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He X, Zhang S, Wu J, Fu Q, Zhang Q, Peng W. The global/local (limited to some regions) effect of cesarean delivery on the risk of pediatric allergic rhinitis: a systematic review and meta-analysis. Front Pediatr 2023; 11:1228737. [PMID: 37601128 PMCID: PMC10435734 DOI: 10.3389/fped.2023.1228737] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 07/17/2023] [Indexed: 08/22/2023] Open
Abstract
Background Allergic rhinitis is a chronic and refractory disease that can be affected by a variety of factors. Studies have shown an association between cesarean section and the risk of pediatric allergic rhinitis. Methods The PubMed, Springer, Embase, Cochrane Library, and Web of Science databases were searched to retrieve all studies published from January 2000 to November 2022, focusing on the relationship between cesarean section and the risk of pediatric allergic rhinitis. A meta-analysis was conducted to find a correlation between cesarean section and the risk of pediatric allergic rhinitis. A subgroup analysis was performed, considering the region and family history of allergy, after adjusting for confounding factors. Pooled odds ratios (ORs) were calculated, publication bias was assessed using a funnel plot, and heterogeneity between study-specific relative risks was taken into account. Results The results showed that cesarean section was significantly associated with an increased risk of pediatric allergic rhinitis (OR: 1.27, 95% CI: 1.20-1.35). Subgroup analysis stratified by region indicated that cesarean section increased the risk of pediatric allergic rhinitis, with the highest increase in South America (OR: 1.67, 95% CI: 1.10-2.52) and the lowest in Europe (OR: 1.13, 95% CI: 1.02-1.25). The results of the subgroup analysis stratified by family history of allergy indicate that family history of allergy was not associated with the risk of pediatric allergic rhinitis. Conclusion An association exists between cesarean section as the mode of delivery and the increased risk of pediatric allergic rhinitis, and cesarean section is a risk factor for allergic rhinitis.
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Affiliation(s)
- Xingyi He
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shipeng Zhang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jiamin Wu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qinwei Fu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qinxiu Zhang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- World Health Organization Collaborating Centre (WHOCC), Chengdu, China
| | - Wenyu Peng
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Kawabe T, Kawashima K, Okuno M, Yamamoto M, Sasaki T, Hanada Y, Tanaka S, Kumon J, Yamaguchi T, Ueno R, Tsurinaga Y, Fukazawa Y, Shigekawa A, Takaoka Y, Yoshida Y, Kameda M. [OBJECTIVE EVALUATION OF SUBLINGUAL IMMUNOTHERAPY FOR PEDIATRIC ALLERGIC RHINITIS RESPOND TO SQ HOUSE DUST MITE]. Arerugi 2023; 72:375-387. [PMID: 37316242 DOI: 10.15036/arerugi.72.375] [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] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Sublingual immunotherapy (SLIT) has become applicable to insurance for children in Japan in 2018. However, as for the efficacy of SLIT for children, objective evaluation methods have not been sufficiently investigated. SUBJECTS AND METHODS We investigated the efficacy of SLIT as both subjective and objective evaluation in 44 children with allergic rhinitis sensitized to house dust mite who started the treatment in the summer of 2018 in our hospital. The children and their patients wrote the allergy diary every day, and in winter/spring/summer vacations, they answered Japanese allergic rhinitis quality of life standard questionnaire and were evaluated with nasal provocation test, blood test, rhinomanometry for 3 years. RESULTS 29 (66%) of the 44 children continued SLIT for 3 years. Symptom scores, QOL scores, symptom medication scores halved in a year and the effect lasted in the second and third year. Nasal provocation test and rhinomanometry showed significant improvement. Specific IgE increased transiently and then decreased. Specific IgG4 increased annually. CONCLUSION The present study showed a decrease in scores not only for subjective assessments but also for objective evaluation methods, the house dust nasal provocation test and the nasal airway resistance.
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Affiliation(s)
- Takanari Kawabe
- Department of Otorhinolaryngology, Osaka Habikino Medical center
| | - Kayoko Kawashima
- Department of Otorhinolaryngology, Osaka Habikino Medical center
| | - Mika Okuno
- Department of Otorhinolaryngology, Osaka Habikino Medical center
| | | | | | - Yukiko Hanada
- Department of Otorhinolaryngology, Osaka Habikino Medical center
| | - Shohei Tanaka
- Department of Otorhinolaryngology, Osaka National Hospital
| | - Junko Kumon
- Department of Pediatrics, Osaka Habikino Medical center
| | | | - Rumi Ueno
- Department of Pediatrics, Osaka Habikino Medical center
| | | | | | | | - Yuri Takaoka
- Department of Pediatrics, Osaka Habikino Medical center
| | | | - Makoto Kameda
- Department of Pediatrics, Osaka Habikino Medical center
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Cansever M, Sari N. The association of allergic rhinitis severity with neutrophil-lymphocyte and platelet-lymphocyte ratio in children. North Clin Istanb 2022; 9:602-9. [PMID: 36685620 DOI: 10.14744/nci.2022.96236] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/20/2021] [Accepted: 04/27/2022] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE The aim of the study was to investigate the relationship between the severity of allergic rhinitis (AR) and neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in pediatric patients. METHODS This study is a retrospective, cross-sectional, and observational study including 200 AR patients and 160 healthy controls. Of the patients, 39% were boys with a mean age of 10.5 years. The study included children with persistent and intermittent AR. Of the controls, 50.6% were boys with a mean age of 10.3 years. We compared NLR and PLR from blood test between study and control groups. They were also compared according to AR severity within the patient group. RESULTS The NLR was 1.64±1.29 in the study group whereas 1.18±0.31 in the control group. The PLR was 102.72±31.20 in the study group whereas 79.36±11.72 in the control group. When NLR and PLR were compared between groups, we found statistically significant differences in both NLR and PLR (p=0.003, p=0.001, respectively). We found a statistically significant difference when comparing both NLR and PLR in patients with intermittent and persistent AR. These rates increased with disease severity (p=0.000, p=0.000, respectively). CONCLUSION Both NLR and PLR are useful markers for the diagnosis and severity of AR. Clinicians can use these markers to assess disease severity in pediatric patients at the beginning of the diagnostic process.
