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Xu X, Zhang Y, Cheng L, Fan Y, Han Y, Jie Y, Li H, Li X, Liu H, Liu J, Liu W, Lv W, Ma Y, Ouyang Y, Shan C, Shi G, Song X, Sun S, Wang J, Wang X, Wang X, Wang Z, Xu Y, Yang Q, Zhang Y, Zhang Y, Zhu D, Wang C, Chen R, Zhang L. Chinese Expert Consensus on the Impact of Ambient Air Pollution on Allergic Rhinitis and Recommendations for Mitigation Strategies. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2025; 17:149-164. [PMID: 40204502 PMCID: PMC11982644 DOI: 10.4168/aair.2025.17.2.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2024] [Revised: 03/09/2025] [Accepted: 03/19/2025] [Indexed: 04/11/2025]
Abstract
Ambient air pollution poses a significant yet manageable threat to human health. The growing consensus on the impact of ambient air pollutants on allergic rhinitis (AR) emphasizes the importance of prevention, control, and treatment strategies. A multidisciplinary consensus development group was established to further standardize management strategies for AR in the presence of exposure to ambient air pollutants. The quality of the evidence and the strength of the recommendations were evaluated using the grading of recommendations, assessment, development, and evaluation (GRADE) system based on domestic and international relevant medical evidence. This consensus evaluates the effects of key air pollutants on public health in relation to AR, including the synergistic effects of air pollutants with meteorological conditions and aeroallergens. At the same time, the consensus provides recommendations for targeted therapeutic and preventive measures for AR under conditions of ambient air pollution, aiming to improve AR-related health outcomes. These recommendations aim to increase public and clinical awareness of the contribution of environmental factors to AR, and offer evidence-based insights for policymakers and regulators to establish informed ambient air quality standards.
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Affiliation(s)
- Xu Xu
- Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yuan Zhang
- Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Laboratory of Allergic Diseases and Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
- Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
| | - Lei Cheng
- Department of Otorhinolaryngology & Clinical Allergy Center, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Yunping Fan
- Department of Otolaryngology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Yaozhong Han
- Department of Otorhinolaryngology, The NO.2 Hospital of Baoding, Baoding, China
| | - Ying Jie
- Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Huabin Li
- Allergy Center, Department of Otolaryngology, Affiliated Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Xiaobo Li
- School of Public Health, Capital Medical University, Beijing, China
| | - Huanhai Liu
- Department of Otolaryngology-Head and Neck Surgery, Second Affiliated Hospital (Changzheng Hospital) of Naval Medical University, Shanghai, China
| | - Jianfeng Liu
- Department of Otorhinolaryngology Head & Neck Surgery, China-Japan Friendship Hospital, Beijing, China
| | - Weiwei Liu
- Department of Otolaryngology, Cangzhou Central Hospital, Cangzhou, China
| | - Wei Lv
- Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Yongjian Ma
- Department of Otolaryngology, Weifang NO.2 People's Hospital, Weifang, China
| | - Yuhui Ouyang
- Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Laboratory of Allergic Diseases and Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
- Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
| | - Chunguang Shan
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Guanggang Shi
- Department of Otolaryngology Head and Neck Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Xicheng Song
- Department of Otolaryngology Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
- Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases, Yantai, China
- Shandong Provincial Key Laboratory of Neuroimmune Interaction and Regulation, Yantai, China
| | - Shengzhi Sun
- School of Public Health, Capital Medical University, Beijing, China
| | - Jiajia Wang
- School of Public Health, Capital Medical University, Beijing, China
| | - Xiangdong Wang
- Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Laboratory of Allergic Diseases and Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
- Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
| | - Xueyan Wang
- Department of Allergy, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Zhenlin Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yu Xu
- Department of Rhinology and Allergy, Otolaryngology-Head and Neck Surgery Center, Renmin Hospital of Wuhan University, Wuhan, China
| | - Qintai Yang
- Department of Otolaryngology Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yana Zhang
- Department of Otolaryngology Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yu Zhang
- Department of Otolaryngology Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
- Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases, Yantai, China
- Shandong Provincial Key Laboratory of Neuroimmune Interaction and Regulation, Yantai, China
| | - Dongdong Zhu
- Department of Otolaryngology Head and Neck Surgery, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
- Jilin Provincial Key Laboratory of Precise Diagnosis and Treatment of Upper Airway Allergic Diseases, Changchun, Jilin, China
| | - Chengshuo Wang
- Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Laboratory of Allergic Diseases and Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
- Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
- Laboratory for Environmental Health and Allergic Nasal Diseases, Laboratory for Clinical Medicine, Capital Medical University, Beijing, China.
| | - Rui Chen
- School of Public Health, Capital Medical University, Beijing, China
- Laboratory for Environmental Health and Allergic Nasal Diseases, Laboratory for Clinical Medicine, Capital Medical University, Beijing, China.
| | - Luo Zhang
- Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Laboratory of Allergic Diseases and Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
- Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China.
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Guo S, Cao C. Effects of montelukast sodium combined with budesonide on pulmonary function, serum IgE levels, and EOS percentage in children with comorbid allergic rhinitis and asthma. Am J Transl Res 2023; 15:6823-6831. [PMID: 38186993 PMCID: PMC10767537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 10/16/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVE This study was designed to determine the effects of montelukast sodium combined with budesonide on pulmonary function, serum immunoglobulin (Ig)E levels, and eosinophil (EOS) percentage in children comorbid with allergic rhinitis (AR) and asthma. METHODS The medical records of 114 children comorbid with AR and asthma treated in the Guizhou Provincial People's Hospital from February 2020 to September 2022 were collected and analyzed retrospectively. Among them, 54 children treated with budesonide were assigned to a control group, and the remaining 60 children treated with montelukast sodium combined with budesonide were assigned to an observation group. The efficacy was compared between the two groups. Additionally, the changes in pulmonary function, serum IgE levels, and EOS percentage were compared between the two groups before and after treatment (one month). The adverse reactions during the treatment and the recurrence of AR within 3 months were recorded. Logistics regression was conducted to analyze the risk factors affecting the efficacy in children. RESULTS The observation group showed a significantly higher overall response rate than the control group (P<0.05). After treatment, the observation group showed significantly higher levels of forced expiratory volume in 1 second (FEV1)%, FEV1/forced vital capacity (FVC), and peak expiratory flow (PEF) than the control group (P<0.05), and significantly lower IgE levels and EOS percentage than the control group (P<0.05). No significant difference was found between the two groups in terms of the total incidence of adverse reactions (P>0.05). According to the follow-up results of prognosis, the observation group presented a greatly lower recurrence rate of AR within 3 months than the control group (P<0.05). Multivariate logistics regression analysis showed that therapeutic regimen, IgE, and EOS were independent risk factors affecting the efficacy in the patients (P<0.05). CONCLUSION Montelukast sodium combined with budesonide can substantially improve the pulmonary function in children with comorbid AR and asthma, alleviate their symptoms of asthma and rhinitis, and lower the IgE level and EOS percentage. In addition, therapeutic regimen, IgE and EOS are independent risk factors affecting the efficacy in patients.
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Affiliation(s)
- Shasha Guo
- Department of Pediatric Medicine, Guizhou Provincial People’s HospitalGuiyang 550002, Guizhou, China
| | - Changxing Cao
- Department of Otorhinolaryngology, Guizhou Provincial People’s HospitalGuiyang 550002, Guizhou, China
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