-01-01

    The literature on the nature and prevalence of indoor and/or outdoor aeroallergens, atopy and symptoms of rhinitis and asthma in the Middle East region (defined here as Bahrain, Egypt, Iran, Iraq, Israel, Jordan, Kuwait, Lebanon, Oman, Palestine, Qatar, Kingdom of Saudi Arabia - KSA, Syria, United Arab Emirates and Yemen) was reviewed. Although documentation was poor in all countries other than Iran and the KSA, a wide range of "global" and "local" aeroallergens (grass, weed and tree pollens, fungal spores, insect allergens, dander, and house dust mites) has been observed across the region. The prevalence of current self-reported or parent-reported symptoms of rhinitis ranged from 9% to 38%. Researchers have suggested that the high atopy rates and self-reported rhinitis rates are associated with an on-going shift towards a "western" lifestyle. PMID:26808447

  12. Natural Course of Allergic and Nonallergic Rhinitis After 2 Years in Korean Children

    PubMed Central

    Lee, Seung-Hoon; Choi, Ji Ho; Suh, Jeffrey D.; Chung, Sochung; Hong, Seok-Chan; Kim, Jin Kook; Cho, Jae Hoon

    2016-01-01

    Objectives. Allergic and nonallergic rhinitis are very common disease for children, however, little is known about their natural courses in the general population. The purpose is to evaluate the natural course of allergic and nonallergic rhinitis in children. Methods. We analyzed data from Snoring Child Cohort of 178 children (107 boys and 71 girls). All children entered the study at the age of 7 years (range, 6.5 to 7.4 years). Questionnaires regarding chronic rhinitis, a skin prick test (SPT) for 5 inhalent allergens, and specific IgE for 2 dust mites were administered. Children were classified into 4 groups: allergic rhinitis (rhinitis, positive SPT), nonallergic rhinitis (rhinitis, negative SPT), sensitization only (no rhinitis, positive SPT), and control (no rhinitis, negative SPT). We repeated follow them annually, and analyzed the data of first and third year for this study. Results. Finally, the data of 122 children were analyzed. Among 18 children with allergic rhinitis at 7 year, 13 (72%) became sensitization only after 2 years and 5 (28%) were remained having allergic rhinitis. Five out of 19 children (26%) with nonallergic rhinitis developed into allergic rhinitis and 7 (37%) into control at 9 years. Twenty-four out of 28 children (86%) with sensitization only at 7 years remained the same at 9 years. Among 57 control children at 7 year, 2 (4%) developed into allergic rhinitis, 7 (12%) with nonallergic rhinitis, and 16 (28%) with sensitization only at 9 years. Conclusion. The status of chronic rhinitis and allergen sensitization is ever-changing in children. PMID:27095517

  13. A common IL-13 Arg130Gln single nucleotide polymorphism among Chinese atopy patients with allergic rhinitis.

    PubMed

    Wang, Min; Xing, Zhi-Min; Lu, Chao; Ma, You-Xiang; Yu, De-Lin; Yan, Zheng; Wang, Shen-Wu; Yu, Li-Sheng

    2003-10-01

    Allergic rhinitis is a major public health problem and has seen its prevalence increase during the past few decades. Interleukin 13 (IL-13) has been implicated in the pathogenesis and in the regulation of immunoglobulin E (IgE) production. Single nucleotide polymorphisms (SNPs) have been found in both the coding sequence and the promoter region of IL-13, and such SNPs have been associated with allergic asthma. We have investigated whether IL-13 SNPs are associated with allergic rhinitis. Among 188 Chinese adult patients with allergic rhinitis and 87 normal controls, no significant difference was found in either allele or haplotype frequency of the SNPs between the two groups. Within patients, there was a significant association of the IL-13 Arg130Gln SNP, but not of the IL-13 promoter -1112(C/T) SNP, with serum total IgE levels. Patients with a Gln/Gln genotype showed much higher serum total IgE than those with an Arg/Arg genotype. When tested for serum-specific IgE, patients allergic to Derp 1, but not those allergic to Artemisia pollen, showed a significant association with the IL-13 promoter SNP. Thus, our results suggest a possible involvement of IL-13 SNPs in the regulation of IgE production in response to allergens in this Chinese population. PMID:12928861

  14. Asthma and Allergic Diseases in Pregnancy: A Review

    PubMed Central

    2009-01-01

    Asthma and allergic disorders can affect the course and outcome of pregnancy. Pregnancy itself may also affect the course of asthma and related diseases. Optimal management of these disorders during pregnancy is vital to ensure the welfare of the mother and the baby. Specific pharmacological agents for treatment of asthma or allergic diseases must be cautiously selected and are discussed here with respect to safety considerations in pregnancy. Although most drugs do not harm the fetus, this knowledge is incomplete. Any drug may carry a small risk that must be balanced against the benefits of keeping the mother and baby healthy. The goals and principles of management for acute and chronic asthma, rhinitis, and dermatologic disorders are the same during pregnancy as those for asthma in the general population. Diagnosis of allergy during pregnancy should mainly consist of the patient's history and in vitro testing. The assured and well-evaluated risk factors revealed for sensitization in mother and child are very limited, to date, and include alcohol consumption, exposure to tobacco smoke, maternal diet and diet of the newborn, drug usage, and insufficient exposure to environmental bacteria. Consequently, the recommendations for primary and secondary preventive measures are also very limited in number and verification. PMID:21151812

  15. Skin Prick Test Analysis in Allergic Rhinitis Patients: A Preliminary Study in Abuja, Nigeria

    PubMed Central

    Ibekwe, T. S.

    2016-01-01

    Allergic rhinitis (AR) is prevalent in Nigeria, though little information exists on the allergen. We assessed the clinical features of AR patients in our environment based on the allergic rhinitis impact on asthma (ARIA) classification. Only patients with positive skin prick test (SPT) were recruited. Seventy-four patients participated in the study. AR and asthma comorbidity were observed in 13.5%. The proportion of “sneezers-runners” was higher than “blockers” with significantly more “sneezers-runners” having persistent AR (P = 0.007). No relationship was established between these predominant symptoms and the aeroallergens used in this study. Intermittent mild and moderate/severe AR were evident in 13.5% and 31.1%, while persistent mild and moderate/severe were seen in 20.3% and 35.1%, respectively. House dust mites allergen yielded the highest number of positive responses (22.6%) followed by tree pollen (16.8%). No relationship was observed between the allergens tested and AR severity. Majority of patients were oligosensitive (33.8%) and polysensitive (35.1%) and were not significantly associated with AR severity (P = 0.07). Most AR patients presenting for treatment in Abuja, Nigeria, had moderate-severe persistent AR and showed similar SPT sensitization pattern with countries having similar climatic conditions. Sensitization patterns were not related to ARIA classification or predominant AR symptoms. PMID:27247577

  16. Weighted Road Density and Allergic Disease in Children at High Risk of Developing Asthma

    PubMed Central

    Hansell, Anna L.; Rose, Nectarios; Cowie, Christine T.; Belousova, Elena G.; Bakolis, Ioannis; Ng, Kitty; Toelle, Brett G.; Marks, Guy B.; Almqvist, plus Catarina; Ampon, Rosario D; Ayer, Julian; Bird, Tessa; Brew, Bronwyn K; Britton, Warwick J; Celermajer, David; Cowell, Christopher T; Crisafulli, Daniele; Criss, Sally; Davis, Stella; Nabil Ezz, Wafaa; Forbes, Samantha; Garden, Frances L; Kemp, Andrew S; Knezevic, Natalia; Krause, William; Leeder, Stephen R; Mellis, Craig M; Mihrshahi, Seema; Neumann, Mark; Peat, Jennifer K; Quinones-Lucio, Andres; Skilton, Michael; Tattam, Anne; Tovey, Euan R; Vanlaar, Carl H.; Vukasin, Nicola; Wainwright, Craig; Webb, Karen L; Weber-Chrysochoou, Christina; Woolcock, Ann J; Zhou, Jie

    2014-01-01

    Background Evidence for an association between traffic-related air pollution and allergic disease is inconsistent, possibly because the adverse effects may be limited to susceptible subgroups and these have not been identified. This study examined children in the Childhood Asthma Prevention Study (CAPS), potentially susceptible to air pollution effects because of a family history of asthma. Methods We examined cross-sectional associations at age eight years between road density within 75 m and 50 m of home address weighted by road type (traffic density), as a proxy for traffic-related air pollution, on the following allergic and respiratory outcomes: skin prick tests (SPTs), total and specific serum IgE, pre- and post-bronchodilator lung function, airway hyperresponsiveness, exhaled NO, and reported asthma and rhinitis. Results Weighted road density was positively associated with allergic sensitisation and allergic rhinitis. Adjusted relative risk (RR) for house dust mite (HDM) positive SPT was 1.25 (95% CI: 1.06–1.48), for detectable house dust mite-specific IgE was 1.19 (95% CI: 1.01–1.41) and for allergic rhinitis was 1.30 (95% CI: 1.03–1.63) per 100 m local road or 33.3 m motorway within 50 m of home. Associations were also seen with small decrements of peak and mid-expiratory flows and increased risk of asthma, current wheeze and rhinitis in atopic children. Conclusion Associations between road density and allergic disease were found in a potentially susceptible subgroup of children at high risk of developing atopy and asthma. PMID:24949625

  17. High prevalence of rhinitis symptoms without allergic sensitization in Estonia and Finland

    PubMed Central

    Pallasaho, Paula; Kainu, Annette; Juusela, Maria; Meren, Mari; Sovijärvi, Anssi

    2015-01-01

    Objectives Allergic rhinitis and atopy are more common in urban than rural environments. Non-allergic rhinitis has not been studied to a great extent. We aimed to assess the relationship of rhinitis symptoms with different profiles of allergic sensitization, comparing this in rural and urban environments. Methods The study population consisted of population-based cohorts of adults aged 26–60 from Helsinki, Finland, and rural Saaremaa and urban Tallinn, Estonia. We compared the results of a structured interview and skin prick tests and assessed the risk factors for rhinitis. Results The prevalence of rhinitis symptoms with atopy was 32.7% in Helsinki, 20.8% in Tallinn, and 12.5% in Saaremaa (p<0.001). Rhinitis symptoms without atopy were found in 26.4%, 29.8%, and 29.3% (p=n.s.), respectively. In Helsinki, 87.3% of participants with atopy identified symptoms as allergic, compared to 57.0% in Tallinn and 47.5% in Saaremaa. Childhood in the countryside (OR 0.63), family history of allergic rhinitis (OR 1.89), and polysensitization (OR 15.99) were significantly associated with rhinitis symptoms with atopy in a multivariate logistic regression model. The most common sensitizers were pollens and animals in Helsinki and mites in Estonia. Exposure to environmental tobacco smoke (OR 1.50) and family history of allergic rhinitis (OR 1.70) were associated with rhinitis symptoms without atopy. Conclusion Rhinitis symptoms without allergic sensitization were common in both Finland and Estonia and were associated with environmental tobacco smoke. Family history of allergic rhinitis predisposed to rhinitis symptoms irrespective of atopy status. PMID:26557256

  18. 32 Peak Nasal Inspiratory Flow Levels in Children With Allergic Rhinitis and Their Health Related Quality of Life (HRQL)

    PubMed Central

    Nagaraju, Major K.

    2012-01-01

    Background Allergic rhinitis impairs the quality of life children. There is paucity of data with regards to clinical profile and health related quality of life (HRQL) of children with Allergic rhinitis in India and hence we studied the clinical profile and measured Peak nasal inspiratory flow (PNIF) of children with allergic rhinitis in an urban population, and assessed their Quality of life. Methods Children with moderate to severe persistent Allergic rhinitis, diagnosed as per Allergic Rhinitis and Impact on Asthma (ARIA) guidelines, in the age group of 6 to 18 years were included in this study. The quality of life questionnaire, pediatric and adolescent by Juniper et al was used. PNIF was measured by using ‘In- Check’ peak nasal inspiratory flow meter. Results Of the 100 children studied, 70 (70%) were in the age group of 6 to 11years and 30/100 (30%) were between 12 and 18 years of age. An equal distribution of sex was observed in 6 to 11 year age group, and in the 12 to 18 year age group there was a male preponderance (1.9:1). Majority (87%) of children in our study had Moderate Allergic rhinitis and 13% had severe Allergic rhinitis. Bronchial asthma, a commonly reported entity in Allergic rhinitis was seen in 19% of the cases. 66% of children in our study had PNIF values of the fifth to 50th percentile where as 24% were in the third to fifth percentile and 10% had their PNIF values less than third percentile. PNIF showed a linear correlation with severity of allergic rhinitis. HRQL assessment showed that children in the 6 to 11 year group had derangement in the activity and physical symptoms domain while children in the12 to 18 year group had predominately involvement of emotional and practical problem domains. Quality of life score worsened with decrease in PNIF. Conclusions PNIF is very useful tool to quantify the nasal obstruction in Allergic Rhinitis. PNIF is easy to administer, reproducible and correlates well with the severity of the disease. HRQL

  19. Survey on the Prevalence of Allergic Rhinitis and its Effect on the Quality of High School Students’ Life

    PubMed Central

    Amizadeh, Maryam; Safizadeh, Hossein; Bazargan, Nasrin; Farrokhdoost, Zahra

    2013-01-01

    Introduction: Allergic rhinitis (AR) is a common airway disease. In order to study the prevalence of AR in high school students in Kerman, the Score for Allergic Rhinitis (SFAR) was used and the quality of life in the students affected by rhinitis was evaluated using the SF-36 questionnaire. Materials and Methods: This was a cross-sectional, analytical, descriptive study, based on the SFAR scale. Quality of life in students with AR was evaluated using the SF-36 questionnaire. Results: From 1511 students who completed the SFAR questionnaire, 291 (52.6%, girls; 47.4%, boys) had AR. Domestic dust was the most common cause of the disease. The most common symptoms of AR were rhinorrhea (76.6%), epiphora (76.3%), nasal congestion (64.3%), and itching (54.3%). According to the ARYA scale, (Allergic Rhinitis and its Impact on Asthma), 41.9% of students had moderate-to-severe rhinitis and 58.1% had mild rhinitis. A total of 43.1% of patients with moderate-to-severe rhinitis had a persistent condition and 56.9% had an intermediate condition. Results of the SF-36 questionnaire among students with AR showed a significant difference in physical functioning and bodily pain in comparison with healthy students. Conclusion: The results of this study show that the prevalence of AR among Kerman high school students is 19.3%. Because of the effect of this disease on the life quality of high school students in terms of both physical functioning and bodily pain, efforts should be made to reduce allergen levels as far as possible. PMID:24303424

  20. Academic Functioning and Quality of Life of Children and Adolescents with Allergic Rhinitis--Part I

    ERIC Educational Resources Information Center

    McCabe, Paul C.

    2008-01-01

    This article is the first of a two-part series on allergic rhinitis. Allergic rhinitis, which includes seasonal allergies, has been considered by physicians, parents, and the general public as a mild, transitory nuisance for children and adults that is easily remedied with over-the-counter or prescription medications. Recent research, however,…

  1. A Survey of Clinical Features of Allergic Rhinitis in Adults

    PubMed Central

    Frati, Franco; Dell’Albani, Ilaria; Passalacqua, Giovanni; Bonini, Sergio; Rossi, Oliviero; Senna, Gianenrico; Incorvaia, Cristoforo

    2014-01-01

    Background Allergic rhinitis (AR) has high prevalence and substantial socio-economic burden. Material/Methods The study included 35 Italian Centers recruiting an overall number of 3383 adult patients with rhinitis (48% males, 52% females, mean age 29.1, range 18–45 years). For each patient, the attending physician had to fill in a standardized questionnaire, covering, in particular, some issues such as the ARIA classification of allergic rhinitis (AR), the results of skin prick test (SPT), the kind of treatment, the response to treatment, and the satisfaction with treatment. Results Out of the 3383 patients with rhinitis, 2788 (82.4%) had AR: 311 (11.5%) had a mild intermittent, 229 (8.8%) a mild persistent, 636 (23.5%) a moderate-severe intermittent, and 1518 (56.1%) a moderate-severe persistent form. The most frequently used drugs were oral antihistamines (77.1%) and topical corticosteroids (60.8%). The response to treatment was judged as excellent in 12.2%, good in 41.3%, fair in 31.2%, poor in 14.5%, and very bad in 0.8% of subjects. The rate of treatment dissatisfaction was significantly higher in patients with moderate-to-severe AR than in patients with mild AR (p<0.0001). Indication to allergen immunotherapy (AIT) was significantly more frequent (p<0.01) in patients with severe AR than with mild AR. Conclusions These findings confirm the appropriateness of ARIA guidelines in classifying the AR patients and the association of severe symptoms with unsuccessful drug treatment. The optimal targeting of patients to be treated with AIT needs to be reassessed. PMID:25366169

  2. [Intermittent or persistent rhinitis in children and adolescents with Asthma: «the Swiss LARA paediatrics survey»].

    PubMed

    Leuppi, J D; Wildhaber, J H; Spertini, F; Helbling, A

    2011-10-01

    Asthma and allergic rhinitis are chronic inflammatory airway diseases which often occur concomitantly. The objective of the LARA program was to identify the comorbidities and characteristics of asthma (A), intermittent or persistent rhinitis (IPR) and physician defined atopic dermatitis (AD) in 6- to 16-year old asthmatic Swiss children and adolescents. Overall, 126 general practitioners and paediatricians collected the data of 670 asthmatics. Approximately one third of the asthmatic children in Switzerland had well-controlled asthma. Almost two thirds of these asthmatics suffered from concomitant IPR. The latter presented with significantly less symptoms while the treatment rates with inhaled corticosteroids (approximately 90%) and leukotriene-receptorantagonists (approximately 50%) were comparable. However, there were almost twice as many passive smokers in the less well-controlled group. The prevalence of AD was similar in both groups. IPR and AD may play an important role as risk factors in the future development of asthma. PMID:21971616

  3. The prevalence and risk factors of asthma and allergic diseases among working adolescents.

    PubMed

    Cakir, Erkan; Ersu, Refika; Uyan, Zeynep Seda; Oktem, Sedat; Varol, Nezih; Karakoc, Fazilet; Karadag, Bulent; Akyol, Mesut; Dagli, Elif

    2010-01-01

    Certain occupational groups are known to be at particularly high risk of developing allergic diseases. The objective of the present study was to evaluate the prevalence of allergic diseases among working adolescents. The International Study of Asthma and Allergies in Childhood questionnaire was used. Four hundred and thirty six adolescents working in motor, lathe-finish, coiffure and textile and 366 high school students as control group were enrolled to the study. Mean age was 16.8 +/- 1.2 years and 82.9% of them were male. There was no significant difference among groups for ever and current wheezing while doctor diagnosed asthma was higher in lathe- finish group (p = 0.036). Family history of allergy, history of allergic rhinitis, and active smoking were found to be risk factors for asthma and related symptoms. Working in coiffure (p = 0.054), and textile (p = 0.003) were significant risk factors for ever allergic rhinitis. Working in lathe finish (p = 0.023), coiffure (p = .002), and textile (p < 0.001) were associated with a higher risk for current allergic rhinitis. Working in coiffure was a risk factor for ever eczema (p = 0.008) and doctor diagnosed eczema (p = 0.014). It was concluded that working in lathe-finish was associated with doctor diagnosed asthma and active smoking was a risk factor for asthma and related symptoms. Working in coiffure, textile and lathe- finish were risk factors for rhinitis, and working in coiffure was a risk factor for eczema. Preventive measures should be taken at the onset of employment in order to prevent or reduce the detrimental effects of exposures in these occupational groups. PMID:21038780

  4. Association Between Neonatal Urinary Tract Infection and Risk of Childhood Allergic Rhinitis

    PubMed Central

    Lin, Chien-Heng; Lin, Wei-Ching; Wang, Yu-Chiao; Lin, I. Ching; Kao, Chia-Hung

    2015-01-01

    Abstract The current population-based study investigated the onset of neonatal urinary tract infection (UTI) and the associated risks of allergic rhinitis. From 2000 to 2005, 3285 children with neonatal UTI and 13,128 randomly selected controls were enrolled from the National Health Insurance Research Database in Taiwan and frequency matched by gender, urbanization of residential area, parental occupation, and baseline year. We compared the risk of allergic rhinitis between the non-UTI and UTI cohorts by performing multivariable Cox regression analysis. We observed a significant relationship between UTI and allergic rhinitis. This study examined 16,413 patients, among whom 3285 had UTI and 13,128 did not have UTI. The overall incidence rate ratio of allergic rhinitis was 1.41-fold higher in the UTI cohort than in the non-UTI cohort (100.2 vs 70.93 per 1000 person-y). After potential risk factors were adjusted for, the adjusted hazard ratio of allergic rhinitis was 1.32 (95% confidence interval = 1.23–1.41). Regardless of gender, the UTI cohort had a higher risk of allergic rhinitis than that of the non-UTI cohort. The patients with UTI in different follow-up durations were equally susceptible to developing allergic rhinitis compared with those without UTI, especially in follow-up durations shorter than 5 years. Patients with UTI and particular comorbidities such as infections and neonatal jaundice had a significantly increased risk of allergic rhinitis. UTI in newborns is significantly associated with the development of allergic rhinitis in childhood and might be a risk factor for subsequent childhood allergic rhinitis. PMID:26402832

  5. Local Effect of Neurotrophin-3 in Neuronal Inflammation of Allergic Rhinitis: Preliminary Report

    PubMed Central

    İsmi, Onur; Özcan, Cengiz; Karabacak, Tuba; Polat, Gürbüz; Vayisoğlu, Yusuf; Güçlütürk, Taylan; Görür, Kemal

    2015-01-01

    Background: Allergic rhinitis is a common inflammatory nasal mucosal disease characterized by sneezing, watery nasal discharge, nasal obstruction and itching. Although allergen-specific antibodies play a main role in the allergic airway inflammation, neuronal inflammation may also contribute to the symptoms of allergic rhinitis. Neuronal inflammation is primarily caused by the stimulation of sensory nerve endings with histamine. It has been shown that neurotrophins may also have a role in allergic reactions and neuronal inflammation. Nerve growth factor, neurotrophin 3 (NT-3), neurotrophin 4/5 and brain-derived neurotrophic factor are members of the neurotrophin family. Although nerve growth factor and brain-derived neurotrophic factor are well studied in allergic rhinitis patients, the exact role of Neurotrophin-3 is not known. Aims: To investigate the possible roles of neurotrophin-3 in allergic rhinitis patients. Study Design: Case-control study. Methods: Neurotrophin-3 levels were studied in the inferior turbinate and serum samples of 20 allergic rhinitis and 13 control patients. Neurotrophin-3 staining of nasal tissues was evaluated by immunohistochemistry and ELISA was used for the determination of serum Neurotrophin-3 levels. Results: Neurotrophin-3 staining scores were statistically higher in the study group than in the control patients (p=0.001). Regarding serum Neurotrophin-3 levels, no statistically significant difference could be determined between allergic rhinitis and control patients (p=0.156). When comparing the serum NT-3 levels with tissue staining scores, there were no statistically significant differences in the allergic rhinitis and control groups (p=0.254 for allergic rhinitis and p=0.624 for control groups). Conclusion: We suggest that Neurotrophin-3 might affect the nasal mucosa locally without being released into the systemic circulation in allergic rhinitis patients. PMID:26740895

  6. Role of Crosstalk between Epithelial and Immune Cells, the Epimmunome, in Allergic Rhinitis Pathogenesis.

    PubMed

    Kamekura, Ryuta; Yamashita, Keiji; Jitsukawa, Sumito; Nagaya, Tomonori; Ito, Fumie; Ichimiya, Shingo; Himi, Tetsuo

    2016-01-01

    Recently, the prevalence of allergic rhinitis has been dramatically increasing worldwide. As conventional therapies for allergic rhinitis, such as antihistamines, leukotriene receptor antagonists, nasal sprays and allergen immunotherapy, have limitations, the development of new drugs is required. Recent studies have revealed that epithelial cell-derived cytokines, including thymic stromal lymphopoietin, interleukin (IL)-25 and IL-33, are able to control immune cells, such as dendritic cells and T cells, thereby acting as 'master switches' in allergic disease. In addition, new roles have been identified for follicular helper T cells and regulatory B cells in allergic disease, and they are considered to be promising targets for new therapies. Thus, crosstalk between epithelial and immune cells, the epimmunome, underlies the pathogenesis of allergic rhinitis. Greater understanding of the epimmunome may lead to breakthroughs in the development of new treatments for allergic rhinitis and will help us cure many patients suffering from its severe symptoms in the future. PMID:27116609

  7. Clinical Distinctness of Allergic Rhinitis in Patients with Allergy to Molds

    PubMed Central

    Kołodziejczyk, Krzysztof

    2016-01-01

    Introduction. Molds are a very diverse group of allergens. Exposure and sensitization to fungal allergens can promote the development and worsening of allergic rhinitis (AR). Objective. The natural course of allergic rhinitis was compared between a group of patients with allergy to molds and patients with AR to other allergens as the control groups. Material and Methods. The study group consisted of 229 patients, with a mean age of 27.4 ± 6.5 yrs. The study group was compared to groups of AR patients with allergy to house dust mites or pollens or with multivalent allergy. Allergic sensitization was assessed using the skin prick test (SPT) with a panel of 15 allergens to molds and other common inhalant allergens. Specific IgEs against all tested allergens were measured. Nasal fractional exhaled nitric oxide (FeNO) level was assessed with a chemiluminescence analyzer (NIOX MINO) and compared between groups. Cluster analysis was performed for determine models of AR in whole population. Results. Patients with allergy to mold have had AR with a higher blockage of nose than in the patients with other allergies. Alternaria alternata (59% of examined), Cladosporium herbarum (40%), and Aspergillus fumigatus (36%) were the predominant allergens in the study group. Patients with allergy to mold were more often present in two clusters: there were patients with more frequent accompanying asthma and high level of FeNO. Conclusion. Patients with allergy to molds have a significantly greater predisposition for bronchial asthma and high concentration of FeNO. PMID:27340656

  8. dsRNA-induced changes in gene expression profiles of primary nasal and bronchial epithelial cells from patients with asthma, rhinitis and controls

    PubMed Central

    2014-01-01

    Background Rhinovirus infections are the most common cause of asthma exacerbations. The complex responses by airway epithelium to rhinovirus can be captured by gene expression profiling. We hypothesized that: a) upper and lower airway epithelium exhibit differential responses to double-stranded RNA (dsRNA), and b) that this is modulated by the presence of asthma and allergic rhinitis. Objectives Identification of dsRNA-induced gene expression profiles of primary nasal and bronchial epithelial cells from the same individuals and examining the impact of allergic rhinitis with and without concomitant allergic asthma on expression profiles. Methods This study had a cross-sectional design including 18 subjects: 6 patients with allergic asthma with concomitant rhinitis, 6 patients with allergic rhinitis, and 6 healthy controls. Comparing 6 subjects per group, the estimated false discovery rate was approximately 5%. RNA was extracted from isolated and cultured primary epithelial cells from nasal biopsies and bronchial brushings stimulated with dsRNA (poly(I:C)), and analyzed by microarray (Affymetrix U133+ PM Genechip Array). Data were analysed using R and the Bioconductor Limma package. Overrepresentation of gene ontology groups were captured by GeneSpring GX12. Results In total, 17 subjects completed the study successfully (6 allergic asthma with rhinitis, 5 allergic rhinitis, 6 healthy controls). dsRNA-stimulated upper and lower airway epithelium from asthma patients demonstrated significantly fewer induced genes, exhibiting reduced down-regulation of mitochondrial genes. The majority of genes related to viral responses appeared to be similarly induced in upper and lower airways in all groups. However, the induction of several interferon-related genes (IRF3, IFNAR1, IFNB1, IFNGR1, IL28B) was impaired in patients with asthma. Conclusions dsRNA differentially changes transcriptional profiles of primary nasal and bronchial epithelial cells from patients with allergic

  9. Fluticasone furoate nasal spray in the treatment of allergic rhinitis

    PubMed Central

    Giavina-Bianchi, Pedro; Agondi, Rosana; Stelmach, Rafael; Cukier, Alberto; Kalil, Jorge

    2008-01-01

    Allergic rhinitis (AR) is a prevalent disease with great morbidity and significant societal and economic burden. Intranasal corticosteroids are recommended as first-line therapy for patients with moderate-to-severe disease, especially when nasal congestion is a major component of symptoms. To compare the efficacy and safety profile of different available intranasal corticosteroids for the treatment of AR, it is important to understand their different structures and pharmacokinetic and pharmacodynamic properties. Knowledge of these drugs has increased tremendously over the last decade. Studies have elucidated mechanisms of action, pharmacologic properties, and the clinical impact of these drugs in allergic respiratory diseases. Although the existing intranasal corticosteroids are already highly efficient, the introduction of further improved formulations with a better efficacy/safety profile is always desired. Fluticasone furoate nasal spray is a new topical corticosteroid, with enhanced-affinity and a unique side-actuated delivery device. As it has high topical potency and low potential for systemic effects, it is a good candidate for rhinitis treatment. PMID:18728833

  10. The activity of recent anti-allergic drugs in the treatment of seasonal allergic rhinitis.

    PubMed

    Wang, D; Clement, P; Smitz, J; De Waele, M

    1996-01-01

    Two experiments were performed during the pollen season to study the activity of different antiallergic drugs in the treatment of seasonal allergic rhinitis. Nasal allergen challenge (NAC) was performed to mimic an acute attack of allergic rhinitis and to objectively evaluate the effect of the drugs on the early-phase reaction during the season. The first study assessed the effect of H1 (Cetirizine 10 mg a day) and of a combination of H1 (Cetirizine 10 mg) plus H2 (Cimetidine 800 mg a day) antagonists on nasal symptoms, mediator release and eosinophil count in a group of 16 patients with seasonal allergic rhinitis. During the same season a second study compared in a randomized way (2 parallel groups) the effect of Budesonide (Rhinocort Aqua) and Azelastine (Allergodil nasal spray) in a group of 14 patients. Results showed that both antihistamines, applied topically of dosed orally, reduced sneezing even when significant increases of histamine concentration in nasal secretions were evidenced immediately after NAC. When a combination of Cetirizine and Cimetidine was administered, a significant (p < 0.01) reduction of nasal airway resistance and increase of nasal airflow after NAC were demonstrated as well. In addition, topical application of Budesonide showed a strong (p < 0.01) effect on the infiltration and activation of eosinophils during the season, and on tryptase release after NAC. These effects lasted at least for one week after therapy. PMID:8669268

  11. Bronchial reactivity and allergy-promoting factors in monozygotic twins discordant for allergic rhinitis.

    PubMed

    Ericsson, C H; Svartengren, M; Mossberg, B; Pedersen, N; Camner, P

    1991-07-01

    Bronchial reactivity was studied twice in eight monozygotic twin pairs discordant for allergic rhinitis with pollen hypersensitivity, during the winter season (all eight pairs) and during the pollen season (seven pairs). On both occasions, the allergic twins showed significantly higher reactivity than their nonallergic siblings. The results indicate that moderate allergic rhinitis is associated with increased bronchial reactivity. This increased reactivity is an acquired trait; however, bronchial reactivity is not constantly increased in pollen rhinitis and may be normal even during the pollen season. The symptoms of allergic rhinitis usually started in childhood before the separation of the siblings. We could not demonstrate any major differences in exposure to allergens or airway irritants between the siblings. The allergic twins tended to have lower birth weight and insufficient weight increase just after birth. PMID:1859042

  12. Personalized symptoms forecasting for pollen-induced allergic rhinitis sufferers

    NASA Astrophysics Data System (ADS)

    Voukantsis, D.; Berger, U.; Tzima, F.; Karatzas, K.; Jaeger, S.; Bergmann, K. C.

    2015-07-01

    Hay fever is a pollen-induced allergic reaction that strongly affects the overall quality of life of many individuals. The disorder may vary in severity and symptoms depending on patient-specific factors such as genetic disposition, individual threshold of pollen concentration levels, medication, former immunotherapy, and others. Thus, information services that improve the quality of life of hay fever sufferers must address the needs of each individual separately. In this paper, we demonstrate the development of information services that offer personalized pollen-induced symptoms forecasts. The backbone of these services consists of data of allergic symptoms reported by the users of the Personal Hay Fever Diary system and pollen concentration levels (European Aeroallergen Network) in several sampling sites. Data were analyzed using computational intelligence methods, resulting in highly customizable forecasting models that offer personalized warnings to users of the Patient Hay Fever Diary system. The overall system performance for the pilot area (Vienna and Lower Austria) reached a correlation coefficient of r = 0.71 ± 0.17 (average ± standard deviation) in a sample of 219 users with major contribution to the Pollen Hay Fever Diary system and an overall performance of r = 0.66 ± 0.18 in a second sample of 393 users, with minor contribution to the system. These findings provide an example of combining data from different sources using advanced data engineering in order to develop innovative e-health services with the capacity to provide more direct and personalized information to allergic rhinitis sufferers.

  13. Recommendations for the pharmacologic management of allergic rhinitis.

    PubMed

    Hoyte, Flavia C L; Meltzer, Eli O; Ostrom, Nancy K; Nelson, Harold S; Bensch, Greg W; Spangler, Dennis L; Storms, William W; Weinstein, Steven F; Katial, Rohit K

    2014-01-01

    Allergic rhinitis (AR) affects at least 60 million people in the United States each year, resulting in a major impact on patient quality of life, productivity, and direct and indirect costs. As new therapies, data, and literature emerge in the management of AR, there is a need to communicate and disseminate important information to health care professionals to advance the practice of medicine and lessen the disease burden from AR. Treatment recommendations for AR have not been updated since the 2012 Food and Drug Administration approval of nonaqueous intranasal aerosol agents using hydrofluoroalkane propellants and the first aqueous intranasal combination product. Here, we present an updated algorithm for the pharmacologic treatment of AR that includes these new treatment options. Treatment recommendations are categorized by disease severity (mild versus moderate/severe) and duration of symptoms (episodic versus nonepisodic, with episodic defined as <3 days/wk or for <3 weeks). Preferred treatments are suggested, as well as alternative options for consideration by clinicians in the context of individual patient needs. This recommendation article also outlines the importance of treatment monitoring, which can be conducted using the recently developed Rhinitis Control Assessment Test. Successful therapeutic outcomes depend on multiple factors, including use of the most effective pharmacologic agents as well as patient adherence to therapy. Therefore, it is imperative that rhinitis patients not only receive the most effective therapeutic options, but that they also understand and are able to adhere to the comprehensive treatment regimen. Successful treatment, with all of these considerations in mind, results in better disease outcomes, improved quality of life for patients, and greater economic productivity in the home and workplace. PMID:25582158

  14. Xanthii Fructus inhibits allergic response in the ovalbumin-sensitized mouse allergic rhinitis model

    PubMed Central

    Gwak, Nam-Gil; Kim, Eun-Young; Lee, Bina; Kim, Jae-Hyun; Im, Yong-Seok; Lee, Ka-Yeon; Jun-Kum, Chang; Kim, Ho-Seok; Cho, Hyun-Joo; Jung, Hyuk-Sang; Sohn, Youngjoo

    2015-01-01

    Background: Xanthii Fructus (XF) is widely used in traditional anti-bacterial and anti-inflammatory Asian medicine. Allergic rhinitis is a common inflammatory disease characterized by markedly increased levels of anti-inflammatory factors and the recruitment of inflammatory cells into the nasal mucosa. We investigated the effects of XF in the allergen-induced rhinitis model. Materials and Methods: Following ovalbumin (OVA)/alum intraperitoneal injection on days 0, 7 and 14, the BALB/c mice (albino, laboratory-bred strain of the house mice) were challenged intranasally with OVA for 10 days a week after the last sensitization. The number of sneezes was recorded for 10 days; additionally, the levels of cytokines, histamine, immunoglobulin E (IgE) and OVA-specific serum IgE were estimated. Eosinophil infiltration, thickness of nasal mucosa and expression of caspase-1 were determined by immunohistochemistry. We also evaluated the effect of XF on the phosphorylation of nuclear factor kappa-B (NF-κB) and inhibitor of nuclear factor kappa B-alpha (IκB-α) in human mast cell-1 (HMC-1), by Western blotting. Results: The administration of XF significantly decreased sneezing and the serum levels of histamine, IgE, OVA-specific IgE, and cytokines such as tumor necrosis factor-alpha (TNF-α), interleukine-1 beta (IL-1β), IL-5, IL-6, monocyte chemoattractant protein-1 (MCP-1) and macrophage inflammatory protein-2 (MIP-2). XF inhibited the changes in thickness of the nasal septum, influx of eosinophils and expression of capase-1. In addition, XF inhibited the phosphorylation of IκB-α and NF-κB in phorbol-myristate-acetate plus calcium ionophore A23187 (A23187) stimulated HMC-1. Conclusion: This study suggests that XF acts a potent anti-allergic drug which alleviates the allergic responses in ovalbumin-sensitized mouse allergic rhinitis model. PMID:26664025

  15. Epigenetic regulation of asthma and allergic disease

    PubMed Central

    2014-01-01

    Epigenetics of asthma and allergic disease is a field that has expanded greatly in the last decade. Previously thought only in terms of cell differentiation, it is now evident the epigenetics regulate many processes. With T cell activation, commitment toward an allergic phenotype is tightly regulated by DNA methylation and histone modifications at the Th2 locus control region. When normal epigenetic control is disturbed, either experimentally or by environmental exposures, Th1/Th2 balance can be affected. Epigenetic marks are not only transferred to daughter cells with cell replication but they can also be inherited through generations. In animal models, with constant environmental pressure, epigenetically determined phenotypes are amplified through generations and can last up to 2 generations after the environment is back to normal. In this review on the epigenetic regulation of asthma and allergic diseases we review basic epigenetic mechanisms and discuss the epigenetic control of Th2 cells. We then cover the transgenerational inheritance model of epigenetic traits and discuss how this could relate the amplification of asthma and allergic disease prevalence and severity through the last decades. Finally, we discuss recent epigenetic association studies for allergic phenotypes and related environmental risk factors as well as potential underlying mechanisms for these associations. PMID:24932182

  16. The history and progression of treatments for allergic rhinitis.

    PubMed

    Ostrom, Nancy K

    2014-01-01

    This article intends to place new treatments in the context of allergic rhinitis (AR) treatment history. The medical literature was searched for significant advances and changes in AR treatment. Historical data on AR treatment options and management were selected. Reviews of AR management published throughout the 20th century were included to provide context for treatment advances. Modern AR treatment began in the early 20th century with immunotherapy and was soon followed by the emergence of antihistamine therapy in the 1930s. Numerous treatments for AR have been used over the ensuing decades, including decongestants, mast cell stabilizers, and leukotriene receptor antagonists. Topical corticosteroid options were developed the 1950s, and, added to baseline antihistamine therapy, became the foundation of AR treatment. Treatment options were significantly impacted after the 1987 Montreal Protocol, which phased out the use of chlorofluorocarbon propellant aerosols because of environmental concerns. From the mid-1990s until recently, this left only aqueous solution options for intranasal corticosteroids (INSs). The approval of the first hydrofluoroalkane propellant aerosol INSs for AR in 2012 restored a "dry" aerosol treatment option. The first combination intranasal antihistamine/INSs was also approved in 2012, providing a novel treatment option for AR. Treatment of AR has progressed with new therapeutic options now available. This should continue to move forward with agents to alter the allergic mechanism itself and impact the disease burden that has a significant impact on patient outcomes. PMID:25582156

  17. Non-Pharmacological Treatments of Allergic Rhinitis (Neglected Treatments)

    PubMed Central

    Zohalinezhad, Mohammad Ebrahim; Zarshenas, Mohammad M.

    2016-01-01

    Background: Allergic rhinitis is the most common diseases affecting people in industrialized society. However, this is not a new disease and it was clinically described and treated for the first time by Rhazes (865-925 CE). The disease was also mentioned in “The Canon of Medicine” by Avicenna (980–1037). Methods: We searched in Scopus, Web of Science, and PubMed for “allergic rhinitis”, “interactions”, “non-prescription”, “prescription”, and in electronic copies of ITM sources the “canon” and “Al-Havi”. Results: Both Persian pioneers of Medicine recommended non-pharmacologic management as an important phase of the therapy. Their recommendations consisted of avoiding overeating and polydipsia, massage of the lower extremities, adjusting the duration and time of sleep, sleeping in the supine position, avoiding exposure of the head to cold air and taking a shower early in the morning. Conclusion: Although some aspects of their recommendations, such as massage of the lower extremities, avoiding of overeating and adjusting of sleep pattern were approved, but further cross-sectional and prospective studies are needed to confirm other non-pharmacological treatments.

  18. Pharmacological profile, efficacy and safety of rupatadine in allergic rhinitis.

    PubMed

    Katiyar, Subodh; Prakash, Shivesh

    2009-06-01

    Allergic rhinitis (AR) is a disease with high prevalence. In AR, exposure to airborne allergens elicits an allergic response which involves epithelial accumulation of effector cells - e.g. mast cells and basophils - and subsequent inflammation. During the early response in AR, histamine has been found to be the most abundant mediator and it is associated with many symptoms of this disease mediated through the histamine H1 receptor. Therefore, anti-histamines have a role to play in the management of AR. However, the available antihistamines have certain well-known side effects like sedation and potential pro-arrythmic effects owing to their interactions with other drugs, as well as having poor or no effect on platelet activating factor (PAF) which also plays an important role in AR. This article is a qualitative systematic literature review on the pharmacological profile of rupatadine in order to evaluate its safety and efficacy in AR as compared to other anti-histamines. Rupatadine is a once-daily non-sedative, selective, long-acting H1 anti-histamine with antagonistic PAF effects through its interaction with specific receptors. Rupatadine significantly improves nasal symptoms in patients with AR. It has a good safety profile and is devoid of arrythmogenic effects. These properties make rupatadine a suitable first line anti-histamine for the treatment of AR. PMID:18695846

  19. Allergies, asthma, and dust

    MedlinePlus

    Allergic rhinitis - dust ... make allergies or asthma worse are called triggers. Dust is a common trigger. When your asthma or allergies become worse due to dust, you are said to have a dust allergy. ...

  20. Allergies, asthma, and molds

    MedlinePlus

    Allergic rhinitis - mold ... make allergies or asthma worse are called triggers. Mold is a common trigger. When your asthma or allergies become worse due to mold, you are said to have a mold allergy. ...

  1. Google unveils a glimpse of allergic rhinitis in the real world.

    PubMed

    Kang, M-G; Song, W-J; Choi, S; Kim, H; Ha, H; Kim, S-H; Cho, S-H; Min, K-U; Yoon, S; Chang, Y-S

    2015-01-01

    Google Trends (GT) is a Web-based surveillance tool used to explore the searching trends of specific queries on Google. Recent studies have suggested the utility of GT in predicting outbreaks of influenza and other diseases. However, this utility has not been thoroughly evaluated for allergic diseases. Therefore, we investigated the utility of GT for predicting the epidemiology of allergic rhinitis. In the USA, GT for allergic rhinitis showed repetitive seasonality that peaked in late April and early May and then rapidly decreased, and a second small peak occurred in September. These trends are highly correlated with the searching trends for other queries such as 'pollen count', antihistamines such as loratadine and cetirizine (all r > 0.88 and all P < 0.001), and even the total pollen count collected from 21 pollen counters across the USA (r = 0.928, P < 0.001). Google Trends for allergic rhinitis was similar to the monthly changes in rhinitis symptoms according to the US National Health and Nutrition Examination Survey III, sales for Claritin(®) and all over-the-counter antihistamines, and the number of monthly page views of 'claritin.com'. In conclusion, GT closely reflects the real-world epidemiology of allergic rhinitis in the USA and could potentially be used as a monitoring tool for allergic rhinitis. PMID:25280183

  2. MP29-02 for the treatment of seasonal allergic rhinitis: a review of clinical pharmacology, efficacy and safety.

    PubMed

    Berger, William E

    2013-09-01

    This review presents the pharmacology, clinical efficacy and safety of MP29-02 (Dymista®), a unique product for the treatment of allergic rhinitis. Allergic rhinitis is often thought of more as a nuisance than a meaningful medical condition, and the health impact of allergic rhinitis can easily be underestimated. As a result, allergic rhinitis can be undertreated, expectations for relief may not be met, and patients may be left dissatisfied and non-compliant with their medications. MP29-02 is the only currently available allergic rhinitis medication to provide potent early-phase histamine-receptor blocking and long-term anti-inflammatory effects in a single intranasal formulation and delivery system that represents an advance in the therapy of allergic rhinitis, in particular for patients with moderate-to-severe disease. PMID:24070043

  3. Sensitization to Airborne Ascospores, Basidiospores, and Fungal Fragments in Allergic Rhinitis and Asthmatic Subjects in San Juan, Puerto Rico

    PubMed Central

    Rivera-Mariani, Félix E.; Nazario-Jiménez, Sylvette; López-Malpica, Fernando; Bolaños-Rosero, Benjamín

    2011-01-01

    Background Fungal spores are the predominant biological particulate in the atmosphere of Puerto Rico, yet their potential as allergens has not been studied in subjects with respiratory allergies. The purpose of this study was to determine the level of sensitization of subjects with respiratory allergies to these particles. Methods Serum samples were drawn from 33 subjects with asthma, allergic rhinitis, or nonallergic rhinitis and 2 controls with different skin prick test reactivity. An MK-3 sampler was used to collect air samples and the reactivity of the sera to fungal particles was detected with a halogen immunoassay. Results All subjects reacted to at least 1 fungal particle. Thirty-one subjects reacted to ascospores, 29 to basidiospores, 19 to hyphae/fungal fragments, and 12 to mitospores. The median percentage of haloes in allergic rhinitis subjects was 4.82% while asthma or nonallergic rhinitis subjects had values of 1.09 and 0.39%, respectively. Subjects with skin prick tests positive to 3, 2, 1, or no extract had 5.24, 1.09, 1.61, and, 0.57% of haloed particles, respectively. If skin prick tests were positive to basidiomycetes, pollen, animals, or deuteromycetes, the percentages of haloes were 4.72, 4.15, 3.63, and 3.31%, respectively. Of all haloed particles, 46% were unidentified, 25% ascospores, 20% basidiospores, 7% hyphae/fungal fragments, and 2% mitospores. IgE levels and the number of positive skin prick test extracts correlated with the percentage of haloes. Conclusion In tropical environments, sensitization to airborne basidiomycetes, ascomycetes, and fungal fragments seems to be more prevalent than sensitization to mitospores in subjects with active allergies, suggesting a possible role in exacerbations of respiratory allergies. PMID:21346362

  4. The burden of allergic rhinitis (AR) in Canada: perspectives of physicians and patients

    PubMed Central

    2012-01-01

    Background Allergic rhinitis (AR) is a common problem and we sought to examine the burden of disease and its management in Canada from the perspectives of patients and physicians. Methods Two parallel, Canadawide structured telephone interviews surveyed 1,001 AR patients and 160 physicians in July 2006. Results 44% of patients had experienced nasal symptoms unrelated to a cold and 20% had a physician diagnosis of AR. At screening 27% reported asthma, 15% chronic or recurrent sinusitis and 5% nasal polyps. With attacks nasal congestion and runny nose were the most bothersome symptoms. Other problems experienced were fatigue (46%), poor concentration (32%), and reduced productivity (23%). Most (77%) had not seen a physician in the past year. Physicians estimated they prescribed intranasal cortico steroids (INCS) to most AR patients (77%) consistent with guidelines but only 19% of patients had used one in the last month. Only 48% of patients were very satisfied with their current INCS. 41% of AR patients reported discontinuing their INCS with the most common reason being a perceived lack of long-lasting symptom relief (44%). 52% of patients felt that their current INCS lost effectiveness over 24 h. The most common INCS side effects included dripping down the throat, bad taste, and dryness. Most AR patients reported lifestyle limitations despite treatment (66%). 61% of patients felt that their symptoms were only somewhat controlled or poorly/not controlled during their worst month in the past year. Conclusions AR symptoms are common and many patients experience inadequate control. Physicians report they commonly prescribe intranasal corticosteroids, but patient’s perceived loss of efficacy and side effects lead to their discontinuation. Persistent relief of allergic rhinitis symptoms remains a major unmet need. Better treatments and education are required. PMID:22656186

  5. Oral mucosal immunotherapy for allergic rhinitis: A pilot study

    PubMed Central

    Suurna, Maria V.; Rochlin, Kate; Bremberg, Maria G.; Tropper, Guy

    2016-01-01

    Background: The sublingual mucosa has been used for many years to apply allergenic extracts for the purpose of specific immunotherapy (IT). Although sublingual IT (SLIT) is both safe and efficacious, the density of antigen-presenting cells is higher in other regions of the oral cavity and vestibule, which make them a potentially desirable target for IT. Objective: To present the concept of oral mucosal IT (OMIT) and to provide pilot data for this extended application of SLIT. Methods: An open-label, 12-month, prospective study was undertaken as a preliminary step before a full-scale clinical investigation. Twenty-four individuals with allergic rhinitis received IT by applying allergenic extracts daily to either the oral vestibule plus oral cavity mucosa by using a glycerin-based toothpaste or to the sublingual mucosa by using 50% glycerin liquid drops. Adverse events, adherence rates, total combined scores, rhinoconjunctivitis quality-of-life questionnaire scores, changes in skin reactivity, and changes in serum antibody levels were measured for each participant. Results: No severe adverse events occurred in either group. The adherence rate was 80% for the OMIT group and 62% for the SLIT group (p = 0.61). Decreased total combined scores were demonstrated for both the OMIT group (15.6%) and the SLIT group (22.3%), although this decrease did not reach statistical significance in either group. Both groups achieved a meaningful clinical improvement of at least 0.5 points on rhinoconjunctivitis quality-of-life questionnaire. A statistically significant rise in specific immunoglobulin G4 (IgG4) was seen in both groups over the first 6 months of treatment. Conclusion: OMIT and SLIT demonstrated similar safety profiles and adherence rates. Measurements of clinical efficacy improved for both groups, but only changes in IgG4 achieved statistical significance. These pilot data provide enough evidence to proceed with a full-scale investigation to explore the role of OMIT in

  6. [The gene or genes of allergic asthma?].

    PubMed

    Demoly, P; Bousquet, J; Godard, P; Michel, F B

    1993-05-15

    Asthma is a multifactorial disease in which the hereditary component has been demonstrated by familial and identical twin studies. Allergy is important in the aetiology of asthma and is characterized by a hyperreaction to allergens triggering predominantly the immunoglobulines E. The levels of these antibodies are found to be elevated even in non allergic asthmatics. The majority of genetic research in this area is focused on either the genes of the specific immune response or that of the non allergic response. These are the genes of the class II MHC, and the APY gene on chromosome 11q respectively. The modern techniques of molecular genetics and in particular those of inverse genetics have recently contributed to a more comprehensive understanding of this disease. PMID:8316547

  7. Environmental risk factors and allergic bronchial asthma.

    PubMed

    D'Amato, G; Liccardi, G; D'Amato, M; Holgate, S

    2005-09-01

    The prevalence of allergic respiratory diseases such as bronchial asthma has increased in recent years, especially in industrialized countries. A change in the genetic predisposition is an unlikely cause of the increase in allergic diseases because genetic changes in a population require several generations. Consequently, this increase may be explained by changes in environmental factors, including indoor and outdoor air pollution. Over the past two decades, there has been increasing interest in studies of air pollution and its effects on human health. Although the role played by outdoor pollutants in allergic sensitization of the airways has yet to be clarified, a body of evidence suggests that urbanization, with its high levels of vehicle emissions, and a westernized lifestyle are linked to the rising frequency of respiratory allergic diseases observed in most industrialized countries, and there is considerable evidence that asthmatic persons are at increased risk of developing asthma exacerbations with exposure to ozone, nitrogen dioxide, sulphur dioxide and inhalable particulate matter. However, it is not easy to evaluate the impact of air pollution on the timing of asthma exacerbations and on the prevalence of asthma in general. As concentrations of airborne allergens and air pollutants are frequently increased contemporaneously, an enhanced IgE-mediated response to aeroallergens and enhanced airway inflammation could account for the increasing frequency of allergic respiratory allergy and bronchial asthma. Pollinosis is frequently used to study the interrelationship between air pollution and respiratory allergy. Climatic factors (temperature, wind speed, humidity, thunderstorms, etc) can affect both components (biological and chemical) of this interaction. By attaching to the surface of pollen grains and of plant-derived particles of paucimicronic size, pollutants could modify not only the morphology of these antigen-carrying agents but also their allergenic

  8. Tap water nasal irrigation in adults with seasonal allergic rhinitis: a randomized double-blind study.

    PubMed

    Xiong, Min; Fu, Xiaoyan; Deng, Wenting; Lai, Huangwen; Yang, Chuanhong

    2014-06-01

    Saline nasal irrigation is effective in the treatment of seasonal allergic rhinitis, and sodium chloride itself has no antiallergic effects. The mechanism of saline nasal irrigation depends mainly on washing away allergens and inflammatory mediators induced by allergic reactions. Tap water has the same washing effects as saline. In this study, it was investigated if tap water nasal irrigation was effective in the treatment of seasonal allergic rhinitis. Sixty-four patients diagnosed with seasonal allergic rhinitis were enrolled. Patients were randomized to tap water nasal irrigation group and non-tap water nasal irrigation group for treatment. Patients of both groups were treated with desloratadine. Treatment outcomes were measured using allergic rhinitis Quality of Life (QoL) survey was completed at baseline and after 3 weeks of therapy. There were statistically significant differences in QoL scores between tap water nasal irrigation group and non-tap water nasal irrigation group. The tap water nasal irrigation group had better QoL scores than the non-tap water nasal irrigation group. Tap water nasal irrigation can be a valuable adjuvant therapy for patients with seasonal allergic rhinitis. PMID:24091560

  9. TOTALL: high cost of allergic rhinitis-a national Swedish population-based questionnaire study.

    PubMed

    Cardell, Lars-Olaf; Olsson, Petter; Andersson, Morgan; Welin, Karl-Olof; Svensson, Johanna; Tennvall, Gunnel Ragnarson; Hellgren, Johan

    2016-01-01

    Allergic rhinitis is a global illness with a well-recognised impact on quality of life and work performance. Comparatively little is known about the extent of its economic impact on society. The TOTALL study estimates the total cost of allergic rhinitis using a sample representing the entire Swedish population of working age. A questionnaire focused on allergic rhinitis was mailed out to a random population of Swedish residents, aged 18-65 years. Health-care contacts, medications, absenteeism (absence from work) and presenteeism (reduced working capacity at work) were assessed, and the direct and indirect costs of allergic rhinitis were calculated. Medication use was evaluated in relation to the ARIA guidelines. In all, 3,501 of 8,001 (44%) answered the questionnaire, and 855 (24%) of these reported allergic rhinitis. The mean annual direct and indirect costs because of allergic rhinitis were €210.3 and €750.8, respectively, resulting in a total cost of €961.1 per individual/year. Presenteeism represented 70% of the total cost. Antihistamines appear to be used in excess in relation to topical steroids, and the use of nasal decongestants was alarmingly high. The total cost of allergic rhinitis in Sweden, with a population of 9.5 million, was estimated at €1.3 billion annually. These unexpectedly high costs could be related to the high prevalence of disease, in combination with the previously often underestimated indirect costs. Improved adherence to guidelines might ease the economic burden on society. PMID:26845513

  10. Prevalence and risk factors for allergic rhinitis in bakers in Douala, Cameroon

    PubMed Central

    Mbatchou Ngahane, Bertrand Hugo; Afane Ze, Emmanuel; Nde, Francis; Ngomo, Eliane; Mapoure Njankouo, Yacouba; Njock, Louis Richard

    2014-01-01

    Objective To determine the prevalence and risk factors of allergic rhinitis among bakers in Douala. Design A cross-sectional study; the logistic regression model was use to find the risk factors of allergic rhinitis. Setting The study was conducted in 42 bakeries randomly selected among a total of 151 bakeries in the city of Douala. Participants All bakers who consented to participate in the study between 1 May and 31 July 2013. Outcome measures Allergic rhinitis was the outcome of interest. It was defined as the presence of the following symptoms: itchy nose, rhinorrhea, nasal obstruction and sneezing. Results During the study period, a total of 273 bakers were invited and 229 finally agreed to participate in this study. Males were the most represented gender with 222 (96.9%) participants. The mean age of the participants was 36.29±8.9 years. Smoking was found in 55 participants (24.5%). The symptoms of allergic rhinitis were observed in 24.5% of participants. Work related nasal symptoms were present in 15% of participants. Sensitisation to wheat flour and α-amylase was found in 16.6% and 8.3% of participants, respectively. The Prick test was positive for mites in 12.2% of participants. After multivariate analysis, sensitisation to flour (OR 3.95, 95% CI 1.85 to 8.47) and storage mites (OR 3.44, 95% CI 1.45 to 8.18) were the factors independently associated with symptoms of allergic rhinitis. Conclusions Allergic rhinitis is frequent among bakers in Cameroon. Implementation of preventive measures against inhalation of airborne allergens in bakeries and clinical monitoring of bakers sensitised to wheat flour and mites could help to reduce the prevalence of allergic rhinitis among bakers. PMID:25180053

  11. Pollen count and exhaled nitric oxide levels in a seasonal allergic rhinitis patient.

    PubMed

    Shirai, Toshihiro; Mochizuki, Eisuke; Asada, Kazuhiro; Suda, Takafumi

    2014-09-01

    The subject was a 52-year-old man with Japanese cedar pollinosis, which developed between February and May. He had no history of asthma and was an ex-smoker. He underwent fractional exhaled nitric oxide (FeNO) measurements twice a week from 2010 to 2012. The pollen counts in 2010 were the lowest during the last decade, and the FeNO level was less than 30 ppb for the whole year. In contrast, the mean pollen count in 2011 was very high and the patient's FeNO level rose to more than 100 ppb. The mean pollen count in 2012 was comparable with that of 2010; however, high counts were detected in April and May, and the FeNO level rose to 70 ppb during the latter stages of the pollen season. These results indicate that pollen counts should be taken into consideration during the interpretation of FeNO data in asthma or allergic rhinitis. PMID:25473586

  12. Sensitization and exposure to pet allergens in asthmatics versus non-asthmatics with allergic rhinitis.

    PubMed

    Henriksen, A H; Holmen, T L; Bjermer, L

    2001-02-01

    In sensitized subjects with allergic rhinitis (AR) or asthma, allergen exposure provokes symptoms. Among non-asthmatics with AR, an association between allergen sensitization, pollen season and lower airway inflammation has been demonstrated. Our aims were to compare AR and asthma with regard to patterns of allergen sensitization, the degree of airway hyperresponsiveness (AHR) and levels of exhaled nitric oxide (ENO). Finally, we wanted to relate our findings to previous or current exposure to household pets. Four hundred and thirty-one adolescents with different clinical phenotypes were randomly selected from a large-scale epidemiological survey. They were investigated with allergy screening, measurements of ENO and a methacholine bronchoprovocation test. Sensitization to pet allergens (cat, dog and horse) was associated with increased AHR and ENO both in asthmatics and non-asthmatics with AR. The risk of being sensitized to cat allergens was significantly reduced in those who had kept cats vs. those who had never kept them. Keeping dogs or horses did not influence the risk of being sensitized to the respective allergens. Only in steroid-naive, non-smoking asthmatics, a trend towards increased ENO in those sensitized and exposed to cat or dog allergens was seen. Although sensitization towards pet allergens was associated with inflammation in the lower airways irrespective of clinical phenotype, keeping pets did not increase the risk of being sensitized to pet allergens. PMID:11217908

  13. Asthma and other allergic diseases in 13-14-year-old schoolchildren in Urmia, Iran. [corrected].

    PubMed

    Rahimi Rad, M H; Hejazi, M E; Behrouzian, R

    2007-01-01

    We determined the prevalence and risk factors of asthma, allergic rhinitis and atopic eczema in 3000 13-14-year-old schoolchildren in Urmia, Islamic Republic of Iran. We used the International Study of Asthma and Allergies in Childhood (ISAAC) written and video questionnaires. With the written questionnaire, the prevalence of current symptoms (within the past 12 months) was: wheeze 14.5%, allergic rhinitis 23.6% and eczema 10.1%. Self-reported asthma ever was only 2.1%. With the video questionnaire, the prevalence of wheeze was lower; 7.4% for wheeze at rest ever and 4.6% during the past 12 months. Boys had a significantly higher prevalence for most items examined except for eczema. PMID:18290392

  14. A dual role for complement in allergic asthma.

    PubMed

    Köhl, Jörg; Wills-Karp, Marsha

    2007-06-01

    Complement is an ancient danger-sensor system of innate immunity, providing first-line defence against pathogens. Concordant with its pro-inflammatory properties, complement contributes to airway inflammation, hyperresponsiveness and mucus production during the effector phase of allergic asthma. In contrast to these pro-allergic properties, complement can also protect from the development of the maladaptive Th2-biased immune response that drives airway inflammation and hyperreactivity in allergic asthma. As such, selective targeting of pro-allergic complement pathways appears an attractive therapeutic option in allergic asthma. PMID:17475559

  15. Allergic asthma biomarkers using systems approaches

    PubMed Central

    Sircar, Gaurab; Saha, Bodhisattwa; Bhattacharya, Swati G.; Saha, Sudipto

    2013-01-01

    Asthma is characterized by lung inflammation caused by complex interaction between the immune system and environmental factors such as allergens and inorganic pollutants. Recent research in this field is focused on discovering new biomarkers associated with asthma pathogenesis. This review illustrates updated research associating biomarkers of allergic asthma and their potential use in systems biology of the disease. We focus on biomolecules with altered expression, which may serve as inflammatory, diagnostic and therapeutic biomarkers of asthma discovered in human or experimental asthma model using genomic, proteomic and epigenomic approaches for gene and protein expression profiling. These include high-throughput technologies such as state of the art microarray and proteomics Mass Spectrometry (MS) platforms. Emerging concepts of molecular interactions and pathways may provide new insights in searching potential clinical biomarkers. We summarized certain pathways with significant linkage to asthma pathophysiology by analyzing the compiled biomarkers. Systems approaches with this data can identify the regulating networks, which will eventually identify the key biomarkers to be used for diagnostics and drug discovery. PMID:24409194

  16. Asthma and Rhinitis in South America: How Different They are From Other Parts of the World

    PubMed Central

    Chong Neto, Herberto José; Solé, Dirceu

    2012-01-01

    Asthma and rhinitis epidemiology has wide variations around the world. The aim of this review was verify the prevalence of asthma and rhinitis in South America and report differences from other regions of the world. We reviewed studies with International Study of Asthma and Allergies in Childhood (ISAAC) methodology in South America, Phases I and III. In South America the ISAAC Phase I ranked four countries among top ten in prevalence of asthma and three countries among top ten in prevalence of rhinoconjunctivitis. ISAAC Phase III showed little changes in asthma and rhinitis prevalence in South American countries. The prevalence increases of asthma and rhinitis in South American centers indicate that the burden of both is continuing to rise, but the differences in prevalence are lessening. PMID:22379600

  17. Active or Passive Exposure to Tobacco Smoking and Allergic Rhinitis, Allergic Dermatitis, and Food Allergy in Adults and Children: A Systematic Review and Meta-Analysis

    PubMed Central

    Saulyte, Jurgita; Regueira, Carlos; Montes-Martínez, Agustín; Khudyakov, Polyna; Takkouche, Bahi

    2014-01-01

    Background Allergic rhinitis, allergic dermatitis, and food allergy are extremely common diseases, especially among children, and are frequently associated to each other and to asthma. Smoking is a potential risk factor for these conditions, but so far, results from individual studies have been conflicting. The objective of this study was to examine the evidence for an association between active smoking (AS) or passive exposure to secondhand smoke and allergic conditions. Methods and Findings We retrieved studies published in any language up to June 30th, 2013 by systematically searching Medline, Embase, the five regional bibliographic databases of the World Health Organization, and ISI-Proceedings databases, by manually examining the references of the original articles and reviews retrieved, and by establishing personal contact with clinical researchers. We included cohort, case-control, and cross-sectional studies reporting odds ratio (OR) or relative risk (RR) estimates and confidence intervals of smoking and allergic conditions, first among the general population and then among children. We retrieved 97 studies on allergic rhinitis, 91 on allergic dermatitis, and eight on food allergy published in 139 different articles. When all studies were analyzed together (showing random effects model results and pooled ORs expressed as RR), allergic rhinitis was not associated with active smoking (pooled RR, 1.02 [95% CI 0.92–1.15]), but was associated with passive smoking (pooled RR 1.10 [95% CI 1.06–1.15]). Allergic dermatitis was associated with both active (pooled RR, 1.21 [95% CI 1.14–1.29]) and passive smoking (pooled RR, 1.07 [95% CI 1.03–1.12]). In children and adolescent, allergic rhinitis was associated with active (pooled RR, 1.40 (95% CI 1.24–1.59) and passive smoking (pooled RR, 1.09 [95% CI 1.04–1.14]). Allergic dermatitis was associated with active (pooled RR, 1.36 [95% CI 1.17–1.46]) and passive smoking (pooled RR, 1.06 [95% CI 1.01–1

  18. Rupatadine improves nasal symptoms, airflow and inflammation in patients with persistent allergic rhinitis: a pilot study.

