Impact of Aeroallergen Sensitization on Chronic Rhinosinusitis.

PURPOSE: This study investigated the impact of aeroallergens on the development and progression of chronic rhinosinusitis (CRS), with a focus on the specific associations between aeroallergens and CRS according to allergen type, number, and extent of sensitization. METHODS: The medical records of 256 CRS patients were retrospectively analyzed. All were divided into nonallergic, house dust mite (HDM)-allergic, pollen-allergic, and double allergic groups via specific immunoglobulin E (IgE) testing. Clinical characteristics, computed tomography (CT) scores, olfactory functions, and demographic data were compared. Correlation analysis was performed to explore the relationships between the extent of allergen sensitization and CRS severity. Binary logistic regression analysis was used to identify risk factors for hyposmia and anosmia. RESULTS: The allergic group exhibited higher total CT scores than the nonallergic group (P = 0.001). Sensitivity to HDM or pollen allergens alone was not significantly associated with increased CRS severity. No significant differences were observed between the effects of HDM and pollen allergens on CRS severity. However, the double allergic group exhibited significantly higher CT scores (P < 0.001, < 0.001, and 0.003) than the other groups. Although the prevalence rates of anosmia and hyposmia were notably higher in the double allergic group, the difference was not statistically significant. The maximum specific IgE levels to HDM and pollen allergens positively correlated with the CT scores (P = 0.001 and 0.001, respectively). CONCLUSIONS: Allergen sensitization, particularly to multiple common allergens, contributed to CRS severity. CRS patients sensitized to both HDM and pollen allergens tended to experience the diminished olfactory function. These findings underscore the importance of considering the allergen sensitization pattern when assessing CRS severity and its potential progression.

Association between allergic diseases, generalized anxiety disorder, and depressive symptoms in South Korean adolescents: a secondary data analysis of the 2022 Korea Youth Risk Behavior Survey.

PURPOSE: This study investigated the relationship between allergic diseases, general anxiety disorder, and depressive symptoms among Korean adolescents. METHODS: A secondary analysis was conducted on the findings of the 18th Korea Youth Risk Behavior Survey (2022). The study included 51,850 adolescents and analyzed the relationships among allergic diseases, general anxiety disorder, and depressive symptoms using complex samples logistic regression analysis. RESULTS: Among the Korean adolescents, 12.7% experienced general anxiety disorder, while 28.7% experienced depressive symptoms. The prevalence of allergic diseases was 5.7% for asthma, 36.3% for allergic rhinitis, and 22.2% for atopic dermatitis. General anxiety disorder was associated with asthma and allergic rhinitis but not atopic dermatitis. Depressive symptoms were associated asthma, allergic rhinitis, and atopic dermatitis. CONCLUSION: Examining the correlation among allergic diseases, general anxiety disorder, and depressive symptoms in adolescents underscores the need for implementing suitable strategies. Moreover, when addressing general anxiety disorder and depressive symptoms in adolescents, it becomes crucial to consider the presence of allergic diseases.

Prediction Model for Annual Variation in Total Pollen by Allergenic Trees in Korean Cities.

PURPOSE: Pollen forecasting systems can provide information for coping with respiratory allergies. They estimate daily pollen production, dispersal, deposition, and removal based on daily weather conditions to predict daily pollen concentrations and provide allergy warnings. As of 2023, the Korea Meteorological Administration (KMA) provides 2-day forecast of allergenic pollens. However, unlike these models, long-term analysis of annual observations of tree pollen reveal annual variations. Therefore, in this study, we aimed to develop annual prediction models for allergenic tree pollens based on long-term multi-site pollen and meteorological data. METHODS: Daily pollen concentrations were observed using Hirst-type volumetric spore traps at nine sites in Korea from 1998 to 2021, and daily weather data from the closest KMA stations were utilized. Models were developed to predict the seasonal pollen integral of seven tree species based on monthly mean temperature, wind speed, and total precipitation using three variable selection methods: 1) the t-test based key variable screening followed by linear regression with stepwise procedure (TM), 2) direct linear regression with stepwise procedure from the full variable model (FM), and 3) LASSO regression from the full variable model (LM). RESULTS: Data obtained during 1998-2017 and 2018=2021 were utilized for model development and validation, respectively. The root mean squared error, mean absolute error, mean error, and coefficient of determination (R²) revealed that the TM models were best suited for actual forecasting, even though R² in the TM model was lower than those of the FM and LM models. CONCLUSIONS: The annual variation model in this study can be integrated with the daily pollen forecast model by controlling the annual pollen potential, and the accuracy of the daily forecast can be improved accordingly.

