Allergic Respiratory Diseases Research Articles

Intestinal microflora in children with secondary hyperoxaluria and allergic respiratory diseases

Intestinal microflora in children with secondary hyperoxaluria and allergic respiratory diseases

Multifactorial analysis of willingness to undergo subcutaneous allergen immunotherapy in pediatric patients

Objective: To explore factors influencing the acceptance of allergen immunotherapy (AIT) for the treatment of allergic respiratory diseases by pediatric patients and their families.
 Methods: A total of 406 children (210 males and 196 females) attending the pediatric outpatient clinics and wards of the Renji Hospital, Shanghai Jiao Tong University School of Medicine from June 2020 to April 2022. Those who met the criteria for the AIT treatment, were included in the survey. An online 20-item questionnaire was developed. Data on patient’s general characteristics, allergic disease status, family history of allergies, general family information, parental knowledge of allergic diseases, and whether the AIT treatment was recommended by a physician, were collected. The patients were divided into two groups according to their willingness to receive AIT: a reluctant or neutral group (n = 182), and a willing group (n = 224). A univariate analysis of the willingness to undergo AIT was done to detect parameters that significantly differed between the groups, and the identified factors were used as independent variables in the multifactorial logistic regression analysis.
 Results: The severity of allergic disease, presence of drug allergy, occurrence of severe allergic reactions, mother’s education, distance from home to the hospital, parental knowledge of allergic diseases, and whether the doctor recommended AIT were all statistically different between the groups (p < 0.05). Multifactorial logistic regression analysis showed that the degree of allergic rhinitis (AR), or asthma (AS), parental knowledge of allergic diseases, and doctor’s recommendation of AIT were the factors that influenced the willingness of pediatric patients to receive AIT.
 Conclusions: The severity of AR and AS, parental knowledge of allergic diseases, and doctor’s recommendation influenced the willingness of pediatric patients to receive AIT.
 doi: https://doi.org/10.12669/pjms.40.5.8581
 How to cite this: Ding B, Zhong J, Jiang C, Ma T, Shen Q, Lu Y. Measurement of Service Quality Gaps in Dental Services using SERVQUAL in Public Hospitals of Rawalpindi. Pak J Med Sci. 2024;40(5):820-828. doi: https://doi.org/10.12669/pjms.40.5.8581
 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Changes in Cellular and Humoral Immunity of Children with Respiratory Diseases Living in Areas of Kyrgyzstan at Different Altitudes

Immunological aspects of respiratory diseases due to altitude can have a significant impact on the pathogenesis and clinical course of the disease. Research objectives: to study changes in cellular and humoral immunity in children with respiratory diseases living in areas of Kyrgyzstan located at different altitudes above sea level. This study used methods to assess cellular and humoral immunity in 209 children living at various altitudes above sea level in Kyrgyzstan. Research results contribute to a deeper understanding of the immunological mechanisms underlying respiratory diseases in children at high altitudes, which may be of practical importance for the development of more effective methods for diagnosis, prevention and treatment of such diseases. It is assumed that at high altitude the number of allergens in the body decreases, in particular, the number of dust mites, which often act as a provoking factor in allergic respiratory diseases.

Development and in vitro/in vivo evaluation of a nanosponge formulation loaded with Boswellia carterii oil extracts for the enhanced anti-inflammatory activity for the management of respiratory allergies

Abstract Purpose In several nations, it has been known that Boswellia carterii (BC) plants have a long history of usage as an anti-inflammatory medicine. Our current study deals with the study of two different ways of extraction of BC volatile oil and fixed oil as main constituents (Octyl acetate, 46.46% and β-Boswellic acid, 10.21%, respectively), preparation, and evaluation of Nano sponges loaded with either dexamethasone (DEX) or B. carterii volatile/fixed oil mixture. Methods Nano sponges were created utilizing an ultrasound-assisted synthesis method. Using spectrophotometry, the entrapment efficiency (EE%) of drugs in Nano sponges was considered. Several techniques were used to characterize Nano sponges. Results EE% of drugs inside Nano sponges ranged from 99.15 ± 3.50 to 100% ± 4.76%. Particle size of Nano sponges ranged from 59.9 ± 26.3 to 229.2 ± 30.23 nm. Drugs released from Nano sponges bi-phasically according to Korsmeyer–Peppas model. The anti-inflammatory activity of either B. carterii oil mixture or Dexa salt and their Nano formulations (D4 and O1) in the treatment of respiratory allergy were evaluated in rat model mimicking chronic allergic respiratory diseases. Histopathologic examinations and measurement of Intracellular adhesion molecule-1 (ICAM-1), Leukotriene B4 (LTB4) and Interleukin β4 (ILβ4) levels exposed that, the treatment significantly lowered the levels of the inflammatory biomarkers in treated rats and exhibited improved histopathologic profiles when compared to positive control group. Conclusion Boswellia oil and its Nano sponge formulation O1 as well as Dexa salt Nano sponge formulation D4 had promising therapeutic effects on upper and lower respiratory allergic conditions.

Preventive allergen immunotherapy with inhalant allergens in children.

The efficacy and safety of preventive allergen immunotherapy (pAIT) in children are currently under investigation. Here, we provide an overview of pAIT with respiratory allergens concerning the prevention of new sensitizations, allergic disease onset and progression as well as further immunomodulatory effects. Three databases were searched for clinical pAIT studies in children. Selected publications were reviewed for preventive outcomes according to prevention level (primary, secondary, and tertiary), allergen type, administration route, dose, and treatment duration. The primary prevention approach appears safe but showed no allergen-specific effect on new sensitizations. Secondary prevention seems feasible and may induce regulatory T cell-mediated immunotolerance. The number of studies at these prevention levels is limited. Tertiary prevention with grass and/or tree pollen-based pAIT has shown efficacy in preventing disease progression from allergic rhinitis/conjunctivitis to asthma. Data on tertiary pAIT with house dust mites and other allergen types are inconclusive. Subcutaneous and sublingual routes appear similarly effective, but head-to-head comparative paediatric studies are scarce. Additionally, there are fewer placebo-controlled studies. Nevertheless, immunomodulatory outcomes of pAIT are encouraging. Currently, limited but favourably suggestive evidence is available for preventing respiratory allergic diseases in children by pAIT. Primary and secondary prevention have potential and warrant further investigation through well-designed studies.

Perinatal Risk Factors in Relation to Asthma and Allergic Rhinitis in Children and Adolescents.

To evaluate the associations between birth-related exposures and postnasal factors and risk for allergic rhinitis and asthma in children and adolescents. We conducted a comprehensive search of five literature databases up until May 2023. To estimate the associations between birth-related exposures (birth weight, mode of delivery, prematurity, sex, maternal age, and parental history of allergy) and postnatal factors (birth order, number of siblings, exclusive, and duration of breastfeeding) and allergic disease, we calculated pooled odds ratios with 95% confidence intervals. In addition, we performed subgroup analyses according to allergic disease, birth order, number of siblings, and parental history of allergy. Methodological quality of the included studies was assessed using the Newcastle-Ottawa scale. This meta-analysis included 31 studies with 218,899 patients. Among the birth-related exposures, low birth weight, maternal age, and prematurity (<37 weeks) showed no significant associations with risk for asthma or allergic rhinitis in childhood or adolescence. On the other hand, male sex, family history of allergy, and cesarean section were related to higher risk for asthma or allergic rhinitis. Among postnatal factors, exclusive breastfeeding, long duration (>6 months) of breastfeeding, birth order second or later, and presence of sibling(s) showed preventive effects against allergic disease in offspring. The risks for allergic rhinitis and asthma were higher in male patients delivered by cesarean section and with a family history of allergy. By contrast, exclusive and long duration (>6 months) breastfeeding and the presence of sibling(s) reduced the risk of developing respiratory allergic disease.

Distinct proteomes and allergen profiles appear across the life cycle stages of Alternaria alternata

Alternaria alternata is associated with allergic respiratory diseases, which can be managed with allergen extract-based diagnostics and immunotherapy. It is not known how spores and hyphae contribute to allergen content. Commercial allergen extracts are manufactured by extracting proteins without separating the different forms of the fungus. To determine differences between spore and hyphae proteomes and how allergens are distributed in A. alternata. Data independent acquisition mass spectrometry to quantitatively compare the proteomes of asexual spores (non-germinating and germinating) with vegetative hyphae. We identified 4515 proteins in non-germinating spores, germinating spores and hyphae; most known allergens are more abundant in non-germinating spores. Comparing significant protein fold change differences between non-germinating spores and hyphae, 174 proteins were upregulated in non-germinating spores and 80 proteins in hyphae. Among the spore proteins are ones functionally involved in cell wall synthesis, responding to cellular stress, and maintaining redox balance and homeostasis. Comparing non-germinating and germinating spores, 25 proteins were upregulated in non-germinating spores and 54 in germinating spores. Among the proteins specific to germinating spores were proteases known to be virulence factors. One of the most abundant proteins in the spore proteome is sialidase, which has not been identified as an allergen but may be important in the pathogenicity of this fungus. Major allergen Alt a 1 is present at low levels in spores and hyphae and appears to be largely secreted into growth media. Spores and hyphae express overlapping but distinct proteomes. Most known allergens are found more abundantly in non-germinating spores.

Evaluation of patients’ expectation and benefits of sublingual Named-Patient Products in the treatment of allergic respiratory diseases: The French ERAPP prospective cohort study

Evaluation of patients’ expectation and benefits of sublingual Named-Patient Products in the treatment of allergic respiratory diseases: The French ERAPP prospective cohort study

Progressive pollen calendar to detect long-term changes in the biological air quality of cities in the Madrid Region, Spain

Rhinoconjunctivitis and allergic asthma are among the most frequent diseases in the world, and pollen is their main cause. The incidence of respiratory allergic diseases is expected to grow in the coming years as a consequence of ambient pollution, changes in land use and land cover in cities, and climate change. In this context of global change, the environmental information provided by monitoring and warning networks must be as updated as possible in order to be useful to the end users in the cities. The Madrid Autonomous Region (central Spain) has suffered a noticeable change in its land-use configuration in recent decades and a significant upward temperature trend throughout the entire area. We found that the aerobiological stations in the Madrid Region Palynological Network, covering the most populated cities of this region in central Spain, registered a marked shift towards a greater airborne pollen load of the most abundant tree pollen taxa (Cupressaceae, Platanus and Quercus, but also Pinaceae, Olea and others). These temporal changes are very evident in the pollen calendar for two periods, 1994–2004 (past) and 2012–2022 (present), pointing to changes in the phenology and intensity of the airborne pollen dynamic in cities in the Madrid Region. Based on these findings, we present a technical proposal to the Madrid Region Palynological Network to generate pollen calendars for each city using the reference period of the last ten years, and to update this information every three years. Finally, we propose the latest pollen calendar for all the aerobiological stations in the Madrid Region Palynological Network for the last ten years (2013–2022), which is considered the reference aerobiological information at present for one of the most populated metropolitan areas in Europe.

Study of the Role of Genes Involved in the Metabolism of Histamine in the Development of Allergic Respiratory Diseases

Study of the Role of Genes Involved in the Metabolism of Histamine in the Development of Allergic Respiratory Diseases

Experimental in- vivo animal models for asthma/ allergic asthma: importance and documented parameters- A review

Allergies are related to foods, drugs, synthetic materials, diseases, a person's immunity, and other factors, and they cause major morbidity and socioeconomic consequences. Asthma is among the most widespread respiratory conditions in the world, affecting 6.4 million children in the United States and 350 million individuals globally; within the next 30 years, 400 million individuals are estimated to be affected. The European Union has the greatest mortality rate and the largest yearly costs at 72.2 billion euros. Allergic respiratory disorders can lead to serious, life-threatening illnesses like anaphylaxis. According to epidemiological research, these disorders and their clