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Quah PL, Loo EXL, Lee GNLY, Kuo IC, Gerez I, Llanora GV, Chan YH, Aw M, Shek LPC, Lee BW. Clinical phenotype and allergen sensitization in the first 2 years as predictors of atopic disorders at age 5 years. World Allergy Organ J 2015; 8:33. [PMID: 26664574 PMCID: PMC4667513 DOI: 10.1186/s40413-015-0082-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 11/03/2015] [Indexed: 12/27/2022] Open
Abstract
Introduction From a birth cohort of at-risk Asian infants, we prospectively investigated the role of early onset allergen sensitization and clinical phenotypes as risk factors for atopic disorders at the age of 5 years. Methods and materials The study recruited 253 families with a history of allergic disease in a first degree relative from an antenatal clinic in Singapore. The children were followed prospectively to assess clinical outcomes and skin prick test was performed at 2 and 5 years of age. Results Allergen sensitization (food and/or house dust mites) alone at 2 years of age was not associated with increased risk of wheeze and eczema at 5 years. However, the clinical phenotype (eczema and wheeze) with or without the presence of concomitant allergen sensitization at 2 years increased this risk. For eczema, eczema alone at year 2 increased the risk of eczema at year 5 (adjOR = 7.1; 95 % CI: 1.8–27.8) and this was further increased by the presence of allergen sensitization (adjOR = 25.4; 95 % CI: 4.7–138.5) and the concomitant presence of both wheeze and allergen sensitization (adjOR = 64.9; 95 % CI: 4.7–900.0). For wheeze, wheeze alone at 2 years (adjOR = 4.5; 95 % CI: 1.4 -14.8), and wheeze with concomitant allergen sensitization and eczema (adjOR = 13.9; 95 % CI: 1.2–168.5) increased the risk of wheeze at 5 years. The exception was rhinitis, where allergen sensitization alone at 2 years (adjOR = 5.6; 95 % CI: 1.1–29.2) increased the risk of rhinitis at 5 years. Early onset of eczema at 2 years also increased the risk of rhinitis (adjOR = 6.8; 95 % CI: 2.0–23.1). Conclusion In this Asian birth cohort, the clinical phenotype (eczema and wheeze) with or without concomitant allergen sensitization in the first 2 years of life were strong predictors of atopic disorders at 5 years.
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Affiliation(s)
- Phaik Ling Quah
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore ; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Evelyn Xiu Ling Loo
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
| | - Gabriella Nadine Li Yuan Lee
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore ; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - I-Chun Kuo
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore ; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Irvin Gerez
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | | | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Marion Aw
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore ; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Lynette Pei-Chi Shek
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore ; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Bee Wah Lee
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore ; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore ; Department of Paediatrics, NUHS Tower Block, Level 12, 1E Kent Ridge Road, Singapore, 119228 Singapore
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402
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Keleş E, Özkara Ş, İlhan N, Güngör H, Karlıdağ T, Yalçın Ş. The Relationship between Th1/Th2 Balance and 1α, 25-Dihydroxyvitamin D 3 in Patients with Allergic Rhinitis. Turk Arch Otorhinolaryngol 2015; 53:139-143. [PMID: 29391997 DOI: 10.5152/tao.2015.1187] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 01/09/2016] [Indexed: 11/22/2022] Open
Abstract
Objective With regard to the correlation between T helper1/T helper2 (Th1/Th2) cell balance and 1α,25-dihydroxyvitamin D3, active metabolite of vitamin D, we studied Th1/Th2 cell balance by measuring levels of the cytokines interleukin (IL)-4, IL-10 and interferon-gamma (IFN-γ), which are important for immune response of patients with allergic rhinitis. Methods Thirty adult patients diagnosed with allergic rhinitis (study group) and 40 healthy volunteers (control group) are examined in the research. IFN-γ, IL-4, IL-10, and total immunoglobulin E (IgE) levels from serum samples and vitamin D3 levels from plasma were determined in all patients. Results In IgE, IL-4, IL-10, IFN-γ, and 1α,25-dihydroxyvitamin D3 levels (p<0.05), a statistically noticeable difference was observed between the study and control group. The 1α,25-dihydroxyvitamin D3 levels in both groups were compared and a statistically significant difference between the 1α,25-dihydroxyvitamin D3 levels in the study group and that in the control group (p<0.05) was observed. There was a positive correlation between IFN-γ and vitamin D levels (p<0.05) in the study group, whereas IgE, IL-4, and IL-10 levels showed a negative correlation with vitamin D3 levels (p<0.05). Conclusion In our study, 1α,25-dihydroxyvitamin D3 levels were associated with Th1/Th2 balance in allergic rhinitis, and a remarkable correlation was observed among vitamin D deficiency and allergy. These findings show that 1α,25-dihydroxyvitamin D3 may have a remarkable role in the severity and control of allergic disorders. In addition, further investigations are required to confirm how vitamin D should be used in allergic diseases. Furthermore, to reveal the exact mechanism of vitamin D on allergic diseases, further studies are required.
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Affiliation(s)
- Erol Keleş
- Department of Otorhinoloryngolojy, Fırat Universty School of Medicine, Elazığ, Turkey
| | - Şule Özkara
- Department of Otorhinoloryngolojy, Fırat Universty School of Medicine, Elazığ, Turkey
| | - Nevin İlhan
- Department of Biochemistry, Fırat Universty School of Medicine, Elazığ, Turkey
| | - Hilal Güngör
- Department of Biochemistry, Fırat Universty School of Medicine, Elazığ, Turkey
| | - Turgut Karlıdağ
- Department of Otorhinoloryngolojy, Fırat Universty School of Medicine, Elazığ, Turkey
| | - Şinasi Yalçın
- Department of Otorhinoloryngolojy, Fırat Universty School of Medicine, Elazığ, Turkey
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403
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Hamerschmidt R, Hamerschmidt R, Moreira ATR, Tenório SB, Timi JRR. Comparison of turbinoplasty surgery efficacy in patients with and without allergic rhinitis. Braz J Otorhinolaryngol 2015; 82:131-9. [PMID: 26857793 PMCID: PMC9449029 DOI: 10.1016/j.bjorl.2015.10.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Accepted: 01/23/2015] [Indexed: 11/28/2022] Open
Abstract
Introduction Turbinoplasty is a procedure that aims to reduce the size of the inferior turbinate through exuberant bone removal with high mucosal preservation. The procedure is recommended for patients with or without allergic rhinitis and those showing irreversible hypertrophy of inferior turbinates. Objective To evaluate the efficacy of inferior turbinoplasty for obstructive and non-obstructive symptoms in patients with or without allergic rhinitis. Methods Prospective study with 57 patients who underwent inferior turbinoplasty. They were evaluated for nasal obstruction, snoring, facial pressure, smell alterations, sneezing, nasal itching and runny nose symptoms, surgery time, and intraoperative bleeding. The last evaluation took place three months after surgery. Results Thirty-nine patients with allergic rhinitis and 18 without were assessed. Ninety days after surgery, 94.7% of patients showed degrees IV and V of breathing improvement; 89.5% showed moderate or complete improvement in snoring; all patients showed smell improvement (only one showed moderate improvement; all the others had full improvement); 95.5% experienced complete facial pressure improvement; and 89.7% showed moderate to complete improvement in nasal itching and runny nose symptoms, as well as in sneezing. Conclusion The efficacy of inferior turbinoplasty was confirmed not only for obstructive symptoms, but also for non-obstructive symptoms in patients with and without allergic rhinitis.
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Affiliation(s)
- Rodrigo Hamerschmidt
- Department of Otorhinolaryngology, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil; Clinical Surgery, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil.
| | - Rogério Hamerschmidt
- Department of Otorhinolaryngology, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil; Hospital de Clínicas, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil; Clinical Surgery, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil
| | - Ana Tereza Ramos Moreira
- Hospital de Clínicas, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil; Department of Ophthalmology, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil
| | - Sérgio Bernardo Tenório
- Hospital de Clínicas, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil; Department of Anesthesiology, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil
| | - Jorge Rufno Ribas Timi
- Hospital de Clínicas, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil; Vascular Surgery, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil
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404
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Leung N, Mawby TAR, Turner H, Qureishi A. Osteitis and chronic rhinosinusitis: a review of the current literature. Eur Arch Otorhinolaryngol 2015; 273:2917-23. [PMID: 26525884 DOI: 10.1007/s00405-015-3817-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Accepted: 10/22/2015] [Indexed: 11/30/2022]
Abstract
Chronic rhinosinusitis is a common debilitating condition characterized by inflammation of the nose and paranasal sinuses. Osteitis is an associated finding but it is not clear whether it is cause or effect. This review will report on studies that have examined the role of osteitis in CRS, with the ultimate aim of clarifying the definition, pathogenesis and clinical implications of this relatively new clinical entity. Literature searches of Medline, EMBASE and CENTRAL using the search terms osteitis, rhinosinusitis, sinusitis, rhinitis, chronic disease, and recurrence were performed. 21 articles were identified and reviewed. The papers highlighted key pathological features including periosteal thickening, new woven bone formation, bone resorption, fibrosis and inflammatory cell infiltration. Radiological grading systems and basic science research into the role of matrix metalloproteinases and P-glycoprotein were also identified and reviewed.
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Affiliation(s)
- N Leung
- Department of ENT, John Radcliffe Hospital, Oxford, UK.
| | - T A R Mawby
- Department of ENT, John Radcliffe Hospital, Oxford, UK
| | - H Turner
- Department of ENT, John Radcliffe Hospital, Oxford, UK
| | - A Qureishi
- Department of ENT, John Radcliffe Hospital, Oxford, UK
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405
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Aksoy F, Senturk E, Doğan R, Veyseller B, Ozturan O, Gönüllü N, Yilmaz F. Effects of azelastine nasal spray on nasal and nasopharyngeal microflora. J Laryngol Otol 2016; 130:95-9. [PMID: 26515526 DOI: 10.1017/S0022215115002959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Azelastine nasal spray is a topical antihistaminic drug for the symptomatic treatment of allergic rhinitis. This study aimed to investigate the effects of azelastine on nasal and nasopharyngeal microflora. METHODS Swab samples from 25 patients prescribed azelastine nasal spray monotherapy were collected just before treatment and after 1 month of treatment. After incubation of inoculates, the number of bacteria present in cultures was measured (in colony-forming units per millilitre). RESULTS Evaluation of the number of microflora revealed increased bacterial reproduction after treatment, but this difference was not statistically significant. The use of azelastine nasal spray decreased the reproduction of three potentially pathogenic bacteria; however, it did not affect the reproduction of other potentially pathogenic bacteria. CONCLUSION The use of azelastine nasal spray for one month did not have a statistically significant effect on the numbers of nasal and nasopharyngeal microflora; it is therefore safe from a microbiological viewpoint.
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406
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Imbaud TCDS, Mallozi MC, Domingos VBTC, Solé D. [Frequency of rhinitis and orofacial disorders in patients with dental malocclusion]. Rev Paul Pediatr 2015; 34:184-8. [PMID: 26631324 DOI: 10.1016/j.rpped.2015.10.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 04/20/2015] [Accepted: 05/21/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To describe the frequency and etiology of rhinitis, oral breathing, types of malocclusion and orofacial disorders in patients treated for dental malocclusion. METHODS Patients with poor dental occlusion (n=89, 8-15 years) undergoing orthodontic treatment at the Postgraduate Orthodontics Center (Sao Paulo, Brazil) participated in the study. Rhinitis and oral breathing were diagnosed by anamnesis, clinical assessment and allergic etiology of rhinitis through immediate hypersensitivity skin prick test (SPT) with airborne allergens. The association between types of breathing (oral or nasal), rhinitis and types of dental malocclusion, bruxism and cephalometric alterations (increased Y axis of facial growth) compared to standard cephalometric tracing (Escola de Odontologia da Universidade de São Paulo) were assessed. RESULTS The frequency of rhinitis in patients with dental malocclusion was 76.4% (68), and, of these, 81.7% were allergic (49/60 positive skin prick test), whereas the frequency of oral breathing was 62.9%. There was a significant association between an increased Y axis of facial growth and oral breathing (p<0.001), as well as between oral breathing and rhinitis (p=0.009). There was no association between rhinitis and bruxism. CONCLUSIONS The frequency of rhinitis in children with dental malocclusion is higher than that in the general population, which is approximately 30%. Patients with oral breathing have a tendency to a dolichofacial growth pattern (increased Y axis of facial growth). In patients with rhinitis, regardless of the presence of oral breathing, the dolichofacial growth tendency was not observed.
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Affiliation(s)
| | - Márcia Carvalho Mallozi
- Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brasil
| | | | - Dirceu Solé
- Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brasil
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407
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Sedaghat AR, Matsui EC, Baxi SN, Bollinger ME, Miller R, Perzanowski M, Phipatanakul W. Mouse Sensitivity is an Independent Risk Factor for Rhinitis in Children with Asthma. J Allergy Clin Immunol Pract 2016; 4:82-8.e1. [PMID: 26441149 DOI: 10.1016/j.jaip.2015.09.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 08/31/2015] [Accepted: 09/01/2015] [Indexed: 01/02/2023]
Abstract
BACKGROUND Although mouse and cockroach allergy is known to be important in urban children with asthma, the independent association of mouse and cockroach sensitization with rhinitis in these children is unknown. OBJECTIVE To determine the association of mouse and cockroach sensitization with rhinitis in urban children with asthma. METHODS As part of the Mouse Allergen and Asthma Intervention Trial, 499 urban children (5-17 years) with persistent asthma underwent spirometry, skin prick testing to 14 common environmental allergens, and serology for mouse-specific IgE. In 269 subjects, cockroach-specific IgE serology was also obtained. Patient/parent-reported rhinitis in the last 2 weeks and the last 1 year was the primary outcome measure. Mouse/cockroach exposure was measured by reported frequency of sightings. Mouse allergen-settled bedroom dust samples were also measured in mouse-sensitized children. RESULTS Rhinitis was reported in 49.9% and 70.2% of the participants within the last 2 weeks and the last 1 year, respectively. Serum mouse IgE level of 0.35 IU/mL or more was associated with rhinitis in the past 2 weeks (adjusted odds ratio, 2.15; 95% CI, 1.02-4.54; P = .04) and the past 1 year (adjusted odds ratio, 2.40; 95% CI, 1.12-5.1; P = .02) after controlling for age, race, sex, the presence of any smokers at home, primary caregiver education level, number of allergen sensitivities, cockroach IgE level of 0.35 IU/mL or more, and study site (Boston or Baltimore). Measures of home mouse exposure were not associated with rhinitis, regardless of mouse sensitivity. Cockroach sensitivity was not associated with rhinitis regardless of sensitization to other allergens. CONCLUSIONS In urban children with asthma, increased mouse IgE, but not cockroach IgE, in the sera (mouse IgE ≥ 0.35 IU/mL) may be associated independently with rhinitis.
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408
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Cerejeira R, Fernandes S, Pinto Moura C. Increased expression of α7nAChR in chronic rhinosinusitis: The intranasal cholinergic anti-inflammatory hypothesis. Auris Nasus Larynx 2016; 43:176-81. [PMID: 26410356 DOI: 10.1016/j.anl.2015.08.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 08/17/2015] [Accepted: 08/26/2015] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Chronic rhinosinusitis results from a dysfunctional host-environment interaction at the site of interface, in the nose and paranasal sinuses. A parasympathetic-mediated anti-inflammatory reflex is known to have a pivotal role in the control of damage induced by immune response to injury and infection; acetylcholine released by peripheral nerves interacts with nicotinic acetylcholine receptor subunit α7 - α7nAChR - of innate immune cells, inhibiting pro-inflammatory signalling. This work aims to investigate whether cholinergic function is implicated in chronic rhinosinusitis. METHODS α7nAChR mRNA and protein levels were measured in nasal biopsy specimens of 14 patients with CRSwNP, 8 with CRSsNP and 10 control subjects, undergoing surgery. RESULTS Gene expression levels of α7nAChR did not differ between groups; protein expression was significantly higher in CRSwNP than in CRSsNP (p=0.041), and both of these patient groups showed significant higher levels than controls (CRSwNP vs Controls - p=0.001; CRSsNP vs Controls - p=0.041). CONCLUSION Elevated α7nAChR protein levels suggest that the cholinergic system is involved in the inflammatory response of chronic rhinosinusitis. This can shed light on both, the disease pathophysiology and the development of future treatment options.
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409
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Song Y, Wang M, Xie J, Li W, Zhang X, Wang T, Tan G. Prevalence of allergic rhinitis among elementary and middle school students in Changsha city and its impact on quality of life. J Laryngol Otol 2015; 129:1108-14. [PMID: 26391176 DOI: 10.1017/S0022215115002492] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES To investigate the prevalence of allergic rhinitis among elementary and middle school students and examine its impact on their quality of life. METHODS Stratified sampling and cluster sampling surveys were performed among 10-17-year-old students in Changsha city from June 2011 to April 2012. RESULTS In the stratified sampling survey, the self-reported allergic rhinitis rate was 42.5 per cent. Further examination demonstrated that the average prevalence of allergic rhinitis was 19.4 per cent. The cluster sampling survey demonstrated that 214 of 814 students appeared to be atopic (26.3 per cent). The prevalence of allergic rhinitis and asthma was 17.2 and 2.1 per cent, respectively. In total, 71 atopic individuals (8.7 per cent) were without any symptoms of allergic disease. Further analysis showed that allergic rhinitis influenced the students' sleep, emotions and memory (p < 0.001). CONCLUSION The prevalence of allergic rhinitis was 15.8 -19.4 per cent, showing an increase with age. Allergic rhinitis affected students' sleep, emotions and memory.
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410
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Carreiro-Martins P, Rosado-Pinto J, do Céu Teixeira M, Neuparth N, Silva O, Papoila AL, Khaltaev N, Bousquet J, Annesi-Maesano I. Distribution and etiology of chronic respiratory diseases in primary healthcare departments in Cape Verde. Rev Epidemiol Sante Publique 2015; 63:305-13. [PMID: 26386633 DOI: 10.1016/j.respe.2015.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 04/22/2015] [Accepted: 06/03/2015] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Data on chronic respiratory diseases (CRD) are scarce or unavailable in most African countries. We aimed to determine the prevalence of CRD and associated risk factors in Cape Verde, at the primary healthcare level. METHODS In the frame of the Global Alliance Against Chronic Respiratory Diseases, a cross-sectional study was carried out in October 2006 in 3256 outpatients (2142 women) (median age of 30 years) seeking care at primary healthcare departments, through a standardized interview questionnaire during two weeks. RESULTS The prevalence of emphysema, tuberculosis, chronic bronchitis, rhinoconjunctivitis and asthma were 0.7%, 2%, 4.5%, 12.3% and 6.2%, respectively. Current smoking was associated with emphysema (OR: 3.36; 95% CI: 0.97-11.40) and tuberculosis (OR: 2.14; 95% CI: 1.07-4.30), ever exposed to a dusty workplace with chronic bronchitis (OR: 2.20; CI 95%: 1.50-3.21) and rhinoconjunctivitis (OR: 1.56; CI 95%: 1.23-1.98) and cooking or heating using an open fire with asthma (OR: 1.59; CI 95%: 1.16-2.19). The estimates of attributable risks percent indicated that, in the sample, a noticeable part of CRD could be attributed to active smoking, exposure to dust and biomass. Results varied according to gender, particularly regarding current smoking which was more important for men. CONCLUSIONS Tobacco smoking, exposure to dust at work and using an open fire were important risk factors for CRD. Our results suggest that if actions were taken in order to reduce the aforementioned exposures, an important CRD decrease could be achieved.
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411
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Khazaei HA, Khazaei B, Dashtizadeh GA, Mohammadi M. Cigarette Smoking and Skin Prick Test in Patients With Allergic Rhinitis. Int J High Risk Behav Addict 2015; 4:e23483. [PMID: 26495257 PMCID: PMC4609504 DOI: 10.5812/ijhrba.23483v2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 02/15/2015] [Accepted: 04/25/2015] [Indexed: 12/16/2022]
Abstract
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.
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Affiliation(s)
- Hossein Ali Khazaei
- Department of Immunology and Hematology, Research Center for Clinical Immunology, Ali Ebne Abi Taleb Hospital, Zahedan University of Medical Sciences, Zahedan, IR Iran
| | - Bahman Khazaei
- Ali Ebne Abi Taleb Hospital, Zahedan University of Medical Sciences, Chabahar Branch, Zahedan, IR Iran
- Corresponding author: Bahman Khazaei, Ali Ebne Abi Taleb Hospital, Zahedan University of Medical Sciences, Chabahar Branch, Zahedan, IR Iran. Tel: +98-5433224122, Fax: +98-5433295563, E-mail:
| | - Gholam Ali Dashtizadeh
- Department of ENT, Faculty of Medicine, Ali Ebne Abi Taleb Hospital, Zahedan University of Medical Sciences, Zahedan, IR Iran
| | - Mahdi Mohammadi
- Department of Biostatistics and Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, IR Iran
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412
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Perotin JM, Barbe C, Nguyen KL, Fontaine JF, Gabignon Y, Nardi J, Launois C, Lebargy F, Lavaud F, Deslee G. Work-related respiratory symptoms in Champagne vineyard workers. Eur Ann Allergy Clin Immunol 2015; 47:140-144. [PMID: 26356997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Vineyard workers (VW) are exposed to various respiratory allergens. The aims of the study were to determine the prevalence of work related respiratory symptoms (WRS) in Champagne VW in France and to analyze the relationships between symptoms, occupational exposure and sensitization profile. METHODS VW of Reims area were prospectively recruited between 2007 and 2010. Demographic and occupational characteristics were recorded. Respiratory symptoms were scored for each month of the past year. Results of respiratory functional tests and skin prick tests for common respiratory allergens, grape moulds and vine pollen were recorded. RESULTS 307 subjects were included. The prevalence of WRS was 11%. Compared to subjects with symptoms unrelated to work, subjects with WRS were more frequently sensitized to gramineae (34% vs 18%, p = 0.05), described ocular itching (74% vs 37%, p < 0.001) and seasonal symptoms (88% vs 69%, p = 0.03) mainly during lifting and trellising (57% vs 17%, p < 0.001). CONCLUSION WRS are frequent in Champagne WV and are associated with a sensitization to gramineae and with activities performed close to vine in late spring.
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Affiliation(s)
- J-M Perotin
- Department of Respiratory Medicine, University Hospital, 51100 Reims, France. INSERM UMRS 903, University Hospital, 51100, 45 Rue Cognacq Jay, 51100 Reims, France. Phone: +33 32 67 87 614 Fax: +33 32 678 40 30 E-mail:
| | - C Barbe
- Clinical Research Unit, University Hospital, 51100 Reims, France
| | - K L Nguyen
- Department of Respiratory Medicine, University Hospital, 51100 Reims, France
| | - J-F Fontaine
- Department of Respiratory Medicine, University Hospital, 51100 Reims, France
| | - Y Gabignon
- Department of Occupational Medicine, Mutualité Sociale Agricole, 51100 Reims, France
| | - J Nardi
- Department of Respiratory Medicine, University Hospital, 51100 Reims, France
| | - C Launois
- Department of Respiratory Medicine, University Hospital, 51100 Reims, France
| | - F Lebargy
- Department of Respiratory Medicine, University Hospital, 51100 Reims, France
| | - F Lavaud
- Department of Respiratory Medicine, University Hospital, 51100 Reims, France
| | - G Deslee
- Department of Respiratory Medicine, University Hospital, 51100 Reims, France. INSERM UMRS 903, University Hospital, 51100 Reims, France
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413
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Kim TH, Kang HM, Oh IH, Yeo SG. Relationship Between Otorhinolaryngologic Diseases and Obesity. Clin Exp Otorhinolaryngol 2015; 8:194-7. [PMID: 26330910 DOI: 10.3342/ceo.2015.8.3.194] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2013] [Revised: 03/26/2014] [Accepted: 04/22/2014] [Indexed: 01/16/2023] Open
Abstract
Objectives Obesity rates have been increasing for all population groups worldwide, leading to the increased development of various diseases. This study was designed is to identify the relationships between obesity and several important otorhinolaryngologic diseases, including chronic otitis media (COM), chronic rhinosinusitis, and chronic tonsillitis. Methods Mean body mass index (BMI) was compared in patients with COM, rhinosinusitis, and tonsillitis and in a control group. The relationships among the prevalence rates of overweight and obesity, morbidity period, and BMI were assessed in each group. Results Mean BMIs in the COM, rhinosinusitis, and tonsillitis groups were 24.45±2.72 kg/m2, 24.68±3.25 kg/m2, and 24.67±3.82 kg/m2, respectively, with each significantly higher than in the control group (23.22±3.01 kg/m2, P<0.05). The rates of obesity in the COM, rhinosinusitis, and tonsillitis groups were 37.5%, 42.9%, and 40.1%, respectively, each significantly higher than in the control group (24.3%, P<0.05). However, the rates of overweight did not differ significantly in the COM, rhinosinusitis, and tonsillitis compared with the control group (P>0.05 each). Conclusion Mean BMI and the prevalence of obesity were elevated in the three groups of patients with representative otorhinolaryngologic inflammatory diseases, including COM, chronic rhinosinusitis, and chronic tonsillitis.
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414
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Fsadni C, Fsadni P, Fava S, Montefort S. Association of prevalence of rhinitis, atopic eczema, rhinoconjunctivitis and wheezing with mortality from infectious diseases and with antibiotic susceptibility at a country level. Asia Pac Allergy 2015; 5:145-55. [PMID: 26240791 PMCID: PMC4521163 DOI: 10.5415/apallergy.2015.5.3.145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 06/22/2015] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND It was previously reported that there is a positive correlation between incidence of type 1 diabetes and prevalence of asthma and atopic eczema. A negative correlation between the prevalence of type 1 diabetes and mortality from infectious diseases as well as a positive correlation with antibiotic susceptibility at a country level have also been reported. OBJECTIVE The aim of this study was to investigate the association between country prevalence of rhinitis, atopic eczema, rhinoconjunctivitis, and wheezing with mortality from infectious diseases and also with antibiotic susceptibility at a country level. METHODS Data for prevalence of rhinitis, eczema, rhinoconjunctivitis, and wheezing was obtained from the International Study of Asthma and Allergies in Childhood study (ISAAC). ISAAC Phase one was a multicentre multicountry cross sectional study involving over 700,000 children in 2 age groups of school children, 13-14 years old (adolescents) and 6-7 years old (children) in 156 centres from 56 countries. Mortality from infectious diseases was taken from World Health Organisation data. The Alexander project was used to identify antibiotic susceptibilities to common bacteria. RESULTS There were significant positive correlations between atopic eczema and mortality from all infectious diseases studied, diarrhoeal illness, tropical infections, and childhood infections. A negative correlation exists between the prevalence of rhinitis and Streptococcus pneumoniae susceptibility to penicillin and to erythromycin, rhinitis and Haemophilus influenzae susceptibility to ampicillin and between rhinoconjunctivitis and H. influenzae susceptibility to ampicillin. CONCLUSION Th1/Th2 responses might influence the pathogenesis of infectious disease mortality, while antibiotic overprescription could explain the negative association between atopy and antibiotic susceptibility.
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Affiliation(s)
- Claudia Fsadni
- Department of Medicine, Mater Dei Hospital, Msida, MSD 2090, Malta. ; Faculty of Medicine and Surgery, University of Malta, Msida, MSD 2090, Malta
| | - Peter Fsadni
- Department of Medicine, Mater Dei Hospital, Msida, MSD 2090, Malta. ; Faculty of Medicine and Surgery, University of Malta, Msida, MSD 2090, Malta
| | - Stephen Fava
- Department of Medicine, Mater Dei Hospital, Msida, MSD 2090, Malta. ; Faculty of Medicine and Surgery, University of Malta, Msida, MSD 2090, Malta
| | - Stephen Montefort
- Department of Medicine, Mater Dei Hospital, Msida, MSD 2090, Malta. ; Faculty of Medicine and Surgery, University of Malta, Msida, MSD 2090, Malta
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415
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Nemati S, Jafari Shakib R, Shakiba M, Araghi N, Azimi SZ. Allergic Rhinitis in Adults with Chronic Suppurative Otitis Media. Iran J Otorhinolaryngol 2015; 27:261-6. [PMID: 26788473 PMCID: PMC4710877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Chronic suppurative otitis media (CSOM) is considered one of the most common causes of acquired hearing impairment in developing countries. CSOM is a multifactorial persistent inflammatory disease of the middle ear. A distinct pathophysiologic mechanism linking allergic rhinitis (AR) and CSOM remains to evolve. The purpose of this study was to investigate the association between AR and CSOM in adults.This was a case-control study. MATERIALS AND METHODS The subjects were 62 adults (23 male, 39 female) with established CSOM and 61 healthy controls. CSOM was diagnosed when there was a history of chronic (persisting for at least 3 months) otorrhea, accumulation of mucopurulent exudates in the external auditory canal or middle ear and/or perforated tympanic membrane on otoscopy. All participants were evaluated for the presence of AR by clinical evaluation of allergic symptoms, and underwent a skin-prick test for 23 common regional allergens. Statistical analysis was performed using SPSS version 16. RESULTS The prevalence of clinical rhinitis (allergic and non-allergic) was significantly higher among the cases compared with controls (62.5% vs. 37.5%, P=0.02). The prevalence of AR (proven by positive skin-prick test) was also significantly higher among affected adults than controls (24.6% and 13.8%, respectively). Adjusting for age, a logistic regression model showed that there was a significant difference between the two groups. Patients with AR and non-AR were at 3.27- (95% CI=1.15-9.29; P=0.036) and 2.57-(95% CI=1.01-6.57; P=0.048) fold increased risk of developing CSOM, respectively, compared with healthy individuals. CONCLUSION The study showed a higher prevalence of AR in CSOM patients than in controls. It may be valuable to evaluate and control this factor in these patients.
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Affiliation(s)
- Shadman Nemati
- Sinonasal Diseases Research Centre, Amiralmomenin Hospital, Guilan University of Medical Sciences, Rasht, Iran.
| | - Reza Jafari Shakib
- Department of Immunology, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
| | - Maryam Shakiba
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of medical Sciences, Tehran, Iran.
| | - Nematollah Araghi
- Department of Otolaryngology, Amiralmomenin Hospital, Guilan University of Medical Sciences, Rasht, Iran.
| | - Seyyede Zeinab Azimi
- Sinonasal Diseases Research Centre, Amiralmomenin Hospital, Guilan University of Medical Sciences, Rasht, Iran.,Corresponding Author: Sinonasal Diseases Research Centre, Amiralmomenin Hospital, Guilan University of Medical Sciences, Rasht, Iran. Tel: +98-9113379430, E-mail:
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416
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McDonell AL, Wahn U, Demuth D, Richards C, Hawes C, Andreasen JN, Allen-Ramey F. Allergy immunotherapy prescribing trends for grass pollen-induced allergic rhinitis in Germany: a retrospective cohort analysis. Allergy Asthma Clin Immunol 2015; 11:19. [PMID: 26085832 PMCID: PMC4470112 DOI: 10.1186/s13223-015-0085-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 05/20/2015] [Indexed: 11/25/2022] Open
Abstract
Background Allergy immunotherapy is an effective treatment for patients with allergic rhinitis whose symptoms are unresolved with pharmacotherapy. Allergy immunotherapy for grass pollen-induced allergic rhinitis is available in three modalities: subcutaneous immunotherapy and sublingual immunotherapy as a tablet or drop. This study aimed to understand trends in allergy immunotherapy prescribing and practice patterns for grass allergies in adult and paediatric patients in Germany. Methods A retrospective cohort study was conducted using IMS Disease Analyzer in Germany. Patients with an allergy immunotherapy prescription for grass pollen (Anatomical Therapeutic Chemical [ATC] classification code V01AA02) from September 2005 to December 2012 were included in the study. General Practitioners (GPs), dermatologists, Ear, Nose and Throat (ENT)-specialists, paediatricians and pneumologists were included as the allergy immunotherapy prescribing physicians in the study. Descriptive analyses were conducted on patient characteristics at index and prescribing physician specialty; a test for trend was conducted for timing of initiation of first allergy immunotherapy prescription in each annual prescribing season. Results Eighteen thousand eight hundred fifty eligible patients were identified during the study period. The majority of patients received subcutaneous immunotherapy; however, the proportion of patients receiving sublingual immunotherapy tablets increased from 8 % in 2006/2007 to 29 % in 2011/2012 (p < 0.001). Initiation of subcutaneous immunotherapy and Oralair® generally peaked during each prescribing year in two seasons (September-October and January) while GRAZAX® prescriptions peaked in autumn (September-October). ENT-specialists and dermatologists were the largest allergy immunotherapy prescribers in adults, while paediatricians and ENT-specialists were the largest prescribers of allergy immunotherapy in paediatric patients. Conclusions Subcutaneous immunotherapy remained the dominant allergy immunotherapy modality for grass pollen-induced allergic rhinitis in Germany for adult and paediatric patients; however, there was a marked increase in proportion of patients receiving sublingual immunotherapy tablets from 2006/2007 to 2011/2012, after their introduction to the market in 2006. ENT-specialists, dermatologists and paediatricians were responsible for the majority of prescribing. The predominance of particular modalities within certain physician specialties likely reflects different treatment goals or needs.
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Affiliation(s)
- Amanda L McDonell
- Real-World Evidence Solutions and Health Economics & Outcomes Research, IMS Health, 210 Pentonville Road, London, N1 9JY UK
| | - Ulrich Wahn
- Department for Pediatric Pneumology and Immunology, Charité Medical University, Berlin, Germany
| | - Dirk Demuth
- Real-World Evidence Solutions and Health Economics & Outcomes Research, IMS Health, 210 Pentonville Road, London, N1 9JY UK
| | - Catrina Richards
- Real-World Evidence Solutions and Health Economics & Outcomes Research, IMS Health, 210 Pentonville Road, London, N1 9JY UK
| | - Charlie Hawes
- Worked at IMS Health at time of study, Real-World Evidence Solutions and Health Economics & Outcomes Research, London, UK
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417
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Ohno K, Matsuda Y, Arai T, Kimura Y. Nasal manifestations of IgG4-related disease: A report of two cases. Auris Nasus Larynx 2015; 42:483-7. [PMID: 26060132 DOI: 10.1016/j.anl.2015.05.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 05/14/2015] [Accepted: 05/16/2015] [Indexed: 01/13/2023]
Abstract
IgG4-related disease (IgG4-RD) is a recently recognized clinical disease entity characterized by elevated serum IgG4, tumefaction, tissue infiltration of IgG4-positive plasma cells and fibrosis. IgG4-RD may occur, either synchronously or metachronously, in a variety of organs throughout the body. We describe herein two representative cases of the nasal manifestations of IgG4-RD, characterized by diffuse, crusty, erosive lesions on nasal mucosa. Oral steroid administration was effective in treating these nasal manifestations. We report a decrease in IgG4 positive plasma cell infiltrates in nasal mucosa biopsy specimens after steroid therapy, demonstrating that infiltration of IgG4-positive cells is reversible.
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418
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Dantas IDP, Valera FCP, Zappelini CEM, Anselmo-Lima WT. Prevalence of rhinitis symptoms among textile industry workers exposed to cotton dust. Int Arch Otorhinolaryngol 2015; 17:26-30. [PMID: 25991990 PMCID: PMC4423310 DOI: 10.7162/s1809-97772013000100005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Accepted: 10/07/2012] [Indexed: 11/05/2022] Open
Abstract
Introduction: The respiratory tract is one of the main points of entry of foreign substances into the body. Because of its location, the respiratory tract is heavily exposed to harmful agents, such as gases, vapors, or aerosols. Aim: Our objective was to evaluate the symptoms of occupational rhinitis in workers exposed to cotton dust. Method: The prospective study population consisted of workers from the “Nova Esperança” Cooperative of Nova Odessa (Sao Paulo), who were studied between September and December 2008. Data were collected through an individually and privately answered questionnaire designed by the author considering the clinical criteria for rhinitis. Results: Using the questionnaire, we evaluated a total of 124 workers. Among these patients, 63.7% complained of nasal obstruction, 57.2% of nasal itching, 46.7% of rhinorrhea, and 66.1% of sneezing. Of the patients considered to have very serious symptoms, 9% had nasal obstruction; 9%, itching; 4%, rhinorrhea; and 6.4%, sneezing. Discussion: Aerosol agents in the environment can clearly aggravate and even initiate rhinitis. From the standpoint of pathogenesis, the mechanisms of classical allergic airway inflammation involving mast cells, IgE, histamine, eosinophils, and lymphocytes may be responsible for the development of rhinitis after exposure to high molecular weight allergens such as proteins derived from animals and plants. This study showed a strong relationship between the occupational exposures associated with work in the cotton textile industry and the symptoms of rhinitis. Conclusion: Analysis of the data clearly showed the occurrence of rhinitis symptoms in these patients, demonstrating that the prevention and treatment of this condition in the workplace is extremely important.
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Affiliation(s)
- Ivan de Picoli Dantas
- Otorhinolaryngologist. PhD Student, University Hospital, Faculty of Medicine of Ribeirão Preto, Universidade de São Paulo (HCFMRP-USP)
| | - Fabiana Cardoso Pereira Valera
- Postdoctoral in Otorhinolaryngology. Professor, Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, HCFMRP-USP
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419
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Cavone L, Cuppari C, Manti S, Grasso L, Arrigo T, Calamai L, Salpietro C, Chiarugi A. Increase in the Level of Proinflammatory Cytokine HMGB1 in Nasal Fluids of Patients With Rhinitis and its Sequestration by Glycyrrhizin Induces Eosinophil Cell Death. Clin Exp Otorhinolaryngol 2015; 8:123-8. [PMID: 26045910 DOI: 10.3342/ceo.2015.8.2.123] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 08/29/2013] [Accepted: 11/07/2013] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES The nuclear protein high mobility group protein box 1 (HMGB1) is a proinflammatory mediator that belongs to the alarmin family of proinflammatory mediators, and it has recently emerged as a key player in different acute and chronic immune disorders. Several lines of evidence demonstrate that HMGB1 is actively released extracellularly from immune cells or passively released from necrotic cells. Because of the ability of HMGB1 to sustain chronic inflammation, we investigated whether the protein is present in nasal fluids of patients with different forms of rhinitis. METHODS HMGB1 levels were evaluated in nasal fluids of healthy subjects or rhinitis patients who were treated or not treated with different treatments. RESULTS We report that the level of HMGB1 was significantly increased in nasal fluids of patients with allergic rhinitis, patients with NARES (nonallergic rhinitis with eosinophiliac syndrome), as well as patients with polyps. We also found that a formulation containing the HMGB1-binding compound glycyrrhizin (GLT) reduced the HMGB1 content in nasal fluids of rhinitis patients to an extent similar to that with nasal budesonide treatment. We also found that among the cultured human leukocyte populations, eosinophils released higher amounts of HMGB1. Based on the ability of HMGB1 to sustain eosinophil survival and the ability of GLT to inactivate HMGB1, we report that GLT selectively killed cultured eosinophils and had no effect on neutrophils, macrophages, and lymphocytes. CONCLUSION Collectively, these data underscore the role of HMGB1 in rhinitis pathogenesis and the therapeutic potential of GLT formulations in treatment of chronic inflammatory disorders of the nasal mucosa.
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420
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Fuiano N, Diddi G, Delvecchio M, C CI. Prevalence of positive atopy patch test in an unselected pediatric population. Clin Mol Allergy 2015; 13:2. [PMID: 25954139 PMCID: PMC4423149 DOI: 10.1186/s12948-015-0011-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 03/11/2015] [Indexed: 11/15/2022] Open
Abstract
Background In the latest decades, epidemiological studies on allergic disorders in children, including atopic dermatitis, rhinitis and asthma, demonstrated a continuous increase in prevalence. However, such studies are usually performed by questionnaires and, sometimes, by skin prick test or in vitro IgE tests, while the portion of allergy sustained by the cell-mediated mechanism is neglected, because the essential test, i.e. the atopy patch test is not performed. Methods This cross-sectional survey studied by a specific questionnaire, skin prick test and atopy patch test, an unselected population, represented by the entire scholastic population attending a Primary school and a Junior Secondary school in the rural town of San Marco in Lamis, 12.000 inhabitants (Puglia, Italy). Results Among the 456 subjects included, 78 (17.1 %) had a positive skin prick test and 57 (12.5 %) had a positive atopy patch test. In particular, 13.4 % of subjects were positive only to skin prick test and 8.8 % were positive only to atopy patch test. The allergen most frequently positive was the house dust mite, with 41 positive results to skin prick test and 55 to atopy patch test, while for pollen positive results concerned almost exclusively the skin prick test. Conclusions This survey on an unselected population of children detected a prevalence of positive results to atopy patch test not so distant from the positive results to skin prick test, and in 8.8 % of subjects the atopy patch test was the only positive test. This would suggest to add the atopy patch test in future epidemiological studies on allergy, in order to avoid to overlook the not negligible portion of patients with T-cell-mediated allergy.
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Affiliation(s)
- Nicola Fuiano
- Pediatric Allergy Service, ASL FG Torremaggiore, I, Rome, Italy
| | - Giuliana Diddi
- Pediatric Allergy Service, ASL FG Torremaggiore, I, Rome, Italy
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421
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Calogiuri GF, Muratore L, Nettis E, Casto AM, Di Leo E, Vacca A. Immediate-type hypersensitivity reaction to Mannitol as drug excipient (E421): a case report. Eur Ann Allergy Clin Immunol 2015; 47:99-102. [PMID: 25951149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Allergic reactions to mannitol have been reported rarely, despite its widespread use as a drug and as a food excipient. This is the first case report in which oral mannitol induces an immediate type hypersensitivity as a drug excipient, in a 42 year old man affected by rhinitis to olive tree pollen. Unusual and undervalued risk factors for mannitol hypersensitivity are examined.
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Affiliation(s)
- G F Calogiuri
- Pneumology Department, Hospital Ninetto Melli, San Pietro Vernotico, Brindisi, Italy. Section of Allergology and Clinical Immunology, Department of Internal Medicine and Infectious Diseases, University of Bari Medical School, Bari, Italy. E-mail:
| | - L Muratore
- Allergy and Clinical Immunology Center, Civil Hospital Vito Fazzi, Lecce, Italy
| | - E Nettis
- Section of Allergology and Clinical Immunology, Department of Internal Medicine and Infectious Diseases, University of Bari Medical School, Bari, Italy
| | - A M Casto
- Allergy and Clinical Immunology Center, Civil Hospital Vito Fazzi, Lecce, Italy
| | - E Di Leo
- Section of Allergology and Clinical Immunology, Department of Internal Medicine and Infectious Diseases, University of Bari Medical School, Bari, Italy
| | - A Vacca
- Section of Allergology and Clinical Immunology, Department of Internal Medicine and Infectious Diseases, University of Bari Medical School, Bari, Italy. Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, Bari, Italy
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422
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Yawn J, Lawrence LA, Carroll WW, Mulligan JK. Vitamin D for the treatment of respiratory diseases: is it the end or just the beginning? J Steroid Biochem Mol Biol 2015; 148:326-37. [PMID: 25625665 DOI: 10.1016/j.jsbmb.2015.01.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Revised: 12/16/2014] [Accepted: 01/22/2015] [Indexed: 12/22/2022]
Abstract
A large number of human, animal and in vitro studies have suggested that vitamin D3 (VD3) plays a critical role in inflammatory airway diseases such as asthma, chronic rhinosinusitis, and allergic rhinitis. VD3 acts upon a broad range of immune cells involved in the pathogenesis of these diseases including T-cells, dendritic cells (DCs), macrophages, and B-cells. In addition, VD3 can also regulate the functions of a number of non-immune cells including epithelial cells, fibroblasts, and smooth muscle cells. Given that VD3 has known effects on the immune system, it seems logical that supplementation with VD3 would prove efficacious in the treatment of these three diseases. While many studies, most of which are observational, have suggested that VD3 deficiency is associated with more severe disease, VD3 supplementation trials in humans have resulted in varied outcomes in terms of efficacy. In this review article we will discuss the role of VD3 in these three commonly associated respiratory diseases. We will explore the literature describing associations of VD3 deficiency with patient outcomes, cells in the respiratory microenvironment susceptible to VD3 regulation, conflicting results of VD3 supplementation trials, and potential gaps in our knowledge that may be limiting the widespread use of VD3 for the treatment of respiratory diseases such asthma, chronic rhinosinusitis and allergic rhinitis. This article is part of a Special Issue entitled '17th Vitamin D Workshop'.
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Affiliation(s)
- James Yawn
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, United States
| | - Lauren A Lawrence
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, United States
| | - William W Carroll
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, United States
| | - Jennifer K Mulligan
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, United States; Department of Pediatrics, Medical University of South Carolina, Charleston, SC, United States; Ralph H. Johnson VA Medical Center, Charleston, SC, United States.
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423
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Santos AF, Borrego LM, Rotiroti G, Scadding G, Roberts G. The need for patient-focused therapy for children and teenagers with allergic rhinitis: a case-based review of current European practice. Clin Transl Allergy 2015; 5:2. [PMID: 25657844 PMCID: PMC4318152 DOI: 10.1186/s13601-014-0044-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 12/30/2014] [Indexed: 12/21/2022] Open
Abstract
Allergic rhinitis is a common problem in childhood and adolescence, with a negative impact on the quality of life of patients and their families. The treatment modalities for allergic rhinitis include allergen avoidance, anti-inflammatory symptomatic treatment and allergen specific immunotherapy. In this review, four cases of children with allergic rhinitis are presented to illustrate how the recently published EAACI Guidelines on Pediatric Allergic Rhinitis can be implemented in clinical practice.
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Affiliation(s)
- Alexandra F Santos
- Department of Paediatric Allergy, Division of Asthma, Allergy & Lung Biology, King's College London, London, UK ; MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK ; Immunoallergology Department, Coimbra University Hospital, Coimbra, Portugal
| | - Luis Miguel Borrego
- CUF Descobertas Hospital, Lisbon, Portugal ; CEDOC, Nova Medical School, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Giuseppina Rotiroti
- The Royal National Throat, Nose and Ear Hospital & University College London Hospitals, London, UK
| | - Glenis Scadding
- The Royal National Throat, Nose and Ear Hospital & University College London Hospitals, London, UK
| | - Graham Roberts
- David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of Wight, UK ; Human Development and Health and Clinical Experimental Sciences Academic Subunits, University of Southampton Faculty of Medicine, Southampton, UK ; Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK ; Paediatric Allergy and Respiratory Medicine, University Child Health (MP803), University Hospital Southampton NHS Foundation Trust, Southampton, UK
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424
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Bjerg A, Eriksson J, Ólafsdóttir IS, Middelveld R, Franklin K, Forsberg B, Larsson K, Torén K, Dahlén SE, Janson C. The association between asthma and rhinitis is stable over time despite diverging trends in prevalence. Respir Med 2015; 109:312-9. [PMID: 25638411 DOI: 10.1016/j.rmed.2015.01.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Revised: 01/09/2015] [Accepted: 01/13/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND Despite the well-known association between asthma and rhinitis, in Swedish adults the prevalence of rhinitis rose from 22% to 31% between 1990 and 2008 while asthma prevalence was unchanged. We tested whether the association of rhinitis with asthma was stable over time using the same population-based databases. METHODS Two surveys of adults (20-44 years) living in three regions of Sweden, carried out in 1990 (n = 8982) and 2008 (n = 9156) were compared. Identical questions regarding respiratory symptoms, asthma and rhinitis were used. Asthmatic wheeze: Wheeze with breathlessness apart from colds. Current asthma: Asthma attacks and/or asthma medication use. RESULTS Subjects with rhinitis had level time trends in asthmatic wheeze, current asthma and most nocturnal respiratory symptoms between 1990 and 2008, adjusted for age, sex, area and smoking. Any wheeze however decreased slightly. In never-smokers asthma symptoms were similarly associated with rhinitis in 1990 and 2008: any wheeze OR 4.0 vs. 4.4 (p = 0.339); asthmatic wheeze OR 6.0 vs. 5.9 (p = 0.937); and current asthma OR 9.6 vs. 7.7 (p = 0.213). In the whole population there were decreases in the asthma symptoms most closely associated to smoking, which decreased by half 1990-2008. Conversely current asthma, which was strongly associated with rhinitis and not with smoking, increased (p < 0.001). CONCLUSIONS The association of rhinitis with asthma was stable between 1990 and 2008. The pattern in the time trends of asthma outcomes strongly suggests that decreased smoking counterbalanced the driving effect of increased rhinitis on asthma prevalence. The findings illustrate the public health benefits of decreased smoking.
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Affiliation(s)
- Anders Bjerg
- Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, Göteborg, Sweden.
| | - Jonas Eriksson
- Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, Göteborg, Sweden
| | - Inga Sif Ólafsdóttir
- Department of Medical Sciences, Respiratory Medicine and Allergology, Uppsala University, Uppsala, Sweden
| | - Roelinde Middelveld
- Experimental Asthma and Allergy Research, The National Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Karl Franklin
- Department of Surgery, University of Umeå, Umeå, Sweden
| | - Bertil Forsberg
- Environmental and Occupational Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Kjell Larsson
- Unit of Lung and Allergy Research, The National Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kjell Torén
- Department of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Sven-Erik Dahlén
- Experimental Asthma and Allergy Research, The National Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Christer Janson
- Department of Medical Sciences, Respiratory Medicine and Allergology, Uppsala University, Uppsala, Sweden
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425
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Soylu E, Orhan I, Cakir A, Istanbullu A, Altin G, Yilmazer R, Calim OF. Effect of a moustache on nasal Staphylococcus aureus colonisation and nasal cytology results in men. J Laryngol Otol 2015; 129:155-8. [PMID: 25599929 DOI: 10.1017/S002221511400334X] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study compared the results of nasal Staphylococcus aureus carriage and nasal cytology in men with and without a moustache. METHODS The study group comprised 118 adult men with a moustache, and the control group consisted of 123 adult men without a moustache. Samples were taken from the participants' right nasal cavity for cytology and from the left nasal cavity for microbiology. RESULTS The results for S aureus were positive in 19.5 per cent (n = 23) of participants with a moustache and in 20.3 per cent (n = 25) of men without a moustache. This difference was not significant (p > 0.05). However, nasal cytology revealed rich eosinophil clusters in participants with a moustache. CONCLUSION The presence or absence of a moustache had no effect on nasal S aureus colonisation. However, further research is needed to understand whether the presence of a moustache increases the risk of allergic or non-allergic rhinitis.
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426
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Scott DR, Simon RA. Supraesophageal Reflux: Correlation of Position and Occurrence of Acid Reflux-Effect of Head-of-Bed Elevation on Supine Reflux. J Allergy Clin Immunol Pract 2015; 3:356-61. [PMID: 25609349 DOI: 10.1016/j.jaip.2014.11.019] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 11/08/2014] [Accepted: 11/10/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND Supraesophageal reflux of gastric contents can contribute to perennial nasopharyngitis, cough, and asthma. However, effective treatment strategies for supraesophageal reflux disease (SERD) remain inadequately defined. OBJECTIVE The purpose of this study is to assess the prevalence and timing of SERD and to investigate the efficacy of head-of-bed elevation in its treatment. METHODS A retrospective chart review of patients seen at Scripps Clinic Division of Allergy, Asthma and Immunology was performed who had undergone overnight nasopharyngeal pH monitoring with a commercially available nasopharyngeal pH-monitoring device, Dx-pH Measurement System from Restech, San Diego, Calif. Subjects with reflux were classified based on the position of reflux as either supine only, upright only, or both supine and upright. In a subset of subjects with supine-only reflux, pH monitoring was compared before and after elevating the head of bed 6 inches. RESULTS Adequate nasopharyngeal pH-monitoring data were obtained for 235 patients. Reflux was detected in 113 (48%) patients. The pattern of reflux observed was 62 (55%) supine only, 4 (4%) upright only, and 47 (42%) upright and supine. Sequential overnight nasopharyngeal pH monitoring before and after head-of-bed elevation was obtained in 13 individuals with supine-only reflux. Ten subjects demonstrated significant improvement, 8 of whom demonstrated complete resolution of supine reflux with 6 inches of head-of-bed elevation. CONCLUSION This study provides new evidence that SERD frequently occurs in the supine position and that 6 inches of head-of-bed elevation is effective in reducing supine SERD.
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Affiliation(s)
- David R Scott
- Allergy and Asthma Center of Western Colorado, Grand Junction, Colo.
| | - Ronald A Simon
- Scripps Clinic Division of Allergy, Asthma and Immunology, San Diego, Calif
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427
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Tsabouri S, Tseretopoulou X, Priftis K, Ntzani EE. Omalizumab for the treatment of inadequately controlled allergic rhinitis: a systematic review and meta-analysis of randomized clinical trials. J Allergy Clin Immunol Pract 2015; 2:332-40.e1. [PMID: 24811026 DOI: 10.1016/j.jaip.2014.02.001] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Revised: 01/29/2014] [Accepted: 02/04/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND Patients with moderate-to-severe allergic rhinitis who are inadequately controlled despite treatment according to current rhinitis management guidelines have a significant unmet medical need. Such patients have a negative impact on daily functioning and are at risk of developing serious comorbidities, such as asthma and chronic rhinosinusitis. OBJECTIVE To assess the efficacy and safety of omalizumab in poorly controlled allergic rhinitis under a meta-analysis framework. METHODS MEDLINE and the Cochrane Central Register of Controlled Trials were searched through September 2013. Studies on the efficacy of omalizumab in allergic rhinitis that assessed clinical outcomes were selected. Descriptive and quantitative information was extracted; mean differences and relative risk estimates were synthesized under a fixed or random effects model. Heterogeneity was assessed by using the Q statistic and the I(2) metric. Subgroup analyses were performed for the presence of specific immunotherapy treatment. RESULTS Of the 352 citations retrieved, 11 studies of 2870 patients were finally included. A statistically significant reduction in the daily nasal symptom severity score (standardized mean difference -0.67 [95% CI, -1.3 to -0.31]; P < .0001; I(2), 92%) and a statistically significant reduction in daily nasal rescue medication score (-0.22 [95% CI, -0.39 to -0.05; P = .01; I(2), 58%) were observed. There was not a statistically significant difference in the occurrence of any adverse event (relative risk 1.06 [95% CI, 0.94-1.19; I(2), 55%). CONCLUSIONS Omalizumab is statistically significantly associated with symptom relief, decreased rescue medication use, and improvement of quality of life in patients with inadequately controlled allergic rhinosinusitis.
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Affiliation(s)
- Sophia Tsabouri
- Department of Paediatrics, University of Ioannina School of Medicine, Ioannina, Greece
| | - Xanthippi Tseretopoulou
- Evidence-based Medicine Unit, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Konstantinos Priftis
- Third Department of Paediatrics, University of Athens School of Medicine, Attikon University Hospital, Athens, Greece
| | - Evangelia E Ntzani
- Evidence-based Medicine Unit, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece.
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428
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Della Giustina A, Landi M, Bellini F, Bosoni M, Ferrante G, Onorari M, Travaglini A, Pingitore G, Passalacqua G, Tripodi S. Vitamin D, allergies and asthma: focus on pediatric patients. World Allergy Organ J 2014; 7:27. [PMID: 25829979 PMCID: PMC4363348 DOI: 10.1186/1939-4551-7-27] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 09/11/2014] [Indexed: 11/10/2022] Open
Abstract
In recent years, the interest of the scientific world towards vitamin D gradually increased, and several studies have been conducted to dissect its possible role in modulating the development/course of allergic diseases. Also, Vitamin D supplementation has been assessed as a beneficial approach for treating allergies in some, but not all studies. We reviewed herein the available and relevant literature concerning the possible links between Vitamin D, its supplementation and allergic diseases. A literature search was made independently by the Authors, identifying articles for a narrative review. As per literature, Vitamin D plays a key role in calcium and phosphate metabolism, and it is essential for bone health in infants, children and adolescents. However, there is presently insufficient evidence to support vitamin D supplementation for prevention or treatment of allergic diseases in infants, children and adolescents, concerning allergic rhinitis, asthma, food allergy and atopic dermatitis.
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Affiliation(s)
| | - Massimo Landi
- Department of Pediatrics, National Healthcare System ASL TO1, Turin, Italy
| | - Federica Bellini
- Pediatric Unit Department of Gynecologic, Obstetric and Pediatric Sciences, University of Bologna, Bologna, Italy
| | | | - Giuliana Ferrante
- Department of Sciences for Health Promotion and mother and child, University of Palermo, Palermo, Italy
| | - Marzia Onorari
- Department of Prato, Environmental Protection Agency of Tuscany (ARPAT), Prato, Italy
| | | | | | - Giovanni Passalacqua
- Allergy and Respiratory Diseases, IRCCS San Martino-Ist-University of Genoa, Pad. Maragliano, L.go R Benzi 10, 16133 Genoa, Italy
| | - Salvatore Tripodi
- Department of Pediatrics and Allergy Unit Sandro Pertini Hospital, Rome, Italy
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429
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Wardas P, Markowski J, Piotrowska-Seweryn A, Slaska-Kaspera A, Latacz B, Kołodziej W. Impact of rhinosinusitis symptoms on patients' self-esteem before and after FESS. Otolaryngol Pol 2014; 68:293-7. [PMID: 25441935 DOI: 10.1016/j.otpol.2014.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Revised: 05/11/2014] [Accepted: 05/20/2014] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Chronic rhinosinusitis (CRS) is one of the most common diseases in Polish society. According to the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS) 2012 the incidence of CRS among European and US citizens varies from 5 to 16%. Its treatment is based on pharmacotherapy or surgical procedure. The aim of the study was to evaluate the correlation between general health condition of the patients with CRS with each symptom of the disease before and after Functional Endonasal Sinus Surgery (FESS) procedure. MATERIALS AND METHODS The study was conducted on 100 patients, who evaluated symptoms and general health condition twice - before and after FESS, by means of visual analogue scale (VAS). RESULTS Before FESS the highest severity among all symptoms concerned the nasal blockade and olfactory disorders, while after the procedure this ratio was found to be the opposite. All results were statistically significant (p<0.05). CONCLUSIONS The authors emphasize a great role of general health assessment in patients with CRS as the element of proper diagnosis and better comprehension of patients' needs. They indicate that the patient's estimation of the disease and its symptoms differs from the clinician's interpretation to much extent.
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Affiliation(s)
- Piotr Wardas
- Clinical Department of Laryngology, Medical University of Silesia, Head of Department: Jarosław Markowski, MD PhD, Katowice, Poland; ENT Department, Municipal Hospital, Head of Department: Mariusz Kozłowski, MD PhD, Sosnowiec, Poland.
| | - Jarosław Markowski
- Clinical Department of Laryngology, Medical University of Silesia, Head of Department: Jarosław Markowski, MD PhD, Katowice, Poland
| | - Agnieszka Piotrowska-Seweryn
- Clinical Department of Laryngology, Medical University of Silesia, Head of Department: Jarosław Markowski, MD PhD, Katowice, Poland
| | - Aleksandra Slaska-Kaspera
- Clinical Department of Laryngology, Medical University of Silesia, Head of Department: Jarosław Markowski, MD PhD, Katowice, Poland
| | - Beata Latacz
- ENT Department, Municipal Hospital, Head of Department: Mariusz Kozłowski, MD PhD, Sosnowiec, Poland
| | - Wiesława Kołodziej
- Academy of Strategic Planning, Medical Faculty, Head: Wiesława Kołodziej, DNSc, Dąbrowa Górnicza, Poland
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430
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Yukselen A, Kendirli SG. Subcutaneous and sublingual immunotherapy: Where do we stand? World J Immunol 2014; 4:130-140. [DOI: 10.5411/wji.v4.i3.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Revised: 05/01/2014] [Accepted: 07/14/2014] [Indexed: 02/05/2023] Open
Abstract
Though symptoms of allergic diseases can be reduced by the use of drugs such as corticosteroids, antihistamines or leukotrien antagonists, the only treatment directed to change the natural course of allergic disease is allergen-specific immunotherapy (SIT). Its efficacy can last years after the cessassion of the treatment. SIT brings on regulatory T cells with the capacity to generate interleukin-10 and transforming growth factor-b, restricts activation of mast cells and basophils, and shifts antibody isotype from IgE to the noninflammatory type immunoglobulin G4. Subcutaneous (SCIT) and sublingual (SLIT) immunotherapy are the two most used ways at the present for applying SIT. These two treatments were demonstrated to be effective on reducing symptoms and medication use, in prevention of new sensitizations and in protecting from progression of rhinitis to asthma. The safety of SLIT appears to be better than SCIT although there have been a few head to head comparisons. In order to overcome compliance problems or possible systemic side effects which may be faced during this long-term treatment, recent investigations have been focused on the implementation of allergens in quite efficacious and safer ways.
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431
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Nishimura T, Saeki M, Kaminuma O, Takaiwa F, Hiroi T. Transgenic plants for allergen-specific immunotherapy. World J Immunol 2014; 4:141-148. [DOI: 10.5411/wji.v4.i3.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 05/14/2014] [Accepted: 09/10/2014] [Indexed: 02/05/2023] Open
Abstract
Allergen-specific immunotherapy (IT) is an effective treatment for allergic diseases. Although subcutaneous and sublingual ITs are currently used, safer, easier, and more effective IT is under development. Induction of immune tolerance by oral administration of allergen has been proven, though oral IT has not been applied clinically. It is mainly because a large amount of purified allergen is required to induce oral tolerance. To overcome this problem, plants, peculiarly rice, have been investigated as allergen vehicles for oral IT. Rice can store a considerable amount of expressed allergen in its seeds and the accumulated allergen is stable and resistant to gastrointestinal digestion. Therefore, we have developed transgenic rice seeds (Tg rice) in which major epitopes of cedar pollen or house dust mites are expressed. We are establishing Tg rice with demonstrated efficacy in murine models of allergic rhinitis and bronchial asthma by oral administration at practical doses. In addition, the amount, distribution, and allergenicity of the expressed allergen have been improved in our Tg rice. Rice-based oral IT is a promising new concept in IT for the treatment of allergic diseases.
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432
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Brandelius A, Andersson M, Uller L. Topical dsRNA challenges may induce overexpression of airway antiviral cytokines in symptomatic allergic disease. A pilot in vivo study in nasal airways. Respir Med 2014; 108:1816-9. [PMID: 25456711 DOI: 10.1016/j.rmed.2014.10.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 10/16/2014] [Accepted: 10/17/2014] [Indexed: 12/01/2022]
Abstract
BACKGROUND Airway challenge with dsRNA is of interest since this agent acts on TLR3 and mimics rhinoviral (RV) infection-induced interferons/cytokines. Contrasting frequent employment of dsRNA in epithelial cell cultures there is no information on effects of dsRNA administered to human airways in vivo. Here we explore effects of nasal dsRNA challenges in subjects with seasonal allergic rhinitis inside and outside Swedish birch pollen season. METHODS We examined effects of dsRNA in seven patients with seasonal allergic rhinitis. By being studied both inside and outside of an active pollen season they served as their own controls. Based on pilot experiments a repeat dose regimen of dsRNA, 4 × 100 μg, was given daily into the right nostril on two consecutive days; left nostril received corresponding saline challenges. Airway cells for gene analyses were obtained by nasal brushing shortly before the first challenge and 48 h after challenges. RESULTS Pollen counts and nasal symptoms indicated a significant season of allergic rhinitis. At the height of the pollen season, dsRNA challenges increased three antiviral proteins, interferons β and λ1 and IL-32, compared to saline challenges. By contrast, outside the pollen season dsRNA did not increase the expression of these antiviral proteins. dsRNA did not cause any symptoms outside the season nor did it increase the allergic symptoms evoked by natural pollen exposure. CONCLUSION These findings suggest the possibility that active mucosal inflammation, induced by natural allergen exposure in human airways, transiently increases in vivo antiviral responsiveness of airway surface cells.
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Affiliation(s)
- Angelica Brandelius
- Unit of Respiratory Immunopharmacology, Dept. Experimental Medical Science, Lund University, Sweden
| | | | - Lena Uller
- Unit of Respiratory Immunopharmacology, Dept. Experimental Medical Science, Lund University, Sweden.
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433
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Hu Y, Liu W, Huang C, Zou ZJ, Zhao ZH, Shen L, Sundell J. Home dampness, childhood asthma, hay fever, and airway symptoms in Shanghai, China: associations, dose-response relationships, and lifestyle's influences. Indoor Air 2014; 24:450-463. [PMID: 24571077 DOI: 10.1111/ina.12104] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 02/20/2013] [Indexed: 06/03/2023]
Abstract
Numerous studies of associations between dampness and respiratory diseases have been conducted, but their implications remain inconclusive. In this study of 13,335 parent-reported questionnaires (response rate: 85.3%), we analyzed associations between home dampness and asthma and related symptoms in 4- to 6-year-old children in a cross-sectional study of Shanghai. Indicators of home dampness were strongly and significantly associated with dry cough, wheeze, and rhinitis symptoms. In the current residence, children with visible mold spots (VMS) exposure had 32% higher risk of asthma (adjusted OR, 95% CI: 1.32, 1.07-1.64); damp clothing and/or bedding (frequently) was strongly associated with dry cough (1.78, 1.37-2.30); condensation on windows was strongly associated with hay fever (1.60, 1.27-2.01). In the early-life residence, VMS or damp stains (frequently) were strongly associated with dry cough (2.20, 1.55-3.11) and rhinitis ever (1.57, 1.11-2.21). Associations between dampness and diseases among children with or without family history of atopy were similar. The total number of dampness indicators had strong dose-response relationships with investigated health outcomes. Actions, including opening windows of the child's room at night and cleaning the child's room frequently, could potentially mitigate 25% of home VMS, thereby preventing more than 1.5% of attributable risk of the studied symptoms.
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Affiliation(s)
- Y Hu
- Department of Building Environment and Equipment Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
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434
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Fey C, Thyroff-Friesinger U, Jones S. Bioequivalence of two formulations of montelukast sodium 4 mg oral granules in healthy adults. Clin Transl Allergy 2014; 4:29. [PMID: 25250173 PMCID: PMC4172315 DOI: 10.1186/2045-7022-4-29] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 08/12/2014] [Indexed: 11/10/2022] Open
Abstract
Montelukast is an effective and well-tolerated treatment for the prophylaxis and chronic treatment of asthma, acute prevention of exercise-induced bronchoconstriction and symptomatic relief of seasonal allergic rhinitis and perennial allergic rhinitis. The aim of the study was to compare bioavailability, and characterise the pharmacokinetic profile and safety of Sandoz generic montelukast 4 mg oral granules relative to Singulair® mini (Merck, Sharp & Dohme). An open-label, randomised, single-dose, two-treatment, two-period, two-sequence, two-way crossover bioequivalence study was conducted in healthy male volunteers aged 18–55 years, under fasting conditions. The duration of the clinical part of the trial was ≈ 11 days. Montelukast levels in plasma were quantified using a validated liquid chromatography tandem mass spectrometry method, and pharmacokinetic parameters calculated from the drug concentration–time profile using a non-compartmental model. A total of 40 subjects completed both study periods. The ratio test/reference of geometric least squares means was calculated for both formulations of montelukast for the In-transformed pharmacokinetic parameters; the 90% confidence intervals (CIs) were within the pre-defined limits of 80.00–125.00%: 92.2% (90% CI: 87.42–97.30%) for Cmax, 98.1% (90% CI: 94.49–101.81%) for AUC0–t and 97.6% (90% CI: 94.14–101.27%) for AUC0–∞. Two study subjects each reported one mild adverse event: dyspepsia (possibly related to study medication) and throat pain (not considered related to study medication). Sandoz montelukast 4 mg oral granules are bioequivalent to Singulair® 4 mg mini oral granules, with a similar safety profile. This suggests that these two preparations can be considered interchangeable in clinical practice.
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435
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Georgopoulos R, Krouse JH, Toskala E. Why otolaryngologists and asthma are a good match: the allergic rhinitis-asthma connection. Otolaryngol Clin North Am 2014; 47:1-12. [PMID: 24286674 DOI: 10.1016/j.otc.2013.08.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Consideration of the unified airway model when managing patients with rhinitis and or asthma allows a more comprehensive care plan and therefore improved patient outcomes. Asthma is linked to rhinitis both epidemiologically and biologically, and this association is even stronger in individuals with atopy. Rhinitis is not only associated with but is a risk factor for the development of asthma. Management of rhinitis improves asthma control. Early and aggressive treatment of allergic rhinitis may prevent the development of asthma. In patients with allergic rhinitis that is not sufficiently controlled by allergy medication, allergen-directed immunotherapy should be considered.
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Affiliation(s)
- Rachel Georgopoulos
- Department of Otolaryngology, Temple University Health System, 3509 North Broad Street, Philadelphia, PA 19140-4105, USA
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436
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Cibella F, Ferrante G, Cuttitta G, Bucchieri S, Melis MR, La Grutta S, Viegi G. The burden of rhinitis and rhinoconjunctivitis in adolescents. Allergy Asthma Immunol Res 2014; 7:44-50. [PMID: 25553262 PMCID: PMC4274469 DOI: 10.4168/aair.2015.7.1.44] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 03/11/2014] [Accepted: 04/16/2014] [Indexed: 12/18/2022]
Abstract
Purpose Rhinitis and conjunctivitis are common diseases worldwide that are frequently associated. Nevertheless, the risk factors for rhinoconjunctivitis are not well-described and the impact of conjunctivitis on rhinitis and asthma in children remains unknown. This study explored the different risk factors and evaluated the burden of rhinoconjunctivitis among adolescents. Methods This was a cross-sectional study conducted on a random sample of schoolchildren, aged 10-17 years, using skin prick tests and a self-administered questionnaire on respiratory health investigating the impact of rhinitis and rhinoconjunctivitis on daily activities. Results A complete evaluation was obtained for 2,150 children. The prevalence of rhinitis alone was 18.2% and rhinitis associated with conjunctivitis was 20.5%. Rhinoconjunctivitis was more frequently associated with females, a parental history of atopy, domestic exposure to mold/dampness, passive smoke exposure, and reported truck traffic in residential streets. Moreover, rhinoconjunctivitis was associated with a higher level of allergic sensitization. The prevalence of current asthma was 1.7% in subjects without rhinitis or rhinoconjunctivitis, 5.1% in rhinitis and 10.7% in rhinoconjunctivitis. In a logistic model, rhinoconjunctivitis yielded a 2-fold risk for current asthma with respect to rhinitis. Subjects with rhinoconjunctivitis had poorer quality of life (QoL); there was an impact on daily activities in 4.6% of rhinitis and 10.7% of rhinoconjunctivitis. Conclusions Ocular symptoms increase the role of rhinitis as a risk factor for asthma and its impact on daily activities in children.
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Affiliation(s)
- Fabio Cibella
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Giuliana Ferrante
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Giuseppina Cuttitta
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Salvatore Bucchieri
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Mario R Melis
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Stefania La Grutta
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Giovanni Viegi
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
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437
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Morais-Almeida M, Cabral AJ. Off-label prescribing for allergic diseases in pre-school children. Allergol Immunopathol (Madr) 2014; 42:342-7. [PMID: 23769737 DOI: 10.1016/j.aller.2013.02.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2012] [Accepted: 02/02/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND Several studies have demonstrated that medication is commonly used off-label in children with allergic diseases. The aim of this study was to characterise off-label use of prescriptions for allergic diseases in pre-school children from an allergology outpatient unit. METHODS The clinical files of children aged ≤ 6 years seen in a reference allergology consultation with asthma, allergic rhinitis, and/or atopic eczema were reviewed. A total of 500 patients were consecutively observed from January to June 2012. The data collected included gender, age, diagnosis, and prescriptions with the respective daily dosage. RESULTS A total of 1224 prescriptions were registered. The most prescribed medications were oral antihistamines (34.6%), antileukotrienes (22.6%), topical nasal corticosteroids (20.3%), and inhaled corticosteroids (17.7%). From all prescriptions, 422 (34.5%) were considered off-label for age (62.6%), dosage (31.7%), or clinical indication (5.7%). Off-label use was more frequent in children aged <2 years, with 73.5% prescribed for children of this age. CONCLUSIONS Off-label use of drugs for the treatment of paediatric allergic diseases is high. However, these prescriptions are not necessarily wrong, and are recommended in many guidelines. Randomised controlled studies are limited by methodological difficulties creating the need for more observational studies in order to further evaluate the safety and efficacy of drugs used in children.
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438
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Gaspar-López A, López-Rocha E, Rodríguez-Mireles K, Segura-Méndez N, Del Rivero-Hernández L. Prevalence of pollinosis in patients with allergic asthma, rhinitis and conjunctivitis in the South of Mexico City 2007-2013. Rev Alerg Mex 2014; 61:147-152. [PMID: 25177850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND The prevalence of pollinosis has doubled in the past two decades. Several studies suggest that up to 50% of adult residents of Mexico City can present manifestations of respiratory allergy, and pollens from trees, grasses and weeds are a common cause. To determine the prevalence of their families and antigenic cross-reactivity allows us to offer appropriate diagnoses and treatments. OBJECTIVE To know the prevalence of sensitization of pollens to trees, grasses and weeds in adults with respiratory allergy of the South zone of Mexico City from January 2007 to December 2013. MATERIAL AND METHOD A cross-sectional, observational and prospective study was done with patients from Mexico City, referred to the National Medical Center Siglo XXI, IMSS, from 2007 to 2013 with a diagnosis of allergic rhinitis, asthma and conjunctivitis. We analyzed the results of skin prick tests to pollens from trees, grasses and weeds in selected patients. The results were analyzed using descriptive statistics. RESULTS A total of 672 patients were analyzed, 70% men, the average age was 34 ± 16 years. Regarding occupation 31% were students, 48% employees and 21% housewives. Fifty-three percent had rhinitis, 47% had asthma and 40.5% had both, asthma and rhinitis. Prevalence of sensitization to weeds was 56%, 33% to trees and 11% to grasses. CONCLUSIONS Sensitization to weeds is the first cause of respiratory pollinosis in the south of Mexico City, Amaranthus was the most prevalent pollen in this area. Sensitization to trees is the second cause, with a predominance of trees form Betulaceae, Fagaceae and Oleacea families. Sensitization to grass is the third cause of respiratory pollinosis. The most common are from Pooideae (Lolium perenne), Chloroideae and Cynodon/Dactylon family.
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Affiliation(s)
- Arturo Gaspar-López
- Servicio de Alergia, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, IMSS.
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439
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Pite H, Pereira AM, Morais-Almeida M, Nunes C, Bousquet J, Fonseca JA. Prevalence of asthma and its association with rhinitis in the elderly. Respir Med 2014; 108:1117-26. [PMID: 24877896 DOI: 10.1016/j.rmed.2014.05.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 04/23/2014] [Accepted: 05/01/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Asthma and rhinitis are frequent respiratory diseases in children and adults. Despite the increase in the aging population, there are few epidemiologic data on both diseases in the elderly. So far, no population-based study has analyzed the association between asthma and rhinitis symptoms and severity in this age group. This study aimed to estimate the prevalence of physician-diagnosed asthma in the population aged ≥65 years in mainland Portugal and to evaluate its association with the presence and classification of rhinitis according to ARIA recommendations, in this age group. METHODS A cross-sectional, nationwide, population-based survey of individuals aged ≥65 years, living in mainland Portugal was performed. RESULTS Data were obtained from 3678 respondents. The prevalence of physician-diagnosed asthma was 10.9% (95% confidence interval (95%CI) 9.9-11.9). The frequency of asthma diagnosis increased with the number of nasal symptoms (p < 0.001). A strong association between asthma and rhinitis was found (odds ratio (OR) 13.86 (95%CI 10.66-18.02)). The strength of this association increased with the persistence and severity of rhinitis, being particularly high in elderly subjects with moderate-severe persistent rhinitis (OR 39.9 (95%CI 27.5-58.0)). CONCLUSIONS Asthma is common in the elderly and strongly associated with rhinitis. The OR for asthma is especially high in persistent and severe ARIA classification rhinitis types. This study strengthens the need for an integrated assessment of asthma together with rhinitis in the elderly.
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Affiliation(s)
- H Pite
- Hospital CUF-Descobertas and Hospital CUF-Infante Santo, Immunoallergy Department, Lisbon, Portugal; Sociedade Portuguesa de Alergologia e Imunologia Clínica (SPAIC), Portugal; CEDOC, Faculty of Medical Sciences, Pharmacology Department, Lisbon, Portugal.
| | - A M Pereira
- Hospital CUF-Descobertas and Hospital CUF-Infante Santo, Immunoallergy Department, Lisbon, Portugal; Sociedade Portuguesa de Alergologia e Imunologia Clínica (SPAIC), Portugal; Hospital S. João EPE, Allergy and Clinical Immunology Department, Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Health Information and Decision Sciences Department, Porto, Portugal; Instituto e Hospital CUF Porto, Allergy Unit, Porto, Portugal
| | - M Morais-Almeida
- Hospital CUF-Descobertas and Hospital CUF-Infante Santo, Immunoallergy Department, Lisbon, Portugal; Sociedade Portuguesa de Alergologia e Imunologia Clínica (SPAIC), Portugal; CINTESIS - Center for Research in Health Technologies and Information Systems, Porto, Portugal
| | - C Nunes
- Sociedade Portuguesa de Alergologia e Imunologia Clínica (SPAIC), Portugal; Centro de Imunoalergologia do Algarve, Portimão, Portugal
| | - J Bousquet
- Department of Allergy and Respiratory Diseases, University Hospital and INSERM, Montpellier, France
| | - J A Fonseca
- Sociedade Portuguesa de Alergologia e Imunologia Clínica (SPAIC), Portugal; Hospital S. João EPE, Allergy and Clinical Immunology Department, Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Health Information and Decision Sciences Department, Porto, Portugal; Instituto e Hospital CUF Porto, Allergy Unit, Porto, Portugal; CINTESIS - Center for Research in Health Technologies and Information Systems, Porto, Portugal
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Abstract
OBJECTIVE To determine whether the intensity of bronchial hyperresponsiveness (BHR) is correlated to other clinical data such as patient age at the onset of asthma, the serum IgE levels and familial genetic susceptibility, with the purpose of establishing a prognosis or phenotype. MATERIAL AND METHODS BHR was evaluated using the methacholine provocation test, with the patients divided into six groups according to the amount of methacholine needed to obtain PD20. A total of 138 children and adolescents up to age 18 years (94 males and 44 females) were included. Most had a clinical diagnosis of asthma, while tracheobronchitis or rhinitis was diagnosed among the least reactive subjects. The patients were divided into subjects with a family history of atopic disease (84 cases) and those without such a history (54 cases). In this latter case we discuss possible causes of BHR or dyspnoea triggering factors. RESULTS There were no significant differences in patient age at onset or in serum IgE among the patients with different intensities of BHR, or between those with a family history of atopic disease and those without. CONCLUSIONS No differences were found among the groups. It is therefore concluded that the intensity of BHR is not a valid parameter for establishing a prognosis or phenotype, although it can be used to assess the severity of asthma.
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Affiliation(s)
- F Muñoz-López
- Pediatric Immunoallergology Center, Former Head of the Department of Pediatric Immunoallergology, Clínic Hospital - Sant Joan de Déu Hospital, Faculty of Medicine, University of Barcelona.
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441
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Vlaski E, Stavric K, Seckova L, Kimovska Hristova M, Isjanovska R. The self-reported density of truck traffic on residential streets and the impact on asthma, hay fever and eczema in young adolescents. Allergol Immunopathol (Madr) 2014; 42:224-9. [PMID: 23352596 DOI: 10.1016/j.aller.2012.10.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Accepted: 10/26/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND Conflicting results have been reported, mostly in developed countries, on the relationship between exposure to traffic and allergic diseases. This study aims to examine the impact of truck traffic on asthma, rhinitis and eczema in early adolescence in Skopje, the capital of the Republic of Macedonia, as a developing country with a lower middle rate of high truck traffic exposure and low prevalence rates of allergic diseases. METHODS Self-reported data was used, obtained through the International Study of Asthma and Allergies in Childhood Phase 3 written questionnaires, from 3026 adolescents aged 13-14 years from Skopje. Truck traffic density on the street of residence on weekdays was correlated to current and ever-diagnosed asthma, rhinitis and eczema by odds ratios (OR, 95% CI) in binary logistic regression, with and without adjustments for potential confounding factors separately and for their joint effect. RESULTS A positive association of truck traffic density appeared to be limited to current dry night cough (aOR: 1.63; 1.07-2.47; aOR: 2.17; 1.40-3.35; and aOR: 2.33; 1.43-3.79 for truck traffic seldom, frequently through the day, and almost the whole day, respectively) with an exposure-response relationship and to current wheeze only for truck traffic almost the whole day (aOR: 1.87; 1.02-3.42). CONCLUSION The findings suggest an aggravating effect of truck traffic on current asthma symptoms, but not on asthma, allergic rhinitis and eczema diagnoses. It seems that it probably has an impact as a direct respiratory irritant in early adolescence.
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Affiliation(s)
- E Vlaski
- Department of Pulmonology and Allergology, University Children's Clinic, Skopje, The Former Yugolav Republic of Macedonia.
| | - K Stavric
- Department of Immunology, University Children's Clinic, Skopje, The Former Yugolav Republic of Macedonia
| | - L Seckova
- Department of Pulmonology and Allergology, University Children's Clinic, Skopje, The Former Yugolav Republic of Macedonia
| | - M Kimovska Hristova
- Intensive Care Unit, University Children's Clinic, Skopje, The Former Yugolav Republic of Macedonia
| | - R Isjanovska
- Institute of Epidemiology with Biostatistics and Medical Informatics, Skopje, The Former Yugolav Republic of Macedonia
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442
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Trebuchon F, Lhéritier-Barrand M, David M, Demoly P. Characteristics and management of sublingual allergen immunotherapy in children with allergic rhinitis and asthma induced by house dust mite allergens. Clin Transl Allergy 2014; 4:15. [PMID: 24910771 PMCID: PMC4047545 DOI: 10.1186/2045-7022-4-15] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Accepted: 04/07/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Allergen immunotherapy is a recognised intervention in patients with allergies not responding to standard pharmacotherapy or in whom pharmacotherapy is contraindicated. We describe the sublingual immunotherapy (SLIT) regimens used in children and adolescents with house dust mite (HDM) respiratory allergies in France and assess the efficacy and safety of this treatment. METHODS This was a sub-analysis of paediatric patients included in a previous retrospective, observational, multicentre study. Inclusion criteria were: age 5-17 years; respiratory allergy and proven sensitisation to HDM; at least 2 years follow-up after SLIT initiation. The following data were recorded at SLIT initiation: clinical characteristics; sensitisation profile; concomitant symptomatic medications; details of SLIT protocol. During follow-up and at the end of treatment the following data were recorded: any changes to SLIT treatment; any changes to symptomatic medications; symptom progression; adverse events. SLIT efficacy, patient compliance and satisfaction, and safety were assessed. RESULTS 736 paediatric patients were included in this analysis. Most patients (95.5%) had allergic rhinitis, which was moderate to severe persistent in 62.8%. Allergic asthma was present in 64.0% and was mild to moderate persistent in 52.7% of these patients. The majority of patients had rhinitis with asthma (59.5%). Three-hundred and seventy five (62.3%) patients were polysensitised. Compliance was good in 86.5% of patients and SLIT was effective in 83.8%. Symptoms of rhinitis and asthma were improved in 64.6% and 64.3% of patients, respectively. A decrease in symptomatic medication was observed following SLIT initiation in patients with rhinitis and/or asthma. SLIT was well tolerated with mainly local reactions reported. CONCLUSIONS HDM SLIT appears to be effective in children and adolescents with rhinitis and/or asthma due to HDM allergens, with no tolerability issues and similar benefits as in adults.
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Affiliation(s)
- Florence Trebuchon
- Private Office, Montferrier sur Lez, France ; 3 Chemin du Fescau, F-34980 Montferrier-sur-Lez, France
| | | | | | - Pascal Demoly
- University Hospital of Montpellier, Montpellier, France
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443
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Pefura-Yone EW, Afane-Ze E, Kuaban C. [Sensitization to Blomia tropicalis among asthmatic patients in Yaoundé, Cameroon]. Rev Mal Respir 2014; 32:24-9. [PMID: 25618201 DOI: 10.1016/j.rmr.2014.03.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Accepted: 01/02/2014] [Indexed: 10/25/2022]
Abstract
INTRODUCTION The aim of this study was to determine the prevalence and investigate associated factors for Blomia tropicalis (BT) sensitization in adolescent and adult patients with asthma in Yaoundé (Cameroon). METHODS We performed a cross-sectional study of 18 months duration (January 2012 to June 2013). All asthmatic patients who were seen for a consultation during the study period and who had a skin prick testing for perennial aeroallergens were included in the study. RESULTS Two hundred and one asthmatic patients (132 female patients, 65.7%) with median age (1st-3rd quartiles) of 35 (20-51.5) years were included in the study. Ninety-six (47.8%) patients had positive skin tests to BT. BT sensitization was associated with sensitization to two other dust mites (Dermatophagoides pteronyssinus [DP] and Dermatophagoides farinae [DF]) in 75 (86.2%) patients. The only clinical factor associated with BT sensitization was the presence of persistent rhinitis (odds ratio [confidence interval 95%]: 2.06 [1.12-3.81]). The independent allergenic factors associated with BT sensitization were sensitization to DP (3.49 [CI 95%: 1.49-8.19]), to DF (4.88 [CI 95%: 2.10-11.36]) and to German cockroach (4.16 [CI 95%: 1.72-10.09]). CONCLUSION Blomia tropicalis sensitization is common in asthmatic patients in Yaoundé. It occurs most often in the context of sensitization to multiple aeroallergens, particularly with sensitization to other dust mites and German cockroach.
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Affiliation(s)
- E W Pefura-Yone
- Faculté de médecine et des sciences biomédicales, université de Yaoundé I, Yaoundé, Cameroun; Service de pneumologie, hôpital Jamot, BP 4021, Yaoundé, Cameroun.
| | - E Afane-Ze
- Faculté de médecine et des sciences biomédicales, université de Yaoundé I, Yaoundé, Cameroun; Service de pneumologie, hôpital Jamot, BP 4021, Yaoundé, Cameroun
| | - C Kuaban
- Faculté de médecine et des sciences biomédicales, université de Yaoundé I, Yaoundé, Cameroun; Service de pneumologie, hôpital Jamot, BP 4021, Yaoundé, Cameroun; Faculty of health sciences, university of Bamenda, Bamenda, Cameroun
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444
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Mehuys E, Gevaert P, Brusselle G, Van Hees T, Adriaens E, Christiaens T, Van Bortel L, Van Tongelen I, Remon JP, Boussery K. Self-medication in persistent rhinitis: overuse of decongestants in half of the patients. J Allergy Clin Immunol Pract 2014; 2:313-9. [PMID: 24811023 DOI: 10.1016/j.jaip.2014.01.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Revised: 01/08/2014] [Accepted: 01/14/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Patients with rhinitis often self-medicate with over-the-counter drugs, however this self-treating population has remained largely unstudied. OBJECTIVE To characterize individuals self-medicating persistent rhinitis and to determine the prevalence of and risk factors for intranasal decongestant overuse within this population. METHODS A cross-sectional observational study of individuals self-medicating persistent rhinitis (defined according to the Allergic Rhinitis and its Impact on Asthma guidelines). Participants (n = 895) completed a self-administered questionnaire to assess current symptoms, rhinitis medication, and previous physician diagnosis. Intranasal decongestant overuse was defined as daily use for at least 1 year. RESULTS The vast majority of subjects (95%) had moderate-to-severe rhinitis. Nasal congestion was the predominant symptom (median visual analog scale, 6.6 cm; interquartile range, 3.4 cm). Sixty-five percent had had their current nasal problems for more than 5 years. Approximately 80% had a physician diagnosis (mainly allergic rhinitis or rhinosinusitis). The prevalence of intranasal decongestant overuse was high (49%), despite the fact that most of the patients (80%) were educated about the limit on duration of use. Use of intranasal glucocorticosteroids was inversely related to being an overuser (odds ratio 0.24 [95% CI, 0.17-0.35]). The risk of intranasal decongestant overuse also was reduced by use of other medications (oral H1 antihistamines and decongestants), use of nasal saline solution, and more symptoms of itchy and/or runny eyes or colored mucus. Risk was increased by a more severely blocked nose, longer duration of symptoms, the presence of sleep disturbance, higher body mass index, and previous advice to limit the duration of intranasal decongestant use. CONCLUSION Half of the individuals self-medicating persistent rhinitis overused intranasal decongestants, despite the fact that they were educated about the limit on duration of use.
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Affiliation(s)
- Els Mehuys
- Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium.
| | - Philippe Gevaert
- Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium
| | - Guy Brusselle
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Thierry Van Hees
- Department of Clinical Pharmacy, University of Liège, Avenue de l'Hôpital 1, Liège, Belgium
| | - Els Adriaens
- Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Thierry Christiaens
- Department of Family Medicine and Primary Health Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Luc Van Bortel
- Heymans Institute of Pharmacology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Inge Van Tongelen
- Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Jean-Paul Remon
- Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Koen Boussery
- Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
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Cardona R, Lopez E, Beltrán J, Sánchez J. Safety of immunotherapy in patients with rhinitis, asthma or atopic dermatitis using an ultra-rush buildup. A retrospective study. Allergol Immunopathol (Madr) 2014; 42:90-5. [PMID: 23265265 DOI: 10.1016/j.aller.2012.07.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Revised: 07/12/2012] [Accepted: 07/16/2012] [Indexed: 11/21/2022]
Abstract
BACKGROUND Allergen-specific immunotherapy is a proven, highly effective treatment for IgE-mediated diseases. However, ultra-rush immunotherapy is prescribed infrequently because of the perception that accelerated immunotherapy buildup leads to a higher rate of systemic reactions. OBJECTIVE To evaluate the frequency of adverse reactions in patients with IgE-mediated diseases receiving house dust mite (HDM) ultra-rush immunotherapy. METHODS A retrospective, observational study was conducted for patients with IgE-mediated diseases receiving allergen-specific immunotherapy. Subcutaneous immunotherapy with depigmented polymerized mites extract was administered in two refracted doses of 0.2 and 0.3 ml at first injection, and in single 0.5 ml doses in subsequent monthly injections. A 30 min observation time was required after each injection. Systemic reactions were graded using the World Allergy Organisation grading system. RESULTS 575 patients were included. The age range was 1-83 years. Most patients had respiratory diseases (544) and 101 patients had atopic dermatitis. A total of 27 patients (4.6%) experienced 139 reactions (reactions/injections: 1.9%); 22 patients (3.8%) experienced 134 local reactions (local reactions/injections: 1.8%). Eight patients (1.3%) experienced eight systemic reactions (systemic reactions/injections: 0.1%). Five systemic reactions were grade 2 and three grade 1. Two systemic reactions were reported during buildup. There were no fatalities. CONCLUSION Taking into account the possible bias for the retrospective design of this study we observed that immunotherapy for patients with IgE-mediated diseases using a depigmented polymerized mites extract, with an ultra-rush buildup, has similar frequency of systemic reactions than that seen in slower buildup immunotherapy in other studies. Accelerated buildup could improve patients' adherence and reduce dropout rates.
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446
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Sánchez-Borges M, Fernández-Caldas E, Capriles-Hulett A, Caballero-Fonseca F. Mite hypersensitivity in patients with rhinitis and rhinosinusitis living in a tropical environment. Allergol Immunopathol (Madr) 2014; 42:120-6. [PMID: 23253681 DOI: 10.1016/j.aller.2012.07.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2012] [Revised: 07/16/2012] [Accepted: 07/22/2012] [Indexed: 11/24/2022]
Abstract
PURPOSE Rhinitis and rhinosinusitis are major concerns in public health. Mites are important aetiological agents in the tropics. The present study investigated the in vivo response to mite allergens in patients with rhinitis and rhinosinusitis. METHODS All patients with presumptive nasal allergy were included. Skin tests were done with inhalants and mite extracts. Patients were classified as allergic or non-allergic according to skin tests and history. RESULTS Out of 229 patients, 175 (76.4%) showed positive skin tests. Allergic patients showed positivity to mites in 97.1% of cases, 51.4% to dog dander; 40.5% to cat dander; 36.5% to German cockroach; 22.8% to moulds; and 21.1% to grass pollens. Dermatophagoides farinae induced responses in 90.8% of patients, D. pteronyssinus in 90.1%, Blomia tropicalis in 74.8%, Glycyphagus domesticus in 62.2%, Chortoglyphus arcuatus in 58.2%, Acarus siro in 46.2%, Lepidoglyphus destructor in 35.4%, and Tyrophagus putrescentiae in 35.0%. Higher correlations were found between skin test diameters induced by mites from the same family. CONCLUSIONS Sensitisation to inhalant allergens is present in 76% of allergy clinics' patients with rhinitis or rhinosinusitis. Our results confirm previous observations showing that mites constitute the most important cause of respiratory allergy in tropical settings and suggest that mite allergen cross-reactivity is responsible for the positivity of skin tests to mites not present in the patient's environment since the species Glycyphagus, Chortoglyphus, Acarus, Lepidoglyphus and Tyrophagus have not been found in Caracas house dust.
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447
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Araujo LML, Rosário Filho NA, Riedi CA. Respiratory allergy to moth: the importance of sensitization to Bombyx mori in children with asthma and rhinitis. J Pediatr (Rio J) 2014; 90:176-81. [PMID: 24361294 DOI: 10.1016/j.jped.2013.08.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Revised: 08/01/2013] [Accepted: 08/02/2013] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE this study aimed to prepare a silkworm moth (Bombyx mori) antigenic extract and to perform skin prick tests with this extract in patients with allergic respiratory diseases; to evaluate serum specific immunoglobulin E (IgE) to Bombyx mori using ImmunoCAP® system and to report the frequency of positivity between the two methods and with clinical data. METHODS this was a cross-sectional study with 99 children and adolescents diagnosed with asthma and/or allergic rhinitis, who had skin reactivity to at least one of the six aeroallergens tested. Clinical data were evaluated: skin prick tests with Bombyx mori in-house extract, and total and specific IgE analysis using ImmunoCAP® were performed. RESULTS the frequency of Bombyx mori specific IgE was found to be 52.5% and 60% using the skin prick test and ImmunoCAP®, respectively. An association between a positive skin test for Bombyx mori and the presence of allergic rhinitis, atopic dermatitis, and urticaria was observed, but the same was not true for asthma or allergic conjunctivitis. There was no relation with the severity of asthma or rhinitis symptoms. CONCLUSIONS a high frequency of sensitization to Bombyx mori was observed in a selected population of patients with respiratory allergic diseases in the city of Curitiba, state of Paraná, Brazil. The extract prepared from the wings of this moth species is effective in demonstrating this sensitivity.
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Affiliation(s)
- Laura M L Araujo
- Child and Adolescent Health, Hospital de Clínicas, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil.
| | - Nelson A Rosário Filho
- Pediatrics, Head of the Allergy and Pediatric Immunology Service, Hospital de Clínicas, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil
| | - Carlos A Riedi
- Pediatrics, Hospital de Clínicas, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil
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Naeimi M, Azarnoosh E, Gholparvar MS, Naeimi MR. Histopathologic Relationship Between Ethmoid Sinus and Ipsilateral Middle Turbinate in Non-Polypose Chronic Sinusitis by FESS. Indian J Otolaryngol Head Neck Surg 2013; 65:324-8. [PMID: 24427670 DOI: 10.1007/s12070-012-0483-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2011] [Accepted: 01/16/2012] [Indexed: 10/14/2022] Open
Abstract
Chronic rhinosinusitis (CRS) is a common disease with significant effects on the quality of life. Infection was previously a common cause of rhino sinusitis, while nowadays its main cause is inflammation. Non-polyposis CRS patients who were resistant to medical treatment and underwent endoscopic sinus surgery in Ghaem and Imam Reza hospitals were studied from December 2008 to November 2009. There were 11 males and four females ranging in age from 14 to 57 years with the average age of 32.2. First, samples were taken from the ethmoid sinus and the ipsilateral middle turbinate. Then, histopathologic research on grade of inflammation, mucosal thickness, inflammatory cell count, metaplasia type, and hypersecretion was performed. Fifteen patients were studied. There were positive statistical correlations between inflammation grade, eosinophil counts and plasma cell counts in ethmoid and turbinate; but such a correlation was not found in lymphocyte and neutrophil in two sites. The prominent inflammatory cell in both areas was the same for 11 patients; whereas in other four cases, it was insignificantly different. Positive statistical correlation between the inflammation grades in two sites shows the coexistence of rhinitis and sinusitis; therefore, this proves the correct combination usage of rhinosinusitis. Prominent cells of the samples which were obtained from two places were similar for most patients, so this similarity is a sign of inflammatory process presence in both places. The prominent cells were mostly lymphocytes.There were more lymphocytes than eosinophils in non-allergic patients.
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449
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Vicente-Herrero MT, Prieto-Andrés L, López-González AA, Pérez-Francés C, Ramírez-Íñiguez de la Torre MV, Santamaría-Navarro C, Terradillos-García MJ, Capdevila-García LM. [Prevalence of rhinitis and asthma respiratory symptoms in Spanish working population]. Rev Med Inst Mex Seguro Soc 2014; 52:50-59. [PMID: 24625484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE The aims were to examine the prevalence of respiratory symptoms associated with rhinitis and asthma in Spanish workers and its variations by age, sex, work sector, location in the workplace, smoking habits and the relationship between symptoms in the upper and lower respiratory tract. METHODS The sample was of 2603 workers in different sectors and regions throughout the country. They agreed and answered the questions regarding respiratory symptoms, with the supervision of the company's physician. RESULTS Chronic nasal symptoms were present in 438 workers (16.9 %); 193 (7.5 %) had pulmonary symptoms. With nasal and pulmonary symptoms were 124 patients (28.3 %). Likewise, of the 190 workers with pulmonary symptoms, 124 (64.2 %) had also nasal manifestations. We observed variations in nasal symptoms by sex, professional sector, work area and smoking habits, and variations in pulmonary symptoms by work sector. A higher prevalence was noted in the healthcare, postal, and transport sector as opposed to the construction, furniture or metal sector. CONCLUSIONS The prevalence of nasal symptoms was higher than that of pulmonary symptoms in the working population. The workers affected by these pathologies were not treated adequately, despite they were presenting symptoms. We observed a relationship between pulmonary and nasal symptoms.
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Yukselen A, Kendirli SG, Yilmaz M, Altintas DU, Karakoc GB. Correlation between nasal eosinophils and nasal airflows in children with asthma and/or rhinitis monosensitised to house dust mites. Allergol Immunopathol (Madr) 2014; 42:50-5. [PMID: 23122003 DOI: 10.1016/j.aller.2012.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Revised: 06/21/2012] [Accepted: 07/02/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND Allergic rhinitis and asthma due to mite sensitisation are diseases which are frequently associated and characterised by persistent inflammation. In the present study, we aimed to investigate the relationship between nasal airflows and nasal eosinophils in patients with asthma and/or rhinitis due to house dust mite sensitisation. METHODS Twenty-four children with both rhinitis and asthma (R+A), 13 children with rhinitis and no asthma (R) and 10 non-allergic healthy children were evaluated prospectively. The patients belonging to the first two groups had moderate-severe grade of nasal obstruction. Total nasal symptom scores, peak nasal inspiratory flows (PNIFs) obtained by anterior rhinomanometry, skin prick tests, nasal eosinophils and FEV1 values were all assessed. RESULTS Percentages of nasal eosinophils and PNIFs in patients with R+A and R (r=-0.415, p=0.04) were found to be statistically significant and to have an inverse correlation. Skin prick tests were also significantly correlated with nasal eosinophils and PNIFs (r=0.372, p=0.01 and r=-0.306, p=0.04, respectively). Both PNIFs and nasal eosinophils of patients with R+A were significantly correlated with FEV1 values (r=-0.641, p=0.001 and r=0.548, p=0.007, respectively). CONCLUSION In this study, a close relationship was demonstrated between eosinophil infiltration and nasal airflows in children having asthma and/or rhinitis monosensitised to mites. Additionally, the significant association found between FEV1 values and nasal eosinophils or PNIFs supported the close link of upper and lower airways.
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