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Scadding GK, Smith PK, Blaiss M, Roberts G, Hellings PW, Gevaert P, Mc Donald M, Sih T, Halken S, Zieglmayer PU, Schmid-Grendelmeier P, Valovirta E, Pawankar R, Wahn U. Allergic Rhinitis in Childhood and the New EUFOREA Algorithm. Front Allergy 2022; 2:706589. [PMID: 35387065 PMCID: PMC8974858 DOI: 10.3389/falgy.2021.706589] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [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: 05/07/2021] [Accepted: 06/11/2021] [Indexed: 12/25/2022] Open
Abstract
Allergic rhinitis in childhood has been often missed, mistreated and misunderstood. It has significant comorbidities, adverse effects upon quality of life and educational performance and can progress to asthma or worsen control of existing asthma. Accurate diagnosis and effective treatment are important. The new EUFOREA algorithm provides a succinct but wide- ranging guide to management at all levels, based on previous guidelines with updated evidence and has been adjusted and approved by experts worldwide.
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Affiliation(s)
- Glenis Kathleen Scadding
- Ear, Nose and Throat Department, University College London Hospitals National Health Service Foundation Trust, London, United Kingdom.,Faculty of Medical Sciences, University College London, London, United Kingdom
| | | | - Michael Blaiss
- Department of Paediatrics, Medical College of Georgia, Augusta University, Augusta, GA, United States
| | - Graham Roberts
- National Institute of Health Research Biomedical Research Centre, Southampton General Hospital, Southampton, United Kingdom.,The David Hide Asthma and Allergy Research Centre, Newport, United Kingdom.,Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Peter William Hellings
- Department of Microbiology and Immunology, Department of Otorhinolaryngology, Katholieke Universiteit Leuven, Leuven, Belgium.,Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, Netherlands
| | - Philippe Gevaert
- Department of Otorhinolaryngology, Ghent University, Ghent, Belgium
| | | | - Tania Sih
- Medical School, University of São Paulo, São Paulo, Brazil
| | - Suzanne Halken
- Paediatric Allergy, University of Southern Denmark, Odense, Denmark
| | - Petra Ursula Zieglmayer
- Karl Landsteiner University of Health Sciences, Krems an der Donau, Austria.,Vienna Challenge Chamber, Vienna, Austria
| | - Peter Schmid-Grendelmeier
- Allergy Unit, Dermatology Department, University Hospital of Zurich, Eidgenössische Technische Hochschule Zürich, Zurich, Switzerland
| | - Erkka Valovirta
- Department of Lung Diseases and Clinical Immunology, University of Turku and Terveystalo Allergy Clinic, Turku, Finland
| | - Ruby Pawankar
- Division of Allergy, Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - Ulrich Wahn
- Klinik für Pädiatrie m.S. Pneumologie und Immunologie, Charite-Berlin, Berlin, Germany
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Abstract
INTRODUCTION Allergic rhinitis (AR) is a global health problem in adults as well as the younger population, continuously increasing and posing a significant problem for patients, health care systems and economies. For the younger population, some aspects differ from treatment of adults, namely, prevention, compliance and adherence. AREAS COVERED This narrative review summarizes all the pharmacotherapeutic options with special focus on the pediatric population. Moreover, it elucidates prevention strategies as well as future developments of AR treatment. Currently, symptomatic therapy in the form of steroids and antihistamines is applied topically and systemically where steroids need to be administered with caution and for a very short term. The only disease-modifying and causal treatment is allergen immunotherapy administered sublingually and subcutaneously. Future and current novel therapeutic options are human monoclonal antibodies. EXPERT OPINION The greatest potential for future developments currently lie in allergen immunotherapy and here in different routes of administration and modification of (recombinant) allergens as well as immune-modulating adjuvants and nanoparticles. Secondly, monoclonal antibodies are promising molecules blocking and/or interfering with up- and downstream immune mechanisms. Another important aspect lies in prevention of allergic sensitization and disease progression through both AIT and biologics which is particularly true for the pediatric population.