A successful linkage of a named patient products of sublingual immunotherapy-dispensing registry to French healthcare insurance database (SNDS): methodological constitution of the EfficAPSI cohort.

BACKGROUND: The only causal treatment for allergic rhinitis (AR) is allergen immunotherapy (AIT) including personalized liquid sublingual AIT (SLIT). We present the methodology for establishing the EfficAPSI cohort to further evaluate the real-life effectiveness and use of SLIT liquid. RESEARCH DESIGN AND METHODS: The EfficAPSI cohort was constituted by deterministic linkage of Stallergenes Greer dispensing and nationwide French healthcare insurance system (SNDS) databases. Data from 2006 to 2018 were extracted. All patients who initiated Stallergenes Greer SLIT liquid between 2010 and 2013 were considered as exposed and those dispensed with AR symptomatic treatment only as control. To limit the impact of confounding, the models will be weighted using the inverse probability of treatment weighting (IPTW). RESULTS: A total of 445,574 patients were included; median age was 38 years; 59.1% were female. Exposed patients (n = 112,492) were significantly younger, more frequently males, and less likely to have comorbidities than controls (n = 333,082). After IPTW, patients' characteristics from both groups were similar. CONCLUSIONS: To date, the EfficAPSI cohort has the largest number of person-years of follow-up in the field of AIT. The completeness of the data allows to evaluate SLIT liquid effectiveness with rigorous methodology, leading to important insights on personalized medicine in real-life.

Traditional Chinese Medicine constitution among patients with allergic rhinitis and its correlation with anxiety and depression.

OBJECTIVE: To preliminary investigate the distribution of Traditional Chinese Medicine (TCM) constitution among patients with allergic rhinitis (AR) and reveal the related factors with anxiety and depression. METHODS: Between July 2020 and June 2021, specialist doctor recruited AR patients in Beijing and Shanghai. A total of 630 patients admitted to participate in the survey, and 516 (81.9%) (male 54.3%, female 45.7%) participants completed the questionnaires. Three scales including Constitution in Chinese Medicine Questionnaire (CCMQ), Generalized Anxiety Disorder Questionnaire (GAD-7) and The Patient Health Queationaire-9 (PHQ-9) were applied. The χ2 and the Fisher's exact test were used to evaluate the classification data, multivariate logistic regression was used to explore the related factors of anxiety and depression. RESULTS: According to 516 AR patients, the most commonly first-constitution was Yang-deficiency (22.1%) and frequent of all constitutions was inherited-special (21.6%). One third of AR patients (33.5%) suffered from anxiety, nearly half of AR patients (46.5%) were found to be depressive. Inherited-special (27.7%) was the most common constitution in patients with anxiety whereas Yang-deficiency (26.7%) was most common constitution in patients with depression. Sex, duration of symptoms, balanced, Qi-deficiency, phlegm-dampness, Qi-stagnation, and inherited-special constitutions were related with anxiety; Sex, income, duration of symptoms, balanced, Qi-deficiency, Yang-deficiency, phlegm-dampness, Qi-stagnation, and inherited-special constitutions were related with depression. CONCLUSIONS: According to our study, the commonly constitution types of AR were Yang-deficiency and inherited-special. We found that the prevalence value of anxiety and depression were high. People with Qi-deficiency, phlegm-dampness, Qi-stagnation, and inherited-special constitutions were more likely to have mental problems than the others. Controlling these influential factors might be beneficial for clinical health management of AR patients, and the government should apply appropriate mental health treatment services to offer psychiatric support.

Associations of dietary vitamin A and C intake with asthma, allergic rhinitis, and allergic respiratory diseases.

BACKGROUND/OBJECTIVES: Asthma and allergic rhinitis (AR) are closely related and considered as allergic respiratory diseases (ARD), and their prevalence has recently increased. Data on the association of dietary antioxidant vitamin intake with asthma and AR in adults are limited. The present study aimed to investigate the associations of vitamin A and C intake with asthma, AR, and all cases of both diseases in young adults who participated in a cross-sectional national survey, with the use of high-sensitivity C-reactive protein (hs-CRP) level as an effect modifier. SUBJECTS/METHODS: This study included 6,293 male and female adults aged 20-49 years from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted between 2016 and 2018. The questionnaire-based reports on asthma and AR diagnosis were used to determine outcome variables. Further, 24-h recall data on dietary vitamin A and C, carotene, and retinol intake were acquired. Logistic regression analysis was performed to calculate odds ratios (ORs) and 95% confidence interval (CI). RESULTS: Dietary vitamin C intake was inversely associated with asthma prevalence among participants with hs-CRP levels (≥ 1 mg/L); the OR of asthma prevalence was 0.27 (95% CI, 0.08-0.84) for participants with vitamin C consumption ≥ 75 mg/day compared with those consuming < 20 mg/day. Similar association analyses limiting to non-users of dietary supplements were performed to rule out the potential effects of supplement intake on the outcomes; results showed a stronger association. However, the association between vitamin C and asthma was not significant in participants with hs-CRP levels < 1 mg/L; the OR of asthma was 1.44 (95% CI, 0.66-3.16) for participants with vitamin C consumption ≥ 75 mg/day compared with those consuming < 20 mg/day. Vitamin C intake was not associated with AR. Moreover, there was no association between vitamin A intake and neither asthma nor AR. CONCLUSIONS: These findings suggest that higher vitamin C intake may play a potential role in reducing asthma prevalence. Nevertheless, further studies should be conducted to evaluate whether this association is causal.

Comparative Effectiveness of Cryotherapy and Radiofrequency Ablation for Chronic Rhinitis: A Systematic Review and Meta-analysis.

OBJECTIVES: Multiple minimally invasive techniques for chronic rhinitis treatment focus on posterior nasal nerve ablation. We conducted a systematic review and meta-analysis to evaluate the efficacy of cryotherapy and radiofrequency ablation for alleviating symptoms in patients with allergic and nonallergic rhinitis. METHODS: We retrieved studies from PubMed, Scopus, Embase, Web of Science, and Cochrane Database up to July 2023. Data on the impact of cryotherapy and radiofrequency ablation on quality of life and symptom ratings of rhinitis were extracted and evaluated. RESULTS: An analysis of 12 studies involving 788 patients demonstrated significant improvements in quality of life and rhinitis-related symptoms (nasal obstruction, itching, rhinorrhea, and sneezing) in patients treated with cryotherapy or radiofrequency ablation (symptom score at 24 months and quality of life score at 3 months). However, radiofrequency ablation had a more positive effect on nasal symptoms after 3 months than cryotherapy. Nonallergic rhinitis patients responded more favorably to posterior nerve ablation than patients with allergic rhinitis. Both techniques enhanced disease-specific quality of life during the initial 3 months of treatment (cryotherapy, 84.6%; radiofrequency, 81.6%; P=0.564). After 3 months of treatment, a clinical improvement in all nasal symptoms (minimal clinically important difference in the total nasal symptom score: >1.0 points) was seen in 81.8% and 91.9% of patients who underwent cryotherapy and radiofrequency ablation, respectively (P=0.005), suggesting that radiofrequency is more likely to lead to clinical improvement. CONCLUSION: Rhinitis-associated subjective symptom scores and quality of life may be improved by both cryotherapy and radiofrequency ablation. Ablation was more efficacious than cryotherapy for nasal symptoms in patients with nonallergic rhinitis. To corroborate these findings, further randomized controlled studies directly comparing these two techniques are warranted.

Efficacy of catgut embedding in Baihui (GV20) and Feishu (BL13) and Pishu (BL20) on lung tissue, brain tissue and blood related indexes in rats with allergic rhinitis of lung deficiency type.

OBJECTIVE: To investigate the effects of acupoint catgut embedding for 3 weeks on lung tissue, blood immunoglobulin E (IgE) and interleutin-4 (IL-4), brain tissue microglia x-42 (OX-42) and toll-like receptor-2 (TLR-2) in rats with allergic rhinitis of lung deficiency type. METHODS: Forty-five female Sprague-Dawley rats were randomly divided for two times. The first time, they were randomly divided into model group and blank group (Group C) according to 2:1, and the second time, the model group were randomly divided into model control group (Group B) and intervention treatment group (Group A) according to 1:1. 15 in each group. For Group A and Group B, the lung deficiency model was made by "sulfur-moxa fumigation", and then the allergic rhinitis model was established by "ovalbumin (OVA) sensitization". Then catgut embedding was performed at acupoints in Group A and not in Group B. After 3 weeks, collect lung tissue samples for hematoxylin-eosin staining, then take blood to observe the concentration of IgE and IL-4, and finally take brain tissue to observe the results of OX-42 and TLR-2. RESULTS: IgE level (µg/mL) was (3.11 ± 0.20) in the Group A, (4.19 ± 0.44) in the Group B, and (2.29 ± 0.30) in the Group C (all < 0.001). IL-4 level (pg/mL) was (14.2 ± 0.7) in the Group A, (18.6 ± 2.4) in the Group B, and (11.4 ± 1.2) for the Group C (all < 0.001). The mean OD for OX-42 is (0.1728 ± 0.0016) in the Group A, (0.1810 ± 0.0046) in the Group B and (0.1674 ± 0.0025) in the Group C (all < 0.001). CONCLUSION: Although 3 weeks of acupoint catgut embedding already showed obvious efficacy on rats with allergic rhinitis, the allergic reaction in the body still continued. To achieve further treatment, prolonging the catgut embedding time is necessary.