    PubMed

    Ciprandi, Giorgio; Cirillo, I

    2010-01-01

    Nasal obstruction is the main symptom in patients with allergic rhinitis and may be measured by rhinomanometry. Rupatadine is a new antihistamine with potential antiallergic activities. The aim of this pilot study is to evaluate nasal symptoms, nasal airflow and nasal mediators in patients with persistent allergic rhinitis, before and after treatment with rupatadine. Twenty patients with persistent allergic rhinitis were evaluated, 15 males and 5 females (mean age 35 +/- 9.1 years), all of whom received rupatadine (10 mg/daily) for 3 weeks. Nasal and ocular symptoms (measured by VAS), rhinomanometry, and nasal mediators (ECP and tryptase) were assessed in all subjects before and after treatment. Rupatadine treatment induced significant symptom relief (both nasal and ocular, respectively p=0.005 and p=0.0004), including obstruction (p=0.0015) and significant increase of nasal airflow (p=0.0025). Moreover, there was a significant difference of nasal mediators. In conclusion, this pilot study demonstrates the effectiveness of rupatadine treatment in: i) improving nasal and ocular symptoms, ii) increasing nasal airflow, iii) exerting antiallergic activity in patients with persistent allergic rhinitis. These positive results could explain the effectiveness of rupatadine in the treatment of persistent allergic rhinitis, as reported in a previous study Further controlled studies need to be conducted to confirm these preliminary findings. PMID:20487631

  19. Comparison of Acoustic and Stroboscopic Findings and Voice Handicap Index between Allergic Rhinitis Patients and Controls

    PubMed Central

    Koç, Eltaf Ayça Özbal; Koç, Bülent; Erbek, Selim

    2014-01-01

    Background: In our experience Allergic Rhinitis (AR) patients suffer from voice problems more than health subjects. Aims: To investigate the acoustic analysis of voice, stroscopic findings of larynx and Voice Handicap Index scores in allergic rhinitis patients compared with healthy controls. Study Design: Case-control study. Methods: Thirty adult patients diagnosed with perennial allergic rhinitis were compared with 30 age- and sex-matched healthy controls without allergy. All assessments were performed in the speech physiology laboratory and the testing sequence was as follows: 1. Voice Handicap Index (VHI) questionnaire, 2. Laryngovideostroboscopy, 3. Acoustic analyses. Results: No difference was observed between the allergic rhinitis and control groups regarding mean Maximum Phonation Time (MPT) values, Fo values, and stroboscopic assessment (p>0.05). On the other hand, mean VHI score (p=0.001) and s/z ratio (p=0.011) were significantly higher in the allergic rhinitis group than in controls. Conclusion: Our findings suggest that the presence of allergies could have effects on laryngeal dysfunction and voice-related quality of life. PMID:25667789

  20. IQ Score of Children with Persistent or Perennial Allergic Rhinitis: A Comparison with Healthy Children

    PubMed Central

    GHAFFARI, Javad; ABBASKHANIAN, Ali; JALILI, Masumeh; YAZDANI CHARATI, Jamshid

    2014-01-01

    Objective Prevalence of allergies is different around the world. Allergic rhinitis is a common chronic disease in children. Intelligence quotient (IQ) is an indicator of efficacy and many factors including chronic diseases may affect it. This study compares the IQs of children diagnosed with persistent or perennial allergic rhinitis with healthy children. Material & Methods This was a comparative study that was conducted from June 2011–May 2013 in an academic referral clinic. In this study, 90 patients aged 6- to 14-yearsold who were diagnosed with persistent or perennial allergic rhinitis and were compared to 90 age and gender match healthy patients from their respective families. The Wechsler Intelligence Scale for Children was used to divide and calculate overall IQ, verbal IQ, and practical IQ. The t-test and chi square were used to analyze quantitative variables and qualitative variables, respectively. Results In this study, out of total 180 children, 90 (50%) in the case group and 90 children (50%), the control group participated for IQ comparison. One hundred (57%) were male and 80 (43%) were female. The overall IQ for allergic rhinitis patients and healthy patients was 109.2 and 107.5, respectively. This difference was not considered significant. Furthermore, there was no significant difference between the IQ scores of males and females. Conclusion Although allergic rhinitis is a chronic disease and effects quality of life, there were no identifiable negative effects on IQ. PMID:25143773

  1. Home air-conditioning, traffic exposure, and asthma and allergic symptoms among preschool children.

    PubMed

    Zuraimi, Mohamed Sultan; Tham, Kwok-Wai; Chew, Fook-Tim; Ooi, Peng-Lim; Koh, David

    2011-02-01

    Epidemiological data suggest that traffic exposures can influence asthma and allergic symptoms among preschool children; however, there is no information on risk reduction via home air-conditioning (AC). The aim of this study is to evaluate the associations of self-reported traffic densities with asthma and allergic symptoms among preschool children and determine whether AC is an effect modifier. A cross-sectional study adopting an expanded and modified ISAAC--International Study of Asthma and Allergies in Childhood conducted on randomly selected 2994 children living in homes without any indoor risk factors. Specific information on demographics, indoor home risk factors, and traffic variables were obtained. Adjusted prevalence ratios (PR) and 95% confidence interval (CI) were determined by Cox proportional hazard regression model with assumption of a constant risk period controlled for covariates. We found dose-response significant relationships between validated self-reported traffic densities and asthma and rhinitis symptoms. Among children sleeping in non-air-conditioned homes, there were stronger associations between asthma and rhinitis symptoms studied. PRs for heavy traffic density were 2.06 for wheeze (95% CI 0.97-4.38), 2.89 for asthma (1.14-7.32), 1.73 for rhinitis (1.00-2.99), and 3.39 for rhinoconjunctivitis (1.24-9.27). There were no associations found for children sleeping in air-conditioned homes. Our results suggest that AC in the bedroom modifies the health effects of traffic among preschool children. This finding suggests that attention should also be paid to ventilation characteristics of the homes to remediate health-related traffic pollution problems. PMID:20561230

  2. The anatomical and functional relationship between allergic conjunctivitis and allergic rhinitis

    PubMed Central

    Bielory, Leonard

    2013-01-01

    There are numerous anatomic connections between the allergic conjunctivitis and allergic rhinitis. The most obvious reason is the physical connection via the nasolacrimal apparatus. However, a closer look at innervation, circulatory, lymphatic, and neurogenic systems reveals much more than a physical connection. The eye is richly innervated by parasympathetic nerves that enter the eyes after traveling in conjunction with the parasympathetic input to the nasal cavity. Parasympathetic innervation governing the tear film and nasal secretion can intersect at the pterygopalatine ganglion. Neurogenic inflammation affects both the eye and the nose as evidenced by the presence of the same neurogenic factors. Venous flow is in the SOV area connecting the eye and the nose, once thought to be without valves. In the past, this thinking is the basis for concern about the danger triangle of the face. Recent literature has shown otherwise. Although valves are present, there are still pathways where bidirectional flow exists and a venous connection is made. The most likely area for venous communication is the pterygoid plexus and cavernous sinus. The venous flow and connections also offers a pathway for allergic shiners. Understanding the mutual connections between the nasal mucosa and the ocular surface can also affect treatment strategies. PMID:24498515

  3. [Clinical course and characteristics of cellular and humoral immunity in patients with allergic rhinitis].

    PubMed

    Sakevych, V D; Kutsenko, N L; Mykytiuk, M V; Kaĭdashev, I P

    2014-01-01

    In research the condition cellular and humoral immunity is defined at allergic rhinitis--AR (n = 45) for an estimation of mechanisms pathogeny this disease. The AR in 76% of cases has the hereditary nature mainly from outside mothers (36%), begins more often at children's and teenage age (88%) and in 44% is accompanied by other allergic pathology. In structure of a sensibilization of patients the allergic rhinitis the basic place is occupied with pollen, household, fungoid and epidermal allergens, allergic reaction (83% of cases) thus prevailed. As a result of the spent researches rising of relative quantity CD4+CD25+Foxp3+ regulatory T cells is taped, at the same time rising of an average level of the general IgE--(198,20 +/- 11,42) IU/ml is noted. In cytokine regulations at patients an allergic rhinitis rising IL-4 and depression IL-10 is noted. Thus, the conducted research suggests that an allergic rhinitis--disease with involving in process of regulation of the immune answer of certain type regulatory T of cells. PMID:24908954

  4. Occupational Rhinitis.

    PubMed

    Grammer, Leslie C

    2016-05-01

    Occupational rhinitis (OR) involves nasal congestion, rhinorrhea, nasal itching, and/or sneezing resulting from workplace exposures. OR can have a significant negative effect on quality of life and productivity. OR can be divided into allergic or nonallergic subgroups based on the underlying pathogenesis. Certain occupational exposures place employees at greater risk for developing disease. Primary treatment is avoidance of implicated exposures. Antihistamines, saline rinses, and nasal steroids may be useful. OR can coexist with occupational asthma, and rhinitis symptoms have been reported to precede those of the lower respiratory tract. OR is has both medical and socioeconomic implications. PMID:27083106

  5. Lower airway inflammation and hyperresponsiveness in non-asthmatic patients with non-allergic rhinitis

    PubMed Central

    Wang, Qiuping; Ji, Junfeng; Xie, Yanqing; Guan, Weijie; Zhang, Yong; Wang, Zhiyi; Wu, Kunmin

    2015-01-01

    Background Potential associations between non-allergic rhinitis (NAR) and asthma have been verified epidemiologically, but these associations remain not very clear. It is necessary to further explore the possible implication of lower airway abnormities in NAR patients but without asthma. This study aims to determine lower airway hyperresponsiveness (AHR), inflammation and lung function in non-asthmatic patients with NAR. Methods We recruited 262 non-asthmatic patients with NAR, 377 with AR and 264 healthy subjects. All subjects were non-smokers who underwent meticulous history taking, nasal examination, allergen skin prick test (SPT), blood routine test, measurement of fractional exhaled nitric oxide (FeNO), methacholine bronchial challenge test and induced sputum eosinophil count, in this order. Results Compared with healthy subjects, non-asthmatic patients with NAR yielded markedly lower FEV1/FVC, maximal mid-expiratory flow (MMEF), mid-expiratory flow when 50% of FVC has been expired (MEF50%) and mid-expiratory flow when 75% of FVC has been expired (MEF25%) (P<0.05). Differences in spirometry between group AR and NAR were unremarkable (P>0.05). Patients with NAR yielded higher rate of AHR and higher FeNO levels than healthy subjects but lower than those with AR. The proportion of lower airways disorders (sputum eosinophilia, high FeNO levels or AHR) was highest in group AR (70.8%), followed by NAR (53.4%) and healthy subjects (24.2%) (P<0.01). However, sputum eosinophils in NAR patients were not higher compared with healthy subjects (P>0.05). Sputum eosinophils and FeNO had significant correlation with positive AHR and MMEF in group AR but not in NAR. Conclusions Non-asthmatic patients with NAR harbor lower AHR, small airways dysfunction and inflammation, despite being less significant than those with AR. This offers clues to unravel the link between NAR and asthma. PMID:26623098

  6. New intranasal formulations for the treatment of allergic rhinitis.

    PubMed

    Meltzer, Eli O; Bensch, Greg W; Storms, William W

    2014-01-01

    Intranasal corticosteroids (INSs) have been effectively used for >40 years for the treatment of seasonal allergic rhinitis (SAR) and perennial AR (PAR). Following the Montreal Protocol, the initial aerosol formulations using chlorofluorocarbon (CFC) propellants were phased out. For the past 20 years, aqueous solutions have been the only available option for INS treatment. In 2012, the U.S. Food and Drug Administration approved two new nonaqueous aerosol AR treatments that use a hydrofluoroalkane (HFA) propellant. In 2012, the first intranasal aqueous combination product was also approved. This article reviews the clinical profiles of HFA beclomethasone dipropionate (BDP) and HFA ciclesonide (CIC) and the aqueous combination intranasal antihistamine (INA)/INS formulation of azelastine hydrochloride/fluticasone propionate (AZE/FP). The medical literature was searched for clinical trials investigating the use of BDP, CIC, and AZE/FP in SAR and PAR. Clinical trials involving aqueous solutions and CFC propellant or HFA propellant delivery were included. Data from prescribing information and published efficacy and safety data were presented as part of the clinical profile for the reviewed agents. AZE/FP has shown efficacy and safety comparable or greater with the current AR treatment options. Although efficacy comparisons of new HFA formulations have not been investigated in head-to-head clinical trials with aqueous formulations, HFA formulations have shown similar efficacy rates. Furthermore, HFA formulations may have some additional benefits, including a preferable sensory profile for some patients. These new formulations will provide additional options for clinicians and patients to better individualize therapy for control of AR. PMID:25582157

  7. Recent Patents of Complementary and Alternative Medicine for Allergic Rhinitis.

    PubMed

    Hon, Kam L; Fung, Ching K; Leung, Alexander K C; Lam, Hung S; Lee, So L

    2015-01-01

    Allergic rhinitis (AR) is a common respiratory disease affecting both adults and children worldwide. Affected patients may experience nasal congestion/stuffiness, rhinorrhea (anterior and/or posterior), nasal/ nasopharyngeal itching and sneezing. Allergen avoidance is the principal step in the management. Nasal saline irrigation to remove allergen (s) in the nose is a useful adjunctive therapy in the management of moderate to severe AR. Symptomatic relief and improved quality of life may be achieved in the majority of patients with appropriate pharmacotherapy. Mild-to-moderate cases are usually managed with either an oral second generation antihistamine or an intranasal corticosteroid. More severe cases may require treatment with an intranasal corticosteroid in combination with various oral medications. Patients who require medications for more than 6 months per year or have intolerable side effects from pharmacotherapy can be considered for immunotherapy. A wide range of complementary and alternative medicines (CAM) have also been proposed. This overview evaluates the evidence of use of CAM for AR. Some methods including acupuncture and herbal medicine have supportive evidence, but the efficacy of other CAM is controversial. Conversely, possible side effects of different modalities are often inadequately documented. The herbal formulae include Butterbur, Nigella sativa, Shi-Bi-Lin, Polyherbal formula, Grapeseed extract, Rosmarinic acid, Spirulina, Biminne, and Bhu-zhong-yi-qi-tong. Further research is needed to assess the efficacy and safety before they are employed in treating AR. This review article also discusses recent CAM patents for use in AR, which are exclusively traditional Chinese medicine (TCM) concoctions primarily for oral consumption but two as topical spray. Only 8 pertinent patents, all TCM compositions for treating AR and registered in 2014, were obtained. Description about their efficacy is impressive but objective outcome evaluation tools are

  8. Treatment of allergic rhinitis: effect on occupation productivity and work force costs.

    PubMed

    Fireman, P

    1997-01-01

    Allergic rhinitis, one of the most common chronic illnesses, can have a negative impact on occupational productivity in the work-place. Allergic rhinitis affects over 13 million workers (6.15 million men and 6.11 million women) of the United States work force. Work place productivity can be reduced in the several ways: (1) Employee works at suboptimal efficiency because of the disease or its treatment; (2) employee takes a sick day away from work because of allergic rhinitis or its complications; (3) employee takes time off from work to care for or transport a child or dependent who needs care for allergic rhinitis or its complications, and (4) worker takes time off because of a work-related injury related to the disease or the medication used to treat the illness. Although nonsedating antihistamines and intranasal anti-inflammatory medications have been developed as effective therapies and are available as prescription drugs, many workers (50%) indicate that they manage their allergic rhinitis with over-the-counter medications. Most of these over-the-counter medicines contain sedating antihistamines which are known to alter cognitive and motor function. To determine whether the medications used by 3394 members of a health maintenance organization were associated with incident work-related injury, they were compared to two control groups selected from the membership and matched for age, gender, and Standard Industrial Classification Code of their employer. Medication use was determined from pharmacy data. The injuries included 496 fractures on dislocations, 2728 open, crushing, or superficial injuries, 176 burns, and 63 internal injuries. The risk of injury was statistically significantly elevated among users of sedating antihistamines. Utilizing demographic data the annual cost of last productivity to employers and society as the result of allergic rhinitis and its therapy with the over-the-counter sedating antihistamines is estimated to be greater than $4 billion

  9. Association of allergic rhinitis with pesticide use among grape farmers in Crete, Greece

    PubMed Central

    Chatzi, Leda; Alegakis, Athanasios; Tzanakis, Nikolaos; Siafakas, Nikolaos; Kogevinas, Manolis; Lionis, Christos

    2007-01-01

    Objective To explore the association of allergic rhinitis with the use of pesticides among grape farmers in Crete. Methods A cross‐sectional study of 120 grape farmers and 100 controls at the Malevisi region in Northern Crete was conducted. The protocol consisted of a questionnaire, skin prick tests for 16 common allergens, measurement of specific IgE antibodies against 8 allergens, and spirometry before and after bronchodilatation. Results Grape farmers who used pesticides had higher prevalence rates of allergic rhinitis symptoms (OR, 3.0; 95% CI, 1.4 to 6.2) compared with grape farmers who reported no current use of pesticides, and control subjects. Logistic regression models controlling for age, sex and smoking status showed that 6 of the 12 predefined groups of major pesticides were significantly related to allergic rhinitis symptoms. The highest risks were observed for paraquat and other bipyridyl herbicides (OR, 2.2; 95% CI, 1.0 to 4.8), dithiocarbamate fungicides (OR, 2.5; 95% CI, 1.1 to 5.3) and carbamate insecticides (OR, 3.0; 95% CI, 1.4 to 6.5). A factor analysis of pesticides used identified 3 distinct factors. The most common factor was that of multiple pesticide use that included 9 pesticides and was significantly associated with allergic rhinitis (OR, 1.5; 95% CI, 1.0 to 2.3). ORs were higher when allergic rhinitis was defined using both questionnaire data on symptoms and atopy. Conclusions Occupational exposure to multiple agricultural chemicals could be related to allergic rhinitis in grape farmers. PMID:17182637

  10. Masticatory Changes in Oral Breath Secondary to Allergic Rhinitis: Integrative Review

    PubMed Central

    Bezerra, Luciana Ângelo; Silva, Hilton Justino da; Melo, Ana Carolina Cardoso de; Moraes, Klyvia Juliana Rocha de; Cunha, Renata Andrade da; Cunha, Daniele Andrade da; Medeiros, Décio

    2013-01-01

    Introduction The III Brazilian Consensus on Rhinitis (2012) defines allergic rhinitis as a nasal mucosa inflammation, mediated by immunoglobulin E, after exposure to allergens. The classic signs and symptoms of allergic rhinitis are nasal obstruction, watery rhinorrhea, sneezing, and nasal itching, often reversible either spontaneously or with treatment, and mouth breathing (breathing predominantly through the mouth, regardless of the cause, due to a nasal breathing impairment) in some cases. Objective To evaluate the literature on masticatory changes in children with mouth breathing due to allergic rhinitis. Methods We conducted a search of the past 10 years, at Bireme and MEDLINE databases, for articles that covered masticatory changes in children with mouth breathing secondary to allergic rhinitis. Results We found 1,986 articles, including 15 repeated in databases, but only two articles met the inclusion criteria fully. Discussion We found few studies to answer the question raised in this review, and those studies have some methodological limitations. Most articles claimed no have statistically significant differences in masticatory changes in this population. Conclusion A better controlled study (isolating diseases, exposure time), with a larger sample (sample calculation appropriate), would be necessary to examine such changes. PMID:25992077

  11. Masticatory changes in oral breath secondary to allergic rhinitis: integrative review.

    PubMed

    Bezerra, Luciana Ângelo; Silva, Hilton Justino da; Melo, Ana Carolina Cardoso de; Moraes, Klyvia Juliana Rocha de; Cunha, Renata Andrade da; Cunha, Daniele Andrade da; Medeiros, Décio

    2014-04-01

    Introduction The III Brazilian Consensus on Rhinitis (2012) defines allergic rhinitis as a nasal mucosa inflammation, mediated by immunoglobulin E, after exposure to allergens. The classic signs and symptoms of allergic rhinitis are nasal obstruction, watery rhinorrhea, sneezing, and nasal itching, often reversible either spontaneously or with treatment, and mouth breathing (breathing predominantly through the mouth, regardless of the cause, due to a nasal breathing impairment) in some cases. Objective To evaluate the literature on masticatory changes in children with mouth breathing due to allergic rhinitis. Methods We conducted a search of the past 10 years, at Bireme and MEDLINE databases, for articles that covered masticatory changes in children with mouth breathing secondary to allergic rhinitis. Results We found 1,986 articles, including 15 repeated in databases, but only two articles met the inclusion criteria fully. Discussion We found few studies to answer the question raised in this review, and those studies have some methodological limitations. Most articles claimed no have statistically significant differences in masticatory changes in this population. Conclusion A better controlled study (isolating diseases, exposure time), with a larger sample (sample calculation appropriate), would be necessary to examine such changes. PMID:25992077

  12. Asthma and Rhinitis Are Associated with Less Objectively-Measured Moderate and Vigorous Physical Activity, but Similar Sport Participation, in Adolescent German Boys: GINIplus and LISAplus Cohorts

    PubMed Central

    Berdel, Dietrich; Bauer, Carl-Peter; Koletzko, Sibylle; Nowak, Dennis; Heinrich, Joachim; Schulz, Holger

    2016-01-01

    Introduction Physical activity (PA) protects against most noncommunicable diseases and has been associated with decreased risk of allergic phenotype, which is increasing worldwide. However, the association is not always present; furthermore it is not clear whether it is strongest for asthma, rhinitis, symptoms of these, or atopic sensitization; which sex is most affected; or whether it can be explained by either avoidance of sport or exacerbation of symptoms by exercise. Interventions are thus difficult to target. Methods PA was measured by one-week accelerometry in 1137 Germans (mean age 15.6 years, 47% boys) from the GINIplus and LISAplus birth cohorts, and modeled as a correlate of allergic symptoms, sensitization, or reported doctor-diagnosed asthma or rhinitis. Results 8.3% of children had asthma, of the remainder 7.9% had rhinitis, and of the remainder 32% were sensitized to aero-allergens (atopic). 52% were lung-healthy controls. Lung-healthy boys and girls averaged 46.4 min and 37.8 min moderate-to-vigorous PA per day, of which 14.6 and 11.4 min was vigorous. PA in allergic girls was not altered, but boys with asthma got 13% less moderate and 29% less vigorous PA, and those with rhinitis with 13% less moderate PA, than lung-healthy boys. Both sexes participated comparably in sport (70 to 84%). Adolescents with wheezing (up to 68%, in asthma) and/or nose/eye symptoms (up to 88%, in rhinitis) were no less active. Conclusions We found that asthma and rhinitis, but not atopy, were independently associated with low PA in boys, but not in girls. These results indicate that allergic boys remain a high-risk group for physical inactivity even if they participate comparably in sport. Research into the link between PA and allergy should consider population-specific and sex-specific effects, and clinicians, parents, and designers of PA interventions should specifically address PA in allergic boys to ensure full participation. PMID:27560942

  13. The effects of perennial allergic rhinitis on dental and skeletal development: a comparison of sibling pairs.

    PubMed

    Trask, G M; Shapiro, G G; Shapiro, P A

    1987-10-01

    This study analyzed the effect of perennial allergic rhinitis on dental and facial skeletal characteristics. Twenty-five allergic children who were apparent mouth breathers, their 25 siblings who did not have the disease and were apparent nose breathers, and 14 nasal breathing control subjects were examined medically, dentally, and cephalometrically. Compared with their siblings, the allergic subjects had more nasal mucosal edema, a higher proportion of eosinophils in their nasal secretions, and greater nasal power. The allergic subjects were characterized by deeper palatal height, retroclined mandibular incisors, increased total anterior facial height and lower facial height, a larger gonial angle, and greater SN, palatal, and occlusal planes to mandibular plane angles. All of these measures except gonial angle were also significantly different between the allergic children and the nonconsanguineous controls. Also, the allergic subjects compared with controls had smaller SNB and SN-pogonion angles and an increased overjet. Both allergic and nonallergic sibling groups showed larger mean adenoid size on radiographs than controls. For most variables the nonallergic siblings fell between the allergic children and the control subjects. Overall, the allergic children had longer, more retrusive faces than controls. This retrusive characteristic was present in nonallergic siblings and cannot be ascribed to the apparent breathing mode at the time of the study. These results confirm earlier reports that allergic rhinitis may be associated with altered facial growth. Controlled longitudinal studies to analyze a possible cause-and-effect relationship and the effects of medical and surgical treatments should be undertaken. PMID:3477946

  14. Allergic and nonallergic asthma in children: are they distinct phenotypes?

    PubMed

    Mahdaviani, Seyed Alireza; Mohajerani, Seyed Amir; Fakhri, Mohammad; Ebrahimi, Mazaher; Bashardoost, Bahram; Razavi, Seyed Jafar; Toolabi, Masoumeh; Tajik, Ali; Khalilzadeh, Soheila; Masjedi, Mohamad Reza

    2014-10-01

    The aim of current study is to describe clinical similarities and differences between atopic and non-atopic asthma in children. In a cross-sectional study, 95 asthmatic children (75 allergics and 20 nonallergics) were included in the study. Demographic, clinical, and familial history were compared between two groups. There was no significant differences between variables like sex, age of onset (p=0.75), severity (p=0.70), and family history among the two groups (p=0.42). Patients with allergic asthma were significantly older than those with non- allergic asthma (11.28 ± 3.19 and 9.75 ± 2.35 years, respectively, p=0.02). The controversy lingers over the presence of a completely distinct phenotype of non-atopic asthma in children. Our study suggested that phenotypes of allergic and non-allergic asthma in children were not entirely distinct. PMID:25150079

  15. Do mouse models of allergic asthma mimic clinical disease?

    PubMed

    Epstein, Michelle M

    2004-01-01

    Experimental mouse models of allergic asthma established almost 10 years ago offered new opportunities to study disease pathogenesis and to develop new therapeutics. These models focused on the factors governing the allergic immune response, on modeling clinical behavior of allergic asthma, and led to insights into pulmonary pathophysiology. Although mouse models rarely completely reproduce all the features of human disease, after sensitization and respiratory tract challenges with antigen, wild-type mice develop a clinical syndrome that closely resembles allergic asthma, characterized by eosinophilic lung inflammation, airway hyperresponsiveness (AHR), increased IgE, mucus hypersecretion, and eventually, airway remodeling. There are, however, differences between mouse and human physiology that threaten to limit the value of mouse models. Three examples of such differences relate to both clinical manifestations of disease and underlying pathogenesis. First, in contrast to patients who have increased methacholine-induced AHR even when they are symptom-free, mice exhibit only transient methacholine-induced AHR following allergen exposure. Second, chronic allergen exposure in patients leads to chronic allergic asthma, whereas repeated exposures in sensitized mice causes suppression of disease. Third, IgE and mast cells, in humans, mediate early- and late-phase allergic responses, though both are unnecessary for the generation of allergic asthma in mice. Taken together, these observations suggest that mouse models of allergic asthma are not exact replicas of human disease and thus, question the validity of these models. However, observations from mouse models of allergic asthma support many existing paradigms, although some novel discoveries in mice have yet to be verified in patients. This review presents an overview of the clinical aspects of disease in mouse models of allergic asthma emphasizing (1). the factors influencing the pathophysiological responses during

  16. DOSE-DEPENDENT ALLERGIC ASTHMA RESPONSES TO PENICILLIUM CHRYSOGENUM

    EPA Science Inventory

    ABSTRACT
    Indoor mold has been associated with development of allergic asthma. Penicillium chrysogenum, a common indoor mold, is known to have several allergens and its viable conidia can induce allergic responses in a mouse model of allergic penicilliosis. The hypothesis o...

  17. Treatment of allergic rhinitis and urticaria: a review of the newest antihistamine drug bilastine.

    PubMed

    Wang, Xue Yan; Lim-Jurado, Margaret; Prepageran, Narayanan; Tantilipikorn, Pongsakorn; Wang, De Yun

    2016-01-01

    Allergic rhinitis and urticaria are common allergic diseases that may have a major negative impact on patients' quality of life. Bilastine, a novel new-generation antihistamine that is highly selective for the H1 histamine receptor, has a rapid onset and prolonged duration of action. This agent does not interact with the cytochrome P450 system and does not undergo significant metabolism in humans, suggesting that it has very low potential for drug-drug interactions, and does not require dose adjustment in renal impairment. As bilastine is not metabolized and is excreted largely unchanged, hepatic impairment is not expected to increase systemic exposure above the drug's safety margin. Bilastine has demonstrated similar efficacy to cetirizine and desloratadine in patients with seasonal allergic rhinitis and, in a Vienna Chamber study, a potentially longer duration of action than fexofenadine in patients with asymptomatic seasonal allergic rhinitis. It has also shown significant efficacy (similar to that of cetirizine) and safety in the long-term treatment of perennial allergic rhinitis. Bilastine showed similar efficacy to levocetirizine in patients with chronic spontaneous urticaria and can be safely used at doses of up to fourfold higher than standard dosage (80 mg once daily). The fourfold higher than standard dose is specified as an acceptable second-line treatment option for urticaria in international guidelines. Bilastine is generally well tolerated, both at standard and at supratherapeutic doses, appears to have less sedative potential than other second-generation antihistamines, and has no cardiotoxicity. Based on its pharmacokinetic properties, efficacy, and tolerability profile, bilastine will be valuable in the management of allergic rhinitis and urticaria. PMID:27110120

  18. Treatment of allergic rhinitis and urticaria: a review of the newest antihistamine drug bilastine

    PubMed Central

    Wang, Xue Yan; Lim-Jurado, Margaret; Prepageran, Narayanan; Tantilipikorn, Pongsakorn; Wang, De Yun

    2016-01-01

    Allergic rhinitis and urticaria are common allergic diseases that may have a major negative impact on patients’ quality of life. Bilastine, a novel new-generation antihistamine that is highly selective for the H1 histamine receptor, has a rapid onset and prolonged duration of action. This agent does not interact with the cytochrome P450 system and does not undergo significant metabolism in humans, suggesting that it has very low potential for drug–drug interactions, and does not require dose adjustment in renal impairment. As bilastine is not metabolized and is excreted largely unchanged, hepatic impairment is not expected to increase systemic exposure above the drug’s safety margin. Bilastine has demonstrated similar efficacy to cetirizine and desloratadine in patients with seasonal allergic rhinitis and, in a Vienna Chamber study, a potentially longer duration of action than fexofenadine in patients with asymptomatic seasonal allergic rhinitis. It has also shown significant efficacy (similar to that of cetirizine) and safety in the long-term treatment of perennial allergic rhinitis. Bilastine showed similar efficacy to levocetirizine in patients with chronic spontaneous urticaria and can be safely used at doses of up to fourfold higher than standard dosage (80 mg once daily). The fourfold higher than standard dose is specified as an acceptable second-line treatment option for urticaria in international guidelines. Bilastine is generally well tolerated, both at standard and at supratherapeutic doses, appears to have less sedative potential than other second-generation antihistamines, and has no cardiotoxicity. Based on its pharmacokinetic properties, efficacy, and tolerability profile, bilastine will be valuable in the management of allergic rhinitis and urticaria. PMID:27110120

  19. Presence of other allergic disease modifies the effect of early childhood traffic-related air pollution exposure on asthma prevalence.

    PubMed

    Dell, Sharon D; Jerrett, Michael; Beckerman, Bernard; Brook, Jeffrey R; Foty, Richard G; Gilbert, Nicolas L; Marshall, Laura; Miller, J David; To, Teresa; Walter, Stephen D; Stieb, David M

    2014-04-01

    Nitrogen dioxide (NO2), a surrogate measure of traffic-related air pollution (TRAP), has been associated with incident childhood asthma. Timing of exposure and atopic status may be important effect modifiers. We collected cross-sectional data on asthma outcomes from Toronto school children aged 5-9years in 2006. Lifetime home, school and daycare addresses were obtained to derive birth and cumulative NO2 exposures for a nested case-control subset of 1497 children. Presence of other allergic disease (a proxy for atopy) was defined as self-report of one or more of doctor-diagnosed rhinitis, eczema, or food allergy. Generalized estimating equations were used to adjust for potential confounders, and examine hypothesized effect modifiers while accounting for clustering by school. In children with other allergic disease, birth, cumulative and 2006 NO2 were associated with lifetime asthma (OR 1.46, 95% CI 1.08-1.98; 1.37, 95% CI 1.00-1.86; and 1.60, 95% CI 1.09-2.36 respectively per interquartile range increase) and wheeze (OR 1.44, 95% CI 1.10-1.89; 1.31, 95% CI 1.02-1.67; and 1.60, 95% CI 1.16-2.21). No or weaker effects were seen in those without allergic disease, and effect modification was amplified when a more restrictive algorithm was used to define other allergic disease (at least 2 of doctor diagnosed allergic rhinitis, eczema or food allergy). The effects of modest NO2 levels on childhood asthma were modified by the presence of other allergic disease, suggesting a probable role for allergic sensitization in the pathogenesis of TRAP initiated asthma. PMID:24472824

  20. Prevalence and risk factors of asthma and allergic diseases in primary schoolchildren living in Bushehr, Iran: phase I, III ISAAC protocol.

    PubMed

    Farrokhi, Shokrollah; Gheybi, Mohammad Kazzem; Movahhed, Ali; Dehdari, Reyhaneh; Gooya, Mostafa; Keshvari, Saman; Gholampour, Hossein; Mansourian, Zohreh; Khosravi, Yasaman; Ghahramani, Forough; Zandi, Sahar; Etemadan, Razieh; Tahmasebi, Rahim; Reaisi, Alireza; Keshmiri, Saeed; Fadaizadeh, Lida; Masjedi, Mohammad Reza

    2014-10-01

    Asthma and allergic diseases present a major health burden. Information on the prevalence of these diseases indicates that these diseases are increasing in various parts of the world. It was hoped that this study would be helpful to health system policy-makers in planning allergy prevention programs in the region.The prevalence of asthma and allergic diseases and relation between the various risk factors involved were assessed among schoolchildren in the city of Bushehr, Iran. The ISAAC Phase I and III questionnaires were completed by parents of 1280 children aged 6-7 years and self-completed by 1115 students aged 13-14 years.The prevalence of atopic eczema, allergic rhinitis and asthma among 6-7 year-old students were 12.1%, 11.8% and 6.7%, respectively. While, the prevalence of these diseases among 13-14 year-old students were found to be 19%, 30% and 7.6%, respectively. There was an association between asthma and allergic rhinitis as well as eczema (p<0.05). Consumption of fast food as a risk factor was significantly associated with asthma (p=0.03).The prevalence of asthma and allergic diseases was high among schoolchildren in the city of Bushehr, Iran. Also an association was observed between the fast food consumption and asthma. PMID:25150076

  1. Allergic reaction to mint leads to asthma.

    PubMed

    Szema, Anthony M; Barnett, Tisha

    2011-01-01

    Respiratory and cutaneous adverse reactions to mint can result from several different mechanisms including IgE-mediated hypersensitivity, delayed-type hypersensitivity (contact dermatitis), and nonimmunologic histamine release. Reactions to cross-reacting plants of the Labiatae family, such as oregano and thyme, as well as to the chemical turpentine, may clue the clinician in on the diagnosis of mint allergy. Contact dermatitis can result from menthol in peppermint. Contact allergens have been reported in toothpastes, which often are mint-flavored. Allergic asthma from mint is less well-recognized. A case of a 54-year-old woman with dyspnea on exposure to the scent of peppermint is presented in whom mint exposure, as seemingly innocuous as the breath of others who had consumed Tic Tac candies, exacerbated her underlying asthma. This case highlights the importance of testing with multiple alternative measures of specific IgE to mint, including skin testing with mint extract, and skin testing with fresh mint leaves. Additionally, this cases suggests that asthma can result from inhaling the scent of mint and gives consideration to obtaining confirmatory pre- and postexposure pulmonary function data by both impulse oscillometry and spirometry. PMID:22852115

  2. Levocetirizine: a review of its use in the management of allergic rhinitis and skin allergies.

    PubMed

    Hair, Philip I; Scott, Lesley J

    2006-01-01

    Levocetirizine (Xyzal) is a selective, potent, oral histamine H(1) receptor antagonist of the latest generation that is licensed for the symptomatic treatment of allergic rhinitis (including persistent allergic rhinitis [PER]) and chronic idiopathic urticaria (CIU). Large, well designed trials indicate that levocetirizine is effective and generally well tolerated in the treatment of allergic rhinitis and CIU. Its pharmacological profile offers many positive aspects: a rapid onset and long duration of antihistaminic effect; rapid absorption and high bioavailability; a low potential for drug interactions; a low volume of distribution; and a lack of effect on cognition, psychomotor function and the cardiovascular system. Allergen challenge chamber studies suggest that levocetirizine has better efficacy than desloratadine, loratadine or fexofenadine. Well controlled, long-term studies with other later-generation H(1) receptor antagonists are required to fully define its clinical profile relative to other agents in this class. Overall, levocetirizine is a valuable addition to the oral H(1) receptor antagonists available for the treatment of allergic rhinitis and as first-line therapy in patients with CIU. PMID:16740020

  3. Histopathological effects of intranasal phototherapy and nasal corticosteroids in allergic rhinitis in a rabbit model.

    PubMed

    Yurttas, Veysel; Şereflican, Murat; Erkoçoğlu, Mustafa; Terzi, Elçin Hakan; Kükner, Aysel; Oral, Mesut

    2015-08-01

    Allergic rhinitis is one of the most common health problems and has a major effect on quality of life. Although new-generation antihistamines and nasal steroids are the main treatment options, complete resolution cannot be obtained in some patients. Besides common side effects such as nasal irritation and epistaxis, the use of these drugs is controversial in some patients, such as pregnant or breastfeeding women. These findings highlight the need for new treatment options. Although phototherapy has been successfully used in the treatment of atopic dermatitis, which is an IgE-mediated disease and shares several common pathogenic features with allergic rhinitis, there are limited studies about its role in the treatment of allergic rhinitis. In this study, we aimed to evaluate and compare the histopathological effects of intranasal phototherapy (Rhinolight) and nasal corticosteroid treatment on the nasal mucosa in allergic rhinitis in a rabbit model and we found that both treatment options significantly reduced inflammation in the nasal mucosa without increasing apoptosis of mucosal cells. PMID:26123190

  4. New H1/H3 antagonists for treating allergic rhinitis: WO2010094643.

    PubMed

    Norman, Peter

    2011-03-01

    This application claims dual receptor specificity antihistamines, active as H(1) and H(3) antagonists, which additionally have a long duration of action that renders them suitable for once daily administration via inhalation for the treatment of allergic rhinitis. The compounds lack CNS penetration and have a high affinity for both histamine receptors. PMID:21342057

  5. Allergic Rhinitis: Burden of Illness, Quality of Life, Comorbidities, and Control.

    PubMed

    Meltzer, Eli O

    2016-05-01

    Allergic rhinitis is a highly prevalent and costly condition. The disease burden suffered by patients includes the morbidity of the nasal symptoms, the impairment of multiple domains of quality of life, and numerous comorbidities. The goal of therapy is long-term good control. PMID:27083099

  6. Academic Functioning and Quality of Life of Children and Adolescents with Allergic Rhinitis--Part II

    ERIC Educational Resources Information Center

    McCabe, Paul C.

    2008-01-01

    This article is the second of a two-part series on allergic rhinitis (AR). Treatments for AR are now widely available in both prescription and over-the-counter form. The medication therapies include antihistamines, decongestants, leukotriene receptor antagonists, cromolyn sodium, and immunotherapy. Corticosteroids are also used via nasal…

  7. Effects of Rhinophototherapy on Quality of Life in Persistant Allergic Rhinitis

    PubMed Central

    Korkmaz, Hakan; Sürenoğlu, Ünzile Akpinar; Saylam, Güleser; Özdek, Ali

    2013-01-01

    Objectives To investigate the effect of rhinophototherapy with medical therapy on quality of life in persistent allergic rhinitis. Methods A prospective, randomized study was being performed between December 2009 and March 2010. The study included 65 patients with persistent allergic rhinitis. The diagnosis was confirmed with positive skin tests. All of the patients had house dust mite allergies. We divided the patients into two groups. First group (n=33) was given topical mometasone furoate 200 mcg/day and levocetirizine 5 mg/day for a month. Rhinophototherapy was applied with the same medical therapy to the second group (n=32), twice a week for three weeks continuously. Rhinophototherapy included visible light, ultraviolet A and ultraviolet B. We evaluated patients before the treatment, at the first month and at the third month after treatment with rhinoconjunctivitis quality of life questionnaire, nasal symptom scores and visual analogue scale (VAS) scores. Results Improvements of all variables of the quality of life questionnaire, nasal symptom scores and VAS were statistically significant in the second group both on the first and the third months when compared with the first group. Conclusion Allergic rhinitis is a social problem and impairs quality of life. Rhinophototherapy with medical therapy improves the quality of life in allergic rhinitis. PMID:23799163

  8. A role for the intranasal formulation of azelastine hydrochloride/fluticasone propionate in the treatment of allergic rhinitis.

    PubMed

    Ridolo, Erminia; Montagni, Marcello; Melli, Valerie; Bonzano, Laura; Incorvaia, Cristoforo; Canonica, Giorgio Walter

    2015-01-01

    Rhinitis is a very common disease and represents a health problem for both children and adults globally. Rhinitis can be allergic or occur without any IgE-mediated sensitization to aeroallergens. Common symptoms include nasal congestion, postnasal drainage, nasal itching, rhinorrhea and sneezing. The most effective drugs for the treatment of rhinitis are antihistamines and topical glucocorticoids. MP29-02 (Dymista(®)) is a novel intranasal formulation combining the second-generation antihistamine, azelastine hydrochloride, with fluticasone propionate in a single device that has recently been developed. Here, we review the efficacy and safety profile of this intranasal formulation in the treatment of allergic and nonallergic rhinitis. PMID:25913181

  9. The natural compound nujiangexanthone A suppresses mast cell activation and allergic asthma.

    PubMed

    Lu, Yue; Cai, Shuangfan; Nie, Jia; Li, Yangyang; Shi, Guochao; Hao, Jimin; Fu, Wenwei; Tan, Hongsheng; Chen, Shilin; Li, Bin; Xu, Hongxi

    2016-01-15

    Mast cells play an important role in allergic diseases such as asthma, allergic rhinitis and atopic dermatitis. The genus Garcinia of the family Guttiferae is well known as a prolific source of polycyclic polyprenylated acylphloroglucinols and bioactive prenylated xanthones, which exhibit various biological activities including antibacterial, antifungal, anti-inflammatory, antioxidant, and cytotoxic effects. Nujiangexanthone A (N7) is a novel compound isolated from the leaves of Garcinia nujiangensis. In this paper, we sought to determine the anti-allergic and anti-inflammation activity of N7 in vivo and its mechanism in vitro. We found N7 suppressed IgE/Ag induced mast cell activiation, including degranulation and production of cytokines and eicosanoids, through inhibiting Src kinase activity and Syk dependent pathways. N7 inhibited histamine release, prostaglandin D2 and leukotriene C4 generation in mast cell dependent passive cutaneous anaphylaxis animal model. We also found N7 inhibited the IL-4, IL-5, IL-13 and IgE levels in ovalbumin-induced asthma model. Histological studies demonstrated that N7 substantially inhibited OVA-induced cellular infiltration and increased mucus production in the lung tissue. Our study reveals the anti-allergic function of N7, thereby suggesting the utility of this compound as a possible novel agent for preventing mast cell-related immediate and delayed allergic diseases. PMID:26571438

  10. Incidence of rhinitis and asthma related to welding in Northern Europe.

    PubMed

    Storaas, Torgeir; Zock, Jan-Paul; Morano, Ana Espinosa; Holm, Mathias; Bjørnsson, Eythor; Forsberg, Bertil; Gislason, Thorarinn; Janson, Christer; Norback, Dan; Omenaas, Ernst; Schlünssen, Vivi; Torén, Kjell; Svanes, Cecilie

    2015-11-01

    Welding-related asthma is well recognised but less is known about rhinitis in relation to welding. The aim here, was to study associations between welding, rhinitis and asthma in a general population sample, and factors influencing selection into and out of a welding occupation.Adult-onset asthma and non-infectious rhinitis were investigated in the international multicentre population-based Respiratory Health in Northern Europe (RHINE) study, including 16,191 responders aged 26-54 years. Ever welding (n=2181), welding >25% of working time (n=747), and welding in stainless steel >6 months (n=173) were assessed by questionnaire. Subjects with rhinitis or asthma onset when aged <18 years were excluded. Incidence rates for asthma and rhinitis were calculated from year of disease onset, and start and end of welding job. Cox's proportional hazard models adjusting for age, sex, parental education and study centre, and Kaplan-Meier curves were used.Rhinitis incidence was higher among welders (hazard ratio (HR) 1.4, 95% CI 1.3-1.6), consistent in men and women, and across centres (pheterogeneity=0.4). In men, asthma incidence was higher among welders (HR 1.4, 95% CI 1.04-1.97). Quitting welding was indicated higher after adult-onset rhinitis (HR 1.1, 95% CI 1.0-1.3). Adult-onset rhinitis and asthma was higher among welders, consistent across population samples from Northern Europe. No pre-employment selection was found, whereas selection out of welding jobs was suggested. PMID:26206878

  11. Comparative responses to nasal allergen challenge in allergic rhinitic subjects with or without asthma

    PubMed Central

    2011-01-01

    Background Nasal allergen challenge (NAC) is useful to study the pathophysiology of rhinitis, and multiple challenges may more adequately approximate natural exposure. Objective To determine the effect of 4 consecutive daily NAC, on clinical and inflammatory parameters in rhinitics with or without asthma. Methods Rhinitic subjects were recruited: 19 with mild asthma and 13 without asthma. Subjects underwent a control challenge (normal saline) followed by 4 consecutive daily NAC. Allergen challenge consisted of spraying the chosen allergen extract into each nostril until a positive nasal response occurred. Symptoms were recorded on a Likert scale, and oral peak expiratory and nasal peak inspiratory flows allowed assessment of a nasal blockage index (NBI), for a period of 7 hours. Induced sputum and nasal lavage were performed on control day and after 1 and 4 days of NAC. Results Compared with the control day, there was a significant increase in symptom scores and NBI 10 minutes after each last daily NAC in both groups (p < 0.05). Symptom scores and NBI were similar for the 2 groups, except for nasal obstruction and rhinorrhea, which were more marked in subjects with asthma and rhinitis, respectively. Nasal lavage eosinophils were increased after 4 days of challenges in both groups, but there was no change in sputum eosinophils. No cumulative effect or any late response were observed in any of the groups over the challenge period. Conclusion Multiple NAC may be a useful tool to study the pathophysiology of allergic rhinitis or its relationships with asthma. Trial registration ClinicalTrials.gov NCT01286129 PMID:21507261

  12. Exposure to particulate hexavalent chromium exacerbates allergic asthma pathology

    SciTech Connect

    Schneider, Brent C.; Constant, Stephanie L.; Patierno, Steven R.; Jurjus, Rosalyn A.; Ceryak, Susan M.

    2012-02-15

    Airborne hexavalent chromate, Cr(VI), has been identified by the Environmental Protection Agency as a possible health threat in urban areas, due to the carcinogenic potential of some of its forms. Particulate chromates are produced in many different industrial settings, with high levels of aerosolized forms historically documented. Along with an increased risk of lung cancer, a high incidence of allergic asthma has been reported in workers exposed to certain inhaled particulate Cr(VI) compounds. However, a direct causal association between Cr(VI) and allergic asthma has not been established. We recently showed that inhaled particulate Cr(VI) induces an innate neutrophilic inflammatory response in BALB/c mice. In the current studies we investigated how the inflammation induced by inhaled particulate Cr(VI) might alter the pathology of an allergic asthmatic response. We used a well-established mouse model of allergic asthma. Groups of ovalbumin protein (OVA)-primed mice were challenged either with OVA alone, or with a combination of OVA and particulate zinc chromate, and various parameters associated with asthmatic responses were measured. Co-exposure to particulate Cr(VI) and OVA mediated a mixed form of asthma in which both eosinophils and neutrophils are present in airways, tissue pathology is markedly exacerbated, and airway hyperresponsiveness is significantly increased. Taken together these findings suggest that inhalation of particulate forms of Cr(VI) may augment the severity of ongoing allergic asthma, as well as alter its phenotype. Such findings may have implications for asthmatics in settings in which airborne particulate Cr(VI) compounds are present at high levels. -- Highlights: ► Allergic asthma correlated with exposure to certain inhaled particulate chromates. ► Direct causal association between Cr(VI) and allergic asthma not established. ► Cr exacerbated pathology and airway hyperresponsiveness in an OVA-challenged mouse. ► Particulate Cr

  13. Prevention of allergic rhinitis by ginger and the molecular basis of immunosuppression by 6-gingerol through T cell inactivation.

    PubMed

    Kawamoto, Yoshiyuki; Ueno, Yuki; Nakahashi, Emiko; Obayashi, Momoko; Sugihara, Kento; Qiao, Shanlou; Iida, Machiko; Kumasaka, Mayuko Y; Yajima, Ichiro; Goto, Yuji; Ohgami, Nobutaka; Kato, Masashi; Takeda, Kozue

    2016-01-01

    The incidence of allergies has recently been increasing worldwide. Immunoglobulin E (IgE)-mediated hypersensitivity is central to the pathogenesis of asthma, hay fever and other allergic diseases. Ginger (Zingiber officinale Roscoe) and its extracts have been valued for their medical properties including antinausea, antiinflammation, antipyresis and analgesia properties. In this study, we investigated the antiallergic effects of ginger and 6-gingerol, a major compound of ginger, using a mouse allergy model and primary/cell line culture system. In mice with ovalbumin (OVA)-induced allergic rhinitis, oral administration of 2% ginger diet reduced the severity of sneezing and nasal rubbing by nasal sensitization of OVA and suppressed infiltration of mast cells in nasal mucosa and secretion of OVA-specific IgE in serum. 6-Gingerol inhibited the expression of not only Th2 cytokines but also Th1 cytokines in OVA-sensitized spleen cells. Accordingly, 6-gingerol suppressed in vitro differentiation of both Th1 cells and Th2 cells from naïve T cells. In addition, 6-gingerol suppressed both superantigen staphylococcal enterotoxin B (SEB)- and anti-CD3-induced T cell proliferation. 6-Gingerol also abrogated PMA plus ionomycin- and SEB-induced IL-2 production in T cells, suggesting that 6-gingerol affected T cell receptor-mediated signal transduction rather than the antigen-presentation process. Indeed, 6-gingerol inhibited the phosphorylation of MAP kinases, calcium release and nuclear localization of c-fos and NF-κB by PMA and ionomycin stimulation. Thus, our results demonstrate that 6-gingerol suppresses cytokine production for T cell activation and proliferation, thereby not causing B cell and mast cell activation and resulting in prevention or alleviation of allergic rhinitis symptoms. PMID:26403321

  14. Quality of life in adults and children with allergic rhinitis.

    PubMed

    Meltzer, E O

    2001-07-01

    Quality of life, when referring to an individual's health, is called health-related quality of life (HRQL). HRQL focuses on patients' perceptions of their disease and measures impairments that have significant impact on the patient. Similar symptoms may vary in their effect on different individuals; the goal of therapy should be to reduce impairments that patients consider important. HRQL can be measured with generic or specific questionnaires. Specific questionnaires may be more sensitive and are much more likely to detect clinically important changes in patients' impairments. Specific questionnaires used to assess HRQL in rhinitis are the Rhinoconjunctivitis Quality of Life Questionnaire, the Adolescent Rhinoconjunctivitis Quality of Life Questionnaire, and the Pediatric Rhinoconjunctivitis Quality of Life Questionnaire. HRQL issues in adult rhinitis patients include fatigue, decrease in energy, general health perception, and social function; impairment of HQRL generally increases with increasing degree of symptoms and severity of disease. In children, HRQL issues include learning impairment, inability to integrate with peers, anxiety, and family dysfunction. Comorbid disorders often associated with rhinitis, including sinusitis, otitis media, and frequent respiratory infections, can further compromise HRQL. Pharmacologic treatments can have both positive and negative effects on HRQL. Agents that have troublesome adverse effects such as sedation can have a negative impact, whereas nonsedating antihistamines and intranasal cortico-steroids can significantly improve HRQL in patients of all ages with rhinitis. PMID:11449206

  15. Allergies, asthma, and pollen

    MedlinePlus

    Allergic rhinitis - pollen ... them is your first step toward feeling better. Pollen is a trigger for many people who have allergies and asthma. The types of pollens that are triggers vary from person to person ...

  16. Mouse Model of Cat Allergic Rhinitis and Intranasal Liposome-Adjuvanted Refined Fel d 1 Vaccine

    PubMed Central

    Tasaniyananda, Natt; Chaisri, Urai; Tungtrongchitr, Anchalee; Chaicumpa, Wanpen; Sookrung, Nitat

    2016-01-01

    Cats (Felis domesticus) are rich source of airborne allergens that prevailed in the environment and sensitized a number of people to allergy. In this study, a mouse model of allergic rhinitis caused by the cat allergens was developed for the first time and the model was used for testing therapeutic efficacy of a novel intranasal liposome-entrapped vaccines made of native Fel d 1 (major cat allergen) in comparison with the vaccine made of crude cat hair extract (cCE). BALB/c mice were sensitized with cCE mixed with alum intraperitoneally and intranasally. The allergic mice were treated with eight doses of either liposome (L)-entrapped native Fel d 1 (L-nFD1), L-cCE), or placebo on every alternate day. Vaccine efficacy evaluation was performed one day after provoking the treated mice with aerosolic cCE. All allergenized mice developed histological features of allergic rhinitis with rises of serum specific-IgE and Th2 cytokine gene expression. Serum IgE and intranasal mucus production of allergic mice reduced significantly after vaccination in comparison with the placebo mice. The vaccines also caused a shift of the Th2 response (reduction of Th2 cytokine expressions) towards the non-pathogenic responses: Th1 (down-regulation of the Th1 suppressive cytokine gene, IL-35) and Treg (up-regulation of IL-10 and TGF-β). In conclusions, a mouse model of allergic rhinitis to cat allergens was successfully developed. The intranasal, liposome-adjuvanted vaccines, especially the refined single allergen formulation, assuaged the allergic manifestations in the modeled mice. The prototype vaccine is worthwhile testing further for clinical use in the pet allergic patients. PMID:26954254

  17. Mouse Model of Cat Allergic Rhinitis and Intranasal Liposome-Adjuvanted Refined Fel d 1 Vaccine.

    PubMed

    Tasaniyananda, Natt; Chaisri, Urai; Tungtrongchitr, Anchalee; Chaicumpa, Wanpen; Sookrung, Nitat

    2016-01-01

    Cats (Felis domesticus) are rich source of airborne allergens that prevailed in the environment and sensitized a number of people to allergy. In this study, a mouse model of allergic rhinitis caused by the cat allergens was developed for the first time and the model was used for testing therapeutic efficacy of a novel intranasal liposome-entrapped vaccines made of native Fel d 1 (major cat allergen) in comparison with the vaccine made of crude cat hair extract (cCE). BALB/c mice were sensitized with cCE mixed with alum intraperitoneally and intranasally. The allergic mice were treated with eight doses of either liposome (L)-entrapped native Fel d 1 (L-nFD1), L-cCE), or placebo on every alternate day. Vaccine efficacy evaluation was performed one day after provoking the treated mice with aerosolic cCE. All allergenized mice developed histological features of allergic rhinitis with rises of serum specific-IgE and Th2 cytokine gene expression. Serum IgE and intranasal mucus production of allergic mice reduced significantly after vaccination in comparison with the placebo mice. The vaccines also caused a shift of the Th2 response (reduction of Th2 cytokine expressions) towards the non-pathogenic responses: Th1 (down-regulation of the Th1 suppressive cytokine gene, IL-35) and Treg (up-regulation of IL-10 and TGF-β). In conclusions, a mouse model of allergic rhinitis to cat allergens was successfully developed. The intranasal, liposome-adjuvanted vaccines, especially the refined single allergen formulation, assuaged the allergic manifestations in the modeled mice. The prototype vaccine is worthwhile testing further for clinical use in the pet allergic patients. PMID:26954254

  18. The Effect of PM10 on Allergy Symptoms in Allergic Rhinitis Patients During Spring Season

    PubMed Central

    Kang, Il Gyu; Ju, Youn Hee; Jung, Joo Hyun; Ko, Kwang Pil; Oh, Dae Kyu; Kim, Jeong Hee; Lim, Dae Hyun; Kim, Young Hyo; Jang, Tae Young; Kim, Seon Tae

    2015-01-01

    Background: Asian sand dust (ASD) that originates in the Mongolian Desert in the spring induces serious respiratory health problems throughout East Asia (China, Korea, Japan). PM10 (particulate matter with an aerodynamic diameter <10 μm) is a major air pollutant component in ASD. We studied the effects of PM10 on allergy symptoms in patients with allergic rhinitis during the spring season, when ASD frequently develops. Methods: We investigated the changes in allergic symptoms in 108 allergic patients and 47 healthy subjects by comparing their 120-day symptom scores from February to May 2012. At the same time, the contributions of pollen count and PM10 concentration were also assessed. We also compared symptom scores before and 2 days after the daily PM10 concentration was >100 μg/m3. Results: The PM10 concentration during the 120 days was <150 μg/m3. No significant correlations were observed between changes in the PM10 concentration and allergic symptom scores (p > 0.05). However, allergic symptoms were significantly correlated with outdoor activity time (p < 0.001). Conclusions: These results demonstrate that a PM10 concentration <150 μg/m3 did not influence allergy symptoms in patients with allergic rhinitis during the 2012 ASD season. PMID:25590148

  19. Prevalences of asthma and rhinitis among adolescents in the city of Fortaleza, Brazil: temporal changes *

    PubMed Central

    de Luna, Maria de Fátima Gomes; Fischer, Gilberto Bueno; de Luna, João Rafael Gomes; da Silva, Marcelo Gurgel Carlos; de Almeida, Paulo César; Chiesa, Daniela

    2013-01-01

    OBJECTIVE: To describe the prevalences of asthma and rhinitis in adolescents (13-14 years of age) in the city of Fortaleza, Brazil, in 2010, comparing the results with those obtained in a prevalence survey conducted in 2006-2007. METHODS: This was a cross-sectional study involving probabilistic samples of 3,015 and 3,020 adolescents in surveys conducted in 2006-2007 and 2010, respectively. The International Study of Asthma and Allergies in Childhood protocol was used on both occasions. RESULTS: Comparing the two periods, there were no significant differences regarding cumulative wheezing, active asthma, four or more wheezing attacks within the last year, sleep disturbed by wheezing more than one night per week, and speech-limiting wheezing. The prevalences of exercise-induced wheezing, dry cough at night, and physician-diagnosed asthma were significantly higher in 2010 than in the 2006-2007 period (p < 0.01 for all). The prevalence of physician-diagnosed rhinitis was significantly lower in 2010 (p = 0.01), whereas there were no significant differences between the two periods regarding cumulative rhinitis, current rhinitis, and rhinoconjunctivitis. In both periods, dry cough at night, current rhinitis, and rhinoconjunctivitis were significantly more prevalent in females than in males (p < 0.01 for all). Also in both periods, active asthma, current rhinitis, and rhinoconjunctivitis were more prevalent in private school students than in public school students (p < 0.01 for all). CONCLUSIONS: Our data show that the prevalences of asthma and rhinitis symptoms remain high among 13- and 14-year-olds in Fortaleza, predominantly among females and private school students. PMID:23670497

  20. The Prevalence, Risk Factors and Changes in Symptoms of Self Reported Asthma, Rhinitis and Eczema Among Pregnant Women in Ogbomoso, Nigeria

    PubMed Central

    Adeyemi, Adewale Samson; Adebayo, Philip Babatunde; Tanimowo, Moses O.; Ayodele, Olugbenga Edward

    2015-01-01

    Background Allergic disorders have become a major public health concern worldwide. No Nigerian study has examined the epidemiology of allergic diseases among women. Aim To document the prevalence, risk factors and the changes in the symptoms of allergic disorders during pregnancy. Settings and Design Cross-sectional study conducted at the booking and antenatal clinics of LAUTECH Teaching Hospital and Millennium Development Goals (MDG) Clinic of the Comprehensive Health Center, Oja Igbo, Ogbomoso, Nigeria. Materials and Methods Study enrolled 432 women from two public hospitals. Sociodemographic and clinical history were obtained and allergic disorders were diagnosed using ISAAC questionnaires. Results The prevalence of wheezing, eczema and rhinitis in pregnancy are 7.5%, 4.0% and 5.8% respectively. The prevalence of wheezing and eczema was slightly higher among the pregnant in past 12 months. Wheeze worsened in 70% (18/26), improved in 15% (2/26), and stable in 15% (2/26). Eczema worsened in 50% (7/14), improved in 7.1% (1/14) and stable in 42.9% (6/14), while allergic rhinitis worsened in 50% (11/22), improved in 22.7% (5/22) and stabilized in 27.3 % (6/22). In multivariate analysis, the risk of allergic diseases in pregnancy was increase 2 times by low income earning (CI: 1.2 – 2.1, p = 0.002), low level education (OR = 0.6, CI: 0.3 – 0.9, p = 0.011) and by family history of asthma, OR-4.3, CI – 1.3 – 13.9, p = 0.015. Family history of asthma increase the chances of asthma by 18.7 times, CI-2.3 – 152.2, p = 0.006, while the odd of eczema was increased 9.1 times (CI-2.7 – 30.6, p<0.001) and 2.4 times (CI: 1.2 – 4.7, p = 0.008) by second hand home smoking and low-family income respectively. The risk of allergic rhinitis were raised 1.8 times by low family income (CI 1.1 – 2.8, p = 0.013) and 3.9 times by family history of rhinitis (OR = 3.9, CI 1.2 – 12.7, p = 0.024). Conclusion Prevalence of wheezing and eczema are higher in pregnancy probably

  1. Association of Allergic Rhinitis in Female University Students with Socio-economic Factors and Markers of Estrogens Levels.

    PubMed

    Wronka, I; Kliś, K; Jarzebak, K

    2016-01-01

    The aim of this study is to investigate the association of allergic rhinitis in female university students with socio-economic factors and sex-hormone markers, including age at menarche, menstrual disorders, and selected anthropometrics indexes. The research was conducted among 640 female university students, aged 19-25 years. The measurements of body height, body mass, waist and hip circumference were taken. Each person completed a questionnaire. The occurrence of allergy was determined on the basis of answers to the questions whether the allergy and its allergens were defined on the basis of medical workup. We found that a significantly larger number of cases of allergic rhinitis were recorded in the university students coming from families of high socio-economic level than those from lower level. Allergic rhinitis also was more frequent in the students who spent their childhood in cities than in those who lived in the countryside. The prevalence of allergic rhinitis was inversely correlated to the number of siblings. There were no differences in the prevalence of allergic rhinitis in relation to the birth order. The estrogen level seemed unassociated with rhinitis. However, there were slightly more allergic among females with an earlier age of menarche. PMID:26453067

  2. Key Mediators in the Immunopathogenesis of Allergic Asthma

    PubMed Central

    Hall, Sannette; Agrawal, Devendra K.

    2014-01-01

    Asthma is described as a chronic inflammatory disorder of the conducting airways. It is characterized by reversible airway obstruction, eosinophil and Th2 infiltration, airway hyper-responsiveness and airway remodeling. Our findings to date have largely been dependent on work done using animal models, which have been instrumental in broadening our understanding of the mechanism of the disease. However, using animals to model a uniquely human disease is not without its drawbacks. This review aims to examine some of the key mediators and cells of allergic asthma learned from animal models and shed some light on emerging mediators in the pathogenesis allergic airway inflammation in acute and chronic asthma. PMID:24933589

  3. Grass pollen sublingual immunotherapy and paediatric allergic rhinitis: A patient-oriented decision.

    PubMed

    Miceli Sopo, Stefano; Battista, Andrea; Greco, Monica; Monaco, Serena

    2016-01-01

    Guidelines and systematic review report that allergen immunotherapy (AIT) is, in general, effective in the treatment of allergic rhinitis. However, experts suggest not generalising the results of different clinical studies: for example, it would not be advisable to translate the results found in an adult population to a paediatric population or the results on the efficacy of AIT against a specific allergen to the AIT against a different allergen. Moreover, according to Evidence Based Medicine (EBM), clinical decisions are individualised and should derive from the "integration of best research evidence with clinical expertise and patient values". Taking into account the high specificity of the AIT and EBM principles, we tried to answer the question on how advisable it is to prescribe the AIT for the management of grass allergic rhinitis in children. To do this, we revised the scientific literature in order to solve a specific case scenario. PMID:26321601

  4. Loratadine-pseudoephedrine combination versus placebo in patients with seasonal allergic rhinitis.

    PubMed

    Grossman, J; Bronsky, E A; Lanier, B Q; Linzmayer, M I; Moss, B A; Schenkel, E J; Selner, J C

    1989-10-01

    Two hundred sixty-four patients with moderate to severe seasonal allergic rhinitis were treated with loratadine 5 mg plus pseudoephedrine 120 mg twice a day or placebo in a 28-day multicenter study. Four nasal and four non-nasal symptoms were evaluated for efficacy. At the last evaluable visit, the active treatment group had significantly lower (P = .05) mean combined nasal and non-nasal symptom scores than the placebo group. Also, the physician's rating of overall therapeutic response was significantly better in the active-treatment group (P = .03). Dry mouth, insomnia, and nervousness were reported by a significantly greater proportion (P less than or equal to .04) in the active-treatment group. Sedation occurred in 7% of patients in each treatment group and 6% of patients in each group discontinued the study because of adverse experiences. Loratadine plus pseudoephedrine was safe and significantly more effective than placebo in relieving the symptoms of allergic rhinitis. PMID:2529798

  5. Critical appraisal of Timothy grass pollen extract GRAZAX® in the management of allergic rhinitis

    PubMed Central

    Scaparrotta, Alessandra; Attanasi, Marina; Petrosino, Marianna I; Di Filippo, Paola; Di Pillo, Sabrina; Chiarelli, Francesco

    2015-01-01

    Allergic rhinitis is one of the most common diseases of adult and pediatric age, associated with grass pollen (GP) allergy in >50% cases, with a consistent impact on quality of life of affected patients. A grass allergen tablet, containing standardized extract derived from Timothy grass (Phleum pratense) pollen and ~15 μg major allergen P. pratense (rPhl p 5), may be the future of allergen-specific immunotherapy (IT) for GP allergy. The aim of this review was to critically evaluate the role of Timothy GP extract IT for the management of allergic rhinitis. For this purpose, we have tried to analyze potential mechanisms of action at the basis of Timothy GP extract, we have reviewed efficacy studies to establish potential benefits and clinical response, and we have also evaluated safety and tolerability profiles and patient focus perspective, such as quality of life, satisfaction and acceptability, and compliance to this IT. PMID:26604688

  6. Latest developments in allergic rhinitis in Allergy for clinicians and researchers.

    PubMed

    Ng, C L; Wang, D Y

    2015-12-01

    Research efforts in allergic rhinitis have always been intense. Over the past 3 years, numerous breakthroughs in basic science and clinical research have been made, augmenting our understanding of this condition that afflicts a significant proportion of the global population. New epidemiological findings, novel insights into the molecular and cellular mechanisms of allergy, enhancement of current developmental theories, new concepts of the goals and endpoints of management, and latest therapeutic modalities that includes the harnessing of information technology and big data are some areas where important advances were made. We attempt to bring you a summary of the key research advances made in the field of allergic rhinitis from 2013 to 2015. PMID:26443244

  7. Ancillary therapy of intranasal T-LysYal® for patients with allergic, non-allergic, and mixed rhinitis.

    PubMed

    Gelardi, M; Taliente, S; Fiorella, M L; Quaranta, N; Ciancio, G; Russo, C; Mola, P; Ciofalo, A; Zambetti, G; Caruso Armone, A; Cantone, E; Ciprandi, G

    2016-01-01

    Allergic rhinitis (AR) is caused by an IgE-mediated inflammatory reaction. Non-allergic rhinitis (NAR) is characterized by a non-IgE-mediated pathogenesis. Frequently, patients have the two disorders associated: such as mixed rhinitis (MR). Hyaluronic acid (HA) is a fundamental component of the human connective tissue. HA may exert anti-inflammatory and immune-modulating activities. Recently, an intranasal HA formulation was proposed: a supramolecular system containing lysine hyaluronate, thymine and sodium chloride (T-LysYal®). This randomized study investigated whether intranasal T-LysYal® (rinoLysYal®, Farmigea, Italy) was able to reduce symptom severity, endoscopic features, and nasal cytology in 89 patients (48 males and 41 females, mean age 36.3±7.1 years) with AR, NAR, and MR. Patients were treated with intranasal T-LysYal® or isotonic saline solution as adjunctive therapy to nasal corticosteroid and oral antihistamine for 4 weeks. Patients were visited at baseline, after treatment and after 4-week follow-up. Intranasal T-LysYal® treatment significantly reduced the quote of patients with symptoms, endoscopic features, and inflammatory cells. In conclusion, the present study demonstrates that intranasal T-LysYal® is able, as ancillary therapy, to significantly improve patients with AR, NAR, and MR, and its effect is long lasting. PMID:27049100

  8. Pathological observation of allergic rhinitis after Nd:YAG laser treatment

    NASA Astrophysics Data System (ADS)

    Kang, Mengkui; Zhang, Jihua; Ma, Danjia; Du, Yuqin

    1996-09-01

    Allergic rhinitis is a common disease. Although it is already treated well clinically by widely using a new technology laser that is very popular with patients, but it is still not found home and aboard the detail research report about the pathological changes of nasoturbinal tissues before and after laser treatment. Recently, in order to further study the histopathological changes of the oedematous nasoturbinal mucosa irradiated by Nd:YAG laser. We have made pathological observation of the biopsy.

  9. The effect of combined medical treatment on quality of life in persistent allergic rhinitis.

    PubMed

    Tatar, Emel Çadallı; Sürenoğlu, Unzile Akpınar; Ozdek, Ali; Saylam, Güleser; Korkmaz, Hakan

    2013-08-01

    Allergic rhinitis may significantly affect the patients' quality of life. The aim of this study was to compare the effects of nasal steroids alone, to nasal steroids plus Levocetirizine or Montelukast, on quality of life in persistent allergic rhinitis. This is a prospective, randomized study and included 56 patients with moderate to severe persistent allergic rhinitis. All patients had house dust mite allergy on skin prick test and we divided the patients into three groups. 1 month long medical treatment was; topical Mometasone furoate 200 mcg/day in the first group (n:14), Mometasone furoate 200 mcg/day plus oral Levocetirizine 5 mg/day in the second group (n:21), and Mometasone furoate 200 mcg/day plus oral Montelukast 10 mg/day in the third group (n:21). We evaluated the patients before treatment and at the first month after treatment with mini rhinoconjunctivitis quality of life questionnaire (miniRQLQ) and nasal symptom scores. In the first group nasal symptom and mini RQLQ scores were not improved but in second and third group, both scores were improved significantly (p < 0.05). Nasal obstruction symptom score was better in the third group after treatment (p < 0.01), but other nasal symptom scores (rhinorrhea, sneezing and nasal itching) were better in the second group (For each symptom p < 0.05). Improvement of quality of life scores in the second group were better than the third group (p < 0.05). In persistent allergic rhinitis, combination of levocetirizine or montelukast to nasal steroids was better than the topical mometasone furoate alone in terms of quality of life. PMID:24427672

  10. Platelets promote allergic asthma through the expression of CD154.

    PubMed

    Tian, Jun; Zhu, Tianyi; Liu, Juan; Guo, Zhenhong; Cao, Xuetao

    2015-11-01

    Platelet activation is associated with multiple immune responses and the pathogenesis of various immune-related diseases. However, the exact role and the underlying mechanism of platelets in the progression of allergic asthma remain largely unclear. In this study, we demonstrate that during antigen sensitization, platelets can be activated by ovalbumin (OVA) aerosol via the upregulation of CD154 (CD40L) expression. Platelet transfer promoted allergic asthma progression by inducing more severe leukocyte infiltration and lung inflammation, elevated IgE production and strengthened T helper 2 (Th2) responses in asthma-induced mice. Accordingly, platelet depletion compromised allergic asthma progression. Cd154-deficient platelets failed to promote asthma development, indicating the requirement of CD154 for platelets to promote asthma progression. The mechanistic study showed that platelets inhibited the induction of Foxp3(+) regulatory T cells both in vivo and in vitro at least partially through CD154, providing an explanation for the increase of Th2 responses by platelet transfer. Our study reveals the previously unknown role of platelet CD154 in the promotion of asthma progression by polarizing Th2 responses and inhibiting regulatory T-cell generation and thus provides a potential clue for allergic disease interventions. PMID:25418472

  11. Denervation of nasal mucosa induced by posterior nasal neurectomy suppresses nasal secretion, not hypersensitivity, in an allergic rhinitis rat model.

    PubMed

    Nishijima, Hironobu; Kondo, Kenji; Toma-Hirano, Makiko; Iwasaki, Shinichi; Kikuta, Shu; Fujimoto, Chisato; Ueha, Rumi; Kagoya, Ryoji; Yamasoba, Tatsuya

    2016-09-01

    The posterior nasal nerve is the dominant source of the parasympathetic, sympathetic, and sensory fibers that innervate the nasal respiratory mucosa. Therefore, a posterior nasal neurectomy (PNN) is thought to induce denervation of the nasal mucosa and relieve the nasal symptoms of allergic rhinitis. However, the underlying mechanisms and therapeutic action of PNN remain unknown. To investigate the impact of PNN-induced denervation of the nasal mucosa on allergic rhinitis, we developed a rat model of PNN and examined the effects of PNN on allergic rhinitis in ovalbumin-sensitized rats. This rat model of PNN was characterized by the depletion of nerve fibers, choline acetyltransferase, and neuropeptides (eg, substance P, calcitonin gene-related peptide, vasoactive intestinal peptide, and neuropeptide Y) in the nasal respiratory mucosa. These animals exhibited nasal gland and goblet cell hypertrophy in the septal mucosa and atrophy of the submucosal gland in the lateral nasal wall, as well as reduced nasal secretion due to deficient acetylcholine synthesis. In an ovalbumin-sensitized model of allergic rhinitis, PNN also induced the depletion of nerve fibers, choline acetyltransferase, and neuropeptides in the nasal mucosa and suppressed nasal secretion. However, PNN did not affect mucosal thickening, eosinophil and mast cell infiltration, interleukin-4 and interferon-γ mRNA expression, and allergic symptoms (ie, sneezing and nasal scratching). These results suggest that the peripheral nerves and corresponding neuropeptides regulate nasal secretion, but not hypersensitivity, in allergic rhinitis, and that allergic rhinitis-related mucosal reactions occur in a highly denervated mucosa after PNN. Posterior nasal neurectomy may be a therapeutic option for the treatment of hyperrhinorrhea, but not allergic rhinitis hypersensitivity. PMID:27322954

  12. Role of antioxidants on the clinical outcome of patients with perennial allergic rhinitis

    PubMed Central

    Gupta, Manish; Chauhan, Komal

    2016-01-01

    Background: Antioxidants have a preventive or therapeutic role in oxygen free radical–mediated cell and tissue damage. The study aimed to investigate the therapeutic effects of antioxidants and intranasal steroid fluticasone furoate (FF) on the clinical outcome of patients with perennial allergic rhinitis. Methods: Subjects with perennial allergic rhinitis (n = 61) were randomly divided into two groups, group A (n = 30) received FF and group B (n = 31) received FF with antioxidants for 6 weeks. Nasal and ocular symptoms were evaluated weekly by using a four-point categoric scale. The efficacy of the study drug was assessed based on the mean change from baseline of the total daytime nasal symptom scores, total nighttime nasal symptom scores, and the composite symptom scores. Results: The combined therapy (FF with antioxidants) resulted in marked improvements (p ≤ 0.05) in the mean total daytime nasal symptom scores, total nighttime nasal symptom scores, and composite symptom scores of subjects compared with ones treated with intranasal steroid (FF) alone, which highlighted the therapeutic effect of antioxidants in allergic rhinitis. Conclusion: Significant improvement in clinical outcome was observed in subjects who received antioxidants along with FF. However, because this was an open-label study, the results must be interpreted with caution, and further double-blind, placebo-controlled, dose-ranging trials supplemented with different antioxidants together with intranasal steroids are suggested.

  13. Exposure to foodborne and orofecal microbes versus airborne viruses in relation to atopy and allergic asthma: epidemiological study

    PubMed Central

    Matricardi, Paolo M; Rosmini, Francesco; Riondino, Silvia; Fortini, Michele; Ferrigno, Luigina; Rapicetta, Maria; Bonini, Sergio

    2000-01-01

    Objective To investigate if markers of exposure to foodborne and orofecal microbes versus airborne viruses are associated with atopy and respiratory allergies. Design Retrospective case-control study. Participants 240 atopic cases and 240 non-atopic controls from a population sample of 1659 participants, all Italian male cadets aged 17-24. Setting Air force school in Caserta, Italy. Main outcome measures Serology for Toxoplasma gondii, Helicobacter pylori, hepatitis A virus, measles, mumps, rubella, chickenpox, cytomegalovirus, and herpes simplex virus type 1; skin sensitisation and IgE antibodies to relevant airborne allergens; total IgE concentration; and diagnosis of allergic asthma or rhinitis. Results Compared with controls there was a lower prevalence of T gondii (26% v 18%, P=0.027), hepatitis A virus (30% v 16%, P=0.004), and H pylori (18% v 15%, P=0.325) in atopic participants. Adjusted odds ratios of atopy decreased with a gradient of exposure to H pylori, T gondii, and hepatitis A virus (none, odds ratio 1; one, 0.70; two or three, 0.37; P for trend=0.000045) but not with cumulative exposure to the other viruses. Conversely, total IgE concentration was not independently associated with any infection. Allergic asthma was rare (1/245, 0.4%) and allergic rhinitis infrequent (16/245, 7%) among the participants (245/1659) exposed to at least two orofecal and foodborne infections (H pylori, T gondii, hepatitis A virus). Conclusion Respiratory allergy is less frequent in people heavily exposed to orofecal and foodborne microbes. Hygiene and a westernised, semisterile diet may facilitate atopy by influencing the overall pattern of commensals and pathogens that stimulate the gut associated lymphoid tissue thus contributing to the epidemic of allergic asthma and rhinitis in developed countries. PMID:10669445

  14. Integrated genome-wide association, coexpression network, and expression single nucleotide polymorphism analysis identifies novel pathway in allergic rhinitis

    PubMed Central

    2014-01-01

    Background Allergic rhinitis is a common disease whose genetic basis is incompletely explained. We report an integrated genomic analysis of allergic rhinitis. Methods We performed genome wide association studies (GWAS) of allergic rhinitis in 5633 ethnically diverse North American subjects. Next, we profiled gene expression in disease-relevant tissue (peripheral blood CD4+ lymphocytes) collected from subjects who had been genotyped. We then integrated the GWAS and gene expression data using expression single nucleotide (eSNP), coexpression network, and pathway approaches to identify the biologic relevance of our GWAS. Results GWAS revealed ethnicity-specific findings, with 4 genome-wide significant loci among Latinos and 1 genome-wide significant locus in the GWAS meta-analysis across ethnic groups. To identify biologic context for these results, we constructed a coexpression network to define modules of genes with similar patterns of CD4+ gene expression (coexpression modules) that could serve as constructs of broader gene expression. 6 of the 22 GWAS loci with P-value ≤ 1x10−6 tagged one particular coexpression module (4.0-fold enrichment, P-value 0.0029), and this module also had the greatest enrichment (3.4-fold enrichment, P-value 2.6 × 10−24) for allergic rhinitis-associated eSNPs (genetic variants associated with both gene expression and allergic rhinitis). The integrated GWAS, coexpression network, and eSNP results therefore supported this coexpression module as an allergic rhinitis module. Pathway analysis revealed that the module was enriched for mitochondrial pathways (8.6-fold enrichment, P-value 4.5 × 10−72). Conclusions Our results highlight mitochondrial pathways as a target for further investigation of allergic rhinitis mechanism and treatment. Our integrated approach can be applied to provide biologic context for GWAS of other diseases. PMID:25085501

  15. A Systematic Review and Meta-analysis of Probiotics for the Treatment of Allergic Rhinitis

    PubMed Central

    Zajac, Alexander E.; Adams, Austin S.; Turner, Justin H.

    2016-01-01

    Objective Probiotics have proven beneficial in a number of immune-mediated and allergic diseases. Several human studies have evaluated the efficacy of probiotics in allergic rhinitis, however, evidence for their use has yet to be firmly established. The current systematic review seeks to synthesize the results of available randomized trials. Study Design Systematic review and meta-analysis. Methods The Medline, EMBASE, and Cochrane Library databases were reviewed and randomized controlled trials were extracted based on defined inclusion criteria. The effect of probiotics on Rhinitis Quality of Life (RQLQ) scores, Rhinitis Total Symptom Scores (RTSS), as well as total and antigen-specific serum IgE levels were evaluated by meta-analysis. Results A total of 23 studies with 1919 patients were identified, including 21 double-blind randomized controlled trials and 2 randomized crossover studies. Multiple probiotic strains, study populations, and outcome measures were utilized in individual trials. Seventeen studies showed a significant clinical benefit from the use of probiotics in at least one outcome measure when compared to placebo, while 6 trials showed no benefit. Among the trials eligible for meta-analysis, the use of probiotics resulted in significant improvement in RQLQ scores compared to placebo [standard mean difference (SMD) −2.23; p = 0.02]. Probiotics had no effect on RTSS [SMD −0.36; p = 0.13] or total IgE levels [SMD 0.01; p = 0.94], while there was a trend toward a reduction in antigen-specific IgE [SMD 0.20; p = 0.06] in the placebo group compared to probiotic. Conclusions Probiotics may be beneficial in improving symptoms and quality of life in patients with allergic rhinitis, however, current evidence remains limited due to study heterogeneity and variable outcome measures. Additional high-quality studies are needed to establish appropriate recommendations. PMID:25899251

  16. Improved Diagnosis of the Polysensitized Allergic Rhinitis Patients Using Component Resolved Diagnosis Method.

    PubMed

    Mohamad Yadzir, Zailatul Hani; Bakhtiar, Faizal; Misnan, Rosmilah; Abdullah, Noormalin; Leecyous, Brenda; Murad, Shahnaz

    2016-04-01

    Allergy diagnosis needs to be improved in polysensitized patients due to the existence of possible confounding factors in this type of patients. Component resolved diagnosis (CRD) is a new concept in the investigation of polysensitized patients. The aim of this study was to evaluate if the utilization of ImmunoCAP ISAC improve the diagnosis of the polysensitized allergic rhinitis patients. Skin prick test (SPT) to 58 crude allergen extracts and CRD (ImmunoCAP ISAC) were carried out for 5 polysensitized allergic rhinitis patients. Two patients had a shellfish allergy and avoidance of shellfish was the only way to prevent an allergic reaction. In contrast, although the remaining three patients had low risk for shellfish allergy, but they were the best candidates for immunotherapy using mite extracts. CRD and particularly ImmunoCAP ISAC have proven to be a valuable diagnostic tool in polysensitized patients. ImmunoCAP ISAC helps refine the individual patient's sensitization profile and predict the potential risk of allergic reactions and improve the selection of patients for immunotherapy. PMID:27090369

  17. Janus Kinase-3 Dependent Inflammatory Responses in Allergic Asthma

    PubMed Central

    Malaviya, Rama; Laskin, Debra L.; Malaviya, Ravi

    2010-01-01

    Summary Allergic asthma is a chronic inflammatory condition of the lung characterized by reversible airway obstruction, high serum immunoglobulin (Ig) E levels, and chronic airway inflammation. A number of cells including mast cells, T-cells, macrophages and dendritic cells play a role in the pathogenesis of the disease. Janus Kinase (JAK) −3, a nonreceptor protein tyrosine kinase, traditionally known to mediate cytokine signaling, also regulates functional responses of these cells. In this review the role of JAK-3 in regulating various pathogenic processes in allergic asthma is discussed. We propose that targeting JAK-3 is a rationale approach to control the inflammatory responses of multiple cell types responsible for the pathogenesis of allergic asthma. PMID:20430118

  18. Rhinitis symptoms and asthma among parents of preschool children in relation to the home environment in Chongqing, China.

    PubMed

    Wang, Juan; Li, Baizhan; Yu, Wei; Yang, Qin; Wang, Han; Huang, Duchai; Sundell, Jan; Norbäck, Dan

    2014-01-01

    Risk factors for rhinitis and asthma in the home environment were studied by a questionnaire survey. Parents of 4530 1-8 year old children (one parent per child) from randomly selected kindergartens in Chongqing, China participated. 70.4% were females; 47.1% had rhinitis symptoms in the last three months (current rhinitis, CR); 1.6% reported a history of allergic asthma (AA); 2.7% reported a history of allergic rhinitis (AR); 16.4% were current smokers; 50.8% males and 2.4% females were current smokers. Stuffy odor, unpleasant odor, tobacco smoke odor and dry air were associated with CR (adjustment for gender, current smoking and other perceptions of odor or humidity). Associations between home environment and CR, AR, and AA were studied by multiple logistic regression analyses, adjusting for gender, current smoking and other significant home factors. Living near a main road or highway was a risk factor for both CR (OR(95%CI): 1.31(1.13,1.52)) and AR (OR(95%CI): 2.44(1.48,4.03)). Other risk factors for CR included living in rural areas (OR(95%CI): 1.43(1.10,1.85)), new furniture (OR(95%CI): 1.28(1.11,1.49)), water damage (OR(95%CI): 1.68(1.29,2.18)), cockroaches (OR(95%CI): 1.46(1.23,1.73)), and keeping pets (OR(95%CI): 1.24(1.04,1.49)). Other risk factors for AR included redecoration (OR(95%CI): 2.14(1.34,3.41)), mold spots (OR(95%CI): 2.23(1.06,4.68)), window pane condensation (OR(95%CI): 2.04(1.28,3.26)). Water damage was the only home factor associated with AA (2.56(1.34,4.86)). Frequently put bedding to sunshine was protective for CR (OR(95%CI): 0.79(0.68,0.92); cleaning every day was protective for AR (OR(95%CI): 0.40(0.22,0.71)). In conclusion, parents' CR and AR were related to a number of factors of the home environment. PMID:24733290

  19. Rhinitis Symptoms and Asthma among Parents of Preschool Children in Relation to the Home Environment in Chongqing, China

    PubMed Central

    Wang, Juan; Li, Baizhan; Yu, Wei; Yang, Qin; Wang, Han; Huang, Duchai; Sundell, Jan; Norbäck, Dan

    2014-01-01

    Risk factors for rhinitis and asthma in the home environment were studied by a questionnaire survey. Parents of 4530 1–8 year old children (one parent per child) from randomly selected kindergartens in Chongqing, China participated. 70.4% were females; 47.1% had rhinitis symptoms in the last three months (current rhinitis, CR); 1.6% reported a history of allergic asthma (AA); 2.7% reported a history of allergic rhinitis (AR); 16.4% were current smokers; 50.8% males and 2.4% females were current smokers. Stuffy odor, unpleasant odor, tobacco smoke odor and dry air were associated with CR (adjustment for gender, current smoking and other perceptions of odor or humidity). Associations between home environment and CR, AR, and AA were studied by multiple logistic regression analyses, adjusting for gender, current smoking and other significant home factors. Living near a main road or highway was a risk factor for both CR (OR(95%CI): 1.31(1.13,1.52)) and AR (OR(95%CI): 2.44(1.48,4.03)). Other risk factors for CR included living in rural areas (OR(95%CI): 1.43(1.10,1.85)), new furniture (OR(95%CI): 1.28(1.11,1.49)), water damage (OR(95%CI): 1.68(1.29,2.18)), cockroaches (OR(95%CI): 1.46(1.23,1.73)), and keeping pets (OR(95%CI): 1.24(1.04,1.49)). Other risk factors for AR included redecoration (OR(95%CI): 2.14(1.34,3.41)), mold spots (OR(95%CI): 2.23(1.06,4.68)), window pane condensation (OR(95%CI): 2.04(1.28,3.26)). Water damage was the only home factor associated with AA (2.56(1.34,4.86)). Frequently put bedding to sunshine was protective for CR (OR(95%CI): 0.79(0.68,0.92); cleaning every day was protective for AR (OR(95%CI): 0.40(0.22,0.71)). In conclusion, parents' CR and AR were related to a number of factors of the home environment. PMID:24733290

  20. Safety and efficacy of Nasya/Prevalin in reducing symptoms of allergic rhinitis

    PubMed Central

    Stoelzel, Katharina; Bothe, Gordana; Chong, Pee Win; Lenarz, Minoo

    2014-01-01

    Background Nasya/Prevalin is a natural, drug-free nasal spray for treatment and prevention of allergic rhinitis. Because of its thixotropic property, it forms a barrier on the nasal mucosa, preventing allergen contact. This study assesses the clinical efficacy and safety of Nasya/Prevalin in a nasal provocation test with house dust mite allergens. Methodology/Principal In this randomised, double-blind, placebo-controlled trial, 20 subjects suffering from allergic rhinitis because of house dust mite allergens received a single dose of Nasya/Prevalin or saline spray before allergen challenge. Total nasal symptom score and total ocular symptom score were assessed 15, 30, 60, 75, 90, 120 and 240 min after challenge. Further, the appearance of the mucosa was examined by rhinoscopy. Results A single treatment with Nasya/Prevalin led to a significant reduction of TNSS at 60, 75 and 90 min after dust mite allergen challenge as compared with placebo (pVCAS = 0.021, pVCAS = 0.035, pVCAS = 0.036, respectively). Mucosa changes assessed by the rhinoscopic score (on swelling, secretion and colour) were significantly worse in the placebo group compared with the Nasya/Prevalin group (P = 0.033). Nasya/Prevalin was well tolerated, and the safety was comparable with placebo. Conclusions Treatment with Nasya/Prevalin was effective in preventing allergic reactions induced by dust mite allergen challenge. Please cite this paper as: Stoelzel K, Bothe G, Chong PW and Lenarz M. Safety and efficacy of Nasya/Prevalin in reducing symptoms of allergic rhinitis. Clin Respir J 2014; 8: 382–390. PMID:24279907

  1. Diagnostic significance of nitric oxide concentrations in exhaled air from the airways in allergic rhinitis patients

    PubMed Central

    Krzych-Fałta, Edyta; Samoliński, Bolesław K; Zalewska, Marta

    2016-01-01

    Introduction The effect of nitric oxide (NO) on the human body is very important due its physiological regulation of the following functions of airways: modulation of ciliary movement and maintenance of sterility in sinuses. Aim To evaluate the diagnostic significance of NO concentrations in exhaled air from the upper and lower airways in patients diagnosed with allergic rhinitis (AR). Material and methods The subjects included in the study were a group of 30 people diagnosed with sensitivity to environmental allergens and a control group consisting of 30 healthy subjects. The measurement of NO in the air exhaled from the lower and upper airways was performed using an on-line method by means of Restricted Exhaled Breath (REB), as well as using the measurement procedure (chemiluminescence) set out in the guidelines prepared in 2005 by the American Thoracic Society and the European Respiratory Society. Results In the late phase of the allergic reaction, higher values of the level of exhaled NO concentration from the lower airways were observed in the groups of subjects up to the threshold values of 25.17 ppb in the group of subjects with year-round allergic rhinitis and 21.78 ppb in the group with diagnosed seasonal allergic rhinitis. The difference in the concentration of NO exhaled from the lungs between the test group and the control group in the 4th h of the test was statistically significant (p = 0.045). Conclusions Exhaled NO should be considered as a marker of airway inflammation. It plays an important role in the differential diagnosis of allergy. PMID:27279816

  2. Fetal growth and risk of childhood asthma and allergic disease

    PubMed Central

    Tedner, S G; Örtqvist, A K; Almqvist, C

    2012-01-01

    Introduction Early genetic and environmental factors have been discussed as potential causes for the high prevalence of asthma and allergic disease in the western world, and knowledge on fetal growth and its consequence on future health and disease development is emerging. Objective This review article is an attempt to summarize research on fetal growth and risk of asthma and allergic disease. Current knowledge and novel findings will be reviewed and open research questions identified, to give basic scientists, immunologists and clinicians an overview of an emerging research field. Methods PubMed-search on pre-defined terms and cross-references. Results Several studies have shown a correlation between low birth weight and/or gestational age and asthma and high birth weight and/or gestational age and atopy. The exact mechanism is not yet clear but both environmental and genetic factors seem to contribute to fetal growth. Some of these factors are confounders that can be adjusted for, and twin studies have been very helpful in this context. Suggested mechanisms behind fetal growth are often linked to the feto-maternal circulation, including the development of placenta and umbilical cord. However, the causal link between fetal growth restriction and subsequent asthma and allergic disease remains unexplained. New research regarding the catch-up growth following growth restriction has posited an alternative theory that diseases later on in life result from rapid catch-up growth rather than intrauterine growth restriction per se. Several studies have found a correlation between a rapid weight gain after birth and development of asthma or wheezing in childhood. Conclusion and clinical relevance Asthma and allergic disease are multifactorial. Several mechanisms seem to influence their development. Additional studies are needed before we fully understand the causal links between fetal growth and development of asthma and allergic diseases. PMID:22994341

  3. Role of Interferon-λ in Allergic Asthma.

    PubMed

    Koch, Sonja; Finotto, Susetta

    2015-01-01

    Type III interferons (IFNs), or IFN-λ, are known to have potent antiviral and antiproliferative activities. It inhibits viral replication and upregulates cytotoxic responses to virally infected cells. Besides these characteristics, IFN-λ also has additional activities in the immune system. In fact, it induces the proliferation of Foxp3-expressing regulatory T cells mediated in part by dendritic cells and inhibit the production of IL-5 and IL-13 in vitro. Regulatory T cells and the Th2 cytokines like IL-5 and IL-13 play important roles in the pathogenesis of allergic asthma. In humans, there seems to be an inverse link between IFN-λ and the severity of allergic asthma and allergic asthma exacerbations. Asthmatic patients, without a detectable viral infection show an inverse correlation between IL-28 and IL-29 mRNA levels and severity of allergic responses in the airways. These additional features of IFN-λ that affect the adaptive immune system make it a potential immunotherapeutic agent for the treatment of allergic asthma. PMID:25592858

  4. Respiratory responses of subjects with allergic rhinitis to ozone exposure and their relationship to nonspecific airway reactivity

    SciTech Connect

    McDonnell, W.F.; Horstman, D.H.; Abdul-Salaam, S.; Raggio, L.J.; Green, J.A.

    1987-12-01

    Ozone exposure in man produces changes in respiratory function and symptoms. There is a large degree of unexplained intersubject variability in the magnitude of these responses. There is concern that individuals with chronic respiratory diseases may also be more responsive to ozone than normal individuals. The purpose of this study was to describe the responses of subjects with allergic rhinitis to ozone exposure and to compare these responses to those previously observed in normal individuals. A further purpose was to measure the association of baseline nonspecific airway reactivity with changes in lung function and respiratory symptoms following ozone exposure. A group of 26 nonasthmatic subjects with allergic rhinitis performed a bronchial inhalation challenge with histamine and subsequently underwent two hour exposures to both clean air and to 0.18 part per million ozone with alternating periods of rest and heavy exercise. The airway reactivity of this group of subjects was no greater than that of a comparable group of subjects without allergic rhinitis. The respiratory responses of these subjects to ozone exposure were similar to those previously reported for subjects without allergic rhinitis with the exception that the allergic rhinitis subjects appeared to have a modestly increased bronchoconstrictor response compared to normals. Furthermore, we observed no significant relationships between nonspecific airway reactivity and response to ozone as measured by changes in lung function or the induction of symptoms.

  5. A randomized, controlled study of specific immunotherapy in monosensitized subjects with seasonal rhinitis: effect on bronchial hyperresponsiveness, sputum inflammatory markers and development of asthma symptoms.

    PubMed

    Crimi, Nunzio; Li Gotti, Fabrizio; Mangano, Giuseppe; Paolino, Giuseppina; Mastruzzo, Claudio; Vancheri, Carlo; Lisitano, Natalina; Polosa, Riccardo

    2004-01-01

    Allergic rhinitis is often associated with bronchial hyperresponsiveness (BHR) and airway inflammation, and it seems to be an important risk factor for the development of asthma. Specific immunotherapy (SIT) reduces symptoms and medication requirements in subjects with allergic rhinitis, but the mechanisms by which SIT promotes these beneficial effects are less clear. We have investigated the effects of Parietaria-SIT on rhinitis symptoms, BHR to inhaled methacholine, eosinophilic inflammation and cytokine production (interferon gamma and interleukin-4) in the sputum. The effect on asthma progression was also examined. Thirty non-asthmatic subjects with seasonal rhinitis and monosensitized to Parietaria judaica participated in a randomized, double-blind, placebo-controlled, parallel group study. Participants were randomly assigned to receive injections of a Parietaria pollen vaccine (n = 15) or matched placebo injections (n = 15) in a rapid updosing cluster regimen for 7 weeks, followed by monthly injections for 34 months. Throughout the 3-year study we collected data on symptoms and medication score, airway responsiveness to methacholine, eosinophilia and soluble cytokines in sputum, followed by a complete evaluation of the clinical course of atopy. Hay fever symptom and medication scores were well controlled by SIT. By the end of the study, in the placebo group, symptom and medication scores significantly increased by a median (interquartile range) of 121% (15-280%) and 263% (0-4400%) respectively (p < 0.01), whereas no significant difference was observed in the SIT group. We found no significant changes in the sputum parameters and methacholine PC15 values in both groups throughout the study. By the end of the investigation, a total of 9 out of 29 participants developed asthma symptoms; of these, seven (47%) belonged to the placebo group, whereas only 2 (14%) to the SIT-treated group (p = 0.056). In conclusion, Parietaria-SIT is effective in controlling hay

  6. Understanding the role of the healthcare professional in patient self-management of allergic rhinitis

    PubMed Central

    Abdulnour, Shahad; O’Dell, Michael; Kyle, Theodore K

    2015-01-01

    Objective: Allergic rhinitis is a common, usually long-standing, condition that may be self-diagnosed or have a formal diagnosis. Our aim was to identify how allergic rhinitis sufferers self-manage their condition. Methods: A sample of 276 self-identified adult allergy sufferers pooled from social media completed an online survey comprising 13 questions. The survey was fielded by a professional research organization (Lab42). The main outcome measures included the use of prescription and/or non-prescription allergy medication, and interactions with physician and/or pharmacist with respect to medication use. Results: Of the respondents, 53% (146/276) indicated that they used both prescription and over-the-counter medication to manage their allergy symptoms. Of those who used prescription medication, 53% reported that they discussed their prescription medication in great detail with their physician when it was prescribed, while 42% spoke about it briefly. Following the initial prescription, few discussions about the prescription occur with the physician (45% indicate several discussions, 40% indicate one or two discussions, and 10% indicate no discussions). In most cases (~75% of the time), allergy prescription refills did not require a doctor visit with patients obtaining refills through phone calls to the doctor’s office or through the pharmacy. Two-thirds of patients (69%) report that they have discussed their prescription allergy medication with a pharmacist, with greater than half of respondents having discussed the use of the non-prescription medication with their doctor. Conclusion: Patients with diagnosed allergic rhinitis appear to be self-managing their condition with few interactions with their doctor about their allergy prescription. Interactions with a pharmacist about allergy medication (prescription and non-prescription) appear to be more common than interactions with a physician. PMID:26770793

  7. PRIMARY NOCTURNAL ENURESIS IN CHILDREN WITH ALLERGIC RHINITIS AND SEVERE ADENOTONSILLAR HYPERTROPHY: A SINGLE CENTER PILOT STUDY.

    PubMed

    Chimenz, R; Manti, S; Fede, C; Stroscio, G; Visalli, C; Nicotera, A; Di Rosa, G; Romeo, A C; Salpietro, V; Cuppari, C

    2015-01-01

    Nocturnal enuresis is defined as intermittent urinary incontinence during sleep that occurs at least twice a week for three consecutive months. There is no unifying etiology for nocturnal enuresis in the pediatric population and the disorder is likely to be multifactorial. We aimed to investigate the relationship between primary nocturnal enuresis, allergic rhinitis, and related complications in a paediatric case series from a single Center. We retrospectively reviewed and prospectively followed-up at our Institution (i) 32 children (14 females, 18 males; mean age 6.31±1.21 yrs) affected by allergic rhinitis with adenoidal hypertrophygrade I-II (group A) and (ii) 27 children (11 females, 16 males; mean age 6.52±1.33 yrs) affected by allergic rhinitis with adenoidal hypertrophy grade III-IV (group B). Allergic rhinitis was diagnosed on the basis of (a) typical nasal symptoms due to atopic sensitization (e.g., rhinorrhea , itching, sneezing fits, and nasal congestion and obstruction) and (b) positive skin prick testing and/or increased level of total serum IgE. We identified discrepancies between group A and group B in terms of risk of primary nocturnal enuresis. In fact, only 1 child of group A (3.12%) reported uncomplicated primary nocturnal enuresis; conversely, 6 children of group B (22.22%) showed a history of uncomplicated primary nocturnal enuresis (p=0.040). There was no statistically significant difference between the two groups in terms of atopic sensitization and serum total IgE levels (p=0.43). Allergic rhinitis may potentially influence the onset and the natural history of nocturnal enuresis in some children. Children with allergic rhinitis and more severe respiratory manifestations, seem to be more prone to developing primary nocturnal enuresis, likely due to potential multi-factorial causes (e.g., sleep disorders, chronic phlogosis, immune deregulation). PMID:26634591

  8. Specific IgE in the identification of allergens in allergic rhinitis Malaysian patients.

    PubMed

    Choon-Kook, S; Teck-Soong, S L

    1995-06-01

    The specific serum IgE levels to 20 allergens were determined by enzyme immunoassay in 90 Malaysian patients with allergic rhinitis. Ninety-two percent of patients had elevated IgE to at least 1 of the allergens. The housedust mites D. pteronyssinus and D. farinae were the major allergens, elevated IgE to either allergen being present in 86% of the patients. Prick skin tests were carried out in some of the patients, housedust mites, cat fur, dog hair and shrimp were the allergens used. Close correspondence was found between IgE and prick skin tests to the mites. PMID:7488340

  9. Exposure to Particulate Hexavalent Chromium Exacerbates Allergic Asthma Pathology

    PubMed Central

    Schneider, Brent C.; Constant, Stephanie L.; Patierno, Steven R.; Jurjus, Rosalyn A.; Ceryak, Susan M.

    2011-01-01

    Airborne hexavalent chromate, Cr(VI), has been identified by the Environmental Protection Agency as a possible health threat in urban areas, due to the carcinogenic potential of some of its forms. Particulate chromates are produced in many different industrial settings, with high levels of aerosolized forms historically documented. Along with an increased risk of lung cancer, a high incidence of allergic asthma has been reported in workers exposed to certain inhaled particulate Cr(VI) compounds. However, a direct causal association between Cr(VI) and allergic asthma has not been established. We recently showed that inhaled particulate Cr(VI) induces an innate neutrophilic inflammatory response in BALB/c mice. In the current studies we investigated how the inflammation induced by inhaled particulate Cr(VI) might alter the pathology of an allergic asthmatic response. We used a well-established mouse model of allergic asthma. Groups of ovalbumin protein (OVA)-primed mice were challenged either with OVA alone, or with a combination of OVA and particulate zinc chromate, and various parameters associated with asthmatic responses were measured. Co-exposure to particulate Cr(VI) and OVA mediated a mixed form of asthma in which both eosinophils and neutrophils are present in airways, tissue pathology is markedly exacerbated, and airway hyperresponsiveness is significantly increased. Taken together these findings suggest that inhalation of particulate forms of Cr(VI) may augment the severity of ongoing allergic asthma, as well as alter its phenotype. Such findings may have implications for asthmatics in settings in which airborne particulate Cr(VI) compounds are present at high levels. PMID:22178736

  10. Genetic Ancestry and Asthma and Rhinitis Occurrence in Hispanic Children: Findings from the Southern California Children’s Health Study

    PubMed Central

    Salam, Muhammad T.; Avoundjian, Tigran; Knight, Wendy M.; Gilliland, Frank D.

    2015-01-01

    Background Asthma and rhinitis are common childhood health conditions. Being an understudied and rapidly growing population in the US, Hispanic children have a varying risk for these conditions that may result from sociocultural (including acculturative factors), exposure and genetic diversities. Hispanic populations have varying contributions from European, Amerindian and African ancestries. While previous literature separately reported associations between genetic ancestry and acculturation factors with asthma, whether Amerindian ancestry and acculturative factors have independent associations with development of early-life asthma and rhinitis in Hispanic children remains unknown. We hypothesized that genetic ancestry is an important determinant of early-life asthma and rhinitis occurrence in Hispanic children independent of sociodemographic, acculturation and environmental factors. Methods Subjects were Hispanic children (5–7 years) who participated in the southern California Children’s Health Study. Data from birth certificates and questionnaire provided information on acculturation, sociodemographic and environmental factors. Genetic ancestries (Amerindian, European, African and Asian) were estimated based on 233 ancestry informative markers. Asthma was defined by parental report of doctor-diagnosed asthma. Rhinitis was defined by parental report of a history of chronic sneezing or runny or blocked nose without a cold or flu. Sample sizes were 1,719 and 1,788 for investigating the role of genetic ancestry on asthma and rhinitis, respectively. Results Children had major contributions from Amerindian and European ancestries. After accounting for potential confounders, per 25% increase in Amerindian ancestry was associated with 17.6% (95% confidence interval [CI]: 0.74–0.99) and 13.6% (95% CI: 0.79–0.98) lower odds of asthma and rhinitis, respectively. Acculturation was not associated with either outcome. Conclusions Earlier work documented that Hispanic

  11. Cigarette Smoking and Skin Prick Test in Patients With Allergic Rhinitis

    PubMed Central

    Khazaei, Hossein Ali; Khazaei, Bahman; Dashtizadeh, Gholam Ali; Mohammadi, Mahdi

    2015-01-01

    Background: Allergic Rhinitis (AR) is the most common allergic disease, affecting 30% of population around the world. The disease is predominantly associated with exposure to some aeroallergens like cigarette smoking. Skin Prick Test (SPT) is a method of detecting immediate allergic reactions and is applied for controlling disease and therapeutic modality. Objectives: This study was designed to investigate the effect of cigarette smoking on SPT results among male and female individuals with AR disease. Patients and Methods: A total of 478 patients with AR admitted to the 2 main hospitals of Zahedan City from 2005 to 2012, were recruited in this analytic-descriptive study. Categories of smokers and never smokers were used based on patient’s statements and their history of smoking. SPT was performed with panel of some allergens and results were recorded and analyzed statistically. Odds ratio and confidence interval method were calculated using univariate logistic regression. Results: The results of this study indicated that 41.4% of patients with allergic rhinitis was smoker with ages ranged from 15 to 70 years. The result of this study also showed that smoking has no effect on SPT results of pollen and weeds aeroallergens conducted on male and female AR patients. However, male were significantly more sensitive than female in terms of sensitivity to the aspergillus, cladosporium, house dust mite, grasses, wheat, cockroach, and feather allergens. Conclusions: Our findings did not support the effect of cigarette smoking on SPT reactivity to pollen and weeds aeroallergens. However, male were significantly more sensitive than female in terms of sensitivity to some allergens. PMID:26495257

  12. Inter-Relationship between Rhinitis and Conjunctivitis in Allergic Rhinoconjunctivitis and Associated Risk Factors in Rural UK Children

    PubMed Central

    Perkin, Michael R.; Bader, Tara; Rudnicka, Alicja R.; Strachan, David P.; Owen, Christopher G.

    2015-01-01

    Objective Allergic conjunctivitis (AC) is a common condition, especially in childhood. The extent to which it occurs concurrently with or independently from allergic rhinitis (AR) has not been well described. Aim To examine the inter-relationship between rhinitis and conjunctivitis and the epidemiological risk factors for these conditions in a rural UK population. Methods Cross-sectional study of rural school children (aged 5–11 years). Parental questionnaires were used to diagnose allergic outcomes (including conjunctivitis, rhinitis and rhinoconjunctivitis), and to collect data on atopic history, demographic and environmental exposures. Odds ratios of allergic outcome by exposure were examined adjusted for age, sex, breastfeeding, family history of allergy, number of older and younger siblings. Results Prevalence of conjunctivitis was 17.5%, rhinitis 15.1% and rhinoconjunctivitis 13.0%. Seasonality of symptoms varied by condition: 64.7% of those with conjunctivitis had seasonal symptoms (April-Sept only), 46.7% of those with rhinitis and 92.2% of those with rhinoconjunctivitis. Living on a farm consistently reduced the risk of conjunctivitis (odds ratio 0.47, 95%CI 0.29–0.79, p = 0.004), rhinitis (OR 0.57, 95%CI 0.33–1.01, p = 0.05) and rhinoconjunctivitis (OR 0.57, 95%CI 0.32–1.03, p = 0.06). Exposure to farm animals (particularly in early life), current consumption of unpasteurised milk and playing in a barn or stable significantly reduced the risk of all three conditions. Conclusion More children had parent-reported conjunctivitis than rhinitis. The majority of children with either condition also reported symptoms with the other condition. Farmers’ children have less eye and/or nasal symptoms. A number of farming variables linked with the farm microbial environment are likely to be mediating the protective effect. PMID:26600465

  13. Mechanistic impact of outdoor air pollution on asthma and allergic diseases

    PubMed Central

    Zhang, Qingling; Qiu, Zhiming; Chung, Kian Fan

    2015-01-01

    Over the past decades, asthma and allergic diseases, such as allergic rhinitis and eczema, have become increasingly common, but the reason for this increased prevalence is still unclear. It has become apparent that genetic variation alone is not sufficient to account for the observed changes; rather, the changing environment, together with alterations in lifestyle and eating habits, are likely to have driven the increase in prevalence, and in some cases, severity of disease. This is particularly highlighted by recent awareness of, and concern about, the exposure to ubiquitous environmental pollutants, including chemicals with oxidant-generating capacities, and their impact on the human respiratory and immune systems. Indeed, several epidemiological studies have identified a variety of risk factors, including ambient pollutant gases and airborne particles, for the prevalence and the exacerbation of allergic diseases. However, the responsible pollutants remain unclear and the causal relationship has not been established. Recent studies of cellular and animal models have suggested several plausible mechanisms, with the most consistent observation being the direct effects of particle components on the generation of reactive oxygen species (ROS) and the resultant oxidative stress and inflammatory responses. This review attempts to highlight the experimental findings, with particular emphasis on several major mechanistic events initiated by exposure to particulate matters (PMs) in the exposure-disease relationship. PMID:25694815

  14. Hypertonic saline monotherapy in children with perennial allergic rhinitis: a pilot study.

    PubMed

    Barberi, S; D'Auria, E; Bernardo, L; Ferrara, F; Pietra, B; Pinto, F; Ferrero, F; Ciprandi, G

    2016-01-01

    Perennial allergic rhinitis (PAR) is very common in children and has a relevant impact on their families. House dust mites (HDM) are the most relevant cause of PAR. The present pilot study aimed to evaluate whether hypertonic saline (3%) nasal spray as monotherapy is able to improve: nasal symptom severity and parental perception of rhinitis control, sleep, and school performance in HDM-mono-sensitized children with PAR. Globally, 25 children (13 males and 12 females; mean age 9.5±3.1 years) were treated for 3 weeks. They were visited at baseline, at the end of treatment, and after a 2-week follow-up. Hypertonic saline significantly reduced total symptom score, and improved the perception, according to their parents, of rhinitis control, sleep, and school performance. In conclusion, the present pilot study provided the first evidence that 3% hypertonic saline monotherapy was able to relieve nasal symptoms and parental perception of PAR impact as well as being safe and well tolerated. PMID:27049102

  15. Local Immune Responses in Children and Adults with Allergic and Nonallergic Rhinitis

    PubMed Central

    Choi, Hana; Jang, Man-Young; Kim, Kyung Rae; Choi, Jae-Hoon; Cho, Seok Hyun

    2016-01-01

    Background Allergic rhinitis (AR) is the most common allergic disease but little is known about the difference of local immune responses in children and adults with AR. Objective To compare local immune responses between children and adults with AR and nonallergic rhinitis (NAR), and to investigate whether the association of local and systemic immune responses is different between the two age groups. Methods Fifty-one patients with chronic rhinitis were enrolled and grouped into children (N = 27, mean age 7.2 years) and adults (N = 24, mean age 29.9 years). Diagnosis of AR was based on symptoms, skin prick tests and serum specific IgEs. Nasal lavage (NAL) fluids were collected from all subjects and used to measure the levels of total IgE, specific IgEs to house dust mites (Dp and Df), and cytokines (TNF-α, IL-4, IL-10, IL-17A and IFN-γ). Flow cytometry was used to measure inflammatory cell types in NAL fluids. Results AR had significantly increased local levels of total IgE and specific IgEs to Dp and Df compared with NAR in both age groups (P < 0.05). Nasal eosinophils % (P = 0.01) was significantly increased only in children with AR. Local-systemic correlations of total IgE (r = 0.662, P = 0.000) and eosinophil % (r = 0.461, P = 0.015) between the peripheral blood and NAL fluids were found only in children. Moreover, children had correlations between total IgE and eosinophil % in the peripheral blood (r = 0.629, P = 0.001) and in NAL fluids (r = 0.373, P = 0.061). Conclusion Elevated local IgE is a common feature of AR in children and adults. Local measures in NAR showed naïve state of immune response which disagree with the hypothesis of local allergic rhinitis. Children showed intense local inflammation and close local-systemic interactions compared to adults supporting pediatric AR as a distinct feature. PMID:27281182

  16. SCH 434: a new antihistamine/decongestant for seasonal allergic rhinitis.

    PubMed

    Storms, W W; Bodman, S F; Nathan, R A; Chervinsky, P; Banov, C H; Dockhorn, R J; Jarmoszuk, I; Zeitz, H J; McGeady, S J; Pinnas, J L

    1989-06-01

    In a double-blind, multicenter study, we compared the effects of SCH 434 (Claritin-D; Schering Corp., Kenilworth, N.J.), a new sustained-release, combination antihistamine/decongestant medication, with the effects of its individual components and placebo in 435 patients with seasonal allergic rhinitis. SCH 434 contains 5 mg of loratadine, a nonsedating antihistamine, and 120 mg of pseudoephedrine as the decongestant component. Administered twice daily in this study, SCH 434 effected a 50% decrease in total symptom scores at day 4 and was significantly (p less than or equal to 0.03) more effective than the components alone or the placebo. Loratadine or pseudoephedrine alone, with 43% and 33% decline in symptom scores, respectively, also was more effective than placebo (p less than 0.05). As expected, pseudoephedrine alone was more effective than loratadine (p less than 0.01) in relieving nasal stuffiness; SCH 434 was more effective (p less than or equal to 0.01) than placebo and loratadine in relieving nasal stuffiness. All treatments were safe and well tolerated, although insomnia and dry mouth were noted in a significant number of patients who received either SCH 434 or pseudoephedrine. No serious side effects were noted. The incidence of sedation did not differ significantly among the four treatment groups. We conclude that SCH 434 is a safe and effective treatment for symptoms of seasonal allergic rhinitis. The combination drug (SCH 434) was better than its components for some, but not all, symptoms. PMID:2471718

  17. The effects of histamine and leukotriene receptor antagonism on nasal mannitol challenge in allergic rhinitis

    PubMed Central

    Lee, Daniel K C; Haggart, Kay; Currie, Graeme P; Anderson, Sandra D; Lipworth, Brian J

    2003-01-01

    Aims It is unclear as to which mediators are involved in mediating the response to nasal mannitol challenge, a novel osmotic stimulus. Methods A double-blind, randomized, placebo-controlled, crossover design was employed. Nine patients with allergic rhinitis were randomized to receive a single-dose of desloratadine 5 mg, montelukast 10 mg or placebo, and underwent nasal mannitol challenges with nasal peak inspiratory flow recordings over 60 min. The change in peak nasal inspiratory flow was calculated as percentage change from baseline as the peak response and area under the time–response curve (AUC). Results Desloratadine and montelukast conferred a significant degree of protection compared to placebo for peak and AUC response, but there were no significant differences between the two drugs. For the peak response as percentage fall, the mean difference (95% CI) vs placebo was 27.7 (8.0, 47.4)% for desloratadine and 17.6 (1.9, 33.3)% for montelukast. Conclusions Our results suggest that histamine and cysteinyl-leukotrienes are involved in mediating the response to nasal mannitol in allergic rhinitis. PMID:12814463

  18. Mediators of the Socioeconomic Gradient in Outcomes of Adult Asthma and Rhinitis

    PubMed Central

    Katz, Patricia P.; Balmes, John R.; Chen, Hubert; Yelin, Edward H.; Omachi, Theodore; Blanc, Paul D.

    2013-01-01

    Objectives. We estimated the extent to which socioeconomic status (SES) gradients in adult asthma and rhinitis outcomes can be explained by home and neighborhood environmental factors. Methods. Using survey data for 515 adults with either asthma or rhinitis, or both, we examined environmental mediators of SES associations with disease severity, using the Severity of Asthma Scale, and health-related quality of life (HRQL), using the Rhinasthma Scale. We defined SES on the basis of education and household income. Potential environmental mediators included home type and ownership, exposures to allergens and irritants, and a summary measure of perceived neighborhood problems. We modeled each outcome as a function of SES, and controlled for age, gender, and potential mediators. Results. Gradients in SES were apparent in disease severity and HRQL. Living in a rented house partially mediated the SES gradient for both severity and HRQL (P < .01). Higher perceived levels of neighborhood problems were associated with poorer HRQL and partially mediated the income–HRQL relationship (P < .01). Conclusions. Differences in home and neighborhood environments partially explained associations of SES with adult asthma and rhinitis outcomes. PMID:23237178

  19. Challenges in the management of severe allergic asthma in the elderly

    PubMed Central

    Ozturk, Ayse Bilge; Iliaz, Sinem

    2016-01-01

    Little is known about the features of asthma and allergy in the elderly. A significant number of elderly patients with asthma have uncontrolled and severe asthma. This review aims to provide an analysis of the literature on the assessment and phenotype of severe allergic asthma in the elderly. Gaps and pitfalls in diagnostic and therapeutic approaches, as well as management of severe allergic asthma in the elderly, are also discussed. PMID:27051308

  20. Respiratory and allergic diseases: from upper respiratory tract infections to asthma.

    PubMed

    Jaber, Raja

    2002-06-01

    Patients with asthma and allergic rhinitis may benefit from hydration and a diet low in sodium, omega-6 fatty acids, and transfatty acids, but high in omega-3 fatty acids (i.e., fish, almonds, walnuts, pumpkin, and flax seeds), onions, and fruits and vegetables (at least five servings a day). Physicians may need to be more cautious when prescribing antibiotics to children in their first year of life when they are born to families with a history of atopy. More research is needed to establish whether supplementation with probiotics (lactobacillus and bifidobacterium) during the first year of life or after antibiotic use decreases the risk of developing asthma and allergic rhinitis. Despite a theoretic basis for the use of vitamin C supplements in asthmatic patients, the evidence is still equivocal, and long-term studies are needed. The evidence is stronger for exercise-induced asthma, in which the use of vitamin C supplementation at a dosage of 1 to 2 g per day may be helpful. It is also possible that fish oil supplements, administered in a dosage of 1 to 1.2 g of EPA and DHA per day, also may be helpful to some patients with asthma. Long-term studies of fish oil and vitamin C are needed for more definite answers. For the patient interested in incorporating nutritional approaches, vitamin C and fish oils have a safe profile. However, aspirin-sensitive individuals should avoid fish oils, and red blood cell magnesium levels may help in making the decision whether to use additional magnesium supplements. Combination herbal formulas should be used in the treatment of asthma with medical supervision and in collaboration with an experienced herbalist or practitioner of TCM. Safe herbs, such as Boswellia and gingko, may be used singly as adjuncts to a comprehensive plan of care if the patient and practitioner have an interest in trying them while staying alert for drug-herb interactions. No data on the long-term use of these single herbs in asthma exist. For the motivated

  1. Anti-allergic effect of a Korean traditional medicine, Biyeom-Tang on mast cells and allergic rhinitis

    PubMed Central

    2014-01-01

    Background Biyeom-Tang, a medicine prescribed by oriental clinics, has been used for the treatment of the allergic rhinitis (AR). In the present study, an ethanol extract of Biyeom-Tang (EBT) was investigated for anti-allergic properties on bone-marrow derived mast cells (BMMC) and in vivo models. Methods The anti-allergic properties of EBT were evaluated by measuring β-Hex release and the production of prostaglandin D2 (PGD2) and leukotriene C4 (LTC4) on BMMC in vitro and PCA and OVA-induced AR models in vivo. Results EBT strongly inhibited a degranulation reaction in a dose dependent manner with an IC50 value of 35.6 μg/ml. In addition, the generation of PGD2 and LTC4 was inhibited in BMMC in a concentration-dependent manner with IC50 values of 7.0 μg/ml and 10.9 μg/ml, respectively. When administrated orally, EBT ameliorated the mast cell-mediated PCA reaction. In the OVA-induced AR model, the increased levels of IgE were reduced by EBT. The levels of cytokines, such as IL-4, IL-5, IL-10, and IL-13 decreased in the splenocytes of EBT-treated mice. The histological analysis shows that the infiltration of inflammatory cells increased by OVA-sensitization was also reduced. Conclusions Taken together, these results suggested that EBT has anti-allergic and anti-inflammatory effects in vitro and in vivo models. PMID:24521096

  2. PSYCHOLOGICAL AND ALLERGIC ASPECTS OF ASTHMA.

    ERIC Educational Resources Information Center

    HIRT, MICHAEL L.

    FOCUSED HISTORICALLY AND CHOSEN TO STIMULATE RESEARCH IN PSYCHOSOCIAL IMPLICATIONS OF ASTHMA, THE COLLECTION CONTAINS 18 PAPERS BY DIFFERENT AUTHORS. AREAS OF PSYCHOSOMATIC MEDICINE COVERED ARE (1) PRINCIPLES OF RESEARCH (ONE ARTICLE), (2) HISTORICAL DEVELOPMENTS, THEORETICAL MODELS, AND CORE PROBLEMS (THREE ARTICLES), AND (3) THE HYPOTHESIS,…

  3. The Role of Prostaglandins in Allergic Lung Inflammation and Asthma

    PubMed Central

    Claar, Dru; Hartert, Tina V.; Peebles, R. Stokes

    2015-01-01

    Prostaglandins are products of the cyclooxygenase pathway of arachidonic acid metabolism. There are five primary prostaglandins, PGD2, PGE2, PGF2, PGI2, and thromboxane B2, all of which signal through distinct seven transmembrane, G-protein coupled receptors. Some prostaglandins may counteract the actions of others, or even the same prostaglandin may have opposing physiologic or immunologic effects, depending on the specific receptor through which it signals. In this review, we will examine the effects of cyclooxygenase activity and the various prostaglandins on allergic airway inflammation and physiology that is associated with asthma. We also highlight the potential therapeutic benefit of targeting prostaglandins in allergic lung inflammation and asthma based on basic science, animal model, and human studies. PMID:25541289

  4. Computational fluid dynamics: a suitable assessment tool for demonstrating the antiobstructive effect of drugs in the therapy of allergic rhinitis.

    PubMed

    Achilles, N; Pasch, N; Lintermann, A; Schröder, W; Mösges, R

    2013-02-01

    This systematic review aims first to summarize the previous areas of application of computational fluid dynamics (CFD) and then to demonstrate that CFD is also a suitable instrument for generating three-dimensional images that depict drug effects on nasal mucosa. Special emphasis is placed on the three-dimensional visualization of the antiobstructive effect of nasal steroids and antihistamines in the treatment of allergic rhinitis. In the beginning, CFD technology was only used to demonstrate physiological and pathophysiological airflow conditions in the nose and to aid in preoperative planning and postoperative monitoring of surgical outcome in the field of rhinosurgery. The first studies using CFD examined nasal respiratory physiology, important functions of the nose, such as conditioning and warming of inspired air, and the influence of pathophysiological changes on nasal breathing. Also, postoperative outcome of surgical procedures could be "predicted" using the nasal airflow model. Later studies focused on the three-dimensional visualization of the effect of nasal sprays in healthy subjects and postoperative patients. A completely new approach, however, was the use of CFD in the area of allergic rhinitis and the treatment of its cardinal symptom of nasal obstruction. In two clinical trials, a suitable patient with a positive history of allergic rhinitis was enrolled during a symptom-free period after the pollen season. The patient developed typical allergic rhinitis symptoms after provocation with birch pollen. The 3-D visualization showed that the antiallergic treatment successfully counteracted the effects of nasal allergen provocation on nasal airflow. These observations were attributed to the antiobstructive effect of a nasal steroid (mometasone furoate) and a systemic antihistamine (levocetirizine), respectively. CFD therefore constitutes a non-invasive, precise, reliable and objective examination procedure for generating three-dimensional images that

  5. Prostaglandin D2 Modulates Neuronal Excitation of the Trigeminal Ganglion to Augment Allergic Rhinitis in Guinea Pigs.

    PubMed

    Nagira, Yoji; Goto, Kumiko; Tanaka, Hiroyuki; Aoki, Miwa; Furue, Shingo; Inagaki, Naoki; Tomita, Yasuhiko; Shichijo, Michitaka

    2016-05-01

    Prostaglandin D2(PGD2) is involved in the pathogenesis of allergic rhinitis. However, the sensory nervous system-mediated contributions of PGD2to the symptoms of allergic rhinitis remain unclear. We investigated the involvement of PGD2in these symptoms and in neuronal excitation by in vivo and ex vivo experiments. In an ovalbumin-induced model of allergic rhinitis in guinea pigs, the number of sneezing, nasal rubbing, and nasal secretion events were assessed after the nasal cavity instillation of PGD2, histamine, or a combination of PGD2and histamine. In situ hybridization for PGD2receptor 1 (DP1) mRNA transcripts and immunohistochemical analysis of histamine H1receptor protein expression in guinea pig trigeminal ganglion (TRG) were performed. The effects of DP1receptor activation on the excitability of TRG neurons to electrical and histamine stimuli were assessed using whole-cell patch-clamp recordings. Histamine induced more sneezing, nasal rubbing, and nasal secretion events than PGD2 PGD2augmented histamine-induced responses, whereas pretreatment with a DP1receptor-selective antagonist completely suppressed PGD2-induced augmentation. DP1receptor mRNA transcripts and H1receptor protein expression could be detected in TRG neurons. Moreover, a DP1receptor agonist caused significant increases in the number of histamine-induced action potentials and depolarization, and reduced the current threshold in small-diameter neurons. Our findings show that PGD2-DP1receptor signaling augments the symptoms of allergic rhinitis via the sensory nervous system by modulating nasal neuronal activation to various stimuli, such as histamine. These findings suggest that DP1receptor antagonist has therapeutic potential for the treatment of allergic rhinitis. PMID:26945085

  6. Occupational asthma and occupational rhinitis: the united airways disease model revisited

    PubMed Central

    Ameille, Jacques; Hamelin, Karine; Andujar, Pascal; Bensefa-Colas, Lynda; Bonneterre, Vincent; Dupas, Dominique; Garnier, Robert; Loddé, Brice Alain; Rinaldo, Mickael; Descatha, Alexis; Lasfargues, Gérard; Pairon, Jean-Claude

    2013-01-01

    Objectives Whereas accumulating evidence indicates close associations between rhinitis and asthma, little is known about the relationships between occupational rhinitis (OR) and occupational asthma (OA). This study analyses the prevalence of OR associated with OA, globally and according to the various causal agents, and investigates the temporal relationships between these two conditions. Methods Data on incident cases of OA (2008–2010) were collected through the French national occupational disease surveillance and prevention network, using a standardized form including information on occupation, causal agents, presence of OR, and respective dates of occurrence of rhinitis and asthma. Results Among the 596 reported OA cases with latency period, 555 could be attributed to identified agents: high molecular weight (HMW) agents (n=174); low molecular weight (LMW) agents (n=381). Overall, OR was associated with OA in 324 (58.4%) cases. The frequency of association was significantly higher for HMW agents than for LMW agents (72.2% vs 51.5%, p<0.001). OR occurred before OA significantly more frequently for HMW agents than for LMW agents (p<0.01). Conclusions These results show that OR is frequently associated with OA, especially when HMW agents are involved. They are consistent with the hypothesis that OR, in conjunction with OA, is more likely to be caused by sensitizers that cause disease via IgE-mediated mechanisms and suggest that symptoms of OR should be taken into account in the medical surveillance of workers exposed to HMW agents. PMID:23390199

  7. Potassium ion channels and allergic asthma.

    PubMed

    Kocmalova, M; Oravec, M; Adamkov, M; Sadlonova, V; Kazimierova, I; Medvedova, I; Joskova, M; Franova, S; Sutovska, M

    2015-01-01

    High-conductive calcium-sensitive potassium channels (BK+Ca) and ATP-sensitive potassium (K+ATP) channels play a significant role in the airway smooth muscle cell and goblet cell function, and cytokine production. The present study evaluated the therapeutic potential of BK+Ca and K+ATP openers, NS 1619 and pinacidil, respectively, in an experimental model of allergic inflammation. Airway allergic inflammation was induced with ovalbumine in guinea pigs during 21 days, which was followed by a 14-day treatment with BK+Ca and K+ATP openers. The outcome measures were airway smooth muscle cells reactivity in vivo and in vitro, cilia beating frequency and the level of exhaled NO (ENO), and the level of pro-inflammatory cytokines in the plasma and bronchoalveolar lavage fluid. The openers of both channels decreased airway smooth muscle cells reactivity, cilia beating frequency, and cytokine levels in the serum. Furthermore, NS1619 reduced ENO and inflammatory cells infiltration. The findings confirmed the presence of beneficial effects of BK+Ca and K+ATP openers on airway defence mechanisms. Although both openers dampened pro-inflammatory cytokines and mast cells infiltration, an evident anti-inflammatory effect was provided only by NS1619. Therefore, we conclude that particularly BK+Ca channels represent a promising new drug target in treatment of airway's allergic inflammation. PMID:25315623

  8. [Antihistamines in the treatment of allergic rhinitis--update 2008/2009].

    PubMed

    Kruszewski, Jerzy

    2009-09-01

    The following paper reviews the latest news on antihistamines used in the treatment of allergic rhinitis. It describes the new results of investigations on clinical application of H3 and H4 receptors in therapy of allergic diseases as well as the effect of emedastine on histamine-induced tissue remodeling. Contemporary clinical research of these drugs fulfills the requirements of placebo-controlled trials, including the comparison with a reference drug, usually cetirizine. The paper discusses efficacy and safety of a new drug--bilastine, and the possibility to improve clinical outcome by combining antihistamine drugs with inhaled glucocorticosteroids and antileukotrienes. It also presents the studies on high efficacy of nasal antihistamines, which most probably results from their high concentration in inflamed tissue, as well as describes the latest news on safe use of antihistamines, including studies of fexofenadine enantiomers in drug interactions with P-glycoprotein, safety of a new antihistamine medication--rupatadine, and psychostimulating effect of some other antihistamines. The review shows that antihistamines, the most frequently used class of anti-allergy medications, have been constantly improved, which is of significant importance for progress of allergic diseases treatment. PMID:20564892

  9. Effects of airway exposure to di-(2-ethylhexyl) phthalate on allergic rhinitis.

    PubMed

    He, Miao; Inoue, Ken-Ichiro; Yoshida, Seiichi; Tanaka, Michitaka; Takano, Hirohisa; Sun, Guifan; Ichinose, Takamichi

    2013-06-01

    Recent epidemiological studies have suggested a positive link between atopy morbidity and exposure to phthalate esters, which are environmental chemicals mainly involved in house dust. Nevertheless, experimental studies applying several allergic in vivo models (in addition to epidemiological studies) are needed to prove the precise correlation between phthalates and facilitation of the allergic response/pathophysiology. Among the phthalate esters, di-(2-ethylhexyl) phthalate (DEHP) has been widely used in flexible polyvinyl chloride products, including vinyl flooring and wall covering, and has been widely suggested to have immunomodulating potential. In the present study, we examined the effects of airway exposure to DEHP on allergen (ovalbumin: OVA)-induced rhinitis in mice. The repeated administration of OVA via an intranasal route induced nasal inflammation characterized by the infiltration of granulocytes (neutrophils and eosinophils) into the nasal cavity. In this experimental setting, DEHP did not exaggerate OVA-related inflammatory pathology. However, local (nasal) IL-13 levels were significantly higher in mice treated with allergen plus DEHP than with allergen alone. Taken together, phthalate esters including DEHP have the potential to exacerbate the allergic milieu in the nasal system, as well as dermal and respiratory systems. PMID:23672524

  10. Expression of Toll-like receptors in nasal epithelium in allergic rhinitis.

    PubMed

    Renkonen, Jutta; Toppila-Salmi, Sanna; Joenväärä, Sakari; Mattila, Pirkko; Parviainen, Ville; Hagström, Jaana; Haglund, Caj; Lehtonen, Mikko; Renkonen, Risto

    2015-08-01

    Toll-like receptors (TLRs) are important in barrier homeostasis, but their role in airborne allergies is not fully understood. The aim was to evaluate baseline and allergen-induced expression of TLR proteins in nasal epithelium during allergic rhinitis. Nineteen otherwise healthy non-smoking volunteers both allergic to birch pollen and non-allergic controls were enrolled. We took nasal biopsies before and after off-seasonal intranasal birch pollen or diluent challenge. The expression of epithelial TLR1-7, TLR9-10, and MyD88 proteins was immunohistochemically evaluated from the nasal biopsies. The TLR1-3 and TLR5-10 mRNAs were observed by RNA-microarray. Baseline epithelial expression of TLR proteins was wide and identical in controls and atopics. After off-seasonal intranasal birch pollen challenge, a negative change in the expression score of TLR1 and TLR6 proteins was detected in the atopic group. TLR mRNA expression was not affected by birch pollen challenge. Nasal epithelium seems to express all known TLRs. The mechanisms by which TLR1, and TLR6 proteins could affect pollen allergen transport need further studies. PMID:26061394

  11. Role of bilastine in the management of allergic rhinitis and urticaria: an Asia-Pacific consensus statement.

    PubMed

    Mösges, Ralph; Lee, Dennis Lip Yen; Abong, Jovilia; Siasoco, Bella; Chow, Steven Kw; Leong, Jern-Lin; Singh, Harvinder; Kuljit, S; Campomanes, Benjamin

    2016-01-01

    The prevalence of allergic diseases is increasing globally, most particularly in middle- to low-income countries. This article examines the burden of allergic rhinitis and chronic urticaria in the Asia-Pacific region, unmet clinical needs, and the potential role of bilastine in the management of these conditions. An International Advisory Group meeting was convened in association with the Asian Pacific Society of Respirology Annual Congress in November 2014, followed by a literature review, and consensus-based outcomes from the meeting and literature review are described. Regional estimates of the prevalence of allergic rhinitis range from 10% to 50%, while little is known regarding the burden of urticaria in the Asia-Pacific region. A survey of allergy patients in the region identified fast, complete, and long-lasting symptom relief as the medication attributes most important to patients. International treatment guidelines for allergic rhinitis and urticaria advocate the first-line use of second-generation, no-sedating H1-antihistamines, such as bilastine, over their first-generation counterparts and a range of these agents are available to Asia-Pacific patients. The newer agents possess many of the properties of an "ideal" antihistamine (once daily administration, rapid and complete symptom relief, limited potential for drug-drug interactions, minimal side effects). The burgeoning prevalence of allergic diseases in the Asia-Pacific region and the uncontrolled symptoms that these patients experience demand a new antihistamine that offers the highest number of positive features according to the international guidelines. PMID:26844221

  12. Role of bilastine in the management of allergic rhinitis and urticaria: an Asia-Pacific consensus statement

    PubMed Central

    Lee, Dennis Lip Yen; Abong, Jovilia; Siasoco, Bella; Chow, Steven KW; Leong, Jern-Lin; Singh, Harvinder; Kuljit, S; Campomanes, Benjamin

    2016-01-01

    The prevalence of allergic diseases is increasing globally, most particularly in middle- to low-income countries. This article examines the burden of allergic rhinitis and chronic urticaria in the Asia-Pacific region, unmet clinical needs, and the potential role of bilastine in the management of these conditions. An International Advisory Group meeting was convened in association with the Asian Pacific Society of Respirology Annual Congress in November 2014, followed by a literature review, and consensus-based outcomes from the meeting and literature review are described. Regional estimates of the prevalence of allergic rhinitis range from 10% to 50%, while little is known regarding the burden of urticaria in the Asia-Pacific region. A survey of allergy patients in the region identified fast, complete, and long-lasting symptom relief as the medication attributes most important to patients. International treatment guidelines for allergic rhinitis and urticaria advocate the first-line use of second-generation, no-sedating H1-antihistamines, such as bilastine, over their first-generation counterparts and a range of these agents are available to Asia-Pacific patients. The newer agents possess many of the properties of an "ideal" antihistamine (once daily administration, rapid and complete symptom relief, limited potential for drug-drug interactions, minimal side effects). The burgeoning prevalence of allergic diseases in the Asia-Pacific region and the uncontrolled symptoms that these patients experience demand a new antihistamine that offers the highest number of positive features according to the international guidelines. PMID:26844221

  13. Clara cells drive eosinophil accumulation in allergic asthma.

    PubMed

    Sonar, S S; Ehmke, M; Marsh, L M; Dietze, J; Dudda, J C; Conrad, M L; Renz, H; Nockher, W A

    2012-02-01

    Development of allergic asthma is a complex process involving immune, neuronal and tissue cells. In the lung, Clara cells represent a major part of the "immunomodulatory barrier" of the airway epithelium. To understand the contribution of these cells to the inflammatory outcome of asthma, disease development was assessed using an adjuvant-free ovalbumin model. Mice were sensitised with subcutaneous injections of 10 μg endotoxin-free ovalbumin in conjunction with naphthalene-induced Clara cell depletion. Clara epithelial cell depletion in the lung strongly reduced eosinophil influx, which correlated with decreased eotaxin levels and, moreover, diminished the T-helper cell type 2 inflammatory response, including interleukin (IL)-4, IL-5 and IL-13. In contrast, airway hyperresponsiveness was increased. Further investigation revealed Clara cells as the principal source of eotaxin in the lung. These findings are the first to show that Clara airway epithelial cells substantially contribute to the infiltration of eotaxin-responsive CCR3+ immune cells and augment the allergic immune response in the lung. The present study identifies Clara cells as a potential therapeutic target in inflammatory lung diseases such as allergic asthma. PMID:21828027

  14. [Evaluation of the efficiency and safety of the loratadine with pseudoephedrine combination drug in treatment of seasonal allergic rhinitis].

    PubMed

    Zawisza, E; Lipiec, A; Rapiejko, P

    1998-02-01

    The aim of the study was to assess efficacy and safety of 5 mg loratadine/120 mg pseudoephedrine combination drug in patients with seasonal allergic rhinitis. 30 patients allergic to grass pollen were treated with the new drug (Clarinase) twice a day in 15-day study during grass pollen seasonal. Nasal an non-nasal symptoms were evaluated for efficacy. Loratadine/pseudoephedrine combination effected a significant decrease in total symptoms score as well as individual evaluated symptoms score: nasal stuffiness, itching and discharge, sneezing, eye itching, tearing and redness of the eyes. The treatments was well tolerated. No serious side effects were noticed. The incidence of mild sedation, dry mouth, insomnia and nervousness was only 3 to 7 percent. 5 mg loratadine plus 120 mg pseudoephedrine was safe and effective in relieving the symptoms of allergic rhinitis. PMID:9634291

  15. SQ house dust mite (HDM) SLIT-tablet provides clinical improvement in HDM-induced allergic rhinitis.

    PubMed

    Klimek, Ludger; Mosbech, Holger; Zieglmayer, Petra; Rehm, Dorte; Stage, Brian Sonne; Demoly, Pascal

    2016-04-01

    House dust mite (HDM) allergy represents a highly prevalent inhalant allergy, and exposure to HDM allergens results in allergic rhinitis with persistent symptoms that may not be adequately controlled with available allergy pharmacotherapy. Allergy immunotherapy constitutes a complementary treatment option targeting the underlying immunological mechanisms of allergic disease and represents the only treatment with a potential for disease modification and long-term efficacy. As traditional allergy immunotherapy delivered by subcutaneous injection of specific HDM allergens involves a time-consuming treatment regimen and a risk of systemic adverse reactions, sublingually administered allergy immunotherapy (SLIT) has been investigated as a more convenient treatment option with similar levels of efficacy and an improved safety profile that allows for at-home daily administration. In this Drug Profile, we provide a review of the clinical data behind the SQ HDM SLIT-tablet, which was recently approved for the treatment of HDM-induced allergic rhinitis by regulatory authorities in Europe and Japan. PMID:26788764

  16. Potential of Immunoglobulin A to Prevent Allergic Asthma

    PubMed Central

    Gloudemans, Anouk K.; Lambrecht, Bart N.; Smits, Hermelijn H.

    2013-01-01

    Allergic asthma is characterized by bronchial hyperresponsiveness, a defective barrier function, and eosinophilic lower airway inflammation in response to allergens. The inflammation is dominated by Th2 cells and IgE molecules and supplemented with Th17 cells in severe asthma. In contrast, in healthy individuals, allergen-specific IgA and IgG4 molecules are found but no IgE, and their T cells fail to proliferate in response to allergens, probably because of the development of regulatory processes that actively suppress responses to allergens. The presence of allergen-specific secretory IgA has drawn little attention so far, although a few epidemiological studies point at a reverse association between IgA levels and the incidence of allergic airway disease. This review highlights the latest literature on the role of mucosal IgA in protection against allergic airway disease, the mechanisms described to induce secretory IgA, and the role of (mucosal) dendritic cells in this process. Finally, we discuss how this information can be used to translate into the development of new therapies for allergic diseases based on, or supplemented with, IgA boosting strategies. PMID:23690823

  17. Potential of immunoglobulin A to prevent allergic asthma.

    PubMed

    Gloudemans, Anouk K; Lambrecht, Bart N; Smits, Hermelijn H

    2013-01-01

    Allergic asthma is characterized by bronchial hyperresponsiveness, a defective barrier function, and eosinophilic lower airway inflammation in response to allergens. The inflammation is dominated by Th2 cells and IgE molecules and supplemented with Th17 cells in severe asthma. In contrast, in healthy individuals, allergen-specific IgA and IgG4 molecules are found but no IgE, and their T cells fail to proliferate in response to allergens, probably because of the development of regulatory processes that actively suppress responses to allergens. The presence of allergen-specific secretory IgA has drawn little attention so far, although a few epidemiological studies point at a reverse association between IgA levels and the incidence of allergic airway disease. This review highlights the latest literature on the role of mucosal IgA in protection against allergic airway disease, the mechanisms described to induce secretory IgA, and the role of (mucosal) dendritic cells in this process. Finally, we discuss how this information can be used to translate into the development of new therapies for allergic diseases based on, or supplemented with, IgA boosting strategies. PMID:23690823

  18. Higher environmental relative moldiness index values measured in homes of adults with asthma, rhinitis, or both conditions

    EPA Science Inventory

    Higher values of the Environmental Relative Moldiness Index (ERMI), a DNA-based method for quantifying indoor molds, have been associated with asthma in children. In this study, settled dust samples were collected from the homes of adults with asthma and rhinitis (n=202 homes) i...

  19. Understanding allergic asthma from allergen inhalation tests.

    PubMed

    Cockcroft, Donald W; Hargreave, Fredrick E; O'Byrne, Paul M; Boulet, Louis-Philippe

    2007-10-01

    The allergen challenge has evolved, in less than 150 years, from a crude tool used to document the etiology of allergen-induced disease to a well-controlled tool used today to investigate the pathophysiology and pharmacotherapy of asthma. Highlights of the authors' involvement with the allergen challenge include confirmation of the immunoglobulin E-dependence of the late asthmatic response, importance of (nonallergic) airway hyper-responsiveness as a determinant of the airway response to allergen, identification of allergen-induced increase in airway hyper-responsiveness, documentation of beta(2)-agonist-induced increase in airway response to allergen (including eosinophilic inflammation), advances in understanding the pathophysiology and kinetics of allergen-induced airway responses, and development of a multicentre clinical trial group devoted to using the allergen challenge for investigating promising new therapeutic strategies for asthma. PMID:17948142

  20. Allergic Rhinitis

    PubMed Central

    Wheatley, Lisa M.; Togias, Alkis

    2015-01-01

    A 35-year-old woman has a history of nasal congestion on most days of the year, dating back to her late teens. She has chronic nasal drainage, which is clear and thick. Her congestion is worst in the late summer and early fall and again in the early spring; at these times, she also has sneezing, nasal itching, and cough. Five years ago, she had an episode of shortness of breath with wheezing on a day when her nasal symptoms were severe, but this episode resolved spontaneously and has not recurred. Her eyes do not bother her. Over-the-counter oral antihistamines help her symptoms a little, as do nasal decongestants, which she uses occasionally. Her 6-year-old son has similar symptoms. How should this case be managed? PMID:25629743

  1. Allergic Rhinitis

    MedlinePlus

    ... symptoms are worse on hot, dry days when wind carries the pollen. On rainy days, pollen often ... pollution Cold temperatures Humidity Irritating fumes Tobacco smoke Wind Wood smoke Other Organizations American Academy of Allergy, ...

  2. UK prescribing practices as proxy markers of unmet need in allergic rhinitis: a retrospective observational study

    PubMed Central

    Price, David B; Scadding, Glenis; Bachert, Claus; Saleh, Hesham; Nasser, Shuaib; Carter, Victoria; von Ziegenweidt, Julie; Durieux, Alice M S; Ryan, Dermot

    2016-01-01

    Little data on UK prescribing patterns and treatment effectiveness for allergic rhinitis (AR) are available. We quantified unmet pharmacologic needs in AR by assessing AR treatment effectiveness based on the prescribing behaviour of UK general practitioners (GP) during two consecutive pollen seasons (2009 and 2010). We conducted a retrospective observational study with the data from the Optimum Patient Care Research Database. We assessed diagnoses and prescription data for patients with a recorded diagnosis of rhinitis who took rhinitis medication during the study period. We assessed the data from 25,069 patients in 2009 and 22,381 patients in 2010. Monotherapy was the initial prescription of the season for 67% of patients with seasonal AR (SAR) and 77% of patients with nonseasonal upper airways disease (NSUAD), for both years. Initial oral antihistamine (OAH) or intranasal corticosteroid (INS) monotherapy proved insufficient for >20% of SAR and >37% of NSUAD patients. Multiple therapy was the initial prescription for 33% of SAR and 23% of NSUAD in both years, rising to 45% and >50% by season end, respectively. For NSUAD, dual-therapy prescriptions doubled and triple-therapy prescriptions almost tripled during both seasons. Many patients revisited their GP regardless of initial prescription. Initial OAH or INS monotherapy provides insufficient symptom control for many AR patients. GPs often prescribe multiple therapies at the start of the season, with co-prescription becoming more common as the season progresses. However, patients prescribed multiple therapies frequently revisit their GP, presumably to adjust treatment. These data suggest the need for more effective AR treatment and management strategies. PMID:27334893

  3. Improvement of symptoms of non-allergic chronic rhinitis by local treatment with capsaicin.

    PubMed

    Lacroix, J S; Buvelot, J M; Polla, B S; Lundberg, J M

    1991-09-01

    Sixteen adult patients suffering from severe chronic non-allergic rhinitis with nasal vasoconstrictor abuse for more than a year, received, under local anaesthesia, an intranasal spray of capsaicin (3.3 x 10(-3) mol), the pungent agent in hot pepper, once weekly for 5 weeks. The subjective intensity of their nasal obstruction, rhinorrhoea and sneezing frequency were evaluated throughout the study and the vascular effects of capsaicin on the nasal mucosa were recorded by anterior rhinomanometry and laser Doppler flowmetry. Calcitonin gene-related peptide (CGRP) is a vasodilator agent present in sensory nerves and may play a major role in the vascular component of neurogenic inflammation. Therefore, the nasal mucosa content of CGRP-like immunoreactivity (CGRP-LI) was determined by radioimmunoassay in biopsies obtained before and after the capsaicin treatment. Intra-nasal capsaicin application evoked a larger vascular response in patients with rhinitis than in controls (P less than 0.05). Both nasal vascular responses and subjective discomfort following capsaicin were markedly reduced after the fifth application (P less than 0.01). In parallel, a 50% reduction of the CGRP-LI content in the nasal biopsies was observed. All symptoms were significantly improved throughout a 6 month follow-up period. No significant side-effects occurred and weaning from nasal vasoconstrictor agents was possible. Both the subjective symptom score and objective measurements of vascular reactivity suggest that repeated intra-nasal capsaicin application could be beneficial for patients with chronic rhinitis, possibly by reducing hyperreactive nasal reflexes. PMID:1742652

  4. UK prescribing practices as proxy markers of unmet need in allergic rhinitis: a retrospective observational study.

    PubMed

    Price, David B; Scadding, Glenis; Bachert, Claus; Saleh, Hesham; Nasser, Shuaib; Carter, Victoria; von Ziegenweidt, Julie; Durieux, Alice M S; Ryan, Dermot

    2016-01-01

    Little data on UK prescribing patterns and treatment effectiveness for allergic rhinitis (AR) are available. We quantified unmet pharmacologic needs in AR by assessing AR treatment effectiveness based on the prescribing behaviour of UK general practitioners (GP) during two consecutive pollen seasons (2009 and 2010). We conducted a retrospective observational study with the data from the Optimum Patient Care Research Database. We assessed diagnoses and prescription data for patients with a recorded diagnosis of rhinitis who took rhinitis medication during the study period. We assessed the data from 25,069 patients in 2009 and 22,381 patients in 2010. Monotherapy was the initial prescription of the season for 67% of patients with seasonal AR (SAR) and 77% of patients with nonseasonal upper airways disease (NSUAD), for both years. Initial oral antihistamine (OAH) or intranasal corticosteroid (INS) monotherapy proved insufficient for >20% of SAR and >37% of NSUAD patients. Multiple therapy was the initial prescription for 33% of SAR and 23% of NSUAD in both years, rising to 45% and >50% by season end, respectively. For NSUAD, dual-therapy prescriptions doubled and triple-therapy prescriptions almost tripled during both seasons. Many patients revisited their GP regardless of initial prescription. Initial OAH or INS monotherapy provides insufficient symptom control for many AR patients. GPs often prescribe multiple therapies at the start of the season, with co-prescription becoming more common as the season progresses. However, patients prescribed multiple therapies frequently revisit their GP, presumably to adjust treatment. These data suggest the need for more effective AR treatment and management strategies. PMID:27334893

  5. The international survey on the management of allergic rhinitis by physicians and patients (ISMAR).

    PubMed

    Baena-Cagnani, Carlos E; Canonica, Giorgio W; Zaky Helal, Mohamed; Gómez, René Maximiliano; Compalati, Enrico; Zernotti, Mario E; Sanchez-Borges, Mario; Morato Castro, Fabio F; Murrieta Aguttes, Margarita; López-Garcia, Aida; Tadros, Faheem A

    2015-01-01

    Epidemiologic studies suggest that the prevalence of allergic rhinitis (AR) is rising worldwide. Several reports, in fact, indicate increasing trends in the prevalence of AR especially in developing countries, likely related to the environment and climate changes and the adoption of an urbanized Western lifestyle. The primary objective of the present study was to collect information about management in real-life settings, including a characterization of typical patients' profile referring to physicians, the disease features, the common approaches to diagnostic assessments and therapeutic decisions. This was an international, multicenter, cross-sectional study conducted in adults or children (≥6 years) suffering from rhinitis confirmed by physician's diagnosis for at least one year. The 234 physicians who participated in the study included a total of 2778 patients in Egypt, Mexico, Brazil, Colombia, Guatemala, Iran, Venezuela, Argentina, Israel, Kuwait and United Arab Emirates. It was found that clinical history was the selected tool to diagnose and categorize AR patients (97.1%), with less than half of patients undergoing allergy testing, may be explaining the scarce use of immunotherapy on management of disease. Out of 2776 patients, 93.4% had somehow received a recommendation to avoid allergens and irritant agent exposure. Notably, 91.4% were receiving at least one treatment at the time of the survey, mostly oral antihistamines (79.7%) and intranasal corticosteroids (66.3%). Oral antihistamines, intranasal steroids and decongestants were considered both safe and effective by patients and physicians, preferring oral and nasal route of administration. The ISMAR registry was designed according to the most accepted epidemiological recommendations, and provides interesting information regarding the management of rhinitis from a patient and physician points of view, with many similarities between the participating countries. Further efforts are required to better

  6. Rupatadine: pharmacological profile and its use in the treatment of allergic rhinitis.

    PubMed

    Sudhakara Rao, M; Dwarakanatha Reddy, D; Murthy, P S N

    2009-12-01

    Rupatadine is a once-daily, non-sedating, selective and long-acting new drug with a strong antagonist activity towards both histamine H1 receptors and platelet-activating factor receptors. The use of rupatadine is indicated in adult and adolescent patients (>12 years of age) suffering from intermittent and persistent allergic rhinitis. In the treatment of these conditions, rupatadine is at least as effective as ebastine, cetirizine, loratadine and desloratadine. Avery good safety profile of rupatadine has been evidenced in various studies, including a long-term (1-year) safety study. Rupatadine does not present drug-drug interactions with azithromycin, fluoxetine and lorazepam, but should not be administered concomitantly with known CYP3A4 inhibitors. PMID:23120659

  7. Effect of Inhalation of Aromatherapy Oil on Patients with Perennial Allergic Rhinitis: A Randomized Controlled Trial.

    PubMed

    Choi, Seo Yeon; Park, Kyungsook

    2016-01-01

    This study aimed to investigate the effects of aromatherapy oil inhalation on symptoms, quality of life, sleep quality, and fatigue level among adults with perennial allergic rhinitis (PAR). Fifty-four men and women aged between 20 and 60 were randomized to inhale aromatherapy oil containing essential oil from sandalwood, geranium, and Ravensara or almond oil (the placebo) for 5 minutes twice daily for 7 days. PAR symptoms determined by Total Nasal Symptom Score (TNSS), the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), sleep quality by Verran Synder-Halpern (VSH) scale, and fatigue level by Chalder Fatigue Scale (CFS) were assessed before and after intervention period. Compared with the placebo, the experimental group showed significant improvement in TNSS, especially in nasal obstruction. The aromatherapy group also showed significantly higher improvements in total score of RQLQ and CFS. These findings indicate that inhalation of certain aromatherapy oil helps relieve PAR symptoms, improve rhinitis-specific quality of life, and reduce fatigue in patients with PAR. In conclusion, inhalation of aromatherapy essential oil may have potential as an effective intervention to alleviate PAR. PMID:27034695

  8. Effect of Inhalation of Aromatherapy Oil on Patients with Perennial Allergic Rhinitis: A Randomized Controlled Trial

    PubMed Central

    Choi, Seo Yeon

    2016-01-01

    This study aimed to investigate the effects of aromatherapy oil inhalation on symptoms, quality of life, sleep quality, and fatigue level among adults with perennial allergic rhinitis (PAR). Fifty-four men and women aged between 20 and 60 were randomized to inhale aromatherapy oil containing essential oil from sandalwood, geranium, and Ravensara or almond oil (the placebo) for 5 minutes twice daily for 7 days. PAR symptoms determined by Total Nasal Symptom Score (TNSS), the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), sleep quality by Verran Synder-Halpern (VSH) scale, and fatigue level by Chalder Fatigue Scale (CFS) were assessed before and after intervention period. Compared with the placebo, the experimental group showed significant improvement in TNSS, especially in nasal obstruction. The aromatherapy group also showed significantly higher improvements in total score of RQLQ and CFS. These findings indicate that inhalation of certain aromatherapy oil helps relieve PAR symptoms, improve rhinitis-specific quality of life, and reduce fatigue in patients with PAR. In conclusion, inhalation of aromatherapy essential oil may have potential as an effective intervention to alleviate PAR. PMID:27034695

  9. Breastfeeding, aeroallergen sensitization and environmental exposures during infancy are determinants of childhood allergic rhinitis

    PubMed Central

    Codispoti, Christopher D.; Levin, Levin; LeMasters, Grace K.; Ryan, Patrick; Reponen, Tiina; Villareal, Manuel; Burkle, Jeff; Lockey, James E.; Khurana Hershey, Gurjit K.; Bernstein, David I.

    2016-01-01

    Background Infant predictors of early childhood allergic rhinitis (AR) are poorly understood. Objective Identify environmental exposures and host factors during infancy that predicts AR at age three. Methods High risk children from Greater Cincinnati were followed annually from ages one to three. Allergic rhinitis (AR) was defined as sneezing, runny or blocked nose in the prior 12 months and positive skin prick test (SPT) to one or more aeroallergens. Environmental and standardized medical questionnaires determined exposures and clinical outcomes. Primary activity area dust samples were analyzed for house dust endotoxin (HDE) and (1-3)-β-D-glucan. Fine particulate matter (PM2.5) sampled at 27 monitoring stations was used to estimate personal elemental carbon attributable to traffic (ECAT) exposure by land use regression model. Results Of 361 children in this analysis, 116 had AR and 245 were non-atopic, non-symptomatic. Prolonged breastfeeding in African-American children (aOR 0.8; 95% CI 0.6–0.9) and multiple children in the home during infancy was protective of AR (aOR 0.4; 95% CI 0.2–0.8). Food SPT positivity and tree SPT positivity in infancy increased the risk of AR at age three (aOR 4.4; 95% CI 2.1–9.2) and (aOR 6.8; 95% CI 2.5–18.7), respectively. HDE exposure was associated with AR; the effect was dependent on exposure level. ECAT and ETS exposure showed no effect on AR. Conclusion Prolonged breastfeeding in African-Americans and multiple children in the home during infancy reduced the risk of AR at age three. SPT positivity to food and tree allergens enhanced risk. The HDE effect on AR was related to exposure. PMID:20392478

  10. Current Allergic Rhinitis Experiences Survey (CARES): Health-care practitioners' awareness, attitudes and practices.

    PubMed

    Blaiss, Michael S; Fromer, Leonard M; Jacob-Nara, Juby A; Long, Randall M; Mannion, Karen M; Lauersen, Lori A

    2014-01-01

    Allergic rhinitis (AR) is a common health problem in the United States, with significant comorbidities and impairment of quality of life despite the availability of many prescription (Rx) and over-the-counter (OTC) medications. The health-care practitioners (HCPs) arm of the Current Allergic Rhinitis Experiences Survey (CARES) assessed HCPs' perceptions about the current management of AR. This U.S.-based national survey included 375 primary care physicians and 375 nurse practitioners/physician assistants. Participants were screened to ensure that they treat ≥15 AR sufferers per month during allergy season. The majority of HCPs (86%) agreed that AR patients can easily recognize allergy symptoms after diagnosis and that 57% of their patients come to them self-recognizing their symptoms. A total of 82% strongly agreed that AR sufferers are primarily diagnosed via history and physical and do not typically undergo diagnostic testing until after pharmacologic intervention. HCPs reported that 63-77% of AR sufferers can easily manage AR once treatment is established. According to surveyed HCPs, OTC medication should precede an Rx medication for AR management. A total of 82% HCPs considered intranasal steroids (INSs) to be the gold standard AR treatment and have minimal safety concerns about INS use. HCPs perceive that patients can easily recognize and self-manage their AR symptoms. Patient history/symptoms and physical examination are the primary methods of AR diagnosis. INSs are considered the gold standard for treatment of AR. However, most HCPs feel OTC medication should be tried before Rx medication for AR management. PMID:24992551

  11. Risk of Allergic Rhinitis, Allergic Conjunctivitis, and Eczema in Children Born to Mothers with Gum Inflammation during Pregnancy

    PubMed Central

    Hsieh, Vivian Chia-Rong; Liu, Chin-Chen; Hsiao, Yu-Chen; Wu, Trong-Neng

    2016-01-01

    Purpose Despite links between maternal and child health status, evidence on the association between gum infection in pregnant mothers and childhood allergies is scarce. We aim to evaluate the risk of developing allergy in children born to periodontal mothers in a nationwide study. Methods We conducted a 9-year population-based, retrospective cohort study using Taiwan’s National Health Insurance database. A study cohort of 42,217 newborns born to mothers with periodontal disease during pregnancy was identified in 2001 and matched with 42,334 babies born to mothers without any infection (control) by mother’s age at delivery and baby sex. With a follow-up period from 2001 to 2010, we observed the incidence of allergic rhinitis (AR), allergic conjunctivitis (AC), and eczema in these children. Cox proportional hazards regression models were performed with premature deaths as competing risk for the estimation of allergic disease risks. Results Nine-year cumulative incidences were the highest among children born to periodontal mothers; they reached 46.8%, 24.2%, and 40.4% (vs. 39.5%, 18.3% and 34.8% in control) for AR, AC, and eczema, respectively. Our results showed moderately increased risks for the allergies in children born to periodontal mothers relative to their matched non-inflammatory control (adjusted HRs: 1.17, 95% CI: 1.15–1.20; 1.27, 1.24–1.31; 1.14, 1.12–1.17, respectively). Because the impact of food consumption and living environment cannot be considered using insurance data, we attempted to control it by adjusting for parental income and mother’s residential area. Conclusions Overall cumulative incidence and risks of children born to periodontal mothers for AR, AC, and eczema are significantly higher than those born to non-inflammatory mothers. Gum infection in women during pregnancy is an independent risk factor for allergic diseases in children, thus its intergenerational consequences should be considered in gestational care. PMID:27224053

  12. Application of vitamin E to antagonize SWCNTs-induced exacerbation of allergic asthma.

    PubMed

    Li, Jinquan; Li, Li; Chen, Hanqing; Chang, Qing; Liu, Xudong; Wu, Yang; Wei, Chenxi; Li, Rui; Kwan, Joseph K C; Yeung, King Lun; Xi, Zhuge; Lu, Zhisong; Yang, Xu

    2014-01-01

    The aggravating effects of zero-dimensional, particle-shaped nanomaterials on allergic asthma have been previously investigated, but similar possible effects of one-dimensional shaped nanomaterials have not been reported. More importantly, there are no available means to counteract the adverse nanomaterial effects to allow for their safe use. In this study, an ovalbumin (OVA)-sensitized rat asthma model was established to investigate whether single walled carbon nanotubes (SWCNTs) aggravate allergic asthma. The results showed that SWCNTs in rats exacerbated OVA-induced allergic asthma and that this exacerbation was counteracted by concurrent administration vitamin E. A mechanism involving the elimination of reactive oxygen species, downregulation of Th2 responses, reduced Ig production, and the relief of allergic asthma symptoms was proposed to explain the antagonistic effects of vitamin E. This work could provide a universal strategy to effectively protect people with allergic asthma from SWCNTs or similar nanomaterial-induced aggravating effects. PMID:24589727

  13. Abietic acid attenuates allergic airway inflammation in a mouse allergic asthma model.

    PubMed

    Gao, Yi; Zhaoyu, Liu; Xiangming, Fang; Chunyi, Lin; Jiayu, Pan; Lu, Shen; Jitao, Chen; Liangcai, Chen; Jifang, Liu

    2016-09-01

    Abietic acid (AA), one of the terpenoids isolated from Pimenta racemosa var. grissea, has been reported to have anti-inflammatory and immunomodulatory effects. However, the anti-allergic effects of AA remain unclear. The aim of this study was to investigate the anti-allergic effects of AA in an ovalbumin (OVA)-induced asthma murine model. The model of mouse asthma was established by induction of OVA. AA (10, 20, 40mg/kg) was administered by oral gavage 1h after the OVA treatment on days 21 to 23. At 24h after the last challenge, bronchoalveolar lavage fluid (BALF) and lung tissues were collected to assess pathological changes, cytokines production, and NF-κB expression. The results showed that AA attenuated lung histopathologic changes, inflammatory cells infiltration, and bronchial hyper-responsiveness. AA also inhibited OVA-induced the nitric oxide (NO), IL-4, IL-5, IL-13, and OVA-specific IgE production, as well as NF-κB activation. In conclusion, the current study demonstrated that AA exhibited protective effects against OVA-induced allergic asthma in mice and the possible mechanism was involved in inhibiting NF-κB activation. PMID:27318791

  14. Correlation between Serum Osteopontin and miR-181a Levels in Allergic Rhinitis Children

    PubMed Central

    Liu, Wenlong; Zeng, Qingxiang; Luo, Renzhong

    2016-01-01

    Background. Osteopontin (OPN) has been proved to be associated with allergic airway inflammation. However, the roles of OPN and its regulation in childhood allergic rhinitis (AR) are poorly understood. Objective. This study aims to evaluate the expression of OPN and miR-181a in children with AR and their association with Th1/Th2 immune response. Methods. Children who suffered from AR were included along with control subjects. Serum was collected to examine the level of OPN and Th1/Th2 cytokines by enzyme-linked immunosorbent assay (ELISA) and the level of miR-181a by quantitative polymerase chain reaction (qPCR). Results. Children with AR had significantly higher serum levels of OPN and lower serum levels of miR-181a than healthy controls. Furthermore, serum levels of OPN were positively correlated with Th2 cytokine and negatively correlated with Th1 cytokine. On the contrary, miR-181a level had a negative correlation with IL-4/IL-5 and positive correlation with IFN-γ/IL-12. More importantly, there was also significant negative correlation between OPN and miR-181a. Conclusion. The OPN protein and miR-181a levels may serve as predictors of disease severity in childhood AR and appear to be promising targets for modulating AR. PMID:27199509

  15. Using Parental Perceptions of Childhood Allergic Rhinitis to Inform Primary Care Management

    PubMed Central

    Garbutt, Jane M.; Sterkel, Randall; Mullen, Kathy B.; Conlon, Bridget; Leege, Erin; Bloomberg, Gordon; Strunk, Robert C.

    2014-01-01

    Objective To describe parents’ experience with their child’s allergic rhinitis (AR) to inform management by the primary care provider (PCP). Study Design Two hundred parents with a child 7 to 15 years old with AR symptoms within the past 12-months completed a paper survey. Results The child’s AR was identified as a significant problem in spring (89.3%), fall (63.4%), summer (50.3%) and winter (21.4%); 51.3% had persistent disease. AR symptoms most commonly interfered with the child’s outdoor activities and sleeping, and frequently bothered the parent and other family members. Most parents (88.3%) wanted to know what their child was allergic to and had many concerns about treatment options. 62.9% had sought AR care from the PCP in the past 12 months. Conclusions Many families experience significant morbidity from their child’s AR and turn to their PCP for help. We identified opportunities for the PCP to reduce AR morbidity. PMID:24803628

  16. Pre- and Postnatal Risk Factors in Relation to Allergic Rhinitis in School-Aged Children in China

    PubMed Central

    Li, Youjin; Jiang, Yanrui; Li, Shenghui; Shen, Xiaoming; Liu, Jinfen; Jiang, Fan

    2015-01-01

    Objective The objective of this study was to investigate the relationship between prenatal and postnatal risk factors and the prevalence of allergic rhinitis (AR) in Chinese children of specific ages. Study Design This study was a cross-sectional survey. Students from 8 metropolitan cities in China were studied in November and December, 2005. There were 20,803 elementary-school Chinese children (49.6% boys, mean age, 9.19 years) enrolled. Questions from the standard questionnaire of the International Study of Asthma and Allergies in Children were completed to enable us to examine the pattern of current AR. The potential confounders and pre-and postnatal risk factors were analyzed using logistic regression. Results The overall prevalence of AR was found in this study to be 9.8%. After adjusting for several likely confounders, there was a higher likelihood of AR in school-aged children who were not exclusively breastfed in the first 4 months of their lives (odds ratio [OR]: 1.28; 95% confidence interval [CI]: 1.16–1.41), children who were born post-term (OR: 1.34; 95% CI: 1.12–1.60), children delivered by cesarean section (OR: 1.07; 95% CI: 1.00–1.19), or children born to mothers who experienced depressive symptoms during the pre- and postnatal periods (OR: 1.28; 95% CI: 1.15–1.42). Conclusions AR in school-aged children was found to be associated with pre- and postnatal events. These findings indicate that strategies to reduce exposure to risk factors during pre- and postnatal periods for childhood allergies might be warranted. PMID:25647669

  17. CROSS REACTIVITY IN ALLERGIC ASTHMA-LIKE RESPONSES BETWEEN MOLD AND HOUSE DUST MITE IN MICE

    EPA Science Inventory

    Molds are ubiquitous in the environment and exposures to molds contribute to various human diseases including allergic asthma. Some mold allergens have been implicated as the causal agent for allergic asthma. Western blot analysis demonstrated IgE-binding cross-reactivity among m...

  18. Rhinitis in Older Adults

    PubMed Central

    Nyenhuis, Sharmilee; Mathur, Sameer K.

    2013-01-01

    Rhinitis symptoms of rhinorrhea, congestion, sneezing, nasal/ocular pruritis, and postnasal drainage can significantly affect the quality of life for older adults. As the US population ages, it will be increasingly important for healthcare providers to effectively diagnose and manage rhinitis. Rhinitis is categorized broadly into allergic rhinitis and non-allergic rhinitis. Environmental changes and avoidance measures are a primary means of intervention. In addition, there are several topical therapies (nasal sprays) that can be effective for symptom control. PMID:23389558

  19. Allergic rhinitis, feeding and oral habits, toothbrushing and socioeconomic status. Effects on development of dental caries in primary dentition.

    PubMed

    Vázquez-Nava, F; Vázquez, R E M; Saldivar, G A H; Beltrán, G F J; Almeida, A V M; Vázquez, R C F

    2008-01-01

    The aim was to determine the effect of feeding and oral habits, toothbrushing, socioeconomic status and allergic rhinitis on the development of dental caries in primary dentition. In a cross-sectional study, data were obtained by means of a structured questionnaire on 1,160 children, 4-5 years old (mean = 4.5 +/- 0.5) and born in 1999, 2000 or 2001. The children also had a physical examination by an allergist and dentists. Dental caries was diagnosed according to WHO criteria. Caries experience was measured as number of deft and defs. Logistic regression analysis assessed the association between dental caries and independent variables. The dental caries prevalence was 17.9%, 28.8% of the children had allergic rhinitis symptoms, digit sucking was reported by 9.8% and pacifier use by 13.6% of the children. The mean number of deft of the sample was 1.02 (SD = 2.37) and that of defs was 1.33 (SD = 3.54). Analysis showed that breast-feeding for >12 months (p < 0.01), toothbrushing frequency (p < 0.01), sugar consumption (p < 0.01) and pacifier use (p < 0.01) each had a significant association with dental caries occurrence in primary dentition. Children with pacifier use and allergic rhinitis had more than double the risk of dental caries development. Allergic rhinitis alone has no effect on dental caries. Healthcare professionals attempting to limit dental caries should consider the effect of prolonged breast-feeding, sugary product consumption between meals and nonnutritive habits on dental caries. PMID:18367835

  20. Systems Biology of Asthma and Allergic Diseases: A Multiscale Approach

    PubMed Central

    Bunyavanich, Supinda; Schadt, Eric E.

    2014-01-01

    Systems biology is an approach to understanding living systems that focuses on modeling diverse types of high-dimensional interactions to develop a more comprehensive understanding of complex phenotypes manifested by the system. High throughput molecular, cellular, and physiologic profiling of populations is coupled with bioinformatic and computational techniques to identify new functional roles for genes, regulatory elements, and metabolites in the context of the molecular networks that define biological processes associated with system physiology. Given the complexity and heterogeneity of asthma and allergic diseases, a systems biology approach is attractive, as it has the potential to model the myriad connections and interdependencies between genetic predisposition, environmental perturbations, regulatory intermediaries, and molecular sequelae that ultimately lead to diverse disease phenotypes and treatment responses across individuals. The increasing availability of high-throughput technologies has enabled system-wide profiling of the genome, transcriptome, epigenome, microbiome, and metabolome, providing fodder for systems biology approaches to examine asthma and allergy at a more holistic level. In this article, we review the technologies and approaches for system-wide profiling as well as their more recent applications to asthma and allergy. We discuss approaches for integrating multiscale data through network analyses and provide perspective on how individually-captured health profiles will contribute to more accurate systems biology views of asthma and allergy. PMID:25468194

  1. Mouse models of acute exacerbations of allergic asthma.

    PubMed

    Kumar, Rakesh K; Herbert, Cristan; Foster, Paul S

    2016-07-01

    Most of the healthcare costs associated with asthma relate to emergency department visits and hospitalizations because of acute exacerbations of underlying chronic disease. Development of appropriate animal models of acute exacerbations of asthma is a necessary prerequisite for understanding pathophysiological mechanisms and assessing potential novel therapeutic approaches. Most such models have been developed using mice. Relatively few mouse models attempt to simulate the acute-on-chronic disease that characterizes human asthma exacerbations. Instead, many reported models involve relatively short-term challenge with an antigen to which animals are sensitized, followed closely by an unrelated triggering agent, so are better described as models of potentiation of acute allergic inflammation. Triggers for experimental models of asthma exacerbations include (i) challenge with high levels of the sensitizing allergen (ii) infection by viruses or fungi, or challenge with components of these microorganisms (iii) exposure to environmental pollutants. In this review, we examine the strengths and weaknesses of published mouse models, their application for investigation of novel treatments and potential future developments. PMID:26922049

  2. Preparation of a Paeonol-Containing Temperature-Sensitive In Situ Gel and Its Preliminary Efficacy on Allergic Rhinitis

    PubMed Central

    Chu, Kedan; Chen, Lidian; Xu, Wei; Li, Huang; Zhang, Yuqin; Xie, Weirong; Zheng, Jian

    2013-01-01

    In this paper, the optimal composition of a paeonol temperature-sensitive in situ gel composed of poloxamer 407 (P407) was determined, and a preliminary study of its effect on allergic rhinitis was performed. The optimal composition of the paeonol temperature-sensitive in situ gel included 2% paeonol inclusion, 22% P407, 2% poloxamer 188 (P188) and 2% PEG6000, as assessed by thermodynamic and rheological studies. The toad palate model was employed to study the toxicity of the paeonol temperature-sensitive in situ gel on the nasal mucosa. The result of this experiment showed low toxicity to cilia, which allows the gel to be used for nasal administration. The Franz diffusion cell method was used to study the in vitro release of paeonol and suggested that the in vitro release was in line with the Higuchi equation. This result suggests that the paeonol could be absorbed into the body through mucous membranes and had some characteristics of a sustained effect. Finally, the guinea pig model of ovalbumin sensitized allergic rhinitis was used to evaluate the preliminary efficacy of the gel, with the paeonol temperature-sensitive in situ gel showing a significant effect on the guinea pig model of sensitized allergic rhinitis (AR). PMID:23525047

  3. Association between air pollution and daily consultations with general practitioners for allergic rhinitis in London, United Kingdom.

    PubMed

    Hajat, S; Haines, A; Atkinson, R W; Bremner, S A; Anderson, H R; Emberlin, J

    2001-04-01

    Few published studies have looked at the health effects of air pollution in the primary care setting, and most have concentrated on lower rather than upper respiratory diseases. The authors investigated the association of daily consultations with general practitioners for allergic rhinitis with air pollution in London, United Kingdom. Generalized additive models were used to regress time series of daily numbers of patients consulting for allergic rhinitis against 1992--1994 measures of air pollution, after control for possible confounders and adjustment for overdispersion and serial correlation. In children, a 10th--90th percentile increase in sulfur dioxide (SO(2)) levels 4 days prior to consultation (13-31 microg/m(3)) was associated with a 24.5% increase in consultations (95% confidence interval: 14.6, 35.2; p < 0.00001); a 10th--90th percentile increase in averaged ozone (O(3)) concentrations on the day of consultation and the preceding 3 days (6--29 parts per billion) was associated with a 37.6% rise (95% confidence interval: 23.3, 53.5; p < 0.00001). For adults, smaller effect sizes were observed for SO(2) and O(3). The association with SO(2) remained highly significant in the presence of other pollutants. This study suggests that air pollution worsens allergic rhinitis symptoms, leading to substantial increases in consultations. SO(2) and O(3) seem particularly responsible, and both seem to contribute independently. PMID:11282799

  4. Efficacy and Safety of Sanfu Herbal Patch at Acupoints for Persistent Allergic Rhinitis: Study Protocol for a Randomized Controlled Trial

    PubMed Central

    Chen, Xiankun; Lu, Chuanjian; Stålsby-Lundborg, Cecilia; Li, Yunying; Li, Xiaoyan; Sun, Jian; Ouyang, Wenwei; Li, Geng; Su, Guobin; Lu, Liming; Fu, Wenbin; Wen, Zehuai

    2015-01-01

    Background. The Sanfu herbal patch (SHP) has been widely used to treat allergic rhinitis (AR) in China. SHP has been reported to be effective for managing the symptoms of AR, but the evidence suffers from methodological limitations. Therefore, we designed a three-armed, randomized, and placebo-controlled trial to evaluate the efficacy and safety of SHP for persistent allergic rhinitis (PAR). Methods. The trial consists of 5 treatment sessions along with a one-year follow-up. This process is then repeated in the second and third years. Eligible participants diagnosed with PAR were randomized at a ratio of 2 : 2 : 1 into one of three groups: (a) SHP group; (b) placebo group; or (c) waiting-list group. The waiting-list group will receive no treatment in the first year but will receive SHP in the following two years. The primary outcome, total nasal symptoms score, is self-assessed at the beginning of each treatment session and during each annual follow-up. Secondary outcomes include the Rhinoconjunctivitis Quality-of-Life Questionnaire, allergic rhinitis attacks, and relief medications. The trial will be stopped if early termination criteria are met during the interim analysis. Ethics. This protocol has been approved by site ethics committee (number B2014-014-01) and is registered with ClinicalTrials.gov NCT02192645. PMID:26300945

  5. Decongestant effects of nasal xylometazoline and mometasone furoate in persistent allergic rhinitis.

    PubMed

    Barnes, Martyn L; Biallosterski, Bart T; Gray, Robert D; Fardon, Tom C; Lipworth, Brian J

    2005-12-01

    Thirty-six persistent allergic rhinitis (PAR) sufferers were studied, to both compare and correlate 15 minute response to nasal xylometazoline (XYLO) with 28 day response to nasal mometasone furoate (MF). 0.1% XYLO (1 spray each nostril) response was measured on two occasions, then a randomised double blind cross-over comparison of MF (200 mcg daily) to placebo conducted. Outcomes were peak nasal inspiratoly flow (PNIF), nasal forced inspiratory volume in one second (nFIV1) and nasal blockage score (NBS) improvements. Thirty-one participants completed per protocol. Within subject standard deviation for percentage improvement to XYLO was 26.0 for PNIF and 25.2 for nFIV1. Median % improvement (95%CI) in PNIF for XYLO vs. MF was 20.0 (11.4 to 31.0) vs. 9.6 (3.2 to 15.8) and in nFIV1 was 17.8 (10.0 to 28.1) vs. 3.3 (-4.3 to 19.1). XYLO effects were greater than MF (p<0.05) for PNIF, nFIV1 and NBS. There was no significant correlation of MF to XYLO improvements in PNIF, nFIV1 or NBS. In conclusion, acute reversibility to XYLO showed poor repeatability and XYLO reversibility is not predictive of decongestant response to nasal corticosteroid. XYLO was a stronger decongestant than MF but rhinitis medicamentosa still precludes any preference for long term XYLO therapy at this time. PMID:16405274

  6. Using magnetic resonance imaging to quantify the inflammatory response following allergen challenge in allergic rhinitis.

    PubMed

    Leaker, Brian R; Scadding, Glenis; Jones, C Richard; Barnes, Peter J

    2015-12-01

    Current rhinometric and flow assessments measure nasal patency and are often poorly correlated with rhinitis symptoms. To evaluate magnetic resonance imaging (MRI) as a new method to measure inflammatory changes in nasal and sinus mucosa following nasal allergen challenge. A pilot study (n = 6) determined the optimal technical settings for MRI to measure inflammatory change which were then adopted for the main study. This study was a single blind, placebo-controlled, three-way crossover trial in 14 subjects with seasonal allergic rhinitis. Effects of cetirizine, cetirizine and pseudoephedrine (Cet+PE), or placebo on total nasal symptom scores (TNSS), peak nasal inspiratory flow (PNIF), nasal nitric oxide (nNO), acoustic rhinometry, and MRI end points following nasal intranasal allergen challenge were measured. There were significant changes in all parameters after allergen challenge (P < 0.01), except for nNO. MRI end points were less variable and more consistent than PNIF and acoustic rhinometry in detecting changes after allergen challenge. Total nasal airspace volume was the most sensitive and reproducible MRI measurement, with a mean reduction from -5.37 cm(3) (95%CI -7.35, -3.38; P < 0.001), which was maximal 60 min after allergen challenge. A change of one in TNSS corresponded to a change in MRI volume of -0.57 cm(3). There was an improvement in all parameters (except nNO) in subjects taking Cet+PE compared with placebo, however this did not achieve significance probably because of the small study size (overall analysis P > 0.07; comparison of active versus placebo P > 0.09). MRI provides novel insights into the anatomical inflammatory changes post allergen challenge and provides a new method for assessment of nasal patency and objective measurement of inflammatory responses. PMID:26733348

  7. THE ROLE OF TARGET ORGAN DIAGNOSTIC APPROACH IN SEASONAL ALLERGIC RHINITIS: NASAL SMEAR EOSINOPHILS

    PubMed Central

    Nurkic, Jasmina; Ahmad, Mona Al; Arifhodzic, Nermina; Jusufovic, Edin

    2016-01-01

    Background: Allergic rhinitis (AR) related to local weeds pollen sensitization (Chenopodiaceous family) is the most common cause of respiratory allergy in Kuwait. Local nasal accumulation of different cells typical of allergic inflammation is responsible for clinical symptoms of AR. Although nasal smear for Eosinophils (NSE) is one of the earliest included valuable test in diagnosis of AR, with time is underestimated. Aim: Explore possible correlation of natural pollen allergen stimulation with appearance and quantity of Eosinophils in nasal smear. Methods: A group of randomly selected patients with clinical history suggestive for seasonal AR (SAR), who came to Al Rashed Allergy Center in period from October 2014 to October 2015, obtain Nasal Smear for Eosinophils as a screening test before further diagnostic evaluation. Nasal samples were collected by passing a sterile swab, from each nasal cavity, along the medial surface of the inferior turbinate 2 to 3 times and the specimen smeared on a clear glass slide. Nasal smears were examined by light microscopy after staining with hematoxylin and eosin stain. Skin prick test is performed in all symptomatic patients with a battery of inhalant allergens that include local pollens. The control group was recruited, with their voluntary consent, from the medical stuff with a negative history of any allergic nasal symptoms. In this group we performed only nasal smear for Eosinophils. Air Biology Laboratory Kuwait provided us with daily pollen count. Results: From total 158 study participants, 132 had SAR symptoms and are divided in four groups. Fifth, control, group is non symptomatic. For 38.6% of symptomatic patients NSE were positive, while 45% of these patients have negative SPT. From 62.1% NSE negative patients, 37.8% have negative SPT. Our results showed expected positive correlation of NSE positive patients with pollen season in Kuwait, in SPT positive group. However, presence of Eosinophils in nasal smear was moderate

  8. [Genetic study of allergic diseases].

    PubMed

    Zhang, Yuan; Zhang, Luo

    2012-09-01

    Allergic diseases mentioned in this review is regarding to I type allergic inflammation induced by an IgE-mediated reaction, including asthma, allergic rhinitis, atopic dermatitis and food allergy. It is convinced that allergic diseases belong to multiple genes diseases and are controlled by both genetic and environmental factors. Meanwhile there exists gene-gene as well as gene-environment interactions during the development of the disease. The aim of this review is to summarize the toolkit, advance, inherent difficulties and future clinical application prospect in genetic studies of allergic disease. PMID:23214325

  9. Carbon dioxide laser vaporization of the inferior turbinate for allergic rhinitis: short-term results.

    PubMed

    Imamura, Shun-ichi; Honda, Hideyuki

    2003-12-01

    Carbon dioxide laser vaporization of the turbinate has recently become accepted as a common treatment for allergic rhinitis. Usually, only a single procedure is applied to minimize trauma. However, repeated procedures on separate days are often required to achieve an adequate effect. Therefore, we attempted a new method of vaporization and evaluated the outcome, and also tried to determine which patients have good indications for laser treatment. To widely and deeply vaporize the inferior turbinate, we repeated the procedure 3 times in 1 session after removing the carbon coating from the previous vaporization under nasal endoscopic observation. After the procedure, most patients experienced complete nasal obstruction for 2 or 3 days, but there was no intraoperative or postoperative bleeding or severe pain. All patients obtained improvement of their chief complaints and were satisfied 2 months after the operation. In particular, 60% of the patients were completely relieved of refractory nasal obstruction. Most patients were more satisfied with the effects than are those treated by the usual methods. Completely successful cases (improvement in all symptoms and complete satisfaction obtained) were selected and were compared with other cases. Favorable prognostic factors are more severe complaints, longer symptomatic periods, stronger allergic reactions, and worse nasal resistance and its greater improvement with administration of decongestant nasal drops. This method may be especially accepted by patients with severe complaints, in particular nasal obstruction, who do not experience enough relief with conservative therapies or have enough time to make frequent visits to an outpatient clinic over a period of several weeks. PMID:14703108

  10. Allergic rhinitis and its associated co-morbidities at Bugando Medical Centre in Northwestern Tanzania; A prospective review of 190 cases

    PubMed Central

    2012-01-01

    Background Allergic rhinitis is one of the commonest atopic diseases which contribute to significant morbidity world wide while its epidemiology in Tanzania remains sparse. There was paucity of information regarding allergic rhinitis in our setting; therefore it was important to conduct this study to describe our experience on allergic rhinitis, associated co-morbidities and treatment outcome in patients attending Bugando Medical Centre. Methods This was descriptive cross-sectional study involving all patients with a clinical diagnosis of allergic rhinitis at Bugando Medical Centre over a three-month period between June 2011 and August 2011. Data was collected using a pre-tested coded questionnaire and analyzed using SPSS statistical computer software version 17.0. Results A total of 190 patients were studied giving the prevalence of allergic rhinitis 14.7%. The median age of the patients was 8.5 years. The male to female ratio was 1:1. Adenoid hypertrophy, tonsillitis, hypertrophy of inferior turbinate, nasal polyps, otitis media and sinusitis were the most common co-morbidities affecting 92.6% of cases and were the major reason for attending hospital services. Sleep disturbance was common in children with adenoids hypertrophy (χ2 = 28.691, P = 0.000). Allergic conjunctivitis was found in 51.9%. The most common identified triggers were dust, strong perfume odors and cold weather (P < 0.05). Strong perfume odors affect female than males (χ2 = 4.583, P = 0.032). In this study family history of allergic rhinitis was not a significant risk factor (P =0.423). The majority of patients (68.8%) were treated surgically for allergic rhinitis co morbidities. Post operative complication and mortality rates were 2.9% and 1.6% respectively. The overall median duration of hospital stay of in-patients was 3 days (2 – 28 days). Most patients (98.4%) had satisfactory results at discharge. Conclusion The study shows that allergic rhinitis is common in our

  11. Association between the First Occurrence of Allergic Rhinitis in Preschool Children and Air Pollution in Taiwan

    PubMed Central

    Chung, Hui-Ying; Hsieh, Chia-Jung; Tseng, Chun-Chieh; Yiin, Lih-Ming

    2016-01-01

    The occurrence of allergic rhinitis (AR) may be significantly influenced by air pollution. This study examined the association between the first occurrence of AR in preschool children and the pre-incident levels of air pollutants in Taiwan. We identified 9960 eligible subjects from a systematic sampling cohort database containing 400,000 insureds of the National Health Insurance from 2007 to 2011 and matched them with the environmental monitoring data from 2006 to 2011 according to the locations of their clinics. Pre-incident levels were determined using the average concentrations of air pollutants one or two weeks prior to the AR diagnoses. Logistic regression analyses were performed to determine any significant relationships between AR and specific air pollutants. The first AR incidence for Taiwanese preschool children, which increased with age, was 10.9% on average; boys appeared to have a higher percentage (14.2%) than girls (8.27%). Among the air pollutants, carbon monoxide (CO) and nitrogen oxides (NOX) were significantly related to AR after adjusting for age and gender (p < 0.05). Because both pollutants are considered to be traffic emissions, this study suggests that traffic emissions in Taiwan need to be controlled to lower the prevalence of children’s AR. PMID:26927153

  12. Levocetirizine: The latest treatment option for allergic rhinitis and chronic idiopathic urticaria.

    PubMed

    Dubuske, Lawrence M

    2007-01-01

    Levocetirizine is the most recent antihistamine available in the United States and is indicated for the symptomatic treatment of allergic rhinitis (AR; seasonal [SAR] and perennial [PAR]) and chronic idiopathic urticaria (CIU). The purpose of this study was to review the current literature on pharmacologic properties of levocetirizine, its safety, tolerability, and effectiveness in AR and CIU. Relevant articles in English or with English abstracts were identified from systematic Medline searches using combinations of the terms antihistamine/s, CIU, H(1)-receptor antagonist/s, levocetirizine, PAR and persistent AR (PER), pharmacodynamic, pharmacokinetic, and SAR. Levocetirizine is the active enantiomer of cetirizine. Pharmacologic and clinical studies indicate that levocetirizine has a fast onset and long duration of action, with a well-tolerated adverse effect profile. These favorable features may be caused by levocetirizine's pharmacokinetic and pharmacodynamic properties including high bioavailability, low apparent volume of distribution, low degree of metabolism, and high in vivo potency and H(1)-receptor occupancy. Several large well-controlled clinical trials in adults and children aged 6-12 years have shown levocetirizine to be consistently efficacious and well tolerated in relieving the symptoms of SAR, PAR, and PER and CIU. Levocetirizine is a welcome new treatment option in the United States for symptomatic treatment of AR and CIU. PMID:18201439

  13. Air pollution exposure and daily clinical visits for allergic rhinitis in a subtropical city: Taipei, Taiwan.

    PubMed

    Chen, Chih-Cheng; Chiu, Hui-Fen; Yang, Chun-Yuh

    2016-01-01

    This study was undertaken to determine whether there was an association between air pollutant level exposure and daily clinic visits for allergic rhinitis (AR) in Taipei, Taiwan. Daily clinic visits for AR and ambient air pollution data for Taipei were obtained for the period of 2006-2011. The relative risk for clinic visits for AR was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. In the single-pollutant models, on warm days (>23ºC) significant positive associations were found for increased rate of AR occurrence and ambient levels of particulate matter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3). On cool days (<23ºC), all air pollutants were significantly associated with elevated number of AR visits except SO2. For the two-pollutant models, PM10, O3, and NO2 were significantly associated with higher rate of AR visits in combination with each of the other four pollutants on cool days. On warm days, CO levels remained significantly related with increased AR visits in all two-pollutant models. This study provides evidence that higher levels of ambient air contaminants enhance the risk of elevated frequency of clinic visits for AR. PMID:27294298

  14. Multicentre, double-blind comparison of terfenadine and cetirizine in patients with seasonal allergic rhinitis.

    PubMed

    Backhouse, C I; Renton, R; Fidler, C; Rosenberg, R M

    1990-03-01

    This double-blind, multicentre study was designed to compare the efficacy and tolerability of terfenadine 120 mg with cetirizine 10 mg, each taken once daily, in the treatment of seasonal allergic rhinitis. Two hundred and eighty-five patients were recruited to the study by nine general practice centres in the south of England during the 1989 hay-fever season. Symptom severity was assessed daily by the patient and before and after the one-week treatment period by the investigator. At the second clinic visit both patient and investigator assessed the overall response to treatment. The two treatment groups were well matched for all demographic variables and baseline symptom scores. Improvement in all seven symptoms (nasal congestion, sneezing, rhinorrhoea, itching nose, itching eyes, watery eyes and red eyes) and overall response to treatment were similar in both treatment groups. Adverse events were mainly of mild to moderate severity and were reported by 14 patients on terfenadine and 21 patients treated with cetirizine (p = 0.317). This study confirmed terfenadine's role as the treatment of choice in hayfever. A single 120 mg dose in the morning effectively reduced symptoms by 43 to 70 per cent of baseline values, with an acceptably low incidence of side effects. Cetirizine at a single dose of 10 mg displayed equal efficacy in controlling hayfever symptoms but, in common with other studies, had a significantly greater incidence of drowsiness (p = 0.046). PMID:1971516

  15. Attitudes, practices on allergic rhinitis of generalists and specialists in Philippine National Capital Region

    PubMed Central

    Romualdez, Joel A.

    2015-01-01

    Background Treatment of allergic rhinitis (AR) consistent with consensus guidelines is reported to result in better patient outcomes. However, physicians may manage patients independently of guidelines. Asian data on physician perspectives regarding AR diagnosis and management is limited. Objective The study objective is to assess attitudes and practices on AR of Filipino specialists and generalists. Methods A cross sectional survey of 100 specialists and 100 generalists was conducted from November 2014 to January 2015. A previously validated and pilot tested questionnaire was administered via structured face to face interviews. Results Specialists reported greater adequate knowledge of AR (specialists, 58%; generalists, 39%) and adherence to guidelines (specialists, 84%; generalists, 54%). Diagnostic tests were not routinely used (specialists, 81%; generalists, 92%). Monotherapy, specifically antihistamines, was preferred for mild AR. For moderate-severe AR, preference for monotherapy versus combination therapy (specialists, 49% vs. 51%; generalists, 44% vs. 56%) was similar. Both groups preferred intranasal corticosteroid spray (INCS) for monotherapy and antileukotrienes, antihistamines, INCS for combination therapy. For adjuvant therapy, specialists (82%) preferred nasal irrigation/douche. Primary consideration for choice of therapy was efficacy. Cost was the perceived reason for patients' noncompliance with treatment. Conclusion Despite differences in awareness of and adherence to guidelines, prescribing patterns on management of mild and moderate-severe AR are similar among Filipino specialists and generalists. This can be attributed to a shared perception of efficacy and cost as drivers for therapeutic choices. PMID:26539402

  16. Systemic bioactivity of intranasal triamcinolone and mometasone in perennial allergic rhinitis

    PubMed Central

    Lee, Daniel K C; Robb, Fiona M; Sims, Erika J; Currie, Graeme P; McFarlane, Lesley C; Lipworth, Brian J

    2003-01-01

    Aims To evaluate the systemic bioactivity of triamcinolone acetonide (TA) 220 µg or mometasone furoate (MF) 200 µg over 3 weeks in perennial allergic rhinitis. Methods Twenty-seven patients received TA 220 µg or MF 200 µg once daily for 3 weeks with a 2 week placebo washout period prior to each randomized treatment. Measurements were made at baseline after each washout and after each randomized treatment, comprising overnight 10-h urinary cortisol corrected for creatinine (OUCC), 08.00 h plasma cortisol and 08.00 h serum osteocalcin. Results There were no significant differences between baseline values prior to TA or MF, and for any outcome measures comparing randomized treatments to respective baseline values or comparing TA with MF. For OUCC compared with baseline, the geometric mean fold suppression (95% CI) was 1.02 (0.78, 1.33) for TA (2% decrease), 1.07 (0.80, 1.42) for MF (7% decrease), and 1.05 (0.79, 1.39) for TA vs MF (5% decrease). Conclusions Standard doses of TA or MF over 3 weeks showed no differences in systemic bioactivity markers compared with respective baseline values after placebo washout, and there were no differences between TA vs MF. PMID:12630983

  17. Sensitization Rates for Various Allergens in Children with Allergic Rhinitis in Qingdao, China

    PubMed Central

    Lin, Hang; Lin, Rongjun; Li, Na

    2015-01-01

    The aim of this study was to determine the prevalence of sensitization to common allergens in children with allergic rhinitis (AR) living in Qingdao, China. We conducted a retrospective analysis for AR cases, who underwent skin prick tests (SPT) in Qingdao. A total of 2841 children with AR qualified for the inclusion criteria (Age 3–5 years: 1500 children; Age 6–12 years: 1341 children). The most common inhaled allergens to which the AR children were sensitive were Dermatophagoides pteronyssinus (69.3%), Dermatophagoides farinae (66.2%) and mould 1 (Penicillium notatum 38.9%); while the corresponding ingested allergens were mussel (39.2%), shrimp (36.3%) and carp (36.5%). The prevalence of sensitization to inhaled allergens and food allergens was higher in children >6 years of age as compared to that in children 3–5 years of age (all p < 0.05). Children >6 years old were more sensitive to dust mite as compared to children 3–5 years old (p < 0.05). Sensitization to dust mite was more common in males than in females (p = 0.05). In this study, Dermatophagoides pteronyssinus and Dermatophagoides farinae were the most common allergens causing AR in children in Qingdao, China. Older children with AR, particularly males, were found to be more sensitive to dust mite. PMID:26371014

  18. Attitudes, practices on allergic rhinitis of three socioeconomic classes of Filipinos in the National Capital Region

    PubMed Central

    Romualdez, Joel A.

    2016-01-01

    Background Healthcare access and usage may vary according to socioeconomic class (SEC). Knowing this variable's effect on patient attitudes, practices, and health seeking behavior allows better understanding of compliance, adherence to treatment, and educational needs on allergic rhinitis (AR). Objective This study seeks to assess the attitudes and practices on AR of Filipinos in the National Capital Region. Methods A cross sectional survey of 301 Filipinos, stratified into socioeconomic groups ABC1, C2, and DE, was conducted from December 2014 to February 2015. A previously validated and pilot tested questionnaire on AR was administered via structured face to face interviews. Results Most respondents attributed their symptoms to "colds" (ABC1 77%, C2 79%, DE 78%); most did not consult a physician for their symptoms. Only 26% of all respondents were aware of AR. Only the ABC1 group had respondents who specifically used the term AR. Most respondents' symptoms fulfilled criteria for moderate to severe disease. Sleep was the activity most affected by AR (62%). For symptom relief, over the counter antihistamine-decongestants were the most preferred drug preparations (ABC1 30%, C2 38%, DE 34%). Groups ABC1 and C2 cited family, television, and Internet as the top primary sources of health information; DE cited family, television, and friends. Conclusion Regardless of SEC, Filipinos are not aware of AR. Lack of awareness and gaps in knowledge can result to an underestimation of the condition, decrease in health seeking behavior, unmet patient needs, and undertreatment of disease. PMID:27141482

  19. Controlled Allergen Challenge Facilities and Their Unique Contributions to Allergic Rhinitis Research.

    PubMed

    North, Michelle L; Soliman, Mena; Walker, Terry; Steacy, Lisa M; Ellis, Anne K

    2015-04-01

    The aim of this study is to review advances in basic and clinical allergic rhinitis (AR) research over the past decade that have been conducted using controlled allergen challenge facility (CACF) models of allergen challenge. Databases, including PubMed, Medline, and Web of Science were searched for articles employing an ambient pollen exposure in a controlled facility to study AR, published between 2004 and the present date, using the terms as follows: CACF, Environmental Exposure Unit (EEU), Vienna Challenge Chamber (VCC), Fraunhofer Institute Environmental Challenge Chamber, Atlanta Allergen Exposure Unit, Biogenics Research Chamber, Allergen BioCube, Chiba and Osaka Environmental Challenge Chamber, exposure unit, challenge chamber, or environmental exposure chamber. Articles were then selected for relevance to the goals of the present review, including important contributions toward clinical and/or basic science allergy research. CACFs offer sensitive, specific, and reproducible methodology for allergen challenge. They have been employed since the 1980s and offer distinct advantages over traditional in-season multicentre trials when evaluating new treatments for AR. They have provided clinically applicable efficacy and pharmacologic information about important allergy medications, including antihistamines, decongestants, antileukotrienes, immunotherapies, and nasal steroids. CACF models have also contributed to basic science and novel/experimental therapy research. To date, no direct studies have been conducted comparing outcomes from one CACF to another. Over the past decade, CACF models have played an essential role in investigating the pathophysiology of AR and evaluating new therapies. The future opportunities for this model continue to expand. PMID:26130471

  20. Association between the First Occurrence of Allergic Rhinitis in Preschool Children and Air Pollution in Taiwan.

    PubMed

    Chung, Hui-Ying; Hsieh, Chia-Jung; Tseng, Chun-Chieh; Yiin, Lih-Ming

    2016-03-01

    The occurrence of allergic rhinitis (AR) may be significantly influenced by air pollution. This study examined the association between the first occurrence of AR in preschool children and the pre-incident levels of air pollutants in Taiwan. We identified 9960 eligible subjects from a systematic sampling cohort database containing 400,000 insureds of the National Health Insurance from 2007 to 2011 and matched them with the environmental monitoring data from 2006 to 2011 according to the locations of their clinics. Pre-incident levels were determined using the average concentrations of air pollutants one or two weeks prior to the AR diagnoses. Logistic regression analyses were performed to determine any significant relationships between AR and specific air pollutants. The first AR incidence for Taiwanese preschool children, which increased with age, was 10.9% on average; boys appeared to have a higher percentage (14.2%) than girls (8.27%). Among the air pollutants, carbon monoxide (CO) and nitrogen oxides (NOX) were significantly related to AR after adjusting for age and gender (p < 0.05). Because both pollutants are considered to be traffic emissions, this study suggests that traffic emissions in Taiwan need to be controlled to lower the prevalence of children's AR. PMID:26927153

  1. MACVIA clinical decision algorithm in adolescents and adults with allergic rhinitis.

    PubMed

    Bousquet, Jean; Schünemann, Holger J; Hellings, Peter W; Arnavielhe, Sylvie; Bachert, Claus; Bedbrook, Anna; Bergmann, Karl-Christian; Bosnic-Anticevich, Sinthia; Brozek, Jan; Calderon, Moises; Canonica, G Walter; Casale, Thomas B; Chavannes, Niels H; Cox, Linda; Chrystyn, Henry; Cruz, Alvaro A; Dahl, Ronald; De Carlo, Giuseppe; Demoly, Pascal; Devillier, Phillipe; Dray, Gérard; Fletcher, Monica; Fokkens, Wytske J; Fonseca, Joao; Gonzalez-Diaz, Sandra N; Grouse, Lawrence; Keil, Thomas; Kuna, Piotr; Larenas-Linnemann, Désirée; Lodrup Carlsen, Karin C; Meltzer, Eli O; Mullol, Jaoquim; Muraro, Antonella; Naclerio, Robert N; Palkonen, Susanna; Papadopoulos, Nikolaos G; Passalacqua, Giovanni; Price, David; Ryan, Dermot; Samolinski, Boleslaw; Scadding, Glenis K; Sheikh, Aziz; Spertini, François; Valiulis, Arunas; Valovirta, Erkka; Walker, Samantha; Wickman, Magnus; Yorgancioglu, Arzu; Haahtela, Tari; Zuberbier, Torsten

    2016-08-01

    The selection of pharmacotherapy for patients with allergic rhinitis (AR) depends on several factors, including age, prominent symptoms, symptom severity, control of AR, patient preferences, and cost. Allergen exposure and the resulting symptoms vary, and treatment adjustment is required. Clinical decision support systems (CDSSs) might be beneficial for the assessment of disease control. CDSSs should be based on the best evidence and algorithms to aid patients and health care professionals to jointly determine treatment and its step-up or step-down strategy depending on AR control. Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR [fighting chronic diseases for active and healthy ageing]), one of the reference sites of the European Innovation Partnership on Active and Healthy Ageing, has initiated an allergy sentinel network (the MACVIA-ARIA Sentinel Network). A CDSS is currently being developed to optimize AR control. An algorithm developed by consensus is presented in this article. This algorithm should be confirmed by appropriate trials. PMID:27260321

  2. Associations between home dampness and presence of molds with asthma and allergic symptoms among young children in the tropics.

    PubMed

    Tham, Kwok Wai; Zuraimi, Mohamed Sultan; Koh, David; Chew, Fook Tim; Ooi, Peng Lim

    2007-08-01

    Existing literature has shown that home dampness increases indoor mold burden and is associated with increased allergic symptoms among young children in temperate environments. There is no report of any studies of similar nature in the tropics where conditions are characterized typically by high temperatures and humidity with rainfall throughout the year. To evaluate if there are associations between the prevalence of current asthma and allergic symptoms in young children (age 1.5-6 yr) with dampness and indoor mold in children's bedrooms in a tropical environment. A cross-sectional study adopting an expanded and modified ISAAC--International Study on Asthma and Allergies in Children--questionnaire for the evaluation of asthma and allergies was conducted on 6794 children (4759 responded--70%) attending 120 randomly selected daycare centers. Specific information on demographics, home dampness, and the visible presence of indoor molds were obtained. The prevalence ratios (PR) and 95% confidence interval (CI) were determined by Cox proportional hazard regression model with assumption of a constant risk period as recommended for cross-sectional studies. The calculated PRs were controlled for age, gender, ethnicity, socio-economic status, type of housing, maternal and paternal atopy, respiratory infections, environmental tobacco smoke (ETS) exposure, and food allergy. After adjusting for potential confounding effects, home dampness was observed to be significantly associated with current symptoms of rhinoconjunctivitis (adjusted PR 1.53, 95% CI: 1.00-2.33). The visible presence of mold was significantly associated with current symptoms of rhinitis (PR 1.55, 95% CI: 1.16-2.07) and rhinoconjunctivitis (PR 2.38, 95% CI: 1.51-3.75). Indoor dampness and mold in children's bedroom are important risk factors associated with allergic symptoms in young children in Singapore. PMID:17617809

  3. Endotypes of allergic diseases and asthma: An important step in building blocks for the future of precision medicine.

    PubMed

    Agache, Ioana; Akdis, Cezmi A

    2016-07-01

    Discoveries from basic science research in the last decade have brought significant progress in knowledge of pathophysiologic processes of allergic diseases, with a compelling impact on understanding of the natural history, risk prediction, treatment selection or mechanism-specific prevention strategies. The view of the pathophysiology of allergic diseases developed from a mechanistic approach, with a focus on symptoms and organ function, to the recognition of a complex network of immunological pathways. Several subtypes of inflammation and complex immune-regulatory networks and the reasons for their failure are now described, that open the way for the development of new diagnostic tools and innovative targeted-treatments. An endotype is a subtype of a disease condition, which is defined by a distinct pathophysiological mechanism, whereas a disease phenotype defines any observable characteristic of a disease without any implication of a mechanism. Another key word linked to disease endotyping is biomarker that is measured and evaluated to examine any biological or pathogenic processes, including response to a therapeutic intervention. These three keywords will be discussed more and more in the future with the upcoming efforts to revolutionize patient care in the direction of precision medicine and precision health. The understanding of disease endotypes based on pathophysiological principles and their validation across clinically meaningful outcomes in asthma, allergic rhinitis, chronic rhinosinusitis, atopic dermatitis and food allergy will be crucial for the success of precision medicine as a new approach to patient management. PMID:27282212

  4. Rhinitis, asthma and respiratory infections among adults in relation to the home environment in multi-family buildings in Sweden.

    PubMed

    Wang, Juan; Engvall, Karin; Smedje, Greta; Norbäck, Dan

    2014-01-01

    Risk factors for rhinitis, asthma and respiratory infections in the home environment were studied by a questionnaire survey. Totally 5775 occupants (≥ 18 years old) from a stratified random sample of multi-family buildings in Sweden participated (46%). 51.0% had rhinitis in the last 3 months (current rhinitis); 11.5% doctor diagnosed asthma; 46.4% respiratory infections in the last 3 months and 11.9% antibiotic medication for respiratory infections in the last 12 months. Associations between home environment and health were analyzed by multiple logistic regression, controlling for gender, age and smoking and mutual adjustment. Buildings constructed during 1960-1975 were risk factors for day time breathlessness (OR = 1.53, 95%CI 1.03-2.29). And those constructed during 1976-1985 had more current rhinitis (OR = 1.43, 95%CI 1.12-1.84) and respiratory infections (OR = 1.46, 95%CI 1.21-1.78). Cities with higher population density had more current rhinitis (p = 0.008) and respiratory infections (p<0.001). Rented apartments had more current rhinitis (OR = 1.23, 95%CI 1.07-1.40), wheeze (OR = 1.20, 95%CI 1.02-1.41), day time breathlessness (OR = 1.31, 95%CI 1.04-1.66) and respiratory infections (OR = 1.13, 95%CI 1.01-1.26). Living in colder parts of the country was a risk factor for wheeze (p = 0.03) and night time breathlessness (p = 0.002). Building dampness was a risk factor for wheeze (OR = 1.42, 95%CI 1.08-1.86) and day time breathlessness (OR = 1.57, 95%CI 1.09-2.27). Building dampness was a risk factor for health among those below 66 years old. Odor at home was a risk factor for doctor diagnosed asthma (OR = 1.49, 95%CI 1.08-2.06) and current asthma (OR = 1.52, 95%CI 1.03-2.24). Environmental tobacco smoke (ETS) was a risk factor for current asthma (OR = 1.53, 95%CI 1.09-2.16). Window panel condensation was a risk factor for antibiotic medication for respiratory infections (OR = 1.41, 95%CI 1.10-1.82). In conclusion, rhinitis, asthma and respiratory infections

  5. The effects of two Chinese herbal medicinal formulae vs. placebo controls for treatment of allergic rhinitis: a randomised controlled trial

    PubMed Central

    2014-01-01

    Background Allergic rhinitis is a chronic illness, affecting 10 to 40% of the worldwide population. Chinese herbal medicines, the treatment of allergic rhinitis, adopted thousands of years in ancient China, has recently raised much attention among researchers globally. This study evaluates the effects of two Chinese herbal formulae [Cure-allergic-rhinitis Syrup (CS) and Yu-ping-feng San (YS)] in treating undergraduate nursing students with allergic rhinitis over a 3-month follow-up, when compared to a placebo control group. Methods A double-blind, randomised controlled trial with repeated-measures, three-parallel-groups design was conducted in a random sample of 249 participants recruited from one university in Hong Kong. After baseline measurements, participants were randomly assigned to CS, YS, or placebo groups (n = 83 per group). The main outcomes, including symptom severity, quality of life, and body constitution, were measured with self-administered questionnaires at baseline and immediately, 1 and 3 months after the 4-week interventions. Results 240 participants completed the trial, with 9 (3.6%) drop-outs. The results of Generalised Estimating Equations test followed by pairwise contrasts tests indicated that the participants who received CS showed significantly greater reduction of symptoms (mean difference of CS vs. placebo = 26.13–34.55, P <0.0005) and improvements in quality of life (mean difference of CS vs. placebo = 12.81–16.76, P <0.001), and body constitution in ‘Qi-deficiency’, ‘Yang-deficiency’, and ‘Inherited Special’ (mean difference of CS vs. placebo = 7.05–8.12, 7.56–8.92, and 4.48–8.10, P = 0.01– < 0.0005, 0.001–0.004, and 0.01– < 0.0005, accordingly, at three post-tests). The participants who received YS also indicated significant greater improvements in symptom severity, quality of life, and a few patterns of body constitution when compared to the placebo group. However, its effects

  6. 373 Alteration of Smell in Patients with Persistent Allergic Rhinitis

    PubMed Central

    De Barayazarra, Susana; Corelli, S; Cornaglia, S; Zanacchi, A; Sosa, S; Herrera, E; Teijeiro, Alvaro; Canonica, Giorgio Walter; Baena-Cagnani, Carlos E.; Zernotti, Mario

    2012-01-01

    Background A high percentage of patients with moderate-severe persistent allergic rhinitis (PAR) also show symptoms related to impaired smell (21–23%).Olfactory dysfunction can have a significant impact on quality of life (QoL) in these patients. The high frequency of this subjective condition not always reflect the magnitude of the problem experienced by PAR-patients in real life and usually goes unnoticed. The aim of this study was to assess the olfactory dysfunction in patients with PAR and seek the association with the PAR-severity, sleep disturbance and QoL. Methods We studied 50 patients with physician-diagnosed PAR consulting a tertiary medical centre, 33 (66%) were female and 17 (34%) male. Mean age 43 years old, compared with 20 healthy volunteers. Clinical history and assessment of severity based on ARIA criteria, skin prick tests with mite mix, mould and pollens, QoL questionnaire for allergic rhino-conjuntivitis (Juniper RQLQ) were done. In addition the Epworth Sleepiness Scale (ESS) and the Connecticut smell test (CST) were performed in every patient. Results In patients with PAR, 30% had mild PAR and 70% the moderate/severe form.48% of the patients studied had abnormalities of smell. We found an alteration of smell in 18% of mild-PAR and 60% in the severe/moderate patients (P < .006).There was no statistically significant relationship between olfactory impairment and sleep disturbance with the ESS (P < .85), nor in the alteration of smell in patients with polyps detected at physical examination (P < .57) or the relationship between impaired smell and smoking (P < .36).Patients with moderate/severe PAR also had alterations in QoL. Nasal obstruction was the most important parameter (70%) associated with the QoL worsening. Conclusions This study shows the impact of PAR on the olfactory dysfunction. An association between smell impairment and the severity of nasal symptoms was found. Smell impairment plays an important role in worsening QoL. CST is a

  7. Immunological parameters associated with the development of allergic rhinitis: A preliminary prospective study

    PubMed Central

    Uekusa, Yasuhiro; Inamine, Ayako; Yonekura, Syuji; Horiguchi, Shigetoshi; Fujimura, Takashi; Sakurai, Daijyu; Yamamoto, Heizaburo; Suzuki, Homare; Hanazawa, Toyoyuki

    2012-01-01

    Background: Many subjects are sensitized to Japanese cedar pollen but do not develop allergic rhinitis (AR). The aim of this study was to examine the immunologic parameters related to the development of AR in sensitized subjects. Methods: The subjects were 33 adults who were sensitized to Japanese cedar pollen, but had not developed as of 2007. Cedar pollen–specific IgE (sIgE) and total IgE (tIgE) in serum, cedar pollen antigen (Cry j 1) Cry j–specific memory Th2 cell clone size, and the Cry j–specific induced regulatory T cell (iTreg) level were examined before and after the season in 2008. Results: Eight of the 33 subjects developed cedar pollinosis. The sIgE titers before the season in these eight subjects did not differ from those in the subjects who did not develop pollinosis, but the titers after the season were significantly higher in the group that developed pollinosis. The sIgE/tIgE ratio increased in almost all subjects, but the ratio was significantly higher before the season in the subjects who developed pollinosis. Cry j–specific Th2 cells were detected in all subjects, but the clone size only increased in those that developed pollinosis. The Cry j–specific iTreg population did not differ between the two groups. Conclusion: A high sIgE/tIgE ratio before the season may be predictive of development of pollinosis, and an increase in the allergen-specific Th2 clone size during the pollen season could be a biomarker for pollinosis. The role of allergen-specific iTreg cells in the development of pollinosis could not be clarified in this preliminary study. PMID:22487284

  8. Safety and tolerability of levocetirizine dihydrochloride in infants and children with allergic rhinitis or chronic urticaria.

    PubMed

    Hampel, Frank; Ratner, Paul; Haeusler, Jean-Marc C

    2010-01-01

    Allergic rhinitis (AR) and chronic idiopathic urticaria (CIU) are common causes of substantial illness and disability in preschool children. Antihistamines are commonly used to treat preschool children with these conditions, but their use is based mostly on extrapolated efficacy from adult populations; it is thus important to characterize the safety of antihistamines in the pediatric population. This study was designed to assess the safety of levocetirizine dihydrochloride oral liquid drops in infants and children with AR or CIU. Two multicenter, double-blind, randomized, parallel-group studies randomized infants aged 6-11 months (study 1, n = 69) and children aged 1-5 years (study 2, n = 173) to levocetirizine, 1.25 mg (q.d. or b.i.d., respectively), or placebo for 2 weeks, using a 2:1 ratio. Safety evaluations included treatment-emergent adverse events (TEAEs), vital signs, electrocardiographic (ECG) assessments, and laboratory tests. The overall incidence of TEAEs was similar between levocetirizine and placebo in both studies. Most TEAEs were mild or moderate in intensity. TEAEs prompted discontinuation of therapy in three patients receiving levocetirizine in study 1. No clinically relevant changes from baseline in vital signs or laboratory parameters were apparent in either study; changes from baseline in these evaluations were similar between groups. No significant changes were observed in ECG parameters, including corrected QT interval. Levocetirizine, 1.25 and 2.5 mg/day, was well tolerated in infants aged 6-11 months and in children aged 1-5 years, respectively, with AR or CIU. PMID:20819318

  9. FCRL3 Gene Polymorphisms Confer Autoimmunity Risk for Allergic Rhinitis in a Chinese Han Population

    PubMed Central

    Gu, Zheng; Hong, Su-Ling; Ke, Xia; Shen, Yang; Wang, Xiao-Qiang; Hu, Di; Hu, Guo-Hua; Kang, Hou-Yong

    2015-01-01

    Background Heredity and environmental exposures may contribute to a predisposition to allergic rhinitis (AR). Autoimmunity may also involve into this pathologic process. FCRL3 (Fc receptor-like 3 gene), a novel immunoregulatory gene, has recently been reported to play a role in autoimmune diseases. Objective This study was performed to evaluate the potential association of FCRL3 polymorphisms with AR in a Chinese Han population. Methods Five single-nucleotide polymorphisms of FCRL3, rs945635, rs3761959, rs7522061, rs10489678 and rs7528684 were genotyped in 540 AR patients and 600 healthy controls using a PCR-restriction fragment length polymorphism assay. Allele, genotype and haplotype frequencies were compared between patients and controls using the χ2 test. The online software platform SHEsis was used to analyze their haplotypes. Results This study identified three strong risk SNPs rs7528684, rs10489678, rs7522061 and one weak risk SNP rs945635 of FCRL3 in Chinese Han AR patients. For rs7528684, a significantly increased prevalence of the AA genotype and A allele in AR patients was recorded. The frequency of the GG genotype and G allele of rs10489678 was markedly higher in AR patients than those in controls. For rs7522061, a higher frequency of the TT genotype, and a lower frequency of the CT genotype were found in AR patients. Concerning rs945635, a lower frequency of the CC genotype, and a higher frequency of G allele were observed in AR patients. According to the analysis of the three strong positive SNPs, the haplotype of AGT increased significantly in AR cases (AR = 38.8%, Controls = 24.3%, P = 8.29×10-14, OR [95% CI] 1.978 [1.652~2.368]). Conclusions This study found a significant association between the SNPs in FCRL3 gene and AR in Chinese Han patients. The results suggest these gene polymorphisms might be the autoimmunity risk for AR. PMID:25594855

  10. Intranasal steroids: managing allergic rhinitis and tailoring treatment to patient preference.

    PubMed

    Meltzer, Eli O

    2005-01-01

    Allergic rhinitis (AR) can have a significant impact on patient quality of life (QoL), affecting learning ability and work productivity. Both the consequences of the impairment and the costs of treatment are associated with a large economic burden. The management of AR includes allergen avoidance, pharmacotherapy, and immunotherapy. Current pharmacotherapy options are oral and intranasal antihistamines, intranasal corticosteroids (INS), intranasal chromones, oral and intranasal decongestants, oral and intranasal anticholinergic agents, and antileukotrienes. A number of guidelines recommend INS as first-line treatment for persistent and moderate-to-severe AR. Although both patient and physician concern over the long-term safety of oral systemic steroids has previously prevented widespread use of INS, it is important to note that they have a superior risk/benefit ratio compared with other monotherapies. Indeed, the limited systemic bioavailability of INS agents, when used at recommended doses, has resulted in very low rates of systemic adverse effects, as shown by a lack of either hypothalamic-pituitary-adrenal axis or growth suppression. Large, controlled clinical studies have shown comparable efficacy and safety among the newer INS; therefore, clinicians may need to consider other factors, such as good patient compliance, when selecting an appropriate INS agent for a patient. In addition, patients often prefer one agent over another, and compliance may be improved by selecting the preferred agent. The development of two new questionnaires, the Clinical Practice Patient Preference Questionnaire and the Clinical Trial Patient Preference Questionnaire, may prove useful in selecting the optimal treatment regimen for patients. PMID:16541967

  11. The effect of antiallergic treatment with desloratadine-montelukast on salivary glands function in allergic rhinitis.

    PubMed

    Ayan, Arif; Yoruk, Ozgur; Seven, Bedri; Orsal, Ebru; Mutlu, Vahit; Aydin, Berrin

    2014-01-01

    The aim of this study was to evaluate the possible favorable effect of desloratadine-montelukast combination on salivary glands (SG) function in patients with allergic rhinitis (AR) using SG scintigraphy. The study population consisted of 64 patients with AR and 28 healthy controls: 14 males and 14 females, with mean age 32.3±8.6 years. The patients were divided into two groups: the untreated patients group of 32 patients, 16 males and 16 females, mean age 28.5±5.4 years and the treated group, who received the standard clinically recommended oral dose of montelukast 10mg/d and desloratadine 5mg/d for 6 weeks. This group consisted of 32 patients, 16 males and 16 females, mean age 38.3±8.4 years. All patients and healthy controls underwent SG scintigraphy. After the intravenous injection of technetium-99m pertechnetate, ((99m)Tc-P), dynamic SG scintigraphy was performed for 25min. Using the time-activity curves, the following glandular function parameters were calculated for the parotid and the submandibular SG: uptake ratio, maximum accumulation and ejection fraction. Results showed SG hypofunction. All functional parameters obtained for the untreated patients and for the desloratadine-montelukast treated patients were significantly lower than those in healthy controls (P<0.05). There was no statistically significant difference between treated and untreated patients (P>0.05). In conclusion, our study showed that hypofunction of SG was present in all patients with AR. This hypofunction, as tested by semi-quantitative SG scintigraphy, and also the quality of life did not improve after treatment with montelukast and desloratadine. PMID:25397624

  12. Comparison of sensory attributes and immediate efficacy of intranasal ciclesonide and fluticasone propionate in allergic rhinitis: A randomized controlled trial

    PubMed Central

    Varshney, Jitendra; Varshney, Himanshu; Dutta, Sumanta Kumar; Hazra, Avijit

    2012-01-01

    Objectives: Intranasal corticosteroids (INCs) are the most effective modality for treating allergic rhinitis and their sensory attributes are important in patient compliance. This study aimed to compare the sensory attributes (scent, immediate taste, aftertaste, run down to throat, nose run off, soothing feel, nasal irritation, and urge to sneeze) and immediate response to the new intranasal steroid, ciclesonide (CIC), with fluticasone propionate (FLP) in allergic rhinitis. Materials and Methods: A randomized, double blind, single dose, crossover study was done with 74 patients presenting with acute allergic rhinitis. Eligible subjects were randomized in 1:1 ratio to one of the two treatment sequences – CIC followed by FLP or vice versa. Sensory attributes were assessed using a questionnaire to score each item on a seven-point Likert scale, immediately and 2 min after dosing. Total nasal symptom score (TNSS) was calculated to evaluate immediate efficacy 10 min after first drug administration. Overall preference was recorded 10 min after the second drug administration. Patients were queried about treatment emergent adverse events following study drug administration and also 24 h later over the phone. Results: Patients (58% males; pooled median age 32 years [Interquartile range, IQR, 25–41]; pooled median symptom duration 24 months [IQR 12–72]) preferred FLP over CIC nasal spray overall (55.41% vs. 25.68%, P = 0.007) and also with respect to attributes of scent, soothing feel, and nasal irritation. There was no statistically significant difference in immediate efficacy. Two patients reported mild headache following CIC first, while three felt mild headache, one dizziness, and one nasal congestion following FLP first administration. There were no delayed adverse events. Conclusions: There was no difference in immediate outcome following use of either of the two INCs. FLP was preferred over CIC with respect to scent, soothing feel and nasal irritation, and also

  13. Comparative Study of Apo-Cetirizine Single Therapy and Intermittent Sequential Therapy with Cetirizine, Loratadine and Chlorpheniramine in Allergic Rhinitis.

    PubMed

    Safavi Naini, Ali; Ghorbani, Jahangir; Mazloom, Ebrahim

    2016-09-01

    There are limited numbers of articles, studying combined use of antihistamines. In this study, we compare single therapy of Apo-Cetirizine with a new regimen of intermittent sequential therapy with cetirizine, loratadine and chlorpheniramine in treatment of seasonal allergic rhinitis. This randomized clinical trial was performed between April and September at the peak prevalence of seasonal allergic rhinitis. Fifty-four eligible patients diagnosed clinically to have seasonal allergic rhinitis were randomized in two groups: 24 cases in single therapy arm, received Apo-Cetirizine 10 mg tablet daily and in other arm, 30 patients received sequential regimen of cetirizine 10 mg tablet, loratadine 10 mg tablet and chlorpheniramine 4 mg tablet, one tablet each day. Major Symptom Complex Score (MSCS) and Total Symptom Complex Score (TSCS) of patients were recorded before treatment and after 30 days of treatment in two groups. The average post-treatment MSCS and TSCS in combination therapy group showed better improvement than single therapy group but difference was not statistically significant (p value = 0.053 and p value = 0.104 respectively). Combination therapy regimen was better in improvement of nasal congestion (p value = 0.006). There were no significant difference between two groups in efficacy, side effects and patient's satisfaction. Combination therapy would be effective on a wide spectrum of symptoms with lower price and theoretically offers lower chance of tolerance and re-appearance of complaints. PMID:27508135

  14. Respiratory responses of subjects with allergic rhinitis to ozone exposure and their relationship to nonspecific airway reactivity

    SciTech Connect

    McDonnell, W.F.; Horstman, D.H.; Abdul-Salaam, S.; Raggio, L.J.; Green, J.A.