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Affiliation(s)
- Peter Valentin Tomazic
- Department of General Otorhinolaryngology, Head and Neck Surgery, Medical University of Graz, Graz, Austria
| | - Doris Lang-Loidolt
- Department of General Otorhinolaryngology, Head and Neck Surgery, Medical University of Graz, Graz, Austria
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Yamasaki A, Burks CA, Bhattacharyya N. Cognitive and Quality of Life-Related Burdens of Illness in Pediatric Allergic Airway Disease. Otolaryngol Head Neck Surg 2020; 162:566-571. [PMID: 32122241 DOI: 10.1177/0194599820908202] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To analyze the prevalence of pediatric allergic airway disease (PAA) and recognize its impact on cognitive function, childhood activities, use of early intervention, and missed school days. STUDY DESIGN Cross-sectional analysis of National Health Interview Survey (NHIS), 2014 to 2017. SETTING US households. SUBJECTS AND METHODS An NHIS survey of US children and responding caregivers was analyzed to determine the prevalence of PAA, including allergic rhinitis and allergic asthma. Associations were determined between the presence of PAA and activities limited by difficulty remembering, limitation in the amount of childhood play, use of special education/early intervention, and number of missed school days in the past 12 months. Multivariate analysis was used to adjust for age, sex, race, ethnicity, and income level. RESULTS An estimated 11.1 million (10.6-11.6 million, 95% confidence interval) children (mean age, 9.9 years; 56.9% male) reported a diagnosis of PAA (15.1% [14.6-15.6%]). Children with PAA missed 4.0 (3.7-4.4) school days per year vs 2.2 (2.1-2.4) days for those without PAA (P < .001, adjusted). PAA was associated with limited daily activities due to difficulty with memory (odds ratio, 1.8 [1.2-2.9]), limitations in childhood play (3.2 [2.2-4.7]), and need for special education/early intervention services (1.6 [1.4-1.8]) after adjusting for age, sex, race, ethnicity, and income level. CONCLUSION PAA is a common condition and is associated with declines in cognitive function and school attendance as well as increased use of special education/early intervention. Given the significant prevalence and burden of illness of PAA, further attention is needed to ensure timely diagnosis and treatment.
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Affiliation(s)
- Alisa Yamasaki
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, Massachusetts, USA.,Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, USA
| | - Ciersten A Burks
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, Massachusetts, USA.,Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, USA
| | - Neil Bhattacharyya
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, Massachusetts, USA.,Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, USA
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Li Y, Mu Z, Wang H, Liu J, Jiang F. The role of particulate matters on methylation of IFN-γ and IL-4 promoter genes in pediatric allergic rhinitis. Oncotarget 2018; 9:17406-17419. [PMID: 29707116 PMCID: PMC5915124 DOI: 10.18632/oncotarget.24227] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 06/09/2017] [Accepted: 12/27/2017] [Indexed: 01/23/2023] Open
Abstract
Allergic rhinitis (AR) is a chronic inflammatory disorder driven by T cell activation. How particulate matter contributes to epigenetic changes that in turn influence cytokine gene expression in CD4+T cells remains unclear. In this study, 105 children diagnosed with AR and 90 healthy controls were recruited to explore the possible mechanism of particulate matter (PM) on the epigenetic regulation of CD4+T IFN-γ and IL-4 promoter genes. Daily average PM10 and PM2.5 were obtained from five state-controlled monitoring stations, and activity-based dynamic exposure and personal exposure data were collected. DNA methylation patterns of IFN-γ and IL-4 promoter regions were analyzed using bisulfite sequencing. mRNA levels were detected by real-time quantitative reverse transcription polymerase chain reaction. We found that the methylation rate in IFN-γ was higher in AR CD4+T cells than in the controls. IFN-γ mRNA expression was significantly decreased in CD4+T cells, and negatively correlated with the mean methylation level of IFN-γ. However, no correlation between IL-4 methylation and IL-4 mRNA expression was found. After adjusting for age, gender, exclusive breastfeeding within 4 months after birth and parental history of allergic disease, out data showed that PM2.5 exposure level was positively correlated with methylation level in IFN-γ promoter region and decreased cytokine expression. We conclude that the effect of PM2.5 on pediatric AR may be mediated through epigenetic modification of IFN-γ promoter region.
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Affiliation(s)
- Youjin Li
- Department of Otorhinolaryngology-Head and Neck Surgery, Children's Medical Center, Shanghai Jiaotong University, Shanghai 200127, China
| | - Zhe Mu
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.,Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Bureau, Shanghai 200030, China
| | - Hongyang Wang
- Chinese PLA Institute of Otolaryngology, Chinese PLA General Hospital, Medical School of Chinese PLA, Beijing 100853, China
| | - Jinfen Liu
- Department of Pediatrics, Children's Medical Center, Shanghai Jiaotong University, Shanghai Jiaotong University Pediatric Institute, Shanghai 200127, China
| | - Fan Jiang
- Department of Child Development and Behavior, Children's Medical Center, Shanghai Jiaotong University, Shanghai 200127, China.,MOE-Shanghai Key Laboratory of Children's Environmental Health, Shanghai 200127, China
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