[Distribution characteristics and results of allergens in patients with allergic rhinitis in Ningxia area].

Objective:To investigate the distribution of allergens in patients with allergic rhinitis （AR） in Ningxia, and provide theoretical data for the prevention and treatment of AR in this region. Methods:A total of 1664 patients diagnosed with AR in the Otorhinolaryngology Head and Neck Surgery Department of Yinchuan First People's Hospital Outpatient Clinic from January 2018 to December 2021 were retrospectively collected. Use the allergen sIgE antibody detection kit （immunoblotting method） to detect inhalation and ingestion allergens in patients.Results: ①Among all AR patients, 1 158 cases were detected positive, resulting in the detection rate was 69.59%; ②The detection rate of inhalation allergen was 65.87%, and the detection rate of ingestion allergen was 19.83%; ③Mugwort was the most sensitive allergen, and 76.32% of the patients having a positive grade ≥3; ④Out of the patients, 294 cases （25.39%） were allergic to only one allergen, 244 cases （21.07%） were allergic to two allergens, and 620 cases （53.54%） were allergic to three or more allergens; ⑤During different seasons, the highest number of positive allergens detected was in the summer, with 968 cases （83.59%）. Mugwort was the main allergen during this season （69.01%）. After the COVID-19 epidemic, the total positive rate of sIgE tests in AR patients decreased compared to before, and the difference was statistically significant （P<0.001）; ⑥Mugwort, dog epithelium, mold combination, egg, peanut, soybean, Marine fish combination and fruit combination all showed statistically significant differences between different gender groups （P<0.05）; ⑦Common ragweed, mugwort, dust mite combination, cockroach, egg, milk, Marine fish combination, shrimp, fruit combination and nut combination all showed statistically significant differences among different age groups （P<0.05）; ⑧There were statistically significant differences in hay dust among different ethnic groups （P<0.05）. Conclusion:Artemisia argyi is the main allergen in Ningxia, and the distribution characteristics of different allergens are influenced by treatment season, the COVID-19 epidemic, gender, age, ethnicity, and other factors, showing certain distribution patterns and rules.

Early intervention improves clinical responses to seasonal allergic rhinitis by stimulation in sphenopalatine ganglion (Xinwu acupoint).

OBJECTIVE: To examine the efficacy of early intervention (4 weeks before pollen dispersal) with sphenopalatine ganglion (Xinwu acupoint) stimulation in patients with allergies after the onset of seasonal allergic rhinitis (SAR). METHODS: This is a prospective, randomized and unblinded half-open study. Forty-one SAR volunteers were randomly assigned to either the sphenopalatine ganglion (SPG) acupuncture plus supplementary acupuncture (SPG group) or the sham-SPG acupuncture plus supplementary acupuncture (SA group) stimulation 4 weeks before the onset of allergy season. The changes of the total nasal symptom score (TNSS) and the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) scores were measured on the first week in the onset of allergy season. RESULTS: Four patients dropped out due to local hematoma and pain in the SPG and SA groups. The remaining 37 patients continued through to the end of the trial. After early intervention 4 weeks before the onset of allergy season, the sneezing, nasal congestion and itchiness scores in the first week of onset time were significantly lower in the SPG group than in the SA group patients ( 0.001). The RQLQ score obtained at the onset of symptoms indicated that symptoms were more significantly ameliorated in the SPG group than in the SA group (0.001). CONCLUSIONS: The results of this study confirmed that early intervention by sphenopalatine ganglion (Xinwu acupoint) stimulation can effectively improve the symptoms and the quality of SAR patients' daily lives.

KAAACI Allergic Rhinitis Guidelines: Part 2. Update in Non-pharmacological Management.

Allergic rhinitis is the most common chronic disease worldwide. Various upper airway symptoms lower quality of life, and due to the recurrent symptoms, multiple treatments are usually attempted rather than one definitive treatment. There are alternatives to medical (medication-based) and non-medical treatments. A guideline is needed to understand allergic rhinitis and develop an appropriate treatment plan. We have developed guidelines for medical treatment based on previous reports. The current guidelines herein are associated with the "KAAACI Evidence-Based Guidelines for Allergic Rhinitis in Korea, Part 1: Update in pharmacotherapy" in which we aimed to provide evidence-based recommendations for the medical treatment of allergic rhinitis. Part 2 focuses on non-pharmacological management, including allergen-specific immunotherapy, subcutaneous or sublingual immunotherapy, nasal saline irrigation, environmental management strategies, companion animal management, and nasal turbinate surgery. The evidence to support the treatment efficacy, safety, and selection has been systematically reviewed. However, larger controlled studies are needed to elevate the level of evidence to select rational non-medical therapeutic options for patients with allergic rhinitis.

KAAACI Allergic Rhinitis Guidelines: Part 1. Update in Pharmacotherapy.

The prevalence of allergic rhinitis (AR) and the socioeconomic burden associated with the medical cost and quality of life (QOL) of AR have progressively increased. Therefore, practical guidelines for the appropriate management of AR need to be developed based on scientific evidence while considering the real-world environment, values, and preferences of patients and physicians. The Korean Academy of Asthma, Allergy and Clinical Immunology revised clinical guidelines of AR to address key clinical questions of the management of AR. Part 1 of the revised guideline covers the pharmacological management of patients with AR in Korea. Through a meta-analysis and systematic review, we made 4 recommendations for AR pharmacotherapy, including intranasal corticosteroid (INCS)/intranasal antihistamine (INAH) combination therapy, oral antihistamine/INCS combination therapy, leukotriene receptor antagonist treatment in AR patients with asthma, and prophylactic treatment for patients with pollen-induced AR. However, all recommendations are conditional because of the low or very low evidence of certainty. Well-designed and strictly executed randomized controlled trials are needed to measure and report appropriate outcomes.

Rinitis alérgica asociada al grado de compromiso pulmonar por COVID-19 en pacientes de un hospital general peruano / Allergic rhinitis associated with the degree of pulmonary involvement due to COVID-19 in patients from a peruvian general hospital

Objetivos. Evaluar la asociación entre rinitis alérgica y el grado de compromiso pulmonar en pacientes con COVID-19 y evaluar las frecuencias de las variables principales. Materiales y métodos. Se realizó un estudio de tipo observacional, transversal y analítico mediante la revisión de historias clínicas de pacientes atendidos en el Hospital Nacional Cayetano Heredia entre el año 2020 y 2021 con diagnóstico de COVID-19. Se determinó el antecedente de rinitis alérgica, y el compromiso pulmonar se evaluó mediante una tomografía sin contraste usando el puntaje tomográfico (PT), además de, variables sociodemográficas y clínicas. Se estimaron razones de prevalencias tanto crudas (RP) como ajustadas (RPa) con sus respectivos intervalos de confianza (IC) al 95% y se empleó un modelo lineal generalizado de la familia Poisson con función de enlace logarítmica y varianzas robustas. Resultados. Se evaluaron 434 pacientes predominantemente varones, mayores de 60 años y sin antecedentes médicos relevantes. El 56,2% tenía el antecedente de rinitis alérgica y el 43,1% tuvo un compromiso pulmonar moderado a severo. En el modelo de regresión ajustado, se encontró que el antecedente de rinitis alérgica disminuyó la gravedad de COVID-19 evaluada a través del compromiso pulmonar según el PT (RPa: 0,70; IC 95%: 0,56-0,88; p=0,002). Conclusiones. El antecedente de rinitis alérgica representó una disminución en la gravedad de COVID-19 según el PT score del 30,0% en pacientes hospitalizados.

Objectives. To evaluate the association between allergic rhinitis and the degree of pulmonary involvement in patients with COVID-19 and to determine the frequencies of the main variables. Materials and methods. An observational, cross-sectional and analytical study was carried out by reviewing the medical records of patients diagnosed with COVID-19 from the Cayetano Heredia National Hospital between 2020 and 2021. We obtained information regarding the history of allergic rhinitis; pulmonary involvement was assessed by non-contrast tomography results using the chest computed tomography (CT) score. Data regarding sociodemographic and clinical variables was also obtained. Both crude (PR) and adjusted (aPR) prevalence ratios with their respective 95% confidence intervals (CI) were estimated. We also used a generalized linear Poisson family model with log link function and robust variances. Results. We evaluated 434 patients, who were mostly male, older than 60 years and had no relevant medical history. Of these, 56.2% had a history of allergic rhinitis and 43.1% had moderate to severe pulmonary involvement. The adjusted regression model showed that the history of allergic rhinitis reduced the severity of COVID-19 according to the pulmonary involvement assessed by the CT score (aPR: 0.70; 95%CI: 0.56-0.88; p=0.002). Conclusions. The history of allergic rhinitis resulted in a 30.0% decrease in COVID-19 severity according to the CT score in hospitalized patients.

Attenuating the atopic march: Meta-analysis of the dupilumab atopic dermatitis database for incident allergic events.

BACKGROUND: Atopic march refers to the sequential development of allergic diseases from infancy through adolescence, typically beginning with atopic dermatitis (AD), followed by food allergy and then airway diseases, later evolving to broader or worsened spectrum of allergic diatheses. No intervention has shown to alter its course. OBJECTIVE: We sought to determine the rate of acquisition of new or worsened allergic events for dupilumab versus placebo in patients with AD. METHODS: Allergy-associated events from 12 clinical trials were grouped into 17 allergy categories, and IgE changes from baseline were defined. A new/worsened event was considered one step of atopic march. Treatment effect was assessed by incidence rate ratios (IRRs), dupilumab versus placebo, by meta-analysis. RESULTS: The duration of pooled AD studies was 4 to 52 weeks (1359 patient-years; n = 2296 dupilumab, n = 1229 placebo, median age 35 years). The median age at AD onset was 2 years. Baseline allergic disease burden was comparable between groups. Dupilumab reduced the risk of new/worsening allergies by 34% (IRR 0.66; 95% confidence interval [CI], 0.52-0.84) and new allergies by 37% (IRR 0.63; 95% CI, 0.48-0.83) versus placebo. Including IgE category shift, the IRR for combined new/worsening allergies was reduced by 54% (IRR 0.46; 95% CI, 0.36-0.57). These treatment benefits did not reverse on treatment discontinuation in off-treatment follow-up. CONCLUSIONS: The acquisition/worsening of allergic conditions suggestive of atopic march was observed in a pooled adult/adolescent AD study population with inadequately controlled AD. Treatment with dupilumab reduced new/worsened allergy events versus placebo; inclusion of IgE category change increased the apparent benefit.

Omalizumab for the treatment of 74 patients with chronic spontaneous urticaria accompanied by other allergic diseases: a clinical analysis / 中华皮肤科杂志

Objective:To evaluate the clinical efficacy of omalizumab in the treatment of patients with chronic spontaneous urticaria accompanied by other allergic diseases.Methods:Clinical data were retrospectively collected from 74 patients, who were clinically diagnosed with chronic spontaneous urticaria and other allergic diseases, and received subcutaneous injections of omalizumab in the Department of Allergy, Tianjin Medical University General Hospital from June 2020 to September 2022. Types of allergic diseases, serum total IgE (tIgE) and allergen-specific IgE (sIgE) levels before treatment, treatment outcomes and adverse drug reactions were analyzed. Differences before and after treatment were assessed using paired t-test and Wilcoxon signed-rank sum test. Results:A total of 74 patients with chronic spontaneous urticaria were involved, including 29 with complicated allergic asthma (39.2%) , 61 with complicated allergic rhinitis (82.4%) , 6 with complicated atopic dermatitis (8.1%) , and 4 with food allergy (5.4%) . Before treatment, elevated serum tIgE or sIgE levels were observed in 44 (59.5%) patients. After the first omalizumab treatment, the urticaria control test (UCT) score significantly increased compared with that before treatment (16.00 [13.0.0, 16.00] vs. 6.00 [5.75, 9.00], Z = 7.39, P < 0.001) ; after 4 sessions of the omalizumab treatment, 82.5% (33/40) of the patients achieved complete control of urticaria symptoms or showed complete response. After omalizumab treatment, asthmatic attacks were decreased in 29 patients with allergic asthma, and asthma control test (ACT) scores significantly increased compared with those before treatment (21.07 ± 2.88 points [after the first treatment] vs. 18.48 ± 3.20 points [before treatment], t = 8.87, P < 0.001) ; among 61 patients with allergic rhinitis, global rhinitis symptom-based visual analog scale (VAS) scores (before treatment: 5.89 ± 1.29 points; after the first treatment: 3.28 ±1.46 points) and rhinoconjunctivitis quality of life questionnaire (RQLQ) scores (before treatment: 60.10 ± 20.53 points; after the first treatment: 37.26 ± 18.83 points) both significantly decreased after the first treatment ( t = 15.04, 10.01, respectively, both P < 0.001) , and rhinitis symptoms were relieved at the same time; skin itching was relieved in 4 patients with atopic dermatitis, and allergic symptoms after contact with food allergens were also relieved in the 2 patients with food allergy after omalizumab treatment. During the treatment, only 1 patient experienced erythematous swelling, induration, and pain at the injection site. Conclusions:In the treatment of chronic spontaneous urticaria accompanied by allergic diseases, the use of omalizumab not only effectively improved urticaria symptoms, but also well controlled allergic diseases, with a good safety profile. Multiple benefits may be achieved by the use of omalizumabin in patients with chronic spontaneous urticaria accompanied by other allergic diseases.