    1987-01-01

    Ozone exposure in man produces changes in respiratory function and symptoms. There is a large degree of unexplained intersubject variability in the magnitude of these responses. There is concern that individuals with chronic respiratory diseases may also be more responsive to ozone than normal individuals. The purpose of this study was to describe the responses of subjects with allergic rhinitis to ozone exposure and to compare these responses to those previously observed in normal individuals. A further purpose was to measure the association between baseline nonspecific airway reactivity and changes in lung function and respiratory symptoms following ozone exposure.

  15. Report of a patient with complex composites of hepatitis B virus, allergic asthma and diabetes

    PubMed Central

    Athari, Seyyed Shamsadin; Omidi, Razie

    2014-01-01

    HBV is a non-cytopathic virus and cell mediated immune response against this. Humoral mediated immune response are responsible for allergic diseases. Balance between these two subsets of Th CD4+ cells are result of the immune system response. A 56 year old woman presented with chronic HBV infection, allergic asthma, type 2 diabetes mellitus and high blood pressure and high blood lipid. Patients should be followed for the allergic and autoimmune diseases along with their viral reactivation. PMID:25183147

  16. Precision medicine in patients with allergic diseases: Airway diseases and atopic dermatitis-PRACTALL document of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma & Immunology.

    PubMed

    Muraro, Antonella; Lemanske, Robert F; Hellings, Peter W; Akdis, Cezmi A; Bieber, Thomas; Casale, Thomas B; Jutel, Marek; Ong, Peck Y; Poulsen, Lars K; Schmid-Grendelmeier, Peter; Simon, Hans-Uwe; Seys, Sven F; Agache, Ioana

    2016-05-01

    In this consensus document we summarize the current knowledge on major asthma, rhinitis, and atopic dermatitis endotypes under the auspices of the PRACTALL collaboration platform. PRACTALL is an initiative of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma & Immunology aiming to harmonize the European and American approaches to best allergy practice and science. Precision medicine is of broad relevance for the management of asthma, rhinitis, and atopic dermatitis in the context of a better selection of treatment responders, risk prediction, and design of disease-modifying strategies. Progress has been made in profiling the type 2 immune response-driven asthma. The endotype driven approach for non-type 2 immune response asthma, rhinitis, and atopic dermatitis is lagging behind. Validation and qualification of biomarkers are needed to facilitate their translation into pathway-specific diagnostic tests. Wide consensus between academia, governmental regulators, and industry for further development and application of precision medicine in management of allergic diseases is of utmost importance. Improved knowledge of disease pathogenesis together with defining validated and qualified biomarkers are key approaches to precision medicine. PMID:27155030

  17. γ-Secretase Inhibitor Alleviates Acute Airway Inflammation of Allergic Asthma in Mice by Downregulating Th17 Cell Differentiation

    PubMed Central

    Zhang, Weixi; Zhang, Xueya; Sheng, Anqun; Weng, Cuiye; Zhu, Tingting; Zhao, Wei; Li, Changchong

    2015-01-01

    T helper 17 (Th17) cells play an important role in the pathogenesis of allergic asthma. Th17 cell differentiation requires Notch signaling. γ-Secretase inhibitor (GSI) blocks Notch signaling; thus, it may be considered as a potential treatment for allergic asthma. The aim of this study was to evaluate the effect of GSI on Th17 cell differentiation in a mouse model of allergic asthma. OVA was used to induce mouse asthma model in the presence and absence of GSI. GSI ameliorated the development of OVA-induced asthma, including suppressing airway inflammation responses and reducing the severity of clinical signs. GSI also significantly suppressed Th17-cell responses in spleen and reduced IL-17 levels in serum. These findings suggest that GSI directly regulates Th17 responses through a Notch signaling-dependent pathway in mouse model of allergic asthma, supporting the notion that GSI is a potential therapeutic agent for the treatment of allergic asthma. PMID:26339131

  18. Role of Prostaglandin D2 and DP1 Receptor on Japanese Cedar Pollen-Induced Allergic Rhinitis in Mice.

    PubMed

    Nakano, Yoshiyuki; Kidani, Yujiro; Goto, Kumiko; Furue, Shingo; Tomita, Yasuhiko; Inagaki, Naoki; Tanaka, Hiroyuki; Shichijo, Michitaka

    2016-05-01

    Although we previously demonstrated the contribution of the DP1receptor in nasal obstruction using animals sensitized with ovalbumin in the presence of adjuvant, the contribution of the DP1receptor in sneezing is unclear. Here, we developed a mouse model of Japanese cedar (JC:Cryptomeria japonica) pollinosis to evaluate the symptoms of sneezing. To achieve this, we used JC pollen crude extract in the absence of adjuvant to sensitize mice to develop a model closer to the pathophysiology of human JC pollinosis. The immunologic and pharmacologic features of this model are highly similar to those observed in JC pollinosis in humans. Using this model, we found that DP1receptor antagonists suppressed JC pollen extract-induced sneezing and that a DP1receptor agonist induced sneezing. Moreover, JC pollen extract-induced sneezing was diminished in DP1receptor knockout mice. In conclusion, we developed a novel mouse model of allergic rhinitis that closely mimics human JC pollinosis. A strong contribution of DP1receptor signaling to sneezing was demonstrated using this model, suggesting that DP1receptor antagonists could suppress sneezing and nasal obstruction, and therefore these agents could be a new therapeutic option for allergic rhinitis. PMID:26945086

  19. The role of TRPV1 in the CD4+ T cell-mediated inflammatory response of allergic rhinitis

    PubMed Central

    Son, Hye Ran; Rhee, Yun-Hee; Kim, Eun Hee; Kim, Ji Hye; Bae, Jun-Sang; Chung, Young-Jun; Chung, Phil-Sang; Raz, Eyal; Mo, Ji-Hun

    2016-01-01

    Transient receptor potential vanilloid 1 (TRPV1), which has been identified as a molecular target for the activation of sensory neurons by various painful stimuli, was reported to regulate the signaling and activation of CD4+ T cells. However, the role of TRPV1 in CD4+ T cell in allergic rhinitis remains poorly understood. In this study, TRPV1 expression was localized in CD4+ T cells. Both knockout and chemical inhibition of TRPV1 suppressed Th2/Th17 cytokine production in CD4 T cells and Jurkat T cells, respectively, and can suppress T cell receptor signaling pathways including NF-κB, MAP kinase, and NFAT. In TRPV1 knockout allergic rhinitis (AR) mice, eosinophil infiltration, Th2/Th17 cytokines in the nasal mucosa, and total and ova-specific IgE levels in serum decreased, compared with wild-type AR mice. The TRPV1 antagonists, BCTC or theobromine, showed similar inhibitory immunologic effects on AR mice models. In addition, the number of TRPV1+/CD4+ inflammatory cells increased in the nasal mucosa of patients with AR, compared with that of control subjects. Thus, TRPV1 activation on CD4+ T cells is involved in T cell receptor signaling, and it could be a novel therapeutic target in AR. PMID:26700618

  20. The antiallergic mechanisms of Citrus sunki and bamboo salt (K-ALL) in an allergic rhinitis model.

    PubMed

    Oh, Hyun-A; Kim, Myong-Jo; Shin, Tae-Yong; Kim, Hyung-Min; Jeong, Hyun-Ja

    2014-01-01

    The antiallergic effects of traditional medicines have long been studied. Traditional Korean medicine, Citrus sunki and bamboo salt, has been used for the treatment of allergic diseases in Korea. K-ALL, composed of Citrus sunki and bamboo salt, is a newly prepared prescription for allergic patients. To develop the new antiallergic agent, we examined the effects of K-ALL through in vivo and in vitro models. K-ALL and naringin (an active compound of K-ALL) significantly inhibited histamine release from rat peritoneal mast cells. This inhibitory effect of K-ALL on histamine release was higher than effects from other known histamine inhibitors such as bamboo salt, Citrus sunki or disodium cromoglycate. K-ALL significantly inhibited systemic anaphylactic shock induced by the compound 48/80 and passive cutaneous anaphylaxis induced by the IgE. K-ALL also inhibited production and mRNA expression of inflammatory cytokines induced by phorbol 12-myristate 13-acetate and the calcium ionophore A23187 on HMC-1 cells (a human mast cell line). In the ovalbumin-induced allergic rhinitis animal model, rub scores, histamine, IgE, inflammatory cytokines and inflammatory cell counts were all reduced by the oral or nasal administration of K-ALL (pre and posttreatment). These results indicate the great potential of K-ALL as an active immune modulator for the treatment of mast cell-mediated allergic diseases. PMID:24131540

  1. [Asthma and rhinitis prevalence and co-morbidity in 13-14-year-old schoolchildren in the city of Fortaleza, Ceará State, Brazil].

    PubMed

    Luna, Maria de Fátima Gomes de; Almeida, Paulo César de; Silva, Marcelo Gurgel Carlos da

    2011-01-01

    This study aimed to measure the prevalence rates for asthma and rhinitis and the association between the two conditions. This was a cross-sectional study of 3,015 adolescents (13-14 years of age) in Fortaleza, Ceará State, Brazil, in public and private schools, using the protocol from the International Study of Asthma and Allergies in Childhood (ISAAC), in 2006-2007. Prevalence rates were 22.6% for asthma, 43.2% for rhinitis, and 18.7% for rhinoconjunctivitis, with a predominance of females (p = 0.002, p < 0.001, and p < 0/001, respectively) and private school students (p < 0.001). Among adolescents that reported asthma, the rhinitis rate was 64.4% and the rhinoconjunctivitis rate was 35.3%. The rates of association were 14.6% between asthma and rhinitis and 8% between asthma and rhinoconjunctivitis, with a predominance of females (p < 0.001 and p < 0.001, respectively) and associated with speech-limiting wheezing (p = 0.037 and p = 0.004, respectively). The study can help call health professionals' attention to the importance of an integrated approach to these illnesses, considering the "single airway" concept and seeking treatment options that act on both asthma and rhinitis when the two conditions present simultaneously. PMID:21340109

  2. Screening and functional pathway analysis of genes associated with pediatric allergic asthma using a DNA microarray

    PubMed Central

    LU, LI-QUN; LIAO, WEI

    2015-01-01

    The present study aimed to identify differentially expressed genes (DEGs) associated with pediatric allergic asthma, and to analyze the functional pathways of the selected target genes, in order to explore the pathogenesis of the disease. The GSE18965 gene expression profile was downloaded from the Gene Expression Omnibus database and was preprocessed. This gene expression profile consisted of seven normal samples and nine samples from patients with pediatric allergic asthma. The DEGs between the normal and pediatric allergic asthma samples were screened using limma package in R, and the cut-off value was set at false discovery rate <0.05 and log fold change >1. Following hierarchical clustering of the DEGs based on the expression profiles, the up- and downregulated genes underwent a functional enrichment analysis by topological approach (P<0.05), using the Database for Annotation, Visualization and Integrated Discovery. A total of 127 DEGs were identified between the normal and pediatric allergic asthma samples. The up- and downregulated genes were significantly enriched in the actin filament-based process and the monosaccharide metabolic process, respectively. Seven downregulated DEGs (M6PR, TPP1, GLB1, NEU1, ACP2, LAMP1 and HGSNAT) were identified in the lysosomal pathway, with P=6.4×10−9. These results suggested that variation in lysosomal function, triggered by the seven downregulated genes, may lead to aberrant functioning of the T lymphocytes, resulting in asthma. Further research regarding the treatment of pediatric allergic asthma through targeting lysosomal function is required. PMID:25633562

  3. “Resale Shammieh” First Source of Allergic Rhinitis Description by Rhazes

    PubMed Central

    Alembizar, Faranak; Nimrouzi, Majid

    2016-01-01

    Background: Abū Bakr Muhammad ibn Zakariyyā al-Rāzī, known as Rhazes in the Western world (854-925 CE), was an Iranian polymath, physician and one of the most prominent sages in the medieval period. He wrote several medical books and treaties such as “Continents”, a comprehensive medical encyclopedia, treaties in smallpox and measles, “Al-Mansuri” and many other important manuscripts in the medical field. “Resale Shammieh” is one of his pioneering well-known works in medicine; replying to Shahid-Ibn-Hussein Balkhi, dedicated to his master Abuzeid Ahmad-Ibn-sahl Balkhi, who was getting cold in spring at the time of rose blossoming. We are about to review “Resale Shammieh” because of the importance of this treaty as a pioneering work in allergy and its clinical manifestation. Methods: This study is a traditionary review of “Resale Shammieh” and similar copies as well as works cited by Abureihan Birooni, Ibn Abi-Ossaiba’ei, Ibn-e-nadim. Results: It seems that this treatise has been prepared before treatise of Qest-ibn-Looqa, written for Abbasid Caliph Mutawakkil, about hay fever. Rhazes, in “Resale Shammieh” elucidated almost all clinical manifestations of allergic rhinitis and hay fever is mentioned in the conventional medical resources, including nasal stuffiness, itchy nose, sneezing repeatedly, runny nose, red face, and light elevated temperature of the body. He also cited complications of hay fever such as hoarseness, dyspnea and fever; and mentioned primary preventive measures including covering the head in cold weather, abstaining from drinking cold water as well as smelling musk, Costus and myrrh Maki. His proposed remedies for hay fever comprising of dipping a fabric in the nose, fumigation, shaving the head and rubbing mustard and allium on it, as well as ear or forehead bloodletting. Conclusion: “Resale Shammieh”, a valuable work of Rhazes, the Muslim Persian physician, in hay fever is most probably the first known treaty

  4. Detection of Allergen Specific Antibodies From Nasal Secretion of Allergic Rhinitis Patients

    PubMed Central

    Yoon, Moon-Gyeong; Seo, Dae-Hong; Kim, Bong-Sun; Ban, Ga-Young; Ye, Young-Min; Shin, Yoo Seob

    2016-01-01

    Purpose Allergic rhinitis (AR) is a common and increasing disease in which Dermatophagoides (D.) farinae is one of the most common causative allergens. The aims of this study were to confirm the presence of locally produced antibodies to D. farinae in nasal secretions between nasal provocation test (NPT)-positive and -negative groups of AR patients, to evaluate their relationships with the levels of inflammatory mediators, and to determine adaptive and innate immune responses in nasal mucosa. Methods Sixty AR patients sensitive to house dust mites confirmed by skin prick test or serum specific IgE to D. farinae underwent NPT for D. farinae. Nasal packs were placed in both nasal cavities of the patients for 5 minutes to obtain nasal secretions after NPT. The levels of total IgE, specific IgE to D. farinae, eosinophil cationic protein (ECP), and tryptase in nasal secretions were detected by using ImmunoCAP. The levels of specific IgE, IgA, and secretory IgA antibodies to D. farinae in nasal secretions were measured by using ELISA. The levels of IL-8, VEGF, IL-25, and IL-33 were also measured by using ELISA. Results High levels of total IgE, specific IgE, specific IgA, and secretory IgA to D. farinae, as well as inflammatory mediators, such as ECP, IL-8, VEGF and tryptase, were detected in nasal secretions, although the differences were not statistically significant between the NPT-positive and NPT-negative groups. Levels of all immunoglobulins measured in this study significantly correlated with ECP, IL-8, and VEGF (P<0.05), but not with tryptase (P>0.05). IL-33 and IL-25 were also detected, and IL-25 level significantly correlated with IL-8 (r=0.625, P<0.001). Conclusions These findings confirmed the presence of locally produced specific antibodies, including D. farinae-specific IgE and IgA, in nasal secretions collected from D. farinae-sensitive AR patients in both the NPT-positive and NPT-negative groups, and close correlations were noted between antibodies and

  5. Allergen-Dependent Differences in ILC2s Frequencies in Patients With Allergic Rhinitis

    PubMed Central

    Fan, Dachuan; Wang, Xiangdong; Wang, Min; Wang, Yang; Zhang, Liang; Li, Ying; Fan, Erzhong; Cao, Feifei; Van Crombruggen, Koen

    2016-01-01

    Purpose Group 2 innate lymphoid cells (ILC2s) are a novel population of lineage-negative cells that induce innate type 2 responses by producing the critical Th2-type cytokines IL-5 and IL-13 in response to IL-25 and IL-33 stimulation. ILC2s accumulation in the peripheral blood of patients with allergic rhinitis (AR) is controversial; the precise role of ILC2s in the immunopathogenesis of AR is still not clear. We investigated the role of ILC2s in phenotypic AR sensitized to distinct allergens. Methods Flow cytometric analysis of the peripheral blood of 7 healthy controls (HCs), 9 patients monosensitized to house dust mite (HDM), and 8 patients monosensitized to mugwort was performed to quantify ILC2s frequency. Peripheral blood mononuclear cells (PBMCs) were isolated from HDM-AR and mugwort-AR patients, and Lineage- and Lineage+ cells were separated using a fluorescence-activated cell sorter (FACS). IL-5 and IL-13 levels in the supernatants of PBMCs, and Lineage- and Lineage+ cells stimulated with IL-25 and/or IL-33 combined with IL-2 in vitro were assessed using the Milliplex magnetic bead kit. Results The percentage of ILC2s was significantly elevated in HDM-AR patients compared to mugwort-AR patients and HCs, while no significant difference was found between mugwort-AR patients and HCs. IL-33±IL-25 plus IL-2 induced a significantly greater release of IL-5 and IL-13 in the PBMCs of HDM-AR patients compared to PBMCs of mugwort-AR patients. IL-25 plus IL-2 also induced a significantly greater release of IL-13 in the PBMCs of HDM-AR patients compared to PBMCs of mugwort-AR patients. Stimulation with IL-33 and/or IL-25 combined with IL-2 also induced a significantly greater IL-5 and IL-13 release from Lineage- cells compared to Lineage+ cells. Conclusions AR patients sensitized to HDM or mugwort allergen have distinct phenotypic and functional profiles in ILC2s frequencies. ILC2s mediate major type 2 immunity in the development of HDM-AR and may be a potential

  6. Soluble ADAM33 initiates airway remodeling to promote susceptibility for allergic asthma in early life

    PubMed Central

    Davies, Elizabeth R.; Kelly, Joanne F.C.; Howarth, Peter H.; Wilson, David I.; Holgate, Stephen T.; Davies, Donna E.; Whitsett, Jeffrey A.; Haitchi, Hans Michael

    2016-01-01

    Asthma is a chronic inflammatory airways disease that usually begins in early life and involves gene-environment interactions. Although most asthma exhibits allergic inflammation, many allergic individuals do not have asthma. Here, we report how the asthma gene a disintegrin and metalloprotease 33 (ADAM33) acts as local tissue susceptibility gene that promotes allergic asthma. We show that enzymatically active soluble ADAM33 (sADAM33) is increased in asthmatic airways and plays a role in airway remodeling, independent of inflammation. Furthermore, remodeling and inflammation are both suppressed in Adam33-null mice after allergen challenge. When induced in utero or added ex vivo, sADAM33 causes structural remodeling of the airways, which enhances postnatal airway eosinophilia and bronchial hyperresponsiveness following subthreshold challenge with an aeroallergen. This substantial gene-environment interaction helps to explain the end-organ expression of allergic asthma in genetically susceptible individuals. Finally, we show that sADAM33-induced airway remodeling is reversible, highlighting the therapeutic potential of targeting ADAM33 in asthma. PMID:27489884

  7. Capsaicin for Rhinitis.

    PubMed

    Fokkens, Wytske; Hellings, Peter; Segboer, Christine

    2016-08-01

    Rhinitis is a multifactorial disease characterized by symptoms of sneezing, rhinorrhea, postnasal drip, and nasal congestion. Non-allergic rhinitis is characterized by rhinitis symptoms without systemic sensitization of infectious etiology. Based on endotypes, we can categorize non-allergic rhinitis into an inflammatory endotype with usually eosinophilic inflammation encompassing at least NARES and LAR and part of the drug induced rhinitis (e.g., aspirin intolerance) and a neurogenic endotype encompassing idiopathic rhinitis, gustatory rhinitis, and rhinitis of the elderly. Patients with idiopathic rhinitis have a higher baseline TRPV1 expression in the nasal mucosa than healthy controls. Capsaicin (8-methyl-N-vanillyl-6-nonenamide) is the active component of chili peppers, plants of the genus Capsicum. Capsaicin is unique among naturally occurring irritant compounds because the initial neuronal excitation evoked by it is followed by a long-lasting refractory period, during which the previously excited neurons are no longer responsive to a broad range of stimuli. Patients with idiopathic rhinitis benefit from intranasal treatment with capsaicin. Expression of TRPV1 is reduced in patients with idiopathic rhinitis after capsaicin treatment. Recently, in a Cochrane review, the effectiveness of capsaicin in the management of idiopathic rhinitis was evaluated and the authors concluded that given that many other options do not work well in non-allergic rhinitis, capsaicin is a reasonable option to try under physician supervision. Capsaicin has not been shown to be effective in allergic rhinitis nor in other forms of non-allergic rhinitis like the inflammatory endotypes or other neurogenic endotypes like rhinitis of the elderly or smoking induced rhinitis. PMID:27485456

  8. Circulating nerve growth factor levels are increased in humans with allergic diseases and asthma.

    PubMed Central

    Bonini, S; Lambiase, A; Bonini, S; Angelucci, F; Magrini, L; Manni, L; Aloe, L

    1996-01-01

    Nerve growth factor (NGF) serum levels were measured in 49 patients with asthma and/or rhinoconjunctivitis and/or urticaria-angioedema. Clinical and biochemical parameters, such as bronchial reactivity, total and specific serum IgE levels, and circulating eosinophil cationic protein levels, were evaluated in relation to NGF values in asthma patients. NGF was significantly increased in the 42 allergic (skin-test- or radioallergosorbent-test-positive) subjects (49.7 +/- 28.8 pg/ml) versus the 18 matched controls (3.8 +/- 1.7 pg/ml; P < 0.001). NGF levels in allergic patients with asthma, rhinoconjunctivitis, and urticaria-angioedema were 132.1 +/- 90.8, 17.6 +/- 6.1, and 7.6 +/- 1.8 pg/ml (P < 0.001, P < 0.002, and P < 0.05 versus controls), respectively. Patients with more than one allergic disease had higher NGF serum values than those with a single disease. When asthma patients were considered as a group, NGF serum values (87.6 +/- 59.8 pg/ml) were still significantly higher than those of control groups (P < 0.001), but allergic asthma patients had elevated NGF serum levels compared with nonallergic asthma patients (132.1 +/- 90.8 versus 4.9 +/- 2.9 pg/ml; P < 0.001). NGF serum levels correlate to total IgE serum values (rho = 0.43; P < 0.02). The highest NGF values were found in patients with severe allergic asthma, a high degree of bronchial hyperreactivity, and high total IgE and eosinophil cationic protein serum levels. This study represents the first observation (that we know of) that NGF is increased in human allergic inflammatory diseases and asthma. Images Fig. 2 PMID:8855290

  9. Anaphylatoxins coordinate innate and adaptive immune responses in allergic asthma.

    PubMed

    Schmudde, Inken; Laumonnier, Yves; Köhl, Jörg

    2013-02-01

    Allergic asthma is a chronic disease of the airways in which maladaptive Th2 and Th17 immune responses drive airway hyperresponsiveness (AHR), eosinophilic and neutrophilic airway inflammation and mucus overproduction. Airway epithelial and pulmonary vascular endothelial cells in concert with different resident and monocyte-derived dendritic cells (DC) play critical roles in allergen sensing and consecutive activation of TH cells and their differentiation toward TH2 and TH17 effector or regulatory T cells (Treg). Further, myeloid-derived regulatory cells (MDRC) act on TH cells and either suppress or enhance their activation. The complement-derived anaphylatoxins (AT) C3a and C5a are generated during initial antigen encounter and regulate the development of maladaptive immunity at allergen sensitization. Here, we will review the complex role of ATs in activation and modulation of different DC populations, MDRCs and CD4⁺ TH cells. We will also discuss the potential impact of ATs on the regulation of the pulmonary stromal compartment as an important means to regulate DC functions. PMID:23694705

  10. [Oxidation phenotype as a risk factor for development of allergic diseases].

    PubMed

    Niewiński, P; Orzechowska-Juzwenko, K; Patkowski, J; Wolańczyk-Medrala, A; Nittner-Marszalska, M; Rzemisławska, Z

    1999-01-01

    The relationship between genetically determined polymorphic metabolism and susceptibility to allergic diseases has aroused much interest. The aim of our study was to evaluate whether patients with allergic diseases, like atopic asthma and allergic rhinitis differ from healthy persons in their ability to oxidize sparteine as a model drug. The study was completed by 200 persons, 40 patients with allergic diseases--20 with atopic asthma and 20 with allergic rhinitis and 160 healthy volunteers as a control group. The results of our study revealed a predominance of very extensive metabolizers of sparteine among patients with allergic diseases in comparison with healthy volunteers. The difference in the oxidation metabolic ratio (MR) frequency distribution between patients with allergic diseases and healthy persons was statistically significant. Relative risk (odds ratio) of development of atopic asthma was 3.29 times higher, and that of allergic rhinitis 2.94 times higher for persons with very extensive oxidation phenotype. Our results represent some evidence for a possible relationship between extensive, rapid oxidation phenotype and the higher susceptibility to development of atopic asthma and allergic rhinitis. PMID:10592724

  11. Anti-Interleukin-1 Beta/Tumor Necrosis Factor-Alpha IgY Antibodies Reduce Pathological Allergic Responses in Guinea Pigs with Allergic Rhinitis

    PubMed Central

    Wei-xu, Hu; Wen-yun, Zhou; Xi-ling, Zhu; Zhu, Wen; Li-hua, Wu; Xiao-mu, Wu; Hui-ping, Wei; Wen-ding, Wang; Dan, He; Qin, Xiang

    2016-01-01

    This study aims to determine whether the combined blockade of IL-1β and TNF-α can alleviate the pathological allergic inflammatory reaction in the nasal mucosa and lung tissues in allergic rhinitis (AR) guinea pigs. Healthy guinea pigs treated with saline were used as the healthy controls. The AR guinea pigs were randomly divided into (1) the AR model group treated with intranasal saline; (2) the 0.1% nonspecific IgY treatment group; (3) the 0.1% anti-TNF-α IgY treatment group; (4) the 0.1% anti-IL-1β IgY treatment group; (5) the 0.1% combined anti-IL-1β and TNF-α IgY treatment group; and (6) the fluticasone propionate treatment group. The inflammatory cells were evaluated using Wright's staining. Histopathology was examined using hematoxylin-eosin staining. The results showed that the number of eosinophils was significantly decreased in the peripheral blood, nasal lavage fluid, and bronchoalveolar lavage fluid (P < 0.05), and eosinophil, neutrophil, and lymphocyte infiltration and edema were significantly reduced or absent in the nasal mucosa and lung tissues (P < 0.05) in the combined 0.1% anti-IL-1β- and TNF-α IgY-treated guinea pigs. The data suggest that topical blockade of IL-1β and TNF-α could reduce pathological allergic inflammation in the nasal mucosa and lung tissues in AR guinea pigs. PMID:27046957

  12. Probiotics for allergic respiratory diseases--putting it into perspective.

    PubMed

    Singh, Meenu; Ranjan Das, Rashmi

    2010-03-01

    Respiratory allergies include allergic rhinitis, sinusitis and asthma. Increasing attention on pathogenesis of allergic airway diseases has given rise to "atopic march" hypothesis i.e. clinical features of atopic eczema occur first and precede the development of asthma and allergic rhinitis. The "hygiene hypothesis" proposes that the increase in allergic diseases reflects a decrease in infections during childhood. Clinical trials also suggest that the exposure to microbes through the gastrointestinal tract powerfully shapes immune function. Probiotics are live organisms which exert a beneficial effect in the prevention as well as treatment of allergic diseases through modification of immune system of host via gut ecosystem. Intestinal microbiota differs in infants who later develop allergic diseases, and feeding probiotics to infants at risk has been shown to reduce their rate of developing eczema. This has prompted studies of feeding probiotics in prevention as well as treatment of respiratory allergy. We hereby discuss the status of probiotics in respiratory allergy. PMID:19725896

  13. Vitamin E and D regulation of allergic asthma immunopathogenesis

    PubMed Central

    Cook-Mills, Joan M.; Avila, Pedro C.

    2014-01-01

    Asthma occurs as complex interactions of the environmental and genetics. Clinical studies and animal models of asthma indicate dietary factors such as vitamin E and vitamin D as protective for asthma risk. In this review, we discuss opposing regulatory functions of tocopherol isoforms of vitamin E and regulatory functions of vitamin D in asthma and how the variation in global prevalence of asthma may be explained, at least in part, by these dietary components. PMID:25175918

  14. Quality of Life in Adolescents With Mild Asthma

    PubMed Central

    Hallstrand, Teal S.; Curtis, J. Randall; Aitken, Moira L.; Sullivan, Sean D.

    2007-01-01

    Summary The majority of individuals with asthma have mild disease, often in conjunction with allergic rhinitis and exercise-induced bronchoconstriction (EIB). Although health-related quality-of-life (HRQoL) is reduced in moderate to severe asthma and allergic rhinitis, little is known about the effect of mild asthma, mild allergic rhinitis, and EIB on HRQoL outcomes. The objective of this study was to determine the effect of mild asthma, allergic rhinitis, and EIB on HRQoL. A cross-sectional study was conducted of 160 adolescent athletes participating in a screening program to detect EIB. Generic HRQoL was assessed with the teen version of the pediatric quality-of-life inventory (PedsQL™). Prior diagnoses of asthma, allergic rhinitis, and EIB, and current symptoms of dyspnea during exercise and asthma, were recorded. Lung function and the presence of EIB were determined by spirometry before and after an exercise challenge test. Adolescent athletes with a prior physician diagnosis of asthma had a lower HRQoL scale summary score (P < 0.01) and lower physical functioning, emotional functioning, and school functioning domain scores (P values, 0.01–0.02) in comparison to adolescent athletes with no prior diagnosis of these disorders. Athletes with a prior diagnosis of asthma reported dyspnea during exercise more frequently than did those without asthma (P < 0.001). Adolescent athletes with dyspnea during exercise had a lower scale summary score, and lower physical functioning, general well-being, and emotional functioning domain scores (P values, 0.02–0.03). These data show that mild asthma and dyspnea without asthma significantly affect HRQoL. Symptoms of dyspnea during exercise are common in asthma and are associated with lower HRQoL. The clinical significance of these differences in HRQoL is unclear. PMID:14618647

  15. Impact of Histone H1 on the Progression of Allergic Rhinitis and Its Suppression by Neutralizing Antibody in Mice

    PubMed Central

    Nakano, Toshiaki; Kamei, Rikiya; Fujimura, Takashi; Takaoka, Yuki; Hori, Ayane; Lai, Chia-Yun; Chiang, Kuei-Chen; Shimada, Yayoi; Ohmori, Naoya; Goto, Takeshi; Ono, Kazuhisa; Chen, Chao-Long; Goto, Shigeru; Kawamoto, Seiji

    2016-01-01

    Nuclear antigens are known to trigger off innate and adaptive immune responses. Recent studies have found that the complex of nucleic acids and core histones that are derived from damaged cells may regulate allergic responses. However, no fundamental study has been performed concerning the role of linker histone H1 in mast cell-mediated type I hyperreactivity. In this study, we explored the impact of histone H1 on mast cell-mediated allergic responses both in vitro and in vivo. In the course of a bona-fide experimental allergen sensitization model upon co-injection with alum adjuvant, ovalbumin (OVA), but not PBS, induced elevated levels of circulating histone H1. Intranasal challenge with histone H1 to OVA/alum- (but not PBS/alum)-sensitized mice induced significantly severer symptoms of allergic rhinitis than those in mice sensitized and challenged with OVA. A monoclonal antibody against histone H1 not only suppressed mast cell degranulation, but also ameliorated OVA-induced nasal hyperreactivity and IgE-mediated passive cutaneous anaphylaxis. Our present data suggest that nuclear histone H1 represents an alarmin-like endogenous mediator acting on mast cells, and that its blockage has a therapeutic potential for mast cell-mediated type I hyperreactivity. PMID:27088594

  16. Anti-allergic rhinitis effect of caffeoylxanthiazonoside isolated from fruits of Xanthium strumarium L. in rodent animals.

    PubMed

    Peng, Wei; Ming, Qian-Liang; Han, Ping; Zhang, Qiao-Yan; Jiang, Yi-Ping; Zheng, Cheng-Jian; Han, Ting; Qin, Lu-Ping

    2014-05-15

    The fruits of Xanthium strumarium L. (Asteraceae) have been used extensively in China for treatment of various diseases such as allergic rhinitis (AR), tympanitis, urticaria and arthritis or ozena. This study was designed to systemically investigate the effects of the caffeoylxanthiazonoside (CXT) isolated from fruits of X. strumarium on AR in rodent animals. Animals were orally administered with CXT. Anti-allergic activity of CXT was evaluated by passive cutaneous anaphylaxis test (PCA); acetic acid-induced writhing tests were used to evaluate the analgesic effects of CXT; acetic acid-induced vascular permeability tests were performed to evaluate anti-inflammatory effect of CXT. Then, the model AR in rats was established to evaluate the effects of CXT on AR with the following tests: the sneezing and nasal scratching frequencies, IgE level in serum, and histopathological examinations. Our results demonstrated that CXT had favorable anti-allergic, anti-inflammatory and analgesic effects. Additionally, we found that CXT was helpful to ameliorate the nasal symptoms and to down-regulate IgE levels in AR rats. Thus, we suggested that CXT can be treated as a candidate for treating AR. PMID:24613102

  17. Impact of Histone H1 on the Progression of Allergic Rhinitis and Its Suppression by Neutralizing Antibody in Mice.

    PubMed

    Nakano, Toshiaki; Kamei, Rikiya; Fujimura, Takashi; Takaoka, Yuki; Hori, Ayane; Lai, Chia-Yun; Chiang, Kuei-Chen; Shimada, Yayoi; Ohmori, Naoya; Goto, Takeshi; Ono, Kazuhisa; Chen, Chao-Long; Goto, Shigeru; Kawamoto, Seiji

    2016-01-01

    Nuclear antigens are known to trigger off innate and adaptive immune responses. Recent studies have found that the complex of nucleic acids and core histones that are derived from damaged cells may regulate allergic responses. However, no fundamental study has been performed concerning the role of linker histone H1 in mast cell-mediated type I hyperreactivity. In this study, we explored the impact of histone H1 on mast cell-mediated allergic responses both in vitro and in vivo. In the course of a bona-fide experimental allergen sensitization model upon co-injection with alum adjuvant, ovalbumin (OVA), but not PBS, induced elevated levels of circulating histone H1. Intranasal challenge with histone H1 to OVA/alum- (but not PBS/alum)-sensitized mice induced significantly severer symptoms of allergic rhinitis than those in mice sensitized and challenged with OVA. A monoclonal antibody against histone H1 not only suppressed mast cell degranulation, but also ameliorated OVA-induced nasal hyperreactivity and IgE-mediated passive cutaneous anaphylaxis. Our present data suggest that nuclear histone H1 represents an alarmin-like endogenous mediator acting on mast cells, and that its blockage has a therapeutic potential for mast cell-mediated type I hyperreactivity. PMID:27088594

  18. Association of VDR and CYP2R1 Polymorphisms with Mite-Sensitized Persistent Allergic Rhinitis in a Chinese Population

    PubMed Central

    Lu, Wen-Min; Wang, Mei-Lin; Zhao, Hai-Long; Lu, Mei-Ping; Zhou, Han; Chen, Ruo-Xi; Zhang, Zheng-Dong; Shen, Chong; Cheng, Lei

    2015-01-01

    As recent studies have described an association between vitamin D and allergic rhinitis, we hypothesized that vitamin D pathway-related genes may be candidate genes for susceptibility to allergic rhinitis. Thus, we sought to evaluate whether polymorphisms in the vitamin D receptor (VDR) and CYP2R1 genes are associated with mite-sensitized persistent allergic rhinitis (PER) in a Han Chinese population. A hospital-based case-control study consisting of 519 patients with mite-sensitized PER and 447 healthy controls was conducted. Five single nucleotide polymorphisms (SNPs) in VDR and CYP2R1 were selected for genotyping. The genotype and allele frequencies of rs9729, rs2228570, rs1544410, and rs731236 in VDR as well as rs2060793 in CYP2R1 were not significantly associated with susceptibility to mite-sensitized PER. After stratification analyses, however, both the CT and CT/TT genotypes of rs2228570 in VDR exhibited a significantly decreased risk (CT: adjusted odds ratio (OR)=0.58, 95% confidence intervals (CI)=0.37-0.91; CT/TT: adjusted OR=0.61, 95% CI=0.40-0.93) of mite-sensitized PER, while the AA genotype of rs2060793 in CYP2R1 exhibited a significantly increased risk (adjusted OR=1.85, 95% CI=1.03-3.34) of PER in the age subgroup of <16 years old. Both the AG and AG/GG genotypes of rs731236 in VDR exhibited a significantly decreased risk (AG: adjusted OR=0.43, 95% CI=0.21-0.89; AG/GG: adjusted OR=0.46, 95% CI=0.23-0.94) of PER in the female subgroup. Analysis of the locus-locus interactions of VDR and CYP2R1 revealed two models that involved combined SNPs of VDR and CYP2R1 were statistically significant (P<0.05). Our data suggest that age and gender may have an impact on the association of three SNPs (rs2228570, rs731236, and rs2060793) in genes of the vitamin D pathway with the risk of mite-sensitized PER in this Chinese population. The VDR and CYP2R1 variants may be involved in genetic interactions in the pathogenesis of PER. PMID:26177022

  19. Evaluation of Clinical and Immunological Responses: A 2-Year Follow-Up Study in Children with Allergic Rhinitis due to House Dust Mite

    PubMed Central

    Moed, Heleen; Gerth van Wijk, Roy; Hendriks, Rudi W.; van der Wouden, J. C.

    2013-01-01

    Background. Allergic rhinitis is a disease with polarization towards Th2 and a defect of regulatory T cells. Immunological changes have been reported after immunotherapy treatment. However, there is not much known about the natural course of allergic rhinitis with respect to clinical manifestation and the relation with immunological responses. Objective. To evaluate clinical symptoms of allergic rhinitis, in relation to in vivo allergen-specific skin responses and in vitro allergen-specific effector and regulatory T cells determined at baseline and after two years. Methods. From a large trial, 59 children were randomly selected. The following variables were compared: clinical symptoms, allergen skin tests, specific IgE, T-cell proliferation, IL-5, IL-13, IFN-gamma, IL-10, TGF-beta, CD4+CD25hi cells, and Foxp3 expression. Results. Allergic symptoms had decreased after two years. Whereas skin test reactions correlated between years 0 and 2, there was no change in the size of the reaction. Also, proinflammatory reactions did not change after two years, with a positive correlation between years 0 and 2. No relevant changes were observed with respect to regulatory cells. Conclusion. Whereas, comparable to immunotherapy, allergic complaints decrease, the immunological changes of specific T-cell activity (both effector cells and regulator cells) which are observed after immunotherapy, do not change. PMID:23737646

  20. Childhood obesity and risk of allergy or asthma.

    PubMed

    Raj, Dinesh; Kabra, Sushil K; Lodha, Rakesh

    2014-11-01

    The simultaneous increment in the prevalence of obesity and allergic diseases suggests a possible link between them. This review focuses on the consequences of obesity on allergic diseases, especially asthma in children and adolescents, and evaluates the available evidence on the possible mechanisms. Obesity is related more strongly to nonatopic than atopic asthma, suggesting non-eosinophilic inflammation and Th1 polarization. Among other allergic diseases, the association is more consistent with eczema compared to allergic rhinitis/rhinoconjunctivitis. The mechanisms of asthma in obese individuals could involve mechanical effects of obesity on lung function, adipokines-mediated inflammation, shared factors (diet, genetics, sedentary lifestyle) and comorbidities. PMID:25282288

  1. Pathogenesis of rhinitis.

    PubMed

    Eifan, A O; Durham, S R

    2016-09-01

    Rhinitis is a heterogeneous condition that has been associated with inflammatory responses as in allergic rhinitis but can also occur in the absence of inflammation such as in so-called idiopathic (previously 'vasomotor') rhinitis. Allergic rhinitis affects approximately one in four of the population of westernized countries and is characterized by typical symptoms of nasal itching, sneezing, watery discharge and congestion. The intention of this review is to illustrate key concepts of the pathogenesis of rhinitis. Imbalance in innate and adaptive immunity together with environmental factors is likely to play major roles. In allergic rhinitis, initial allergen exposure and sensitization involves antigen-presenting cells, T and B lymphocytes and results in the generation of allergen-specific T cells and allergen-specific IgE antibodies. On re-exposure to relevant allergens, cross-linking of IgE on mast cells results in the release of mediators of hypersensitivity such as histamine and immediate nasal symptoms. Within hours, there is an infiltration by inflammatory cells, particularly Th2 T lymphocytes, eosinophils and basophils into nasal mucosal tissue that results in the late-phase allergic response. Evidence for nasal priming and whether or not remodelling may be a feature of allergic rhinitis will be reviewed. The occurrence of so-called local allergic rhinitis in the absence of systemic IgE will be discussed. Non-allergic (non-IgE-mediated) rhinitis will be considered in the context of inflammatory and non-inflammatory disorders. PMID:27434218

  2. [Occupational rhinitis].

    PubMed

    Endre, László

    2010-06-01

    Occupational rhinitis (OR) is an inflammatory disease of the nose, which is characterized by intermittent or persistent symptoms, arising out of causes and conditions attributable to a particular work environment and not to stimuli encountered outside the workplace. Its clinical symptoms (nasal congestion, sneezing, rhinorrhea, itching, nasal airflow limitation) are very similar with the symptoms of the allergic rhinitis caused by other (classical) agents. According to the 27/1996 NM Departmental Order, OR in Hungary is a notifiable disease. Despite, between year 1997 and 2009, not even a single case was reported in Hungary. In the last 20 years the only Hungarian reference in this field was published in 2004, in the Textbook of Occupational Medicine, edited by Ungváry. This disease is not unknown in other European countries. It can be produced by both high and low molecular weight agents. For example, according to the publications, its prevalence among bakers can be 18-29%, and among workers with diisocyanates (painters, urethane mould workers) 36-42%. Risk factors are atopy, high concentration and multiple irritant agents in the air of workplace. Atopy has been associated with an increased risk of specific sensitization to a variety of HMW agents. Beside of the clinical and occupational history, objective investigations have to be used as well, for the diagnosis of OR. The gold standard for confirming the diagnosis of OR is the nasal provocation test. Objective methods that can be used for assessing nasal patency during the investigation of OR include rhinomanometry, acoustic rhinometry, peak nasal inspiratory flow, and gravimetry of the nasal secret. The management of the OR needs environmental interventions. These are: increasing the ventilation, decreasing the time of exposure, substitution of the irritant agent, investigation of possible asthma in all workers with OR. Medical treatments are: oral antihistamines, local (nasal) corticosteroids, combined

  3. RELATIVE POTENCY OF FUNGAL EXTRACTS IN INDUCING ALLERGIC ASTHMA-LIKE RESPONSES IN BALB/C MICE

    EPA Science Inventory

    Indoor mold has been associated with the development of allergic asthma. However, relative potency of molds in the induction of allergic asthma is not clear. In this study, we tested the relative potency of fungal extracts (Metarizium anisophilae [MACA], Stachybotrys ...

  4. Therapeutic strategies for allergic diseases

    NASA Astrophysics Data System (ADS)

    Barnes, Peter J.

    1999-11-01

    Many drugs are now in development for the treatment of atopic diseases, including asthma, allergic rhinitis and atopic dermatitis. These treatments are based on improvements in existing therapies or on a better understanding of the cellular and molecular mechanisms involved in atopic diseases. Although most attention has been focused on asthma, treatments that inhibit the atopic disease process would have application to all atopic diseases, as they often coincide. Most of the many new therapies in development are aimed at inhibiting components of the allergic inflammatory response, but in the future there are real possibilities for the development of preventative and even curative treatments.

  5. Local expression of interleukin-17a is correlated with nasal eosinophilia and clinical severity in allergic rhinitis

    PubMed Central

    Makihara, Seiichiro; Fujiwara, Tazuko; Noda, Yohei; Higaki, Takaya; Miyateke, Tomomi; Kanai, Kengo; Haruna, Takenori; Kariya, Shin; Nishizaki, Kazunori

    2014-01-01

    Interleukin (IL)-17A is a major cytokine produced by Th17 cells, which are associated with chronic inflammations. The local expression of IL-17A in allergic rhinitis (AR) remains to be characterized. We sought to determine the role of IL-17A expression in human inferior turbinate mucosa in the pathophysiology of AR. Inferior turbinate mucosa was sampled from medical treatment–resistant, surgery-required patients with perennial AR (PAR, n = 21), nonallergic rhinitis with eosinophilia syndrome (NARES, n = 7), and nonallergic hypertrophic rhinitis (HR, n = 13). IL-17A expression was determined with immunohistochemical staining. The mean number of IL-17A+ cells and eosinophils per field were counted. Total serum immunoglobulin E (IgE) levels, blood eosinophil count, and forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) ratio were also examined in each patient. IL-17A was primarily expressed in infiltrating inflammatory cells. The number of IL-17A+ cells in nasal mucosa was significantly higher in the PAR group compared with HR (p = 0.002) and NARES (p = 0.021) groups. There was a significant and positive correlation between the number of IL-17A+ cells and total nasal symptom score (rho = 0.403; p = 0.011), especially sneezing score (rho = 0.471; p = 0.003). The number of IL-17A+ cells was significantly and positively correlated with the degree of eosinophil infiltration (rho = 0.623; p < 0.001), but not with total serum IgE levels (rho = 0.284; p = 0.098), blood eosinophil counts (rho = 0.302; p = 0.056), or FEV1/FVC ratio (rho = 0.092; p = 0.569). The present study provides evidence that IL-17A expression in the nasal mucosa is associated with the pathophysiology of AR, including disease severity and nasal eosinophilia. PMID:24758732

  6. Efficacy of Sublingual Immunotherapy with Dermatophagoides farinae Extract in Monosensitized and Polysensitized Patients with Allergic Rhinitis: Clinical Observation and Analysis

    PubMed Central

    Xu, Chen-Xia; Zhang, Miao-Lian; Li, Bi-Zhou; He, Ying; Zou, Ze-Hong; Wu, Qiu-Rong; Tao, Ai-Lin; Lai, He; Sun, Jin-Lu

    2015-01-01

    Aim. To investigate differences in the efficacy of sublingual immunotherapy with Dermatophagoides farinae drops in monosensitized and polysensitized allergic rhinitis patients. Methods. The patients enrolled in the study were treated for more than one year by sublingual immunotherapy (SLIT) using Dermatophagoides farinae drops and were divided into a monosensitized group (n = 20) and a polysensitized group (n = 30). Total nasal symptom scores of patients before and after SLIT were analyzed to evaluate the curative effect. The phylogenetic tree of dust mite allergens as well as other allergens that were tested by skin prick test was constructed to help the analysis. Results. There was no significant difference in the efficacy of SLIT between dust mite monosensitized and polysensitized patients. Conclusions. Both dust mite monosensitized and polysensitized patients could be cured by SLIT using Dermatophagoides farinae drops. This study provides a reference for the selection of allergens to be used in immunotherapy for polysensitized AR patients. PMID:26000283

  7. Effectiveness of allergic rhinitis treatments in real-life with a focus on MP-AzeFlu.

    PubMed

    Klimek, Ludger; Demoly, Pascal; Price, David

    2016-01-01

    For any allergic rhinitis (AR) treatment, it is crucial to provide evidence not only of efficacy (assessed in randomized controlled trials (RCTs)) but also of effectiveness in real-life. Observational studies provide valuable data on the use and results associated with interventions prescribed in real-life. However, real-life evidence supporting available AR treatment options is sparse with effectiveness only established for oral antihistamines (desloratadine, ebastine), intranasal corticosteroids (mometasone furoate, fluticasone propionate (FP)), allergen immunotherapy and omalizumab. A novel intranasal formulation of azelastine hydrochloride and FP in a single spray (MP-AzeFlu) shows great promise, with the effectiveness observed in real-life exceeding that noted in RCTs. This review summarises real-life data on MP-AzeFlu, which provides rapid and sustained symptom control irrespective of patient age, AR phenotype or disease severity. We call for high quality real-life research in addition to RCTs to inform future AR treatment guidelines. PMID:26839083

  8. Prevalence of asthma, rhinitis and eczema among children in 2 Canadian cities: the International Study of Asthma and Allergies in Childhood

    PubMed Central

    Habbick, B F; Pizzichini, M M; Taylor, B; Rennie, D; Senthilselvan, A; Sears, M R

    1999-01-01

    BACKGROUND: Wide variations in the prevalence of asthma, rhinitis and eczema have been reported between regions within Canada and between different countries. The International Study of Asthma and Allergies in Childhood (ISAAC) was developed to provide a standardized tool and methodology to ascertain the prevalence of asthma and allergies in different regions. Comparisons of prevalence rates across geographic regions and at different times may help to identify factors that contribute to the development of these conditions in individuals. METHODS: Two Canadian centres, Hamilton and Saskatoon, participated in the ISAAC. A standard questionnaire was distributed through schools and completed by 13- and 14-year-old children and by the parents of 6- and 7-year-old children. Prevalence rates and 95% confidence intervals were calculated for asthma, wheezing, rhinitis and eczema. RESULTS: The overall response rates were 75.1% among the children 6 and 7 years old and 68.6% among those 13 and 14 years old. Among the younger children, the lifetime prevalence of asthma was 17.2% in Hamilton and 11.2% in Saskatoon; the corresponding rates among the older children were 19.2% and 12.2% respectively. The prevalence of wheezing in the 12 months before the survey in the younger group was 20.1% in Hamilton and 14.1% in Saskatoon; in the older group it was 30.6% and 24.0% respectively. The prevalence of rhinitis in the 12 months before the survey was 28.6% in Hamilton and 22.6% in Saskatoon in the younger group and 45.8% and 33.8% respectively in the older group. The prevalence of eczema was slightly higher in Saskatoon in both age groups. INTERPRETATION: High prevalence rates of asthma, rhinitis and eczema exist among school children in Hamilton and Saskatoon, similar to rates in other Western countries. Further studies are required to determine the factors associated with the high rates in the 2 regions and possible reasons for the higher rates in Hamilton. PMID:10405666

  9. Inhibition of release of inflammatory mediators in primary and cultured cells by a Chinese herbal medicine formula for allergic rhinitis

    PubMed Central

    Lenon, George B; Xue, Charlie CL; Story, David F; Thien, Frank CK; McPhee, Sarah; Li, Chun G

    2007-01-01

    Background We demonstrated that a Chinese herbal formula, which we refer to as RCM-101, developed from a traditional Chinese medicine formula, reduced nasal and non-nasal symptoms of seasonal allergic rhinitis (SAR). The present study in primary and cultured cells was undertaken to investigate the effects of RCM-101 on the production/release of inflammatory mediators known to be involved in SAR. Methods Compound 48/80-induced histamine release was studied in rat peritoneal mast cells. Production of leukotriene B4 induced by the calcium ionophore A23187 was studied in porcine neutrophils using an HPLC assay and lipopolysaccharide-stimulated prostaglandin E2 production was studied in murine macrophage (Raw 264.7) cells by immune-enzyme assay. Expression of cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) was determined in Raw 264.7 cells, using western blotting techniques. Results RCM-101 (1–100 μg/mL) produced concentration-dependent inhibition of compound 48/80-induced histamine release from rat peritoneal mast cells and of lipopolysaccharide-stimulated prostaglandin E2 release from Raw 264.7 cells. Over the range 1 – 10 μg/mL, it inhibited A23187-induced leukotriene B4 production in porcine neutrophils. In addition, RCM-101 (100 μg/mL) inhibited the expression of COX-2 protein but did not affect that of COX-1. Conclusion The findings indicate that RCM-101 inhibits the release and/or synthesis of histamine, leukotriene B4 and prostaglandin E2 in cultured cells. These interactions of RCM-101 with multiple inflammatory mediators are likely to be related to its ability to reduce symptoms of allergic rhinitis. PMID:17302969

  10. Safety and efficacy of terfenadine/pseudoephedrine versus clemastine/phenylpropanolamine in the treatment of seasonal allergic rhinitis.

    PubMed

    Segal, A T; Falliers, C J; Grant, J A; Podleski, W K; Woehler, T R; Huster, W J; McNutt, B

    1993-05-01

    A double-blind, randomized, placebo-controlled, parallel trial was conducted to compare the efficacy and safety of terfenadine, 60 mg (immediate-release)/pseudoephedrine hydrochloride, 120 mg (controlled-release) (T/Ps) and clemastine fumarate, 1.34 mg (immediate-release)/phenylpropanolamine, 75 mg (sustained-release) (C/Ph) in a combination tablet b.i.d. in 178 patients (12-59 years of age) with symptoms of seasonal allergic rhinitis. After seven days of treatment, the total symptom scores recorded in the diaries of 175 patients showed that both therapies had a highly significant overall treatment effect when compared with placebo (P < or = .02). The overall level of improvement, as well as improvement of individual symptoms, was similar with the two therapies. Total symptom scores assigned by physicians to 170 patients showed significant and similar levels of improvement with both therapies when compared with placebo (P < .01). The two therapies were also similar on physicians' evaluations of overall effectiveness. Both therapies relieved most histamine-mediated symptoms as well as nasal congestion, although only T/Ps showed improvement of the latter symptom in both the patients' diaries and physicians' evaluations. Among 178 patients, drowsiness and fatigue occurred more often in the C/Ph group (25% and 11.7% for the two adverse events, respectively) than in the T/Ps group (10.2% and 1.7%, respectively). The incidence of insomnia and dry mouth/nose/throat was higher with T/Ps (23.7% and 11.9%, respectively) than with C/Ph (6.7% and 3.3%, respectively). No serious or unexpected adverse events were reported. These results indicate that T/Ps and C/Ph are both superior to placebo and equally effective in the treatment of symptoms of seasonal allergic rhinitis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8498730

  11. The effect of allergic rhinitis on the degree of stress, fatigue and quality of life in OSA patients.

    PubMed

    Park, Cheol Eon; Shin, Seung Youp; Lee, Kun Hee; Cho, Joong Saeng; Kim, Sung Wan

    2012-09-01

    Both allergic rhinitis (AR) and obstructive sleep apnea (OSA) are known to increase stress and fatigue, but the result of their coexistence has not been studied. The objective of this study was to evaluate the amount of stress and fatigue when AR is combined with OSA. One hundred and twelve patients diagnosed with OSA by polysomnography were enrolled. Among them, 37 patients were diagnosed with AR by a skin prick test and symptoms (OSA-AR group) and 75 patients were classified into the OSA group since they tested negative for allergies. We evaluated the Epworth sleepiness scale (ESS), stress score, fatigue score, ability to cope with stress, and rhinosinusitis quality of life questionnaire (RQLQ) with questionnaires and statistically compared the scores of both groups. There were no significant differences in BMI and sleep parameters such as LSAT, AHI, and RERA between the two groups. However, the OSA-AR group showed a significantly higher ESS score compared to the OSA group (13.7 ± 4.7 vs. 9.3 ± 4.8). Fatigue scores were also significantly higher in the OSA-AR group than in the OSA group (39.8 ± 11.0 vs. 30.6 ± 5.4). The OSA-AR group had a significantly higher stress score (60.4 ± 18.6 vs. 51.2 ± 10.4). The ability to cope with stress was higher in the OSA group, although this difference was not statistically significant. RQLQ scores were higher in the OSA-AR group (60.2 ± 16.7 compared to 25.1 ± 13.9). In conclusion, management of allergic rhinitis is very important in treating OSA patients in order to eliminate stress and fatigue and to minimize daytime sleepiness and quality of life. PMID:22207526

  12. Rhinitis, Asthma and Respiratory Infections among Adults in Relation to the Home Environment in Multi-Family Buildings in Sweden

    PubMed Central

    Wang, Juan; Engvall, Karin; Smedje, Greta; Norbäck, Dan

    2014-01-01

    Risk factors for rhinitis, asthma and respiratory infections in the home environment were studied by a questionnaire survey. Totally 5775 occupants (≥18 years old) from a stratified random sample of multi-family buildings in Sweden participated (46%). 51.0% had rhinitis in the last 3 months (current rhinitis); 11.5% doctor diagnosed asthma; 46.4% respiratory infections in the last 3 months and 11.9% antibiotic medication for respiratory infections in the last 12 months. Associations between home environment and health were analyzed by multiple logistic regression, controlling for gender, age and smoking and mutual adjustment. Buildings constructed during 1960–1975 were risk factors for day time breathlessness (OR = 1.53, 95%CI 1.03–2.29). And those constructed during 1976–1985 had more current rhinitis (OR = 1.43, 95%CI 1.12–1.84) and respiratory infections (OR = 1.46, 95%CI 1.21–1.78). Cities with higher population density had more current rhinitis (p = 0.008) and respiratory infections (p<0.001). Rented apartments had more current rhinitis (OR = 1.23, 95%CI 1.07–1.40), wheeze (OR = 1.20, 95%CI 1.02–1.41), day time breathlessness (OR = 1.31, 95%CI 1.04–1.66) and respiratory infections (OR = 1.13, 95%CI 1.01–1.26). Living in colder parts of the country was a risk factor for wheeze (p = 0.03) and night time breathlessness (p = 0.002). Building dampness was a risk factor for wheeze (OR = 1.42, 95%CI 1.08–1.86) and day time breathlessness (OR = 1.57, 95%CI 1.09–2.27). Building dampness was a risk factor for health among those below 66 years old. Odor at home was a risk factor for doctor diagnosed asthma (OR = 1.49, 95%CI 1.08–2.06) and current asthma (OR = 1.52, 95%CI 1.03–2.24). Environmental tobacco smoke (ETS) was a risk factor for current asthma (OR = 1.53, 95%CI 1.09–2.16). Window pane condensation was a risk factor for antibiotic medication for respiratory infections (OR

  13. Time trends of the prevalence of asthma and allergic disease in Austrian children.

    PubMed

    Schernhammer, E S; Vutuc, C; Waldhör, T; Haidinger, G

    2008-03-01

    After a substantial increase in the prevalence of atopic disease in Europe, recent studies indicate that a plateau has been reached. However, variation across countries and age groups exists. We studied the prevalence and time trends of asthma and allergic disease among schoolchildren in Austria, a country with traditionally low rates of asthma, hay fever, and eczema. As part of the International Study of Asthma and Allergies in Childhood (ISAAC), symptoms and physician diagnoses of asthma and allergic disease of 13,399 Austrian children aged 6-7 yr and 1516 children aged 12-14 yr were surveyed between 1995 and 1997. A similar survey was conducted between 2001 and 2003. Among children aged 6-7 yr, significant increases were seen in the prevalence of physician-diagnosed asthma (+16%; p = 0.013), hay fever (+22%; p < 0.001), and eczema (+37%; p < 0.001) between 1995 and 2003. These changes were paralleled by an increase in the prevalence of symptoms typical for hay fever (itchy eyes and runny nose), but not by an increase in wheeze. Among children aged 12-14 yr, the lifetime prevalence of diagnosed asthma increased by 32%, of hay fever by 19%, and of eczema by 28% (all, p < 0.001). These changes were paralleled by increases in the prevalence of wheezing as documented by both questions before and after a video showing wheezing children but not by symptoms typical for hay fever such as itchy eyes and runny nose. In conclusion, in Austria, contrary to other European countries, the prevalence of asthma and allergic disease increased among schoolchildren. Additional studies are needed to continue monitoring the dynamics of the prevalence of asthma and allergic disease in Austria and to explore trends in their risk factors. PMID:18086231

  14. [Allergic inflammation in respiratory system].

    PubMed

    An, Lifeng; Wang, Yanshu; Li, Lin

    2015-02-01

    The pathophysiology of allergic disease such as asthma and allergic rhinitis tell the similar story: when the endogenous and exogenous inflammatory mechanisms occur disorder, the body may begin with inflammatory cell activation, namely through the release of cytokine and inflammatory mediator role in the corresponding target cells, activate the sensory nerve fiber, acting on the cell organ specificity effect, clinical symptoms. This article is divided into the following five parts focused on the research progress of allergic inflammatory diseases: (1) inflammatory cells; (2) staphylococcus aureus superantigen; (3) small molecules (cytokines, inflammatory mediators, lipid classes medium); (4) nerve fibers and effect cells; (5) genetic and epigenetic factors. PMID:26012309

  15. Association between exposure to antimicrobial household products and allergic symptoms

    PubMed Central

    Hong, Soyoung; Kwon, Ho-Jang; Choi, Won-Jun; Lim, Wan Ryung; Kim, Jeonghoon; Kim, KyooSang

    2014-01-01

    Objectives Antimicrobial chemicals are used in a variety of household and personal care products. Exposure to antimicrobial household products has been hypothesized to lead to allergic diseases in children. Methods We investigated antimicrobial household product exposure and allergic symptoms in Korean children. An antimicrobial exposure (AE) score was derived. To examine the symptoms of allergic diseases (current wheeze, current rhinitis, and current eczema) in the past 12 months, we used a questionnaire based on the core module of the International Study of Asthma and Allergies in Children. Complete data for the analysis were available for 25,805 of the 35,590 (72.5%) children. Results The prevalence of current allergic diseases was as follows: wheeze, 5.6%; allergic rhinitis, 32.6%; and eczema, 17.7%. The mean (standard deviation) AE score was 14.3 (9.3) (range: 0-40). Compared with subjects with a low AE score (reference), subjects with a high AE score (fourth quartile) were more likely to have symptoms of wheezing and allergic rhinitis (adjusted odds ratio [aOR] for wheezing 1.24, 95% confidence interval [CI], 1.05-1.45, p for trend=0.24; aOR for allergic rhinitis 1.30, 95% CI, 1.20-1.40, p<0.01). Conclusions These findings suggest that frequent use of antimicrobial household products was associated with current wheeze and current allergic rhinitis. PMID:25420879

  16. Immunization with live influenza viruses in an experimental model of allergic bronchial asthma: infection and vaccination

    PubMed Central

    Chirkova, Tatiana; Petukhova, Galina; Korenkov, Daniil; Naikhin, Anatoliy; Rudenko, Larisa

    2008-01-01

    Background  Asthmatics in particular have a need for influenza vaccines because influenza infection is a frequent cause of hospitalization of patients with bronchial asthma. Currently, only inactivated influenza vaccines are recommended for influenza prevention in asthma sufferers. Objective  The aim of our study was to analyze and compare the effects of influenza infection and vaccination with live attenuated influenza vaccine (LAIV) on different phases of experimental murine allergic bronchial asthma (acute asthma and remission phase) and on subsequent exposure to allergen in sensitized animals. Methods  Ovalbumin (OVA)‐specific serum IgE levels, IL‐4 production by spleen and lung lymphocytes, and histological changes in the lungs of mice infected with pathogenic virus or LAIV were studied at two phases of OVA‐induced bronchial asthma (acute asthma and remission). Results  Infection with pathogenic virus both in acute asthma and remission led to asthma exacerbation associated with the production of OVA‐specific IgE, IL‐4 and significant inflammatory infiltration in airways. Infection, even after complete virus clearance, induced the aggravation of lung inflammation and IgE production in asthmatic mice additionally exposed to OVA. Immunization with LAIV at remission did not enhance allergic inflammatory changes in the lung, OVA‐specific IgE or IL‐4 production. Then after additional OVA exposure, histological and immunological changes in these mice were the same as in the control group. Conclusions  Influenza infection provokes asthma exacerbation regardless of the disease phase. Immunization with LAIV during the remission phase of bronchial asthma is safe and does not interfere upon subsequent contact of asthma sufferers with allergen. PMID:19453421

  17. New occupational and environmental causes of asthma and extrinsic allergic alveolitis.

    PubMed

    Fishwick, David

    2012-12-01

    Asthma and extrinsic allergic alveolitis (EAA) remain prevalent respiratory diseases and the cause of a significant disease burden. This article reviews the recent occupational and environmental causes described for these conditions. Even over the limited time spam addressed by this article, novel agents and new data relating to already suggested causes have been described. Various types of work tasks or exposures are described that appear to cause both asthma and EAA. Isocyanates, the best example of dual potential to cause asthma and EAA are discussed, as is the new understanding of the role metal-working fluids play when causing respiratory diseases. PMID:23153603

  18. Murine allergic rhinitis and nasal Th2 activation are mediated via TSLP- and IL-33-signaling pathways.

    PubMed

    Akasaki, Shoko; Matsushita, Kazufumi; Kato, Yukinori; Fukuoka, Ayumi; Iwasaki, Naruhito; Nakahira, Masakiyo; Fujieda, Shigeharu; Yasuda, Koubun; Yoshimoto, Tomohiro

    2016-02-01

    Thymic stromal lymphopoietin (TSLP) and IL-33 are epithelium-derived proallergic cytokines that contribute to allergic diseases. Although the involvement of TSLP in allergic rhinitis (AR) is suggested, the exact role of TSLP in AR is poorly understood. Furthermore, the relative contribution of TSLP and IL-33 in nasal allergic responses has not been described. In this study, we examined the roles of TSLP and IL-33 in AR by analyzing acute and chronic AR models. Acute AR mice were intraperitoneally immunized with ragweed, then intranasally challenged with ragweed pollen for four consecutive days. Chronic AR mice were nasally administrated ragweed pollen on consecutive days for 3 weeks. In both models, TSLP receptor (TSLPR)-deficient mice showed defective sneezing responses and reduced serum ragweed-specific IgE levels compared with wild-type (WT) mice. Analyses of bone-marrow chimeric mice demonstrated that hematopoietic cells were responsible for defective sneezing in TSLPR-deficient mice. In addition, FcεRI(+)-cell-specific TSLPR-deficient mice showed partial but significant reduction in sneezing responses. Of note, Th2 activation and nasal eosinophilia were comparable between WT and TSLPR-deficient mice. ST2- and IL-33-deficient mice showed defective Th2 activation and nasal eosinophilia to acute, but not chronic, ragweed exposure. TSLPR and ST2 double-deficient mice showed defective Th2 activation and nasal eosinophilia even after chronic ragweed exposure. These results demonstrate that TSLPR signaling is critical for the early phase response of AR by controlling the IgE-mast-cell/basophil pathway. The IL-33/ST2 pathway is central to nasal Th2 activation during acute allergen exposure, but both TSLPR and ST2 contribute to Th2 responses in chronically allergen-exposed mice. PMID:26428949

  19. The genetics of asthma and allergic disease: a 21st century perspective.

    PubMed

    Ober, Carole; Yao, Tsung-Chieh

    2011-07-01

    Asthma and allergy are common conditions with complex etiologies involving both genetic and environmental contributions. Recent genome-wide association studies (GWAS) and meta-analyses of GWAS have begun to shed light on both common and distinct pathways that contribute to asthma and allergic diseases. Associations with variation in genes encoding the epithelial cell-derived cytokines, interleukin-33 (IL-33) and thymic stromal lymphopoietin (TSLP), and the IL1RL1 gene encoding the IL-33 receptor, ST2, highlight the central roles for innate immune response pathways that promote the activation and differentiation of T-helper 2 cells in the pathogenesis of both asthma and allergic diseases. In contrast, variation at the 17q21 asthma locus, encoding the ORMDL3 and GSDML genes, is specifically associated with risk for childhood onset asthma. These and other genetic findings are providing a list of well-validated asthma and allergy susceptibility genes that are expanding our understanding of the common and unique biological pathways that are dysregulated in these related conditions. Ongoing studies will continue to broaden our understanding of asthma and allergy and unravel the mechanisms for the development of these complex traits. PMID:21682736

  20. Allergic Patients with Long-Term Asthma Display Low Levels of Bifidobacterium adolescentis.

    PubMed

    Hevia, Arancha; Milani, Christian; López, Patricia; Donado, Carmen D; Cuervo, Adriana; González, Sonia; Suárez, Ana; Turroni, Francesca; Gueimonde, Miguel; Ventura, Marco; Sánchez, Borja; Margolles, Abelardo

    2016-01-01

    Accumulated evidence suggests a relationship between specific allergic processes, such as atopic eczema in children, and an aberrant fecal microbiota. However, little is known about the complete microbiota profile of adult individuals suffering from asthma. We determined the fecal microbiota in 21 adult patients suffering allergic asthma (age 39.43 ± 10.98 years old) and compare it with the fecal microbiota of 22 healthy controls (age 39.29 ± 9.21 years old) using culture independent techniques. An Ion-Torrent 16S rRNA gene-based amplification and sequencing protocol was used to determine the fecal microbiota profile of the individuals. Sequence microbiota analysis showed that the microbial alpha-diversity was not significantly different between healthy and allergic individuals and no clear clustering of the samples was obtained using an unsupervised principal component analysis. However, the analysis of specific bacterial groups allowed us to detect significantly lower levels of bifidobacteria in patients with long-term asthma. Also, in allergic individuals the Bifidobacterium adolescentis species prevailed within the bifidobacterial population. The reduction in the levels on bifidobacteria in patients with long-term asthma suggests a new target in allergy research and opens possibilities for the therapeutic modulation of the gut microbiota in this group of patients. PMID:26840903

  1. Allergic Patients with Long-Term Asthma Display Low Levels of Bifidobacterium adolescentis

    PubMed Central

    Hevia, Arancha; Milani, Christian; López, Patricia; Donado, Carmen D.; Cuervo, Adriana; González, Sonia; Suárez, Ana; Turroni, Francesca; Gueimonde, Miguel; Ventura, Marco; Sánchez, Borja; Margolles, Abelardo

    2016-01-01

    Accumulated evidence suggests a relationship between specific allergic processes, such as atopic eczema in children, and an aberrant fecal microbiota. However, little is known about the complete microbiota profile of adult individuals suffering from asthma. We determined the fecal microbiota in 21 adult patients suffering allergic asthma (age 39.43 ± 10.98 years old) and compare it with the fecal microbiota of 22 healthy controls (age 39.29 ± 9.21 years old) using culture independent techniques. An Ion-Torrent 16S rRNA gene-based amplification and sequencing protocol was used to determine the fecal microbiota profile of the individuals. Sequence microbiota analysis showed that the microbial alpha-diversity was not significantly different between healthy and allergic individuals and no clear clustering of the samples was obtained using an unsupervised principal component analysis. However, the analysis of specific bacterial groups allowed us to detect significantly lower levels of bifidobacteria in patients with long-term asthma. Also, in allergic individuals the Bifidobacterium adolescentis species prevailed within the bifidobacterial population. The reduction in the levels on bifidobacteria in patients with long-term asthma suggests a new target in allergy research and opens possibilities for the therapeutic modulation of the gut microbiota in this group of patients. PMID:26840903

  2. Halting the allergic march.

    PubMed

    Van Bever, Hugo P; Samuel, Sudesh T; Lee, Bee Wah

    2008-04-01

    The prevalence of childhood allergic diseases, such as allergic asthma, allergic rhinitis, and atopic dermatitis, has increased exponentially. In Singapore, the prevalence of asthma at all ages exceeds 20%, and around 50% of Singaporean children show features of an underlying allergy. The exact environmental causes for the increase of allergic diseases have not yet been identified, but most researchers agree that a decreased bacterial load in young children may be one of the reasons for the increase. However, the causes of allergy are multiple, and the development of an allergic disease is the result of complex interactions between genetic constitution and environmental factors. In this review article, different aspects of allergic sensitization are covered, including prenatal and postnatal sensitization. The phenomenon of the "allergic march" (switching from one clinical expression of allergy to another) and its underlying mechanisms are discussed. The last part of this review article is on prevention and treatment of allergic diseases, including the role of bacterial products (probiotics, prebiotics, and synbiotics) and the role of immunotherapy, including sublingual immunotherapy. PMID:23283392

  3. French multicentre double-blind study to evaluate the efficacy and safety of acrivastine as compared with terfenadine in seasonal allergic rhinitis.

    PubMed

    Gervais, P; Bruttman, G; Pedrali, P; Charpin, J; Michel, F B; Grilliat, J P

    1989-01-01

    In this double-blind, multicentre study the antihistamine acrivastine was compared with terfenadine for the treatment of seasonal allergic rhinitis. The study was divided into three periods which together lasted 56 days. Patients (n = 83) were randomly assigned treatment with either 8 mg acrivastine three times daily or 60 mg terfenadine twice daily. Both agents were equally efficacious in reducing the severity of sneezing, itchy nose, blocked nose, running nose, itchy eyes, watery eyes and itchy throat as recorded daily by patients, and as rated by both the patients and their physicians at the end of each treatment period. Acrivastine and terfenadine were equally well tolerated with no serious side-effects. Both effectively controlled the symptoms of seasonal allergic rhinitis in otherwise healthy individuals. PMID:2570002

  4. Prophylactic effects of the histamine H1 receptor antagonist epinastine and the dual thromboxane A2 receptor and chemoattractant receptor-homologous molecule expressed on Th2 cells antagonist ramatroban on allergic rhinitis model in mice.

    PubMed

    Suzuki, Yuh; Inoue, Toshio; Yamamoto, Atsuki; Sugimoto, Yukio

    2011-01-01

    The prophylactic use of anti-allergic drugs has been proposed to be effective in the treatment of seasonal allergic rhinitis in humans. However, there is little information regarding the prophylactic effect of thromboxane A(2) (TXA(2)) receptor antagonist on allergic rhinitis. Recent studies revealed that a TXA(2) receptor antagonist ramatroban could block the prostaglandin D(2) (PGD(2)) receptor and chemoattractant receptor-homologous molecule expressed on Th2 cells (CRTH2). In the present study, we investigated the prophylactic effects of the histamine H(1) receptor antagonist epinastine and the TXA(2) receptor antagonist ramatroban and seratrodast on mouse models of allergic rhinitis. Female BALB/c mice were sensitized by an intraperitoneal injection of ovalbumin and alum on days 0, 5, 14 and 21. Seven days later, mice were sensitized by intranasal application of ovalbumin thrice a week. Drugs were administered once a day from day 22. The severity of allergic rhinitis was assessed by determining the extent of 2 nasal allergic symptoms (sneezing and nasal rubbing). Histamine sensitivity and eosinophil infiltration into the nasal mucosa were also determined. Epinastine and ramatroban significantly reduced nasal symptoms and the number of eosinophils in the nasal mucosa. Seratrodast showed no effect on nasal symptoms and eosinophil infiltration into the nasal mucosa. In addition, histamine sensitivity was reduced by epinastine and ramatroban. These results indicate that epinastine and ramatroban induce the prophylactic effect on allergic rhinitis. PMID:21467637

  5. The Correlation between Chitin and Acidic Mammalian Chitinase in Animal Models of Allergic Asthma

    PubMed Central

    Shen, Chia-Rui; Juang, Horng-Heng; Chen, Hui-Shan; Yang, Ching-Jen; Wu, Chia-Jen; Lee, Meng-Hua; Hwang, Yih-Shiou; Kuo, Ming-Ling; Chen, Ya-Shan; Chen, Jeen-Kuan; Liu, Chao-Lin

    2015-01-01

    Asthma is the result of chronic inflammation of the airways which subsequently results in airway hyper-responsiveness and airflow obstruction. It has been shown that an elicited expression of acidic mammalian chitinase (AMCase) may be involved in the pathogenesis of asthma. Our recent study has demonstrated that the specific suppression of elevated AMCase leads to reduced eosinophilia and Th2-mediated immune responses in an ovalbumin (OVA)-sensitized mouse model of allergic asthma. In the current study, we show that the elicited expression of AMCase in the lung tissues of both ovalbumin- and Der P2-induced allergic asthma mouse models. The effects of allergic mediated molecules on AMCase expression were evaluated by utilizing promoter assay in the lung cells. In fact, the exposure of chitin, a polymerized sugar and the fundamental component of the major allergen mite and several of the inflammatory mediators, showed significant enhancement on AMCase expression. Such obtained results contribute to the basis of developing a promising therapeutic strategy for asthma by silencing AMCase expression. PMID:26580611

  6. Link between allergic asthma and airway mucosal infection suggested by proteinase-secreting household fungi.

    PubMed

    Porter, P; Susarla, S C; Polikepahad, S; Qian, Y; Hampton, J; Kiss, A; Vaidya, S; Sur, S; Ongeri, V; Yang, T; Delclos, G L; Abramson, S; Kheradmand, F; Corry, D B

    2009-11-01

    Active fungal proteinases are powerful allergens that induce experimental allergic lung disease strongly resembling atopic asthma, but the precise relationship between proteinases and asthma remains unknown. Here, we analyzed dust collected from the homes of asthmatic children for the presence and sources of active proteinases to further explore the relationship between active proteinases, atopy, and asthma. Active proteinases were present in all houses and many were derived from fungi, especially Aspergillus niger. Proteinase-active dust extracts were alone insufficient to initiate asthma-like disease in mice, but conidia of A. niger readily established a contained airway mucosal infection, allergic lung disease, and atopy to an innocuous bystander antigen. Proteinase produced by A. niger enhanced fungal clearance from lung and was required for robust allergic disease. Interleukin 13 (IL-13) and IL-5 were required for optimal clearance of lung fungal infection and eosinophils showed potent anti-fungal activity in vitro. Thus, asthma and atopy may both represent a protective response against contained airway infection due to ubiquitous proteinase-producing fungi. PMID:19710638

  7. Role of breast regression protein-39/YKL-40 in asthma and allergic responses

    PubMed Central

    Elias, Jack A

    2010-01-01

    BRP-39 and its human homolog YKL-40 have been regarded as a prototype of chitinase-like proteins (CLP) in mammals. Exaggerated levels of YKL-40 protein and/or mRNA have been noted in a number of diseases characterized by inflammation, tissue remodeling, and aberrant cell growth. Asthma is an inflammatory disease characterized by airway hyperresponsiveness and airway remodeling. Recently, the novel regulatory role of BRP-39/YKL-40 in the pathogenesis of asthma has been demonstrated both in human studies and allergic animal models. The levels of YKL-40 are increased in the circulation and lungs from asthmatics where they correlate with disease severity, and CHI3L1 polymorphisms correlate with serum YKL-40 levels, asthma and abnormal lung function. Animal studies using BRP-39 null mutant mice demonstrated that BRP-39 was required for optimal allergen sensitization and Th2 inflammation. These studies suggest the potential use of BRP-39 as a biomarker as well as a therapeutic target for asthma and other allergic diseases. Here, we present an overview of chitin/chitinase biology and summarize recent findings on the role of BRP-39 in the pathogenesis of asthma and allergic responses. PMID:20224674

  8. Discovery and optimization of a biphenylacetic acid series of prostaglandin D2 receptor DP2 antagonists with efficacy in a murine model of allergic rhinitis.

    PubMed

    Scott, Jill M; Baccei, Christopher; Bain, Gretchen; Broadhead, Alex; Evans, Jilly F; Fagan, Patrick; Hutchinson, John H; King, Christopher; Lorrain, Daniel S; Lee, Catherine; Prasit, Peppi; Prodanovich, Pat; Santini, Angelina; Stearns, Brian A

    2011-11-01

    Biphenylacetic acid (5) was identified through a library screen as an inhibitor of the prostaglandin D(2) receptor DP2 (CRTH2). Optimization for potency and pharmacokinetic properties led to a series of selective CRTH2 antagonists. Compounds demonstrated potency in a human DP2 binding assay and a human whole blood eosinophil shape change assay, as well as good oral bioavailability in rat and dog, and efficacy in a mouse model of allergic rhinitis following oral dosing. PMID:21958540

  9. Perinatal and Early Childhood Environmental Factors Influencing Allergic Asthma Immunopathogenesis

    PubMed Central

    Gaffin, Jonathan M.; Kanchongkittiphon, Watcharoot; Phipatanakul, Wanda

    2014-01-01

    Background The prevalence of asthma has increased dramatically over the past several decades. While hereditary factors are highly important, the rapid rise outstrips the pace of genomic variation. Great emphasis has been placed on potential modifiable early life exposures leading to childhood asthma. Methods We reviewed the recent medical literature for important studies discussing the role of the perinatal and early childhood exposures and the inception of childhood asthma. Results and Discussion Early life exposure to allergens (House dust mite (HDM), furred pets, cockroach, rodent and mold)air pollution (nitrogen dioxide (NO2), ozone (O3), volatile organic compounds (VOCs), and particulate matter (PM)) and viral respiratory tract infections (Respiratory syncytial virus (RSV) and human rhinovirus (hRV)) have been implicated in the development of asthma in high risk children. Conversely, exposure to microbial diversity in the perinatal period may diminish the development of atopy and asthma symptoms. PMID:24952205

  10. A panel study to evaluate quality of life assessments in patients suffering from allergic rhinitis after treatment with a Chinese herbal nasal drop.

    PubMed

    Chui, Shiu Hon; Shek, Siu Lam; Fong, Ming Yiu; Szeto, Yim Tong; Chan, Kelvin

    2010-04-01

    Allergic rhinitis impairs quality of life (QOL). To assess the changes in QOL of patients with perennial allergic rhinitis (PAR) after treatment with Allergic Rhinitis Nose Drops (ARND), 35 patients were divided into 2 groups in a randomized, double-blinded and placebo-controlled study, with a cross-over arrangement over 7 weeks, applying ARND or placebo. Group A (n = 20) started with ARND first for 2 weeks followed by a 3-week washout before placebo for the last 2 weeks, while Group B (n = 15) started with placebo first and finished with ARND after washout. The changes in Clinical Symptoms Score (CSS) and QOL were observed. A decrease in CSS was observed in patients of both groups after treatment with ARND, but no change was observed with the placebo. Group A patients also showed significant improvements in complexion and sleep (P < 0.05 for both) after treatment with ARND, but no change with the placebo. Group B patients showed significant improvements in appetite and digestion (P < 0.01) as well as joy (P < 0.05) after cross-over treatment with ARND, but no change with the placebo. ARND may have a therapeutic effect by relieving clinical symptoms and improving the QOL in patients with PAR. PMID:20014162

  11. Rupatadine 10 mg and cetirizine 10 mg in seasonal allergic rhinitis: a randomised, double-blind parallel study.

    PubMed

    Martínez-Cócera, C; De Molina, M; Martí-Guadaño, E; Pola, J; Conde, J; Borja, J; Pérez, I; Arnaiz, E; Izquierdo, I

    2005-01-01

    This randomised, double-blind, parallel-group, multicentre clinical trial evaluated the efficacy and safety of rupatadine, a new antihistamine with antiplatelet-activating factor (PAF) activity, and cetirizine in the treatment of patients with seasonal allergic rhinitis (SAR). A total 249 patients were randomised to receive rupatadine 10 mg once daily (127 patients) or cetirizine 10 mg (122 patients) for two weeks. The main efficacy variable was the mean total daily symptom score (mTDSS) and was based on the daily subjective assessment of the severity of each rhinitis symptom--nasal (runny nose, sneezing, nasal itching and nasal obstruction) and non-nasal (conjunctival itching, tearing, and pharyngeal itching)--recorded by patients in their diaries. The mTDSS was 0.7 for both treatment groups (intention to treat analysis). In the investigator's global evaluation of efficacy at the seventh day, 93.3% and 83.7% patients in the rupatadine and cetirizine groups, respectively, showed some or great improvement (p = 0.022). In the per protocol analysis (n = 181), runny nose at the seventh day of treatment was absent or mild in 81.1% of patients in the rupatadine group and in 68.6% of patients in the cetirizine group (p = 0.029). In any case statistical significance was not maintained at the second week. Overall, all treatments were well tolerated. Adverse events (AEs) were similar in both treatment groups, i.e. headache, somnolence and fatigue/asthenia as the most often reported. Somnolence was reported in 9.6% and 8.5% of patients treated with rupatadine or cetirizine, respectively. The most reported AEs (67%) were mild in intensity. Our results suggest that rupatadine 10 mg may be a valuable and safe alternative for the symptomatic treatment of SAR. PMID:15864879

  12. Estrogen Signaling Modulates Allergic Inflammation and Contributes to Sex Differences in Asthma

    PubMed Central

    Keselman, Aleksander; Heller, Nicola

    2015-01-01

    Asthma is a chronic airway inflammatory disease that affects ~300 million people worldwide. It is characterized by airway constriction that leads to wheezing, coughing, and shortness of breath. The most common treatments are corticosteroids and β2-adrenergic receptor antagonists, which target inflammation and airway smooth muscle constriction, respectively. The incidence and severity of asthma is greater in women than in men, and women are more prone to develop corticosteroid-resistant or “hard-to-treat” asthma. Puberty, menstruation, pregnancy, menopause, and oral contraceptives are known to contribute to disease outcome in women, suggesting a role for estrogen and other hormones impacting allergic inflammation. Currently, the mechanisms underlying these sex differences are poorly understood, although the effect of sex hormones, such as estrogen, on allergic inflammation is gaining interest. Asthma presents as a heterogeneous disease. In typical Th2-type allergic asthma, interleukin (IL)-4 and IL-13 predominate, driving IgE production and recruitment of eosinophils into the lungs. Chronic Th2-inflammation in the lung results in structural changes and activation of multiple immune cell types, leading to a deterioration of lung function over time. Most immune cells express estrogen receptors (ERα, ERβ, or the membrane-bound G-protein-coupled ER) to varying degrees and can respond to the hormone. Together these receptors have demonstrated the capacity to regulate a spectrum of immune functions, including adhesion, migration, survival, wound healing, and antibody and cytokine production. This review will cover the current understanding of estrogen signaling in allergic inflammation and discuss how this signaling may contribute to sex differences in asthma and allergy. PMID:26635789

  13. Allergic diseases and air pollution

    PubMed Central

    Lee, Suh-Young; Chang, Yoon-Seok

    2013-01-01

    The prevalence of allergic diseases has been increasing rapidly, especially in developing countries. Various adverse health outcomes such as allergic disease can be attributed to rapidly increasing air pollution levels. Rapid urbanization and increased energy consumption worldwide have exposed the human body to not only increased quantities of ambient air pollution, but also a greater variety of pollutants. Many studies clearly demonstrate that air pollutants potently trigger asthma exacerbation. Evidence that transportation-related pollutants contribute to the development of allergies is also emerging. Moreover, exposure to particulate matter, ozone, and nitrogen dioxide contributes to the increased susceptibility to respiratory infections. This article focuses on the current understanding of the detrimental effects of air pollutants on allergic disease including exacerbation to the development of asthma, allergic rhinitis, and eczema as well as epigenetic regulation. PMID:23956961

  14. Transcriptional Profiling of Th2 Cells Identifies Pathogenic Features Associated with Asthma.

    PubMed

    Seumois, Grégory; Zapardiel-Gonzalo, Jose; White, Brandie; Singh, Divya; Schulten, Veronique; Dillon, Myles; Hinz, Denize; Broide, David H; Sette, Alessandro; Peters, Bjoern; Vijayanand, Pandurangan

    2016-07-15

    Allergic asthma and rhinitis are two common chronic allergic diseases that affect the lungs and nose, respectively. Both diseases share clinical and pathological features characteristic of excessive allergen-induced type 2 inflammation, orchestrated by memory CD4(+) T cells that produce type 2 cytokines (Th2 cells). However, a large majority of subjects with allergic rhinitis do not develop asthma, suggesting divergence in disease mechanisms. Because Th2 cells play a pathogenic role in both these diseases and are also present in healthy nonallergic subjects, we performed global transcriptional profiling to determine whether there are qualitative differences in Th2 cells from subjects with allergic asthma, rhinitis, and healthy controls. Th2 cells from asthmatic subjects expressed higher levels of several genes that promote their survival as well as alter their metabolic pathways to favor persistence at sites of allergic inflammation. In addition, genes that enhanced Th2 polarization and Th2 cytokine production were also upregulated in asthma. Several genes that oppose T cell activation were downregulated in asthma, suggesting enhanced activation potential of Th2 cells from asthmatic subjects. Many novel genes with poorly defined functions were also differentially expressed in asthma. Thus, our transcriptomic analysis of circulating Th2 cells has identified several molecules that are likely to confer pathogenic features to Th2 cells that are either unique or common to both asthma and rhinitis. PMID:27271570

  15. Chapter 6: Nonallergic rhinitis.

    PubMed

    Shah, Rachna; McGrath, Kris G

    2012-01-01

    Nonallergic rhinitis represents a non-IgE-mediated group of disorders that share the symptoms of nasal congestion, rhinorrhea, sneezing, and/or postnasal discharge but not pruritus that characterizes allergic rhinitis. Nonallergic rhinitis may be divided into two broad categories, inflammatory and noninflammatory etiologies. The inflammatory causes include postinfectious (viral and bacterial), rhinitis associated with nasal polyps, and nonallergic rhinitis with eosinophilia, where eosinophils are present in nasal smears but skin testing for aeroallergens is negative. The noninflammatory causes include idiopathic nonallergic rhinitis (formerly referred to as vasomotor rhinitis or colloquially as an "overreactive nose"); rhinitis medicamentosa, which is medication-induced rhinitis; hormone related (pregnancy); systemic disease related (severe hypothyroidism); and structural defect related (deviated septum, head trauma causing cerebrospinal fluid rhinorrhea). The classic symptoms of idiopathic nonallergic rhinitis are nasal congestion, postnasal drip, and sneezing triggered by irritant odors, perfumes, wine, and weather changes. The diagnosis of rhinitis begins with a directed history and physical exam. Examination of the nasal cavity with attention to appearance of the septum and inferior turbinates is recommended. Skin testing for seasonal and perennial aeroallergens is helpful in establishing the presence or absence of IgE antibodies and to help differentiate nonallergic from allergic rhinitis. Topical H(1)-receptor antagonist (antihistamine) nasal sprays, intranasal steroids, intranasal anticholinergics, and oral decongestants are options for pharmacotherapy. It is important to inquire about hypertension, arrhythmias, insomnia, prostate hypertrophy, or glaucoma to prevent undesirable side effects associated with the oral decongestant pseudoephedrine. PMID:22794679

  16. Higher Dosage of HIFU Treatment May Lead to Higher and Longer Efficacy for Moderate to Severe Perennial Allergic Rhinitis

    PubMed Central

    Wei, Hongquan; Zhang, Yong; Shi, Lei; Zhang, Jingru; Xia, Yan; Zang, Jian; Yan, Aihui; Li, Wei; Jiang, Xuejun

    2013-01-01

    Objectives: This study was to compare the efficacies and side effects of high intensity focused ultrasound (HIFU) treatment for perennial allergic rhinitis (PAR) with regular and increased dosage. Study design: A prospectively assembled cohort was retrospectively analyzed through visual analogue scale (VAS). Methods: Regular dosage of HIFU treatment was applied to 56 PAR patients in group A. An increased dosage as twice as the regular one was applied to 48 patients in group B. Nasal obstruction, sneezing, rhinorrhea and rhinocnesmus, which were recognized as the four main symptoms of allergic rhinitis (AR), were evaluated before treatment, 3 months after treatment, and 1 year after treatment. The satisfaction of patients was also evaluated at 1 year postoperatively. Biopsy of the inferior turbinate and morphometric analysis were applied to 11 patients in group A and 10 in group B before HIFU treatment and 3 months after treatment. Results: Comparing the AR symptoms before treatment, There is no statistical difference observed between group A and B (p>0.05). The four main symptoms at 3 months and 1 year after treatment were all significantly improved (p<0.01) in both group A and B. The VAS scores of AR symptoms in Group B were lower than those in Group A at the same stage after treatment, especially at 1 year after treatment (p<0.05). Comparing the results at 3 months and 1 year after treatment, a tendency of recurrence of these symptoms was observed statistically in group A (p<0.05), but not in group B (p>0.05). More cases of nasal dryness and perirhinal swelling were found in group B than those in group A (p<0.05), while all side effects were mild and temporary. Patients in group B were more satisfied than those in group A (p=0.0866 >0.05), though not statistically significant. More reduction of the eosinophils, other inflammatory cells, and the submucosal glands was observed after HIFU treatment in group B than that in group A (p<0.05). Conclusions: A proper

  17. A randomised multicentre trial of acupuncture in patients with seasonal allergic rhinitis – trial intervention including physician and treatment characteristics

    PubMed Central

    2014-01-01

    Background In a large randomised trial in patients with seasonal allergic rhinitis (SAR), acupuncture was superior compared to sham acupuncture and rescue medication. The aim of this paper is to describe the characteristics of the trial’s participating physicians and to describe the trial intervention in accordance with the STRICTA (Standards for Reporting Interventions in Controlled Trials of Acupuncture) guidelines, to make details of the trial intervention more transparent to researchers and physicians. Methods ACUSAR (ACUpuncture in Seasonal Allergic Rhinitis) was a three-armed, randomised, controlled multicentre trial. 422 SAR patients were randomised to semi-standardised acupuncture plus rescue medication (RM, cetirizine), sham acupuncture plus RM or RM alone. We sent a questionnaire to trial physicians in order to evaluate their characteristics regarding their education about and experience in providing acupuncture. During the trial, acupuncturists were asked to diagnose all of their patients according to Chinese Medicine (CM) as a basis for the semi-standardised, individualized intervention in the acupuncture group. Every acupuncture point used in this trial had to be documented after each session Results Acupuncture was administered in outpatient clinics by 46 (mean age 47 ± 10 years; 24 female/ 22 male) conventionally-trained medical doctors (67% with postgraduate specialization such as internal or family medicine) with additional extensive acupuncture training (median 500 hours (1st quartile 350, 3rd quartile 1000 hours with 73% presenting a B-diploma in acupuncture training (350 hours)) and experience (mean 14 years in practice). The most reported traditional CM diagnosis was ‘wind-cold invading the lung’ (37%) and ‘wind-heat invading the lung’ (37%), followed by ‘lung and spleen qi deficiency’ (9%). The total number of needles used was higher in the acupuncture group compared to the sham acupuncture group (15.7 ± 2.5 vs. 10.0

  18. ALLERGIC ASTHMA AND THE DEVELOPING IMMUNE SYSTEM: A PILOT STUDY

    EPA Science Inventory

    Rationale: The predisposition towards atopic disease begins early in life, and that the risk of developing asthma is heightened following prenatal exposure to some compounds. Nonetheless, the effect of gestational aeroallergen exposure on the developing immune system is unclear....

  19. Helicobacter pylori infection prevents allergic asthma in mouse models through the induction of regulatory T cells.

    PubMed

    Arnold, Isabelle C; Dehzad, Nina; Reuter, Sebastian; Martin, Helen; Becher, Burkhard; Taube, Christian; Müller, Anne

    2011-08-01

    Atopic asthma is a chronic disease of the airways that has taken on epidemic proportions in the industrialized world. The increase in asthma rates has been linked epidemiologically to the rapid disappearance of Helicobacter pylori, a bacterial pathogen that persistently colonizes the human stomach, from Western societies. In this study, we have utilized mouse models of allergic airway disease induced by ovalbumin or house dust mite allergen to experimentally examine a possible inverse correlation between H. pylori and asthma. H. pylori infection efficiently protected mice from airway hyperresponsiveness, tissue inflammation, and goblet cell metaplasia, which are hallmarks of asthma, and prevented allergen-induced pulmonary and bronchoalveolar infiltration with eosinophils, Th2 cells, and Th17 cells. Protection against asthma was most robust in mice infected neonatally and was abrogated by antibiotic eradication of H. pylori. Asthma protection was further associated with impaired maturation of lung-infiltrating dendritic cells and the accumulation of highly suppressive Tregs in the lungs. Systemic Treg depletion abolished asthma protection; conversely, the adoptive transfer of purified Treg populations was sufficient to transfer protection from infected donor mice to uninfected recipients. Our results thus provide experimental evidence for a beneficial effect of H. pylori colonization on the development of allergen-induced asthma. PMID:21737881

  20. Association Pattern of Interleukin-1 Receptor-Associated Kinase-4 Gene Polymorphisms with Allergic Rhinitis in a Han Chinese Population

    PubMed Central

    Zhang, Yuan; Lin, Xiaoping; Desrosiers, Martin; Zhang, Wei; Meng, Na; Zhao, Liping

    2011-01-01

    Objective Interleukin-1 receptor-associated kinase-4 (IRAK-4) encodes a kinase that is essential for NF-kB activation in Toll-like receptor and T-cell receptor signaling pathways, indicating a possible crosstalk between innate and acquired immunities. We attempted to determine whether the polymorphisms in the Interleukin-1 receptor-associated kinase-4 (IRAK-4) gene are associated with allergic rhinitis (AR) in the Han Chinese population. Methods A population of 379 patients with AR and 333 healthy controls was studied. Blood was drawn for DNA extraction and total serum immunoglobulin E (IgE). A total of 11 single nucleotide polymorphisms (SNPs) in IRAK-4 were selected and individually genotyped. Results Significant allelic differences between cases and controls were obtained for the SNP of rs3794262 in the IRAK-4 gene. In the stratified analysis for gender, two SNPs (rs4251431 and rs6582484) in males appeared as significant associations. Subgroup analysis for the presence of different allergen sensitivities displayed associations only in the house dust mite-allergic cohorts (rs3794262, rs4251481). None of the selected SNPs in IRAK-4 was associated with total IgE level. The haplotype analyisis indicated GCCTGCGA was significantly associated with AR. The SNP-SNP interaction information analysis indicated that the selected sets of polymorphisms had no synergistic effect. Conclusions Our findings did not support the potential contribution of the IRAK-4 gene to serum IgE levels. However, the results demonstrated a gender- and allergen-dependant association pattern between polymorphisms in IRAK-4 and AR in Chinese population. PMID:21738793

  1. Increased expression of IRF4 and ETS1 in CD4+cells from patients with intermittent allergic rhinitis

    PubMed Central

    Bruhn, Sören; Barrenäs, Fredrik; Mobini, Reza; Andersson, Bengt A.; Chavali, Sreenivas; Egan, Brian S.; Hovig, Eivind; Sandve, Geir Kjetil; Langston, Michael A.; Rogers, Gary; Wang, Hui; Benson, Mikael

    2011-01-01

    Background The transcription factor (TF) IRF4 is involved in the regulation of Th1, Th2, Th9 and Th17 cells, and animal studies have indicated an important role in allergy. However, IRF4 and its target genes have not been examined in human allergy. Methods IRF4 and its target genes were examined in allergen-challenged CD4+ cells from patients with IAR using combined gene expression microarrays and chromatin immunoprecipitation chips (ChIP-chips), computational target prediction and RNAi knockdowns. Results IRF4 increased in allergen-challenged CD4+ cells from patients with IAR and functional studies supported its role in Th2 cell activation. IRF4 ChIP-chip showed that IRF4 regulated a large number of genes relevant for Th cell differentiation. However, neither Th1 nor Th2 cytokines were the direct targets of IRF4. To examine if IRF4 induced Th2 cytokines via one or more down-stream TFs, we combined gene expression microarrays, ChIP-chips and computational target prediction and found a putative intermediary TF, namely ETS1 in allergen-challenged CD4+ cells from allergic patients. ETS1 increased significantly in allergen-challenged CD4+ cells from patients compared to controls. Gene expression microarrays before and after ETS1 RNAi knockdown showed that ETS1 induced Th2 cytokines as well as disease-related pathways. Conclusions Increased expression of IRF4 in allergen-challenged CD4+ cells from patients with intermittent allergic rhinitis, leads to activation of a complex transcriptional program, including Th2 cytokines. PMID:21919915

  2. Activated protein C inhibits neutrophil migration in allergic asthma: a randomised trial.

    PubMed

    de Boer, J Daan; Berger, Marieke; Majoor, Christof J; Kager, Liesbeth M; Meijers, Joost C M; Terpstra, Sanne; Nieuwland, Rienk; Boing, Anita N; Lutter, René; Wouters, Diana; van Mierlo, Gerard J; Zeerleder, Sacha S; Bel, Elisabeth H; van't Veer, Cornelis; de Vos, Alex F; van der Zee, Jaring S; van der Poll, Tom

    2015-12-01

    Asthma patients show evidence of a procoagulant state in their airways, accompanied by an impaired function of the anticoagulant protein C system. We aimed to study the effect of recombinant human activated protein C (rhAPC) in allergic asthma patients.We conducted a randomised, double-blind, placebo-controlled, proof-of-concept study in house dust mite (HDM) allergic asthma patients. Patients were randomised to receive intravenous rhAPC (24 µg·kg(-1)·h(-1); n=12) or placebo (n=12) for 11 h. 4 h after the start of infusion, a first bronchoscopy was performed to challenge one lung segment with saline (control) and a contralateral segment with a combination of HDM extract and lipopolysaccharide (HDM+LPS), thereby mimicking environmental house dust exposure. A second bronchoscopy was conducted 8 h after intrabronchial challenge to obtain bronchoalveolar lavage fluid (BALF).rhAPC did not influence HDM+LPS induced procoagulant changes in the lung. In contrast, rhAPC reduced BALF leukocyte counts by 43% relative to placebo, caused by an inhibitory effect on neutrophil influx (64% reduction), while leaving eosinophil influx unaltered. rhAPC also reduced neutrophil degranulation products in the airways.Intravenous rhAPC attenuates HDM+LPS-induced neutrophil migration and protein release in allergic asthma patients by an effect that does not rely on coagulation inhibition. PMID:26381519

  3. Meteorological conditions, climate change, new emerging factors, and asthma and related allergic disorders. A statement of the World Allergy Organization.

    PubMed

    D'Amato, Gennaro; Holgate, Stephen T; Pawankar, Ruby; Ledford, Dennis K; Cecchi, Lorenzo; Al-Ahmad, Mona; Al-Enezi, Fatma; Al-Muhsen, Saleh; Ansotegui, Ignacio; Baena-Cagnani, Carlos E; Baker, David J; Bayram, Hasan; Bergmann, Karl Christian; Boulet, Louis-Philippe; Buters, Jeroen T M; D'Amato, Maria; Dorsano, Sofia; Douwes, Jeroen; Finlay, Sarah Elise; Garrasi, Donata; Gómez, Maximiliano; Haahtela, Tari; Halwani, Rabih; Hassani, Youssouf; Mahboub, Basam; Marks, Guy; Michelozzi, Paola; Montagni, Marcello; Nunes, Carlos; Oh, Jay Jae-Won; Popov, Todor A; Portnoy, Jay; Ridolo, Erminia; Rosário, Nelson; Rottem, Menachem; Sánchez-Borges, Mario; Sibanda, Elopy; Sienra-Monge, Juan José; Vitale, Carolina; Annesi-Maesano, Isabella

    2015-01-01

    The prevalence of allergic airway diseases such as asthma and rhinitis has increased dramatically to epidemic proportions worldwide. Besides air pollution from industry derived emissions and motor vehicles, the rising trend can only be explained by gross changes in the environments where we live. The world economy has been transformed over the last 25 years with developing countries being at the core of these changes. Around the planet, in both developed and developing countries, environments are undergoing profound changes. Many of these changes are considered to have negative effects on respiratory health and to enhance the frequency and severity of respiratory diseases such as asthma in the general population. Increased concentrations of greenhouse gases, and especially carbon dioxide (CO2), in the atmosphere have already warmed the planet substantially, causing more severe and prolonged heat waves, variability in temperature, increased air pollution, forest fires, droughts, and floods - all of which can put the respiratory health of the public at risk. These changes in climate and air quality have a measurable impact not only on the morbidity but also the mortality of patients with asthma and other respiratory diseases. The massive increase in emissions of air pollutants due to economic and industrial growth in the last century has made air quality an environmental problem of the first order in a large number of regions of the world. A body of evidence suggests that major changes to our world are occurring and involve the atmosphere and its associated climate. These changes, including global warming induced by human activity, have an impact on the biosphere, biodiversity, and the human environment. Mitigating this huge health impact and reversing the effects of these changes are major challenges. This statement of the World Allergy Organization (WAO) raises the importance of this health hazard and highlights the facts on climate-related health impacts

  4. Secretory leukocyte protease inhibitor plays an important role in the regulation of allergic asthma in mice.

    PubMed

    Marino, Rafael; Thuraisingam, Thusanth; Camateros, Pierre; Kanagaratham, Cynthia; Xu, Yong Zhong; Henri, Jennifer; Yang, Jingxuan; He, Guoan; Ding, Aihao; Radzioch, Danuta

    2011-04-01

    Secretory leukocyte protease inhibitor (SLPI) is an anti-inflammatory protein that is observed at high levels in asthma patients. Resiquimod, a TLR7/8 ligand, is protective against acute and chronic asthma, and it increases SLPI expression of macrophages in vitro. However, the protective role played by SLPI and the interactions between the SLPI and resiquimod pathways in the immune response occurring in allergic asthma have not been fully elucidated. To evaluate the role of SLPI in the development of asthma phenotypes and the effect of resiquimod treatment on SLPI, we assessed airway resistance and inflammatory parameters in the lungs of OVA-induced asthmatic SLPI transgenic and knockout mice and in mice treated with resiquimod. Compared with wild-type mice, allergic SLPI transgenic mice showed a decrease in lung resistance (p < 0.001), airway eosinophilia (p < 0.001), goblet cell hyperplasia (p < 0.001), and plasma IgE levels (p < 0.001). Allergic SLPI knockout mice displayed phenotype changes significantly more severe compared with wild-type mice. These phenotypes included lung resistance (p < 0.001), airway eosinophilia (p < 0.001), goblet cell hyperplasia (p < 0.001), cytokine levels in the lungs (p < 0.05), and plasma IgE levels (p < 0.001). Treatment of asthmatic transgenic mice with resiquimod increased the expression of SLPI and decreased inflammation in the lungs; resiquimod treatment was still effective in asthmatic SLPI knockout mice. Taken together, our study showed that the expression of SLPI protects against allergic asthma phenotypes, and treatment by resiquimod is independent of SLPI expression, displayed through the use of transgenic and knockout SLPI mice. PMID:21335488

  5. Chapter 14: Nonallergic rhinitis.

    PubMed

    Settipane, Russell A; Kaliner, Michael A

    2013-01-01

    Rhinitis is characterized by one or more of the following nasal symptoms: congestion, rhinorrhea (anterior and posterior), sneezing, and itching. It is classified as allergic or nonallergic, the latter being a diverse syndrome that is characterized by symptoms of rhinitis that are not the result of IgE-mediated events. Excluding infectious rhinitis and underlying systemic diseases, clinical entities that can be classified among the disorders that make up the nonallergic rhinitis syndromes include gustatory rhinitis, nonallergic rhinitis with eosinophilia syndrome (NARES), atrophic, drug-induced (rhinitis medicamentosa), hormone induced, senile rhinitis (of the elderly), rhinitis associated with chronic rhinosinusitis with or without nasal polyps, and the idiopathic variant formerly known as vasomotor rhinitis but more accurately denoted as nonallergic rhinopathy (NAR). The prevalence of nonallergic rhinitis has been observed to be one-third that of allergic rhinitis, affecting ~7% of the U.S. population or ~22 million people. NAR is the most common of the nonallergic rhinitis subtypes, comprising at least two-thirds of all nonallergic rhinitis sufferers. Although certain precipitants such as perfume, strong odors, changes in temperature or humidity, and exposure to tobacco smoke are frequently identified as symptom triggers, NAR may occur in the absence of defined triggers. The diagnosis of nonallergic rhinitis is purely clinical and relies on a detailed history and physical exam. Skin testing or in vitro testing to seasonal and perennial aeroallergens is required to make the diagnosis of nonallergic rhinitis. Because of the heterogeneous nature of this group of disorders, treatment should be individualized to the patient's underlying pathophysiology and/or symptoms and is often empiric. PMID:23711042

  6. Curine inhibits eosinophil activation and airway hyper-responsiveness in a mouse model of allergic asthma.

    PubMed

    Ribeiro-Filho, Jaime; Calheiros, Andrea Surrage; Vieira-de-Abreu, Adriana; de Carvalho, Katharinne Ingrid Moraes; da Silva Mendes, Diego; Melo, Christianne Bandeira; Martins, Marco Aurélio; da Silva Dias, Celidarque; Piuvezam, Márcia Regina; Bozza, Patrícia T

    2013-11-15

    Allergic asthma is a chronic inflammatory airway disease with increasing prevalence around the world. Current asthma therapy includes drugs that usually cause significant side effects, justifying the search for new anti-asthmatic drugs. Curine is a bisbenzylisoquinoline alkaloid that modulates calcium influx in many cell types; however, its anti-allergic and putative toxic effects remain to be elucidated. Our aim was to investigate the effects of curine on eosinophil activation and airway hyper-responsiveness (AHR) and to characterize its potential toxic effects. We used a mouse model of allergic asthma induced by sensitization and challenge with ovalbumin (OVA) to evaluate the anti-allergic effects of oral treatment with curine. The oral administration of curine significantly inhibited eosinophilic inflammation, eosinophil lipid body formation and AHR in animals challenged with OVA compared with animals in the untreated group. The curine treatment also reduced eotaxin and IL-13 production triggered by OVA. Verapamil, a calcium channel antagonist, had similar anti-allergic properties, and curine pre-treatment inhibited the calcium-induced tracheal contractile response ex-vivo, suggesting that the mechanism by which curine exerts its effects is through the inhibition of a calcium-dependent response. A toxicological evaluation showed that orally administered curine did not significantly alter the biochemical, hematological, behavioral and physical parameters measured in the experimental animals compared with saline-treated animals. In conclusion, curine showed anti-allergic activity through mechanisms that involve inhibition of IL-13 and eotaxin and of Ca(++) influx, without inducing evident toxicity and as such, has the potential for the development of anti-asthmatic drugs. PMID:23994558

  7. Residential culturable fungi, (1-3, 1-6)-β-d-glucan, and ergosterol concentrations in dust are not associated with asthma, rhinitis, or eczema diagnoses in children.

    PubMed

    Choi, H; Byrne, S; Larsen, L S; Sigsgaard, T; Thorne, P S; Larsson, L; Sebastian, A; Bornehag, C-G

    2014-04-01

    Qualitative reporting of home indoor moisture problems predicts respiratory diseases. However, causal agents underlying such qualitative markers remain unknown. In the homes of 198 multiple allergic case children and 202 controls in Sweden, we cultivated culturable fungi by directly plating dust, and quantified (1-3, 1-6)-β-D-glucan and ergosterol in dust samples from the child's bedroom. We examined the relationship between these fungal agents and degree of parent or inspector-reported home indoor dampness, and microbiological laboratory's mold index. We also compared the concentrations of these agents between multiple allergic cases and healthy controls, as well as IgE-sensitization among cases. The concentrations of culturable fungal agents were comparable between houses with parent and inspector-reported mold issues and those without. There were no differences in concentrations of the individual or the total summed culturable fungi, (1-3, 1-6)-β-D-glucan, and ergosterol between the controls and the multiple allergic case children, or individual diagnosis of asthma, rhinitis, or eczema. Culturable fungi, (1-3, 1-6)-β-D-glucan, and ergosterol in dust were not associated with qualitative markers of indoor dampness or mold or indoor humidity. Furthermore, these agents in dust samples were not associated with any health outcomes in the children. PMID:24016225

  8. Residential Culturable Fungi, (1–3, 1–6)-β-D-glucan, and Ergosterol Concentrations in Dust Are Not Associated with Asthma, Rhinitis or Eczema Diagnoses in Children

    PubMed Central

    Choi, Hyunok; Byrne, Sam; Larsen, Lisbeth Suldrup; Sigsgaard, Torben; Thorne, Peter S.; Larsson, Lennart; Sebastian, Aleksandra; Bornehag, Carl-Gustaf

    2014-01-01

    Background Qualitative reporting of home indoor moisture problems predicts respiratory diseases. However, causal agents underlying such qualitative markers remain unknown. Methods In the homes of 198 multiple allergic case children and 202 controls in Sweden, we cultivated culturable fungi by directly plating dust, and quantified(1–3, 1–6)-β-D-glucan, and ergosterol in dust samples from the child’s bedroom. We examined the relationship between these fungal agents and degree of parent or inspector reported home indoor dampness, and microbiological laboratory’s mold index. We also compared the concentrations of these agents between multiple allergic cases and healthy controls, as well as IgE-sensitization among cases. Results The concentrations of culturable fungal agents were comparable between houses with parent and inspector reported mold issues and those without. There were no differences in concentrations of the individual or the total summed culturable fungi, (1–3, 1–6)-β-D-glucan, and ergosterol between the controls and the multiple allergic case children, or individual diagnosis of asthma, rhinitis or eczema. Conclusion Culturable fungi, (1–3, 1–6)-β-D-glucan, and ergosterol in dust were not associated with qualitative markers of indoor dampness or mold or indoor humidity. Furthermore, these agents in dust samples were not associated with any health outcomes in the children. PMID:24016225

  9. DOSE-DEPENDENT INCREASE IN THE PRODUCTION OF NERVE GROWTH FACTOR, NEUROTROPHIN-3, AND NEUROTROPHIN-4 IN A PENICILLIUM CHRYSOGENUM-INDUCED ALLERGIC ASTHMA MODEL

    EPA Science Inventory


    Increased levels of neurotrophins (nerve growth factor [NGF], brain-derived neurotrophic factor [BDNF], neurotrophin [NT]-3, and/or NT-4) have been associated with asthma as well as in animal models of allergic asthma. In our mouse model for fungal allergic asthma, repeated ...

  10. A comparative tolerance study of terfenadine-pseudoephedrine combination tablets and pseudoephedrine tablets in patients with allergic or vasomotor rhinitis.

    PubMed

    Stroh, J E; Ayars, G H; Bernstein, I L; Kemp, J P; Podleski, W K; Prenner, B M; Schoenwetter, W F; Salzmann, J K

    1988-01-01

    In this multicentre, double-blind, randomized, parallel group study, 315 patients with allergic or vasomotor rhinitis were treated on a twice daily dosing schedule with either a 60 mg terfenadine-120 mg pseudoephedrine hydrochloride combination or 120 mg pseudoephedrine hydrochloride (extended release) for 2 weeks. No clinically significant differences between the two groups were noted in body weight, temperature, respiration rate or blood pressure following the treatment period. An increase in mean heart rate of approximately 5 beats/min from entry to the final clinic visit was noted in both treatment groups. No clinically significant changes were noted in either treatment group when pre- and post-treatment electrocardiograms were compared. There were also no clinically significant alterations in laboratory values, which included serum chemistry, haematology and urinalysis, within or between either group. The adverse events profiles for both groups were similar. The most frequent adverse event was insomnia, in 40 (25.3%) patients given the terfenadine-pseudoephedrine combination and in 42 (26.8%) of those given pseudoephedrine. No unusual or unexpected adverse events were reported. PMID:2906887

  11. IL-23, rather than IL-17, is crucial for the development of ovalbumin-induced allergic rhinitis.

    PubMed

    Guo, Chaobin; Chen, Guie; Ge, Ruifeng

    2015-10-01

    Interleukin-23 (IL-23) and IL-17 are involved in the pathogenesis of allergic rhinitis (AR). However, the roles of IL-23 and IL-17 in ovalbumin (OVA)-induced AR remain unclear. Therefore in this study we aim to investigate the precise roles of IL-23 and IL-17 in a mouse model of OVA-induced AR. We found that during OVA-induced AR, eosinophil and goblet cells in the nose were significantly decreased in IL-23-deficient, but not in IL-17-deficient mice. However, there was no difference in the serum IgE and IgG1 levels between IL-23-deficient or IL-17-deficient and wild-type mice. Moreover, IL-4 levels in lymph node cell culture supernatants were significantly decreased in IL-23-deficient, but not IL-17-deficient, compared with wild-type mice. Furthermore, OVA-induced AR developed similarly in wild-type mice transferred with either IL-23-deficient BM cells or wild-type BM cells. These findings suggest that IL-23, but not IL-17 is crucial for the development of OVA-induced AR, and IL-23 neutralization may be a potential approach for treatment of OVA-induced AR in humans. PMID:26239416

  12. MP-AzeFlu is more effective than fluticasone propionate for the treatment of allergic rhinitis in children.

    PubMed

    Berger, W; Bousquet, J; Fox, A T; Just, J; Muraro, A; Nieto, A; Valovirta, E; Wickman, M; Wahn, U

    2016-08-01

    The objective was to evaluate the efficacy of MP-AzeFlu (Dymista(®) ) vs fluticasone propionate (FP), (both 1 spray/nostril bid), in children with allergic rhinitis (AR). MP-AzeFlu combines azelastine hydrochloride, FP and a novel formulation in a single spray. Children were randomized in a 3 : 1 ratio to MP-AzeFlu or FP in this open-label, 3-month study. Efficacy was assessed in children aged ≥ 6 to <12 years (MP-AzeFlu: n = 264; FP: n = 89), using a 4-point symptom severity rating scale from 0 to 3 (0 = no symptoms; 3 = severe symptoms). Over the 3-month period, MP-AzeFlu-treated children experienced significantly greater symptom relief than FP-treated children (Diff: -0.14; 95% CI: -0.28, -0.01; P = 0.04), noted from the first day (particularly the first 7 days) and sustained for 90 days. More MP-AzeFlu children achieved symptom-free or mild symptom severity status, and did so up to 16 days faster than FP. MP-AzeFlu provides significantly greater, more rapid and clinically relevant symptom relief than FP in children with AR. PMID:27043452

  13. An evaluation of short-term corticosteroid response in perennial allergic rhinitis using histamine and adenosine monophosphate nasal challenge

    PubMed Central

    Wilson, Andrew M; Sims, Erika J; Orr, Linda C; Robb, Fiona; Lipworth, Brian J

    2003-01-01

    Aims To evaluate the role of AMP nasal challenge as a measure of short-term treatment response in patients receiving intranasal corticosteroids. Adenosine monophosphate (AMP) challenge has been shown to be a good inflammatory surrogate in the lower airways, but it has not been properly evaluated as a nasal challenge test. Methods Fourteen patients with perennial allergic rhinitis (PAR) were randomized to receive 2 weeks treatment with placebo (PL) or 200 µg intranasal mometasone furoate (MF) once daily in a randomized single-blind crossover study. AMP (25–800 mg ml−1) and histamine (0.25–8 mg ml−1) nasal challenge testing were performed after each treatment period with 30% decrease in minimal cross-sectional area (MCA). Domiciliary symptom data were collected. Results There was a significant (P < 0.05) improvement in PC30 MCA and nasal volume with AMP but not with histamine comparing MF vs PL. This amounted to a 2.8 (95% CI 1.5, 4.0) and 0.7 (95% CI −0.5, 1.9) doubling-dose change for AMP and histamine challenges, respectively. There were significant (P < 0.05) improvements in nasal symptoms and quality of life. Conclusions AMP nasal challenge using acoustic rhinometry may be a useful test to assess short-term treatment response in patient with PAR. PMID:12680883

  14. Essential Contribution of CD4+ T Cells to Antigen-Induced Nasal Hyperresponsiveness in Experimental Allergic Rhinitis.

    PubMed

    Nishimura, Tomoe; Kaminuma, Osamu; Saeki, Mayumi; Kitamura, Noriko; Matsuoka, Kunie; Yonekawa, Hiromichi; Mori, Akio; Hiroi, Takachika

    2016-01-01

    Nasal hyperresponsiveness (NHR) is a characteristic feature of allergic rhinitis (AR); however, the pathogenesis of NHR is not fully understood. In this study, during the establishment of an experimental AR model using ovalbumin-immunized and -challenged mice, augmentation of the sneezing reaction in response to nonspecific proteins as well as a chemical stimulant was detected. Whether NHR is independent of mast cells and eosinophils was determined by using mast cell- and eosinophil-deficient mice. NHR was suppressed by treatment with anti-CD4 antibody, suggesting the pivotal contribution of CD4+ T cells. Furthermore, antigen challenge to mice to which in vitro-differentiated Th1, Th2, and Th17 cells but not naïve CD4+ T cells had been adoptively transferred led to the development of equivalent NHR. Since antigen-specific IgE and IgG were not produced in these mice and since antigen-specific IgE-transgenic mice did not develop NHR even upon antigen challenge, humoral immunity would be dispensable for NHR. CD4+ T cells play a crucial role in the pathogenesis of AR via induction of NHR, independent of IgE-, mast cell-, and eosinophil-mediated responses. PMID:26752722

  15. Adverse Events During Immunotherapy Against Grass Pollen-Induced Allergic Rhinitis - Differences Between Subcutaneous and Sublingual Treatment.

    PubMed

    Aasbjerg, Kristian; Dalhoff, Kim Peder; Backer, Vibeke

    2015-08-01

    Allergic rhinitis (AR) triggered by grass pollen is a common disease, affecting millions of people worldwide. Treatment consists of symptom-alleviating drugs, such as topical corticosteroids or antihistamines. Another option is potentially curative immunotherapy, currently available as sublingual and subcutaneous treatment. We investigated the potential differences in the prevalence and severity of adverse events related to subcutaneous and sublingual immunotherapy (SLIT) against grass pollen-induced AR. A thorough literature search was performed with PubMed and EMBASE. The findings were compared with the available summaries of product characteristics (SPC) and with commercial pharmacology databases (Micromedex). The majority of available safety data originate from registered products of standardized allergens. A surprisingly large percentage of drugs, especially those used in the United States, have no systematically collected safety data. No sufficiently powered randomized trials comparing sublingual and subcutaneous immunotherapy (SCIT) were available, but general safety assessments indicate that sublingual tablet treatment is safer than subcutaneous treatment. Not all commonly used immunotherapy drugs are officially registered, and not all have systematically collected safety data. This is especially true for older drugs used in the United States. In contrast, newer drugs that have undergone extensive clinical testing have better documentation, but unified collection of safety data is still lacking. Considering the evidence available, most drugs elicit similar side effects from the same organ systems, and symptoms from the sublingual drug classes are probably less severe. However, a head-to-head comparison of safety and efficacy is lacking. PMID:25968654

  16. Efficacy and safety of D. pteronyssinus immunotherapy in local allergic rhinitis: a double-blind placebo-controlled clinical trial.

    PubMed

    Rondón, C; Campo, P; Salas, M; Aranda, A; Molina, A; González, M; Galindo, L; Mayorga, C; Torres, M J; Blanca, M

    2016-07-01

    The effects of allergen immunotherapy (AIT) on local allergic rhinitis (LAR) are largely unknown. We conducted the first randomized, double-blind, placebo-controlled (DBPC), phase II trial of D. pteronyssinus (DP) subcutaneous AIT (DP-AIT) on LAR (clinicaltrials.gov identifier: NCT02123316). Thirty-six LAR patients received Pangramin PLUS DP or placebo for 24 months. The primary endpoints were symptoms, medication scores, and medication-free days. The secondary included skin test, serum specific IgE and IgG4, nasal allergen provocation test (NAPT), and adverse events. AIT-DP produced significant improvements in both primary and secondary endpoints vs placebo. After 12 months of AIT-DP, we detected a significant and marked increase in allergen tolerance with negative NAPT in 50% of patients, and significant increases of serum sIgG4. Immunotherapy was well tolerated; no systemic reactions were reported. This study demonstrated that AIT-DP is a safe and clinically effective treatment for LAR, confirming that LAR is a new indication for AIT. PMID:27008542

  17. Is Folate Status a Risk Factor for Asthma or Other Allergic Diseases?

    PubMed Central

    Wang, Ting; Zhang, Hong-Ping; Zhang, Xin; Liang, Zong-An; Ji, Yu-Lin

    2015-01-01

    Purpose It is controversial whether folate status is a risk factor for the development of asthma or other allergic diseases. This study was conducted to investigate whether indirect or direct exposure to folate and impaired folate metabolism, reflected as methylene-tetrahydrofolate reductase (MTHFR) C677T polymorphism, would contribute to the development of asthma and other allergic diseases. Methods Electronic databases were searched to identify all studies assessing the association between folate status and asthma or other allergic diseases. Two reviewers independently assessed the eligibility of studies and extracted data. The relative risk (RR) or odds ratio (OR) with 95% confidence intervals (CI) was calculated and pooled. Results Twenty-six studies (16 cohort, 7 case-control, and 3 cross-sectional studies) were identified. Maternal folic acid supplementation was not associated with the development of asthma, atopic dermatitis (AD), eczema, and sensitization in the offspring, whereas exposure during early pregnancy was related to wheeze occurrence in the offspring (RR=1.06, 95% CI=[1.02-1.09]). The TT genotype of MTHFR C677T polymorphism was at high risk of asthma (OR=1.41, 95% CI=[1.07-1.86]). Conclusions It is indicated that maternal folic acid supplementation during early pregnancy may increase the risk of wheeze in early childhood and that the TT genotype of MTHFR C677T polymorphism impairing folic acid metabolism would be at high risk of asthma development. These results might provide additional information for recommendations regarding forced folate consumption or folic acid supplements during pregnancy based on its well-established benefits for the prevention of congenital malformations. However, currently available evidence is of low quality which is needed to further elucidate. PMID:26333700

  18. Anti-IgE treatment, airway inflammation and remodelling in severe allergic asthma: current knowledge and future perspectives.

    PubMed

    Samitas, Konstantinos; Delimpoura, Vasiliki; Zervas, Eleftherios; Gaga, Mina

    2015-12-01

    Asthma is a disorder of the airways involving various inflammatory cells and mediators and characterised by bronchial hyperresponsiveness, chronic inflammation and structural alterations in the airways, also known as remodelling. IgE is an important mediator of allergic reactions and has a central role in allergic asthma pathophysiology, as it is implicated in both the early and late phase allergic response. Moreover, clinical and mechanistic evidence has lately emerged, implicating IgE in the development of airway remodelling. The use of monoclonal antibodies targeting IgE, such as omalizumab, has proven very effective in improving respiratory symptoms and quality of life, while reducing asthma exacerbations, emergency room visits and the use of systemic corticosteroids in allergic severe asthma. These effects are believed to be mainly mediated by omalizumab's inhibitory effect on the initiation and further propagation of the allergic inflammation cascade. However, there is evidence to suggest that anti-IgE treatment remains effective long after it has been discontinued. In part, these findings could be attributed to the possible ameliorating effects of anti-IgE treatment on airway remodelling. In this review, we discuss recent findings supporting the notion that anti-IgE treatment modulates the complex immune responses that manifest clinically as asthma and ameliorates airway remodelling changes often observed in allergic severe asthma phenotypes. PMID:26621973

  19. Evaluation of the anti-allergic activity of Citrus unshiu using rat basophilic leukemia RBL-2H3 cells as well as basophils of patients with seasonal allergic rhinitis to pollen.

    PubMed

    Kobayashi, Shoko; Tanabe, Soichi

    2006-03-01

    The anti-allergic activity of the 50% methanol extract of Citrus unshiu powder (MEC) was examined. Fifty percent methanol extract of MEC powder showed potent inhibitory activity against histamine release from basophils of patients suffering from seasonal allergic rhinitis to ceder pollen. To examine this anti-allergic mechanism in detail, we next used rat basophlilic leukemia RBL-2H3 cells. MEC significantly inhibited IgE-induced histamine and beta-hexosaminidase release from RBL-2H3 cells. Since MEC contains a variety of flavonoids, we selected nobiletin, hesperetin, and hesperidin (hesperetin glycoside) as representative compounds, and further evaluated these inhibitory activities. Among the flavonoids tested, hesperetin was the most potent, while hesperidin had far less, if any, inhibitory activity. The mechanism by which flavonoids inhibited the degranulation process was then examined. As a result, hesperetin and nobiletin suppressed the phosphorylation of Akt-1, direct downstream effector of phosphatidylinositol 3-kinase (PI3-K). Thus, it was assumed that these flavonoids suppressed IgE-mediated stimulation of basophils through PI3-K pathway and that proper intake of Citrus unshiu would be favorable for managing seasonal allergic rhinitis to ceder pollen. PMID:16465400

  20. Resident alveolar macrophages suppress while recruited monocytes promote allergic lung inflammation in murine models of asthma

    PubMed Central

    Zasłona, Zbigniew; Przybranowski, Sally; Wilke, Carol; van Rooijen, Nico; Teitz-Tennenbaum, Seagal; Osterholzer, John J.; Wilkinson, John E.; Moore, Bethany B.; Peters-Golden, Marc

    2014-01-01

    The role and origin of alveolar macrophages (AMs) in asthma are incompletely defined. We sought to clarify these issues in the context of acute allergic lung inflammation utilizing house dust mite and ovalbumin murine models. Use of liposomal clodronate to deplete resident AMs (rAMs) resulted in increased levels of inflammatory cytokines and eosinophil numbers in lavage fluid and augmented histopathologic evidence of lung inflammation, suggesting a suppressive role of rAMs. Lung digests of asthmatic mice revealed an increased percentage of Ly6Chigh/CD11bpos inflammatory monocytes. Clodronate depletion of circulating monocytes, by contrast, resulted in an attenuation of allergic inflammation. A CD45.1/CD45.2 chimera model demonstrated that recruitment at least partially contributes to the AM pool in irradiated non-asthmatic mice, but its contribution was no greater in asthma. Ki-67 staining of AMs supported a role for local proliferation, which was increased in asthma. Our data demonstrate that rAMs dampen, while circulating monocytes promote, early events in allergic lung inflammation. Moreover, maintenance of the AM pool in the early stages of asthmatic inflammation depends on local proliferation but not recruitment. PMID:25225663

  1. The role of autophagy in allergic inflammation: a new target for severe asthma

    PubMed Central

    Liu, Jing-Nan; Suh, Dong-Hyeon; Trinh, Hoang Kim Tu; Chwae, Yong-Joon; Park, Hae-Sim; Shin, Yoo Seob

    2016-01-01

    Autophagy has been investigated for its involvement in inflammatory diseases, but its role in asthma has been little studied. This study aimed to explore the possible role of autophagy and its therapeutic potential in severe allergic asthma. BALB/c mice were sensitized with ovalbumin (OVA) on days 0 and 14, followed by primary OVA challenge on days 28–30. The mice received a secondary 1 or 2% OVA challenge on days 44–46. After the final OVA challenge, the mice were assessed for airway responsiveness (AHR), cell composition and cytokine levels in bronchoalveolar lavage fluid (BALF). LC3 expression in lung tissue was measured by western blot and immunofluorescence staining. Autophagosomes were detected by electron microscopy. 3-Methyladenine (3-MA) treatment and Atg5 knockdown were applied to investigate the potential role of autophagy in allergic asthma mice. AHR, inflammation in BALF and LC3 expression in lung tissue were significantly increased in the 2% OVA-challenged mice compared with the 1% OVA-challenged mice (P<0.05). In addition, eosinophils showed prominent formation of autophagosomes and increased LC3 expression compared with other inflammatory cells in BALF and lung tissue. After autophagy was inhibited by 3-MA and Atg5 shRNA treatment, AHR, eosinophilia, interleukin (IL)-5 levels in BALF and histological inflammatory findings were much improved. Finally, treatment with an anti-IL-5 antibody considerably reduced LC3 II expression in lung homogenates. Our findings suggest that autophagy is closely correlated with the severity of asthma through eosinophilic inflammation, and its modulation may provide novel therapeutic approaches for severe allergic asthma. PMID:27364893

  2. Weight Loss Decreases Inherent and Allergic Methacholine Hyperresponsiveness in Mouse Models of Diet-Induced Obese Asthma.

    PubMed

    Ather, Jennifer L; Chung, Michael; Hoyt, Laura R; Randall, Matthew J; Georgsdottir, Anna; Daphtary, Nirav A; Aliyeva, Minara I; Suratt, Benjamin T; Bates, Jason H T; Irvin, Charles G; Russell, Sheila R; Forgione, Patrick M; Dixon, Anne E; Poynter, Matthew E

    2016-08-01

    Obese asthma presents with inherent hyperresponsiveness to methacholine or augmented allergen-driven allergic asthma, with an even greater magnitude of methacholine hyperresponsiveness. These physiologic parameters and accompanying obese asthma symptoms can be reduced by successful weight loss, yet the underlying mechanisms remain incompletely understood. We implemented mouse models of diet-induced obesity, dietary and surgical weight loss, and environmental allergen exposure to examine the mechanisms and mediators of inherent and allergic obese asthma. We report that the methacholine hyperresponsiveness in these models of inherent obese asthma and obese allergic asthma manifests in distinct anatomical compartments but that both are amenable to interventions that induce substantial weight loss. The inherent obese asthma phenotype, with characteristic increases in distal airspace tissue resistance and tissue elastance, is associated with elevated proinflammatory cytokines that are reduced with dietary weight loss. Surprisingly, bariatric surgery-induced weight loss further elevates these cytokines while reducing methacholine responsiveness to levels similar to those in lean mice or in formerly obese mice rendered lean through dietary intervention. In contrast, the obese allergic asthma phenotype, with characteristic increases in central airway resistance, is not associated with increased adaptive immune responses, yet diet-induced weight loss reduces methacholine hyperresponsiveness without altering immunological variables. Diet-induced weight loss is effective in models of both inherent and allergic obese asthma, and our examination of the fecal microbiome revealed that the obesogenic Firmicutes/Bacteroidetes ratio was normalized after diet-induced weight loss. Our results suggest that structural, immunological, and microbiological factors contribute to the manifold presentations of obese asthma. PMID:27064658

  3. Pericytes contribute to airway remodeling in a mouse model of chronic allergic asthma.

    PubMed

    Johnson, Jill R; Folestad, Erika; Rowley, Jessica E; Noll, Elisa M; Walker, Simone A; Lloyd, Clare M; Rankin, Sara M; Pietras, Kristian; Eriksson, Ulf; Fuxe, Jonas

    2015-04-01

    Myofibroblast accumulation, subepithelial fibrosis, and vascular remodeling are complicating features of chronic asthma, but the mechanisms are not clear. Platelet-derived growth factors (PDGFs) regulate the fate and function of various mesenchymal cells and have been implicated as mediators of lung fibrosis. However, it is not known whether PDGF-BB signaling via PDGFRβ, which is critical for the recruitment of pericytes to blood vessels, plays a role in airway remodeling in chronic asthma. In the present study, we used a selective PDGFRβ inhibitor (CP-673451) to investigate the role of PDGFRβ signaling in the development of airway remodeling and lung dysfunction in an established mouse model of house dust mite-induced chronic allergic asthma. Unexpectedly, we found that pharmacological inhibition of PDGFRβ signaling in the context of chronic aeroallergen exposure led to exacerbated lung dysfunction and airway smooth muscle thickening. Further studies revealed that the inflammatory response to aeroallergen challenge in mice was associated with decreased PDGF-BB expression and the loss of pericytes from the airway microvasculature. In parallel, cells positive for pericyte markers accumulated in the subepithelial region of chronically inflamed airways. This process was exacerbated in animals treated with CP-673451. The results indicate that perturbed PDGF-BB/PDGFRβ signaling and pericyte accumulation in the airway wall may contribute to airway remodeling in chronic allergic asthma. PMID:25637607

  4. The Effects of Maekmoondong-Tang on Cockroach Extract-Induced Allergic Asthma

    PubMed Central

    Sohn, Sung-Hwa; Jung, Kyung-Hwa; Lee, Kun-young; Yeom, Yu Rim; Kim, Gae-Eun; Jung, Sungki; Jung, Heejae; Bae, Hyunsu

    2014-01-01

    Maekmoondong-tang (MMDT) has long been used in Asian countries to treat respiratory diseases. However, the precise mechanisms underlying its effects on asthma are unknown. This study was conducted to evaluate the protective effects of MMDT in a cockroach allergen (CKA-)induced animal model of allergic asthma. After being challenged with CKA, the number of macrophages, eosinophils, neutrophils, lymphocytes, and total cells in the bronchoalveolar lavage fluid (BALF) was evaluated. The Th2 specific cytokines IL-4, IL-5, and IL-13 were also analyzed in BALF along with IgE levels in serum. For histological analysis, hematoxylin and eosin (H&E) staining, periodic acid-Schiff (PAS) staining, and immunohistochemical staining were performed. In addition, airway hyperresponsiveness was assessed by noninvasive plethysmography. The cellular profiles and histopathologic analysis demonstrated that peribronchial and perivascular inflammatory cell infiltrates were significantly decreased in the MMDT-treated groups compared with the cockroach extract-injected (CKA) groups. In addition, the IgE, IL-4, IL-5, and IL-13 levels were significantly decreased in the MMDT group. MMDT treatment also significantly attenuated airway hyperresponsiveness. These results demonstrated that MMDT significantly reduced the hallmark signs of asthma: elevated serum IgE, airway eosinophilia, airway remodeling, mucus hypersecretion, and airway hyperresponsiveness. The remarkable antiasthmatic effects of MMDT suggest its therapeutic potential in allergic asthma treatment. PMID:24723965

  5. 'Real-life' effectiveness studies of omalizumab in adult patients with severe allergic asthma: systematic review.

    PubMed

    Abraham, I; Alhossan, A; Lee, C S; Kutbi, H; MacDonald, K

    2016-05-01

    We reviewed 24 'real-life' effectiveness studies of omalizumab in the treatment of severe allergic asthma that included 4117 unique patients from 32 countries with significant heterogeneity in patients, clinicians and settings. The evidence underscores the short- and long-term benefit of anti-IgE therapy in terms of the following: improving lung function; achieving asthma control and reducing symptomatology, severe exacerbations and associated work/school days lost; reducing healthcare resource utilizations, in particular hospitalizations, hospital lengths of stay and accident specialist or emergency department visits; reducing or discontinuing other asthma medications; and improving quality of life - thus confirming, complementing and extending evidence from randomized trials. Thus, omalizumab therapy is associated with signal improvements across the full objective and subjective burden of illness chain of severe allergic asthma. Benefits of omalizumab may extend up to 2-4 years, and the majority of omalizumab-treated patients may benefit for many years. Omalizumab has positive short- and long-term safety profiles similar to what is known from randomized clinical trials. Initiated patients should be monitored for treatment response at 16 weeks. Those showing positive response at that time are highly likely to show sustained treatment response and benefit in terms of clinical, quality of life and health resource utilization outcomes. PMID:26644231

  6. Thalidomide attenuates airway hyperresponsiveness and eosinophilic inflammation in a murine model of allergic asthma.

    PubMed

    Asano, Toshiaki; Kume, Hiroaki; Taki, Fumitaka; Ito, Satoru; Hasegawa, Yoshinori

    2010-01-01

    Asthma is characterized by chronic eosinophilic inflammation and hyperresponsiveness of the airways. We hypothesized that thalidomide, which has numerous immunomodulatory properties, may have anti-inflammatory effects in allergic asthma. BALB/c mice sensitized and challenged with ovalbumin (OVA) were treated orally with thalidomide (30, 100, or 300 mg/kg) or a vehicle. When thalidomide was administered to OVA-challenged mice, the number of eosinophils in bronchoalveolar lavage fluid (BALF) was significantly decreased. The numbers of inflammatory cells other than eosinophils were not reduced by thalidomide. Thalidomide inhibited the elevated levels of interleukin-5 (IL-5) and tumor necrosis factor-alpha (TNF-alpha) in BALF by OVA challenges. Histological analysis of the lung revealed that both the infiltration of inflammatory cells and the hyperplasia of goblet cells were significantly suppressed by thalidomide treatment. Furthermore, thalidomide significantly inhibited the response to methacholine induced by OVA challenges. Taken together, thalidomide treatment decreased airway inflammation and hyperresponsiveness in a murine model of allergic asthma. These results might provide an opportunity for the development of novel therapeutics to treat severe asthma. PMID:20522972

  7. Pericytes contribute to airway remodeling in a mouse model of chronic allergic asthma

    PubMed Central

    Folestad, Erika; Rowley, Jessica E.; Noll, Elisa M.; Walker, Simone A.; Lloyd, Clare M.; Rankin, Sara M.; Pietras, Kristian; Eriksson, Ulf; Fuxe, Jonas

    2015-01-01

    Myofibroblast accumulation, subepithelial fibrosis, and vascular remodeling are complicating features of chronic asthma, but the mechanisms are not clear. Platelet-derived growth factors (PDGFs) regulate the fate and function of various mesenchymal cells and have been implicated as mediators of lung fibrosis. However, it is not known whether PDGF-BB signaling via PDGFRβ, which is critical for the recruitment of pericytes to blood vessels, plays a role in airway remodeling in chronic asthma. In the present study, we used a selective PDGFRβ inhibitor (CP-673451) to investigate the role of PDGFRβ signaling in the development of airway remodeling and lung dysfunction in an established mouse model of house dust mite-induced chronic allergic asthma. Unexpectedly, we found that pharmacological inhibition of PDGFRβ signaling in the context of chronic aeroallergen exposure led to exacerbated lung dysfunction and airway smooth muscle thickening. Further studies revealed that the inflammatory response to aeroallergen challenge in mice was associated with decreased PDGF-BB expression and the loss of pericytes from the airway microvasculature. In parallel, cells positive for pericyte markers accumulated in the subepithelial region of chronically inflamed airways. This process was exacerbated in animals treated with CP-673451. The results indicate that perturbed PDGF-BB/PDGFRβ signaling and pericyte accumulation in the airway wall may contribute to airway remodeling in chronic allergic asthma. PMID:25637607

  8. Thymol attenuates allergic airway inflammation in ovalbumin (OVA)-induced mouse asthma.

    PubMed

    Zhou, Ershun; Fu, Yunhe; Wei, Zhengkai; Yu, Yuqiang; Zhang, Xichen; Yang, Zhengtao

    2014-07-01

    Thymol, a naturally occurring monocyclic phenolic compound derived from Thymus vulgaris (Lamiaceae), has been reported to exhibit anti-inflammatory property in vivo and vitro. However, the mechanism of thymol is not clear. The aim of the present study was to investigate the effects of thymol on allergic inflammation in OVA-induced mice asthma and explore its mechanism. The model of mouse asthma was established by the induction of OVA. Thymol was orally administered at a dose of 4, 8, and 16 mg/kg body weight 1h before OVA challenge. At 24h after the last challenge, mice were sacrificed, and the data were collected by various experimental methods. The results revealed that pretreatment with thymol reduced the level of OVA-specific IgE, inhibited recruitment of inflammatory cells into airway, and decreased the levels of IL-4, IL-5, and IL-13 in BALF. Moreover, the pathologic changes of lung tissues were obviously ameliorated and goblet cell hyperplasia was effectively inhibited by the pretreatment of thymol. In addition, thymol reduced the development of airway hyperresponsiveness and blocked the activation of NF-κB pathway. All data suggested that thymol ameliorated airway inflammation in OVA-induced mouse asthma, possibly through inhibiting NF-κB activation. These findings indicated that thymol may be used as an alternative agent for treating allergic asthma. PMID:24785965

  9. Local expression of IL-4 and IL-5 in perennial allergic rhinitis and their modulation by topical corticosteroid therapy.

    PubMed

    Hafez, Shereen F; Sallam, Maha M; Ibraheem, Samer A

    2004-01-01

    Perennial allergic rhinitis (PAR) is an increasing problem for which new and exciting therapies are being developed. A T(H)2-polarized cytokine pattern is thought to predominate regulating local IgE synthesis and cell recruitment in PAR and the development of intranasal steroids has resulted in several agents with quick actions, localized effects and great efficacy in its management. The aim of work was to determine the differences in the local expression of IL-4 and IL-5 in patients with PAR compared to non-atopic healthy controls and investigate the relationship between the expression of these cytokines and the clinical aspects of the disease. Also to evaluate local expression of these cytokines in some of these patients before and after treatment with intranasal steroids (fluticasone proprionate). Nasal biopsies from 37 patients with PAR before therapy and from 8 of them after receiving corticosteroids as local nasal spray were taken. PAR was confirmed by a history of perennial nasal blockage, discharge, and/or sneeze for at least 2 years before the study and by positive skin prick test. Also nasal biopsies were taken from 20 age and gender matched non-atopic controls. Biopsies were analyzed using a reverse transcription-polymerase chain reaction (RT-PCR) to investigate local expression of IL-4 mRNA. Enzyme immunoassay was used for estimation of IL-5 levels in the nasal mucosa. By using the ROC curve; (11 pg/ml) was estimated as a cut-off value for IL-5 where levels below this cut off were considered negative. This study showed that the most common causative allergens in PAR were mite dust, followed by wool & pigeon then mixed moulds. There was a significant relation between expression of IL-4 and IL-5 and the occurrence of allergic rhinitis where mRNA of IL-4 was detected in 17/37 [46%] of patient group and in 3/20 (15%) of the control group (P < 0.05). IL-5 levels were more than the calculated cut off value in 22/37 (59.5%) of patient group as compared to 4

  10. Establishment of a new animal model of allergic rhinitis with biphasic sneezing by intranasal sensitization with Staphylococcal enterotoxin B

    PubMed Central

    SUN, RONG; TANG, XINYE; YAO, HONGBING; HONG, SULING; YANG, YANG; KOU, WEI; WEI, PING

    2015-01-01

    Allergic rhinitis (AR) is a global health problem. The effectiveness of currently available medications is limited and therefore investigation for more effective drugs is essential. The aim of the present study was to establish a model of AR in guinea pigs that can be utilized for the further investigation of new drugs. Guinea pigs were intranasally sensitized with 1 µg Staphylococcal enterotoxin B (SEB) dissolved in 40 µl saline once daily for 14 days. One week after the last sensitization, the same treatment was applied intranasally once every four days for a total of 30 times. In the treatment group, terfenadine was administered orally 70 min before the 4th, 14th and 24th challenge. Sneezing and nasal scratching were evaluated following each of the 30 challenges. The quantity of antigen-specific antibodies in the serum was measured. Between the 19th and 30th challenges, the guinea pigs in the model group produced significant biphasic elevations in sneezing number, with peaks 10 min-2 h and 4–8 h after the SEB challenges. In addition, the guinea pigs produced significantly more sneezing in the first peak during the 19th to 30th challenges than during the first to 18th challenges (P<0.01). Terfenadine significantly inhibited the early- and late-phase sneezing at all challenge times. The serum levels of SEB-specific immunoglobulin (Ig) E and IgG1 were higher in the model group in comparison with those in the control group (P<0.01). This experiment demonstrated that SEB can induce typical AR with biphasic sneezing in guinea pigs. Histamine may play an important role in the early- and the late-phase sneezing in the model of AR. This model can be potentially used for the investigation of new drugs. PMID:26622329

  11. Efficacy and safety of fixed-dose loratadine/montelukast in seasonal allergic rhinitis: effects on nasal congestion.

    PubMed

    Prenner, Bruce; Anolik, Robert; Danzig, Melvyn; Yao, Ruji

    2009-01-01

    A need exists for safe, effective therapy for the relief of the symptoms of allergic rhinitis (AR) that also consistently relieves nasal congestion, the most common and bothersome symptom. This study was performed to assess efficacy and safety of a once-daily tablet containing 10 mg of loratadine, an antihistamine, and 10 mg of montelukast, a leukotriene antagonist (SCH 445761) versus placebo and pseudoephedrine (PSE; 240 mg once-daily formulation; active comparator). In a multicenter, parallel-group, double-blind, double-dummy, randomized study, 1095 subjects with documented history of seasonal AR and positive skin-prick test to a prevailing aeroallergen were treated for 15 days with fixed-dose combination loratadine/montelukast (L/M), PSE, or placebo. After randomization, subjects rated severity of nasal congestion and measured peak nasal inspiratory flow (PNIF) rate in the morning and evening. The change in quality of life from baseline was also assessed. L/M and PSE were significantly more effective than placebo in alleviating nighttime and daytime nasal congestion and improving PNIF rate, an objective measure of nasal obstruction. There were no significant differences between L/M and PSE for any efficacy analysis including improvement in the quality of life. Subjects treated with L/M experienced a similar incidence of total adverse events versus placebo and a lower incidence of total adverse events (including dizziness, insomnia, jitteriness, nausea, and dry mouth) versus PSE. Nasal decongestant activity of L/M was significantly higher than that of placebo and similar to that of PSE in symptomatic AR subjects. L/M showed a safety profile similar to placebo and was better tolerated than PSE. Thus, L/M offers a safe and efficacious alternative to PSE for the treatment of nasal congestion associated with AR. PMID:19549427

  12. Optimal dose selection of fluticasone furoate nasal spray for the treatment of seasonal allergic rhinitis in adults and adolescents.

    PubMed

    Martin, Bruce G; Ratner, Paul H; Hampel, Frank C; Andrews, Charles P; Toler, Tom; Wu, Wei; Faris, Melissa A; Philpot, Edward E

    2007-01-01

    Efficacy and safety of fluticasone furoate nasal spray, administered using a unique side-actuated device, were evaluated in patients > or =12 years of age with seasonal allergic rhinitis to determine the optimal dose. A randomized, double-blind, parallel-group, placebo-controlled, dose-ranging study was performed on 641 patients who received placebo (n=128) or fluticasone furoate, 55 microg (n=127), 110 microg (n=127), 220 microg (n=129), or 440 microg (n=130), once daily for 2 weeks. Fluticasone furoate was significantly more effective than placebo for mean changes from baseline over the 2-week treatment period in daily reflective total nasal symptom score (primary end point; p < 0.001 each dose vs. placebo), morning predose instantaneous total nasal symptom score (p < 0.001 each dose versus placebo), daily reflective total ocular symptom score (p < or = 0.013 each dose versus placebo), and morning predose instantaneous total ocular symptom score (p < or = 0.019 for three highest doses versus placebo). The onset of action for fluticasone furoate nasal spray versus placebo was observed 8 hours after the first. dose of study medication in the 110 and 440 microg treatment groups (p < or = 0.032). The incidence of adverse events, results of clinical laboratory tests, and changes in 24-hour urinary cortisol values were similar between active treatment groups and placebo. The preliminary profile of fluticasone furoate is that of a rapidly effective therapy that confers 24-hour efficacy for both nasal and ocular symptoms with once-daily dosing. The 110-microg dose was chosen for phase III development because it achieved statistically significant and clinically meaningful results for all efficacy end points and provided the optimal risk-benefit ratio. PMID:17479608

  13. Epidemiological Characterization and Risk Factors of Allergic Rhinitis in the General Population in Guangzhou City in China

    PubMed Central

    Lin, Zhi Bin; Peng, Hua; Lu, Han Gui; Yang, Yan; Yin, Jia; Li, Tian Ying

    2014-01-01

    The prevalence of allergic rhinitis (AR) in China has increased with an apparent geographic variation. The current study aims to investigate the AR prevalence/classification, diagnosis/treatment conditions, trigger factors, and risk factors in the general population of Guangzhou, the third biggest city in China. A cross-sectional survey was performed in the citizens in Guangzhou from December 2009 to March 2010 by using a stratified multistage cluster sampling method. All subjects were asked to complete a comprehensive questionnaire via a face to face interview. A total of 9,899 questionnaires were valid. The prevalence rate of AR in the general population of Guangzhou was 6.24%, with a significant higher prevalence in urban area (8.32%) versus rural area (3.43%). Among the AR subjects, most (87%) were diagnosed with intermittent AR and 87% suffered from moderate-severe symptoms. High percentages of the AR patients did not have previously physician-based diagnosis (34%) or specific medical treatment (55%). Morning time, winter season, and cold air were the most common trigger factors of AR. Family history of AR, current living place, living place during babyhood, smoking, home renovation, and pet ownership were the significant risk factors associated with AR prevalence in the population. The study demonstrated comprehensive epidemiological and clinical information about the AR in Guangzhou population. Change of living environment and lifestyles had strong impacts on the prevalence of AR. Public health policies should help the patients benefit from a proper diagnosis/treatment and specifically target the local risk factors, in order to control the AR incidence. PMID:25514026

  14. The Association between Polymorphisms in the MRPL4 and TNF-α Genes and Susceptibility to Allergic Rhinitis

    PubMed Central

    Fu, Zheng; Zhang, Luo

    2013-01-01

    Background Allergic rhinitis (AR) is a chronic inflammatory disease of the nasal mucosa, involving a complex interaction between genetic and environmental factors. Evidence suggests that polymorphisms in the gene coding for mitochondrial ribosomal protein L4 (MRPL4), located in close proximity to intercellular adhesion molecule-1 (ICAM-1) gene on chromosome location 19p13.2, may influence the risk factor for the development of AR. Objective The aim of our study was to investigate any association between AR susceptibility and polymorphisms in ICAM-1 gene, as well as associations between AR risk and polymorphisms in MRPL4, nuclear factor-kappaB (NF-κB) and tumor necrosis factor alpha(TNF-α) genes, associated with ICAM-1 expression. Methods A cohort of 414 patients with AR and 293 healthy controls was enrolled from the Han Chinese population in Beijing, China. Blood was drawn for DNA extraction and total serum immunoglobulin E (IgE). A total of 14 single nucleotide polymorphisms (SNPs) in ICAM-1, NF-κB, TNF-α, and MRPL4 genes were selected using the CHB genotyping data from the International Haplotype Mapping (HapMap) and assessed for differences in frequencies of the alleles and genotypes between the AR patients and control subjects. Results TNF-α SNP rs1799964 and MRPL4 SNP rs11668618 were found to occur in significantly greater frequencies in the AR group compared to control group. There were no significant associations between SNPs in NF-κB, ICAM-1 and AR. The SNP-SNP interaction information analysis further indicated that there were no synergistic effects among the selected sets of polymorphisms. Conclusions Our results suggest a strong association between AR risk and polymorphisms of MRPL4 and TNF-α genes in Han Chinese population. PMID:23472126

  15. Rationally designed nanocarriers for intranasaltherapy of allergic rhinitis: influence of carrier type on in vivo nasal deposition

    PubMed Central

    Sallam, Marwa Ahmed; Helal, Hala Mahmoud; Mortada, Sana Mohamed

    2016-01-01

    The aim of this study is to develop a locally acting nasal delivery system of triamcinolone acetonide (TA) for the maintenance therapy of allergic rhinitis. The effect of encapsulating TA in different nanocarriers on its mucosal permeation and retention as well as in vivo nasal deposition has been studied. A comparative study was established between polymeric oil core nanocapsules (NCs), lipid nanocarriers such as nanoemulsion (NE), and nanostructured lipid carriers (NLCs). The elaborated nanocarriers were compared with TA suspension and the commercially available suspension “Nasacort®”. The study revealed that NC provided the highest mucosal retention, as 46.14%±0.048% of the TA initial dose was retained after 24 hours, while showing the least permeation through the nasal mucosa. On the other hand, for TA suspension and Nasacort®, the mucosal retention did not exceed 23.5%±0.047% of the initial dose after 24 hours. For NE and NLC, values of mucosal retention were 19.4%±0.041% and 10.97%±0.13%, respectively. NC also showed lower mucosal irritation and superior stability compared with NE. The in vivo nasal deposition study demonstrated that NC maintained drug in its site of action (nasal cavity mucosa) for the longest period of time. The elaborated polymeric oil core NCs are efficient carriers for the administration of nasally acting TA as it produced the least permeation results, thus decreasing systemic absorption of TA. Although NCs have been administered via various routes, this is the first study to implement the polymeric oil core NC as an efficient carrier for localized nasal drug delivery. PMID:27307734

  16. Add-on histamine receptor-3 antagonist for allergic rhinitis: a double blind randomized crossover trial using the environmental exposure unit

    PubMed Central

    2014-01-01

    Background Oral antihistamines that target the histamine receptor–1, such as fexofenadine, offer suboptimal relief of allergic rhinitis-associated nasal congestion. Combinations with oral sympathomimetics, such as pseudoephedrine, relieve congestion but produce side effects. Previous animal and human studies with histamine receptor-3 antagonists, such as PF-03654764, demonstrate promise. Methods Herein we employ the Environmental Exposure Unit (EEU) to conduct the first randomized controlled trial of PF-03654764 in allergic rhinitis. 64 participants were randomized in a double-blind, placebo-controlled 4-period crossover study. Participants were exposed to ragweed pollen for 6 hours post-dose in the EEU. The primary objective was to compare the effect of PF-03654764 + fexofenadine to pseudoephedrine + fexofenadine on the subjective measures of congestion and Total Nasal Symptom Score (TNSS). The objectives of our post-hoc analyses were to compare all treatments to placebo and determine the onset of action (OA). This trial was registered at ClinicalTrials.gov (NCT01033396). Results PF-03654764 + fexofenadine was not superior to pseudoephedrine + fexofenadine. In post-hoc analyses, PF-03654764 + fexofenadine significantly reduced TNSS, relative to placebo, and OA was 60 minutes. Pseudoephedrine + fexofenadine significantly reduced congestion and TNSS, relative to placebo, with OA of 60 and 30 minutes, respectively. Although this study was not powered for a statistical analysis of safety, it was noted that all PF-03654764-treated groups experienced an elevated incidence of adverse events. Conclusions PF-03654764 + fexofenadine failed to provide superior relief of allergic rhinitis-associated nasal symptoms upon exposure to ragweed pollen compared to fexofenadine + pseudoephedrine. However, in post-hoc analyses, PF-03654764 + fexofenadine improved TNSS compared to placebo. Side effects in the PF-03654764-treated groups were

  17. Long term evaluation of mesenchymal stem cell therapy in a feline model of chronic allergic asthma

    PubMed Central

    Trzil, Julie E; Masseau, Isabelle; Webb, Tracy L; Chang, Chee-hoon; Dodam, John R; Cohn, Leah A; Liu, Hong; Quimby, Jessica M; Dow, Steven W; Reinero, Carol R

    2014-01-01

    Background Mesenchymal stem cells (MSCs) decrease airway eosinophilia, airway hyperresponsiveness (AHR), and remodeling in murine models of acutely induced asthma. We hypothesized that MSCs would diminish these hallmark features in a chronic feline asthma model. Objective To document effects of allogeneic, adipose-derived MSCs on airway inflammation, airway hyperresponsiveness (AHR), and remodeling over time and investigate mechanisms by which MSCs alter local and systemic immunologic responses in chronic experimental feline allergic asthma. Methods Cats with chronic, experimentally-induced asthma received six intravenous infusions of MSCs (0.36–2.5X10E7 MSCs/infusion) or placebo bimonthly at the time of study enrollment. Cats were evaluated at baseline and longitudinally for one year. Outcome measures included: bronchoalveolar lavage fluid cytology to assess airway eosinophilia; pulmonary mechanics and clinical scoring to assess AHR; and thoracic computed tomographic (CT) scans to assess structural changes (airway remodeling). CT scans were evaluated using a scoring system for lung attenuation (LA) and bronchial wall thickening (BWT). To assess mechanisms of MSC action, immunologic assays including allergen-specific IgE, cellular IL-10 production, and allergen-specific lymphocyte proliferation were performed. Results There were no differences between treatment groups or over time with respect to airway eosinophilia or AHR. However, significantly lower LA and BWT scores were noted in CT images of MSC-treated animals compared to placebo-treated cats at month 8 of the study (LA p=0.0311; BWT p=0.0489). No differences were noted between groups in the immunologic assays. Conclusions and Clinical Relevance When administered after development of chronic allergic feline asthma, MSCs failed to reduce airway inflammation and AHR. However, repeated administration of MSCs at the start of study did reduce computed tomographic measures of airway remodeling by month 8, though

  18. Modulation of lung inflammation by vessel dilator in a mouse model of allergic asthma

    PubMed Central

    Wang, Xiaoqin; Xu, Weidong; Kong, Xiaoyuan; Chen, Dongqing; Hellermann, Gary; Ahlert, Terry A; Giaimo, Joseph D; Cormier, Stephania A; Li, Xu; Lockey, Richard F; Mohapatra, Subhra; Mohapatra, Shyam S

    2009-01-01

    Background Atrial natriuretic peptide (ANP) and its receptor, NPRA, have been extensively studied in terms of cardiovascular effects. We have found that the ANP-NPRA signaling pathway is also involved in airway allergic inflammation and asthma. ANP, a C-terminal peptide (amino acid 99–126) of pro-atrial natriuretic factor (proANF) and a recombinant peptide, NP73-102 (amino acid 73–102 of proANF) have been reported to induce bronchoprotective effects in a mouse model of allergic asthma. In this report, we evaluated the effects of vessel dilator (VD), another N-terminal natriuretic peptide covering amino acids 31–67 of proANF, on acute lung inflammation in a mouse model of allergic asthma. Methods A549 cells were transfected with pVD or the pVAX1 control plasmid and cells were collected 24 hrs after transfection to analyze the effect of VD on inactivation of the extracellular-signal regulated receptor kinase (ERK1/2) through western blot. Luciferase assay, western blot and RT-PCR were also performed to analyze the effect of VD on NPRA expression. For determination of VD's attenuation of lung inflammation, BALB/c mice were sensitized and challenged with ovalbumin and then treated intranasally with chitosan nanoparticles containing pVD. Parameters of airway inflammation, such as airway hyperreactivity, proinflammatory cytokine levels, eosinophil recruitment and lung histopathology were compared with control mice receiving nanoparticles containing pVAX1 control plasmid. Results pVD nanoparticles inactivated ERK1/2 and downregulated NPRA expression in vitro, and intranasal treatment with pVD nanoparticles protected mice from airway inflammation. Conclusion VD's modulation of airway inflammation may result from its inactivation of ERK1/2 and downregulation of NPRA expression. Chitosan nanoparticles containing pVD may be therapeutically effective in preventing allergic airway inflammation. PMID:19615076

  19. Type 2 innate lymphoid cells: at the cross-roads in allergic asthma.

    PubMed

    van Rijt, Leonie; von Richthofen, Helen; van Ree, Ronald

    2016-07-01

    Allergic asthma is a chronic inflammatory disease of the lower airways that affects millions of people worldwide. Allergic asthma is a T helper 2 cell (Th2)-mediated disease, in which Th2 cytokines interleukin (IL)-4, IL-5, and IL-13 are closely associated with the symptoms. IL-4 is needed by B cells to switch toward an IgE response, IL-5 recruits and activates eosinophils while IL-13 increases mucus production. The identification of type 2 innate lymphoid cells (ILC2), which are able to rapidly produce large amounts of IL-5 and IL-13 in response to epithelial derived cytokines, implicated a new key player besides Th2 cells. ILCs constitute a family of innate lymphocytes distinct from T and B cells. ILC2s are located in various epithelial compartments in mice and human, including the lung. The recent finding of increased numbers of ILC2s in the airways of severe asthma patients prompts further research to clarify their immunological function. Murine studies have shown that ILC2s are an early innate source of IL-5 and IL-13 after allergen exposure, which induce airway eosinophilic infiltration, mucus hyperproduction, and airway hyperresponsiveness but not allergen-specific IgE production. ILC2s contribute to the initiation as well as to the maintenance of the adaptive type 2 immune response. Here, we review the recent progress on our understanding of the role of ILC2s in the immunopathology of allergic asthma, in particular by studies using murine models which have elucidated fundamental mechanisms by which ILC2s act. PMID:26965110

  20. Improved asthma control in patients with severe, persistent allergic asthma after 12 months of nightly temperature-controlled laminar airflow: an observational study with retrospective comparisons

    PubMed Central

    Schauer, Uwe; Bergmann, Karl-Christian; Gerstlauer, Michael; Lehmann, Sylvia; Gappa, Monika; Brenneken, Amelie; Schulz, Christian; Ahrens, Peter; Schreiber, Jens; Wittmann, Michael; Hamelmann, Eckard

    2015-01-01

    Introduction Continuous or episodic allergen exposure is a major risk factor of frequent symptoms and exacerbations for patients with allergic asthma. It has been shown that temperature-controlled laminar airflow (TLA) significantly reduced allergen exposure and airway inflammation and improved quality of life of patients with poorly controlled allergic asthma. Objective The objective was to evaluate the effects of nighttime TLA when used during real-life conditions for 12 consecutive months in addition to the patients’ regular medication. Methods This multicenter, pre- and postretrospective observational study included patients with inadequately controlled moderate-to-severe allergic asthma who received add-on treatment with TLA for 12 consecutive months. Data on medication use, asthma control, asthma symptoms, lung function, use of hospital resources, and exacerbations were collected after 4 and 12 months and compared with corresponding data collected retrospectively from medical records during the year prior to inclusion in the study. Results Data from 30 patients (mean age 28; range 8–70) completing 4 months and 27 patients completing 12 months of TLA use are presented. The mean number of exacerbations was reduced from 3.6 to 1.3 (p<0.0001), and the ratio of asthma-related emergency room visits or hospitalizations diminished from 72.4 to 23.3% (p=0.001) or from 44.8 to 20.0% (p<0.05), respectively, after 12 months of TLA use. The Asthma Control Test index increased from 14.1 to 18.5 (p<0.0001). After 4 months of TLA use, clear improvements can be shown for most variables in line with the data collected after 12 months. Conclusions The addition of TLA to the patients’ regular medication significantly reduced exacerbations, asthma symptoms, and the utilization of hospital resources. The data support that TLA may be an important new non-pharmacological approach in the management of poorly controlled allergic asthma. PMID:26557252

  1. Rhinitis (Hay Fever): Tips to Remember

    MedlinePlus

    ... Rhinitis Allergic rhinitis is caused by allergens like molds, pollen and animals. These are substances which are ... triggered by outdoor allergens such as pollen and mold spores. Some people have symptoms year-round due ...

  2. The Cohort for Childhood Origin of Asthma and allergic diseases (COCOA) study: design, rationale and methods

    PubMed Central

    2014-01-01

    Background This paper describes the background, aim, and design of a prospective birth-cohort study in Korea called the COhort for Childhood Origin of Asthma and allergic diseases (COCOA). COCOA objectives are to investigate the individual and interactive effects of genetics, perinatal environment, maternal lifestyle, and psychosocial stress of mother and child on pediatric susceptibility to allergic diseases. Methods/Design The participants in COCOA represents a Korean inner-city population. Recruitment started on 19 November, 2007 and will continue until 31 December, 2015. Recruitment is performed at five medical centers and eight public-health centers for antenatal care located in Seoul. Participating mother-baby pairs are followed from before birth to adolescents. COCOA investigates whether the following five environmental variables contribute causally to the development and natural course of allergic diseases: (1) perinatal indoor factors (i.e. house-dust mite, bacterial endotoxin, tobacco smoking, and particulate matters 2.5 and 10), (2) perinatal outdoor pollutants, (3) maternal prenatal psychosocial stress and the child’s neurodevelopment, (4) perinatal nutrition, and (5) perinatal microbiome. Cord blood and blood samples from the child are used to assess whether the child’s genes and epigenetic changes influence allergic-disease susceptibility. Thus, COCOA aims to investigate the contributions of genetics, epigenetics, and various environmental factors in early life to allergic-disease susceptibility in later life. How these variables interact to shape allergic-disease susceptibility is also a key aim. The COCOA data collection schedule includes 11 routine standardized follow-up assessments of all children at 6 months and every year until 10 years of age, regardless of allergic-disease development. The mothers will complete multiple questionnaires to assess the baseline characteristics, the child’s exposure to environmental factors, maternal pre

  3. A systematic review of socioeconomic position in relation to asthma and allergic diseases.

    PubMed

    Uphoff, Eleonora; Cabieses, Báltica; Pinart, Mariona; Valdés, Macarena; Antó, Josep Maria; Wright, John

    2015-08-01

    The role of socioeconomic position (SEP) in the development of asthma and allergies is unclear, with some pointing to the risks of low SEP and other research pointing in the direction of higher SEP being associated with higher prevalence rates. The aim of this systematic review is to clarify associations between SEP and the prevalence of asthma and allergies. Out of 4407 records identified, 183 were included in the analysis. Low SEP was associated with a higher prevalence of asthma in 63% of the studies. Research on allergies, however, showed a positive association between higher SEP and illness in 66% of studies. Pooled estimates for the odds ratio of disease for the highest compared with the lowest SEP confirmed these results for asthma (unadjusted OR 1.38, 95% CI 1.37-1.39), allergies in general (OR 0.67, 95% CI 0.62-0.72), atopic dermatitis (unadjusted OR 0.72, 95% CI 0.61-0.83) and allergic rhinoconjunctivitis (unadjusted OR 0.52, 95% CI 0.46-0.59). Sensitivity analyses with a subsample of high-quality studies led to the same conclusion. Evidence from this systematic review suggests that asthma is associated with lower SEP, whereas the prevalence of allergies is associated with higher SEP. PMID:25537562

  4. Phthalate metabolites in urine and asthma, allergic rhinoconjunctivitis and atopic dermatitis in preschool children.

    PubMed

    Callesen, Michael; Bekö, Gabriel; Weschler, Charles J; Langer, Sarka; Brive, Lena; Clausen, Geo; Toftum, Jørn; Sigsgaard, Torben; Høst, Arne; Jensen, Tina Kold

    2014-07-01

    Phthalate esters are among the most ubiquitous of indoor pollutants and have been associated with various adverse health effects. In the present study we assessed the cross-sectional association between eight different phthalate metabolites in urine and allergic disease in young children. As part of the Danish Indoor Environment and Children's Health study, urine samples were collected from 440 children aged 3-5 years, of whom 222 were healthy controls, 68 were clinically diagnosed with asthma, 76 with rhinoconjunctivitis and 81 with atopic dermatitis (disease subgroups are not mutually exclusive; some children had more than one disease). There were no statistically significant differences in the urine concentrations of phthalate metabolites between cases and healthy controls with the exception of MnBP and MECPP, which were higher in healthy controls compared with the asthma case group. In the crude analysis MnBP and MiBP were negatively associated with asthma. In the analysis adjusted for multiple factors, only a weak positive association between MEP in urine and atopic dermatitis was found; there were no positive associations between any phthalate metabolites in urine and either asthma or rhinoconjunctivitis. These findings appear to contradict earlier studies. Differences may be due to higher exposures to certain phthalates (e.g., BBzP) via non-dietary pathways in earlier studies, phthalates serving as surrogates for an agent associated with asthma (e.g., PVC flooring) in previous studies but not the present study or altered cleaning habits and the use of "allergy friendly" products by parents of children with allergic disease in the current study in contrast to studies conducted earlier. PMID:24388279

  5. Effects of Swimming on the Inflammatory and Redox Response in a Model of Allergic Asthma.

    PubMed

    Brüggemann, T R; Ávila, L C M; Fortkamp, B; Greiffo, F R; Bobinski, F; Mazzardo-Martins, L; Martins, D F; Duarte, M M M F; Dafre, A; Santos, A R S; Silva, M D; Souza, L F; Vieira, R P; Hizume-Kunzler, D C

    2015-06-01

    In this study we hypothesized that swimming during sensitization phase could result in a preventive effect in mice with allergic asthma. Swiss mice were divided into 4 groups: Control and Swimming (non-sensitized), OVA and OVA+Swimming (sensitized). The allergic inflammation was induced by 2 intraperitoneal injections and 4 aerosol challenges using ovalbumin. Swimming sessions were performed at high intensity over 3 weeks. 48 h after the last challenge mice were euthanized. Swimming decreased OVA-increased total IgE, IL-1, IL-4, IL-5 and IL-6 levels, as well as the number of total cells, lymphocytes and eosinophils in bronchoalveolar lavage fluid, (p<0.05). Simultaneously, swimming also increased IL-10 and glutathione levels in the Swimming and OVA+Swimming groups (p<0.05). The levels of glutathione peroxidase and catalase were increased only in the Swimming group when compared to all groups (p<0.05). 21 days of swimming resulted in an attenuation of pulmonary allergic inflammation followed by an increase of glutathione levels in the OVA group. Swimming only increased the levels of glutathione peroxidase and catalase in non-sensitized mice (p<0.05). These data suggest that the pulmonary anti-inflammatory effects produced by 3 weeks of high-intensity swimming in this model of OVA-induced asthma may be, at least partly, modulated by reduced oxidative stress and increased IL-10 production. PMID:25837246

  6. Curine inhibits eosinophil activation and airway hyper-responsiveness in a mouse model of allergic asthma

    SciTech Connect

    Ribeiro-Filho, Jaime; Calheiros, Andrea Surrage; Vieira-de-Abreu, Adriana; Moraes de Carvalho, Katharinne Ingrid; Silva Mendes, Diego da; Melo, Christianne Bandeira; Martins, Marco Aurélio; Silva Dias, Celidarque da; Piuvezam, Márcia Regina; and others

    2013-11-15

    Allergic asthma is a chronic inflammatory airway disease with increasing prevalence around the world. Current asthma therapy includes drugs that usually cause significant side effects, justifying the search for new anti-asthmatic drugs. Curine is a bisbenzylisoquinoline alkaloid that modulates calcium influx in many cell types; however, its anti-allergic and putative toxic effects remain to be elucidated. Our aim was to investigate the effects of curine on eosinophil activation and airway hyper-responsiveness (AHR) and to characterize its potential toxic effects. We used a mouse model of allergic asthma induced by sensitization and challenge with ovalbumin (OVA) to evaluate the anti-allergic effects of oral treatment with curine. The oral administration of curine significantly inhibited eosinophilic inflammation, eosinophil lipid body formation and AHR in animals challenged with OVA compared with animals in the untreated group. The curine treatment also reduced eotaxin and IL-13 production triggered by OVA. Verapamil, a calcium channel antagonist, had similar anti-allergic properties, and curine pre-treatment inhibited the calcium-induced tracheal contractile response ex-vivo, suggesting that the mechanism by which curine exerts its effects is through the inhibition of a calcium-dependent response. A toxicological evaluation showed that orally administered curine did not significantly alter the biochemical, hematological, behavioral and physical parameters measured in the experimental animals compared with saline-treated animals. In conclusion, curine showed anti-allergic activity through mechanisms that involve inhibition of IL-13 and eotaxin and of Ca{sup ++} influx, without inducing evident toxicity and as such, has the potential for the development of anti-asthmatic drugs. - Highlights: • Curine is a bisbenzylisoquinoline alkaloid from Chondrodendron platyphyllum. • Curine inhibits eosinophil influx and activation and airway hyper-responsiveness. • Curine