Efficacy of Yupingfeng granule combined with cetirizine in the treatment of allergic rhinitis and its effects on serum inflammatory factor level / 中国基层医药

Objective:To investigate the efficacy of Yupingfeng granule combined with cetirizine in the treatment of allergic rhinitis and its effects on serum inflammatory factor level. Methods:A total of 162 patients with allergic rhinitis admitted to Zhejiang Provincial Hospital of Chinese Medicine from January 2021 to March 2022 were included in this prospective controlled study. They were randomly divided into a control group and an observation group ( n = 81/group). The control group was treated with cetirizine and the observation group was treated with Yupingfeng granule combined with cetirizine. All patients were treated for 4 weeks. Clinical efficacy was compared between the two groups after 4 weeks of treatment. Main symptom score, nasal function indexes (total nasal airway resistance, nasal minimal cross-sectional area, and 0-5 cm nasal cavity volume), levels of inflammatory factors (interleukin-4, interleukin-6, and interleukin-10), and Rhinoconjunctivitis Quality of Life Questionnaire scores were compared between the two groups before and after 4 weeks of treatment. Results:Total response rate in the observation group was significantly higher than that in the control group [92.59% (75/81) vs. 79.01% (64/81), χ2 = 6.13, P < 0.05]. After 4 weeks of treatment, the scores of nasal congestion, nasal itching, and sneezing in the observation group were (0.63 ± 0.20) points, (0.70 ± 0.21) points, and (0.54 ± 0.17) points, which were significantly lower than (1.07 ± 0.23) points, (1.08 ± 0.24) points, and (0.89 ± 0.22) points in the control group ( t = 12.99, 10.72, 11.33, all P < 0.05). After 4 weeks of treatment, total nasal airway resistance in the observation group was significantly lower than that in the control group [(0.17 ± 0.05) kPa·s -1·L -1vs. (0.26 ± 0.06) kPa·s -1·L -1, t = 10.37, P < 0.05]. Nasal minimal cross-sectional area and 0-5 cm nasal cavity volume in the observation group were (0.94 ± 0.17) cm 2 and (9.74 ± 0.89) cm 3, respectively, which were significantly higher than (0.76 ± 0.10) cm 2 and (8.43 ± 0.78) cm 3 in the control group ( t = 8.21, 9.96, both P < 0.05). After 4 weeks of treatment, serum levels of interleukin-4 and interleukin-6 in the observation group were (67.79 ± 9.94) ng/L and (6.74 ± 1.42) ng/L, respectively, which were significantly lower than (104.31 ± 14.45) ng/L and (10.29 ± 2.56) ng/L in the control group ( t = 18.74, 10.91, both P < 0.05). Serum level of interleukin-10 in the observation group was significantly higher than that in the control group [(17.97 ± 2.54) ng/L vs. (12.48 ± 2.46) ng/L, t = 13.97, P < 0.05]. After 4 weeks of treatment, Rhinoconjunctivitis Quality of Life Questionnaire score in the observation group was significantly lower than that in the control group [(27.43 ± 8.82) points vs. (38.95 ± 7.76) points, t = 8.82, P < 0.05). Conclusion:Yupingfeng granule combined with cetirizine is highly effective on allergic rhinitis. The combined therapy can reduce clinical symptoms and inflammatory reactions, improve nasal function, and thereby improve quality of life.

Distribution characteristics and results of allergens in patients with allergic rhinitis in Ningxia area / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate the distribution of allergens in patients with allergic rhinitis （AR） in Ningxia, and provide theoretical data for the prevention and treatment of AR in this region. Methods:A total of 1664 patients diagnosed with AR in the Otorhinolaryngology Head and Neck Surgery Department of Yinchuan First People's Hospital Outpatient Clinic from January 2018 to December 2021 were retrospectively collected. Use the allergen sIgE antibody detection kit （immunoblotting method） to detect inhalation and ingestion allergens in patients.Results: ①Among all AR patients, 1 158 cases were detected positive, resulting in the detection rate was 69.59%; ②The detection rate of inhalation allergen was 65.87%, and the detection rate of ingestion allergen was 19.83%; ③Mugwort was the most sensitive allergen, and 76.32% of the patients having a positive grade ≥3; ④Out of the patients, 294 cases （25.39%） were allergic to only one allergen, 244 cases （21.07%） were allergic to two allergens, and 620 cases （53.54%） were allergic to three or more allergens; ⑤During different seasons, the highest number of positive allergens detected was in the summer, with 968 cases （83.59%）. Mugwort was the main allergen during this season （69.01%）. After the COVID-19 epidemic, the total positive rate of sIgE tests in AR patients decreased compared to before, and the difference was statistically significant （P<0.001）; ⑥Mugwort, dog epithelium, mold combination, egg, peanut, soybean, Marine fish combination and fruit combination all showed statistically significant differences between different gender groups （P<0.05）; ⑦Common ragweed, mugwort, dust mite combination, cockroach, egg, milk, Marine fish combination, shrimp, fruit combination and nut combination all showed statistically significant differences among different age groups （P<0.05）; ⑧There were statistically significant differences in hay dust among different ethnic groups （P<0.05）. Conclusion:Artemisia argyi is the main allergen in Ningxia, and the distribution characteristics of different allergens are influenced by treatment season, the COVID-19 epidemic, gender, age, ethnicity, and other factors, showing certain distribution patterns and rules.

Modulation of the Immune Response to Allergies Using Alternative Functional Foods.

Modulation of the allergic immune response through alternative therapies is a field of study that aims to address allergic reactions differently from traditional approaches. These therapies encompass the utilization of natural functional foods, which have been observed to exert an influence on the immune response, thus mitigating the severity of allergies. Indeed, some studies suggest that the incorporation of these nutraceuticals can regulate immune function, leading to a reduction in histamine release and subsequent alleviation of allergic symptoms. Moreover, certain herbs and dietary supplements, such as curcumin, are believed to possess anti-inflammatory properties, which may serve to moderate allergic responses. Although the results remain somewhat mixed and require further research, these alternative therapies exhibit the potential to impact the allergic immune response, thereby providing complementary options to conventional treatments. Therefore, in this review, we aim to provide an updated account of functional foods capable of modulating the immune response to allergies. In that sense, the review delves into functional foods sourced from plants (phytochemicals), animals, and marine algae. Emphasis is placed on their potential application in the treatment of allergic disorders. It also provides an overview of how these foods can be effectively utilized as functional foods. Additionally, it explores the molecular mechanisms and scientific validity of various bioactive natural compounds in the management of allergies.

[Establishment of local allergic rhinitis tolerance in mouse model].

Objective:To establish a mouse model of local allergic rhinitis tolerance by intranasal infusion of allergen, and study its immunological indexes and characteristics. Methods:The mice were given ovalbumin（OVA） and phosphate buffer solution（PBS） daily, and their allergic symptoms were recorded. OVA-specific antibodies（IgE, IgG1, IgG2a） in serum and cytokine（IL-4, IL-10, IFN-γ） in splenic culture supernatant were detected. The infiltration of eosinophils and goblet cells in nasal mucosa were observed, and the changes in local nasal mucosa genes were analyzed by RNA-seq technique. Results:Mice first showed aggravation of allergic symptoms when stimulated with OVA. The serum OVA-specific antibodies IgE, IgG1, IgG2a and the cytokine（IL-4, IL-10, IFN-γ） Iin splenic culture supernatant were increased, the eosinophils and goblet cells in nasal mucosa were significantly increased. The expression of encoding IL-10, TGF-ß gene and eosinophils activation gene in nasal mucosa were up-regulated. As the duration of nasal dripping increased, the allergic symptoms gradually decreased, serum OVA-specific antibodies IgE, IgG1, IgG2a continued to increase. Splenic culture supernatant IL-4 decreased, IL-10 increased, IFN-γ had a downward trend. In nasal mucosa, goblet cells decreased significantly. Genes involved in eosinophils activation were significantly down-regulated. The encoding tolerance genes such as IL-10 and TGF-ß genes remained highly expressed. Ten core genes associated with immune tolerance in localized allergic rhinitis were screened, Rps27a, Uba52, Kng2, Gnal, C3, Rtp4, Reep1, Rtp2, Rtp1, Reep5. Conclusion:The mice first develop an allergy and then develop immune tolerance by continuous local drops of the allergen. The generation of immune tolerance may be induced by the continuous action of allergens, which induced systemic and local immune tolerance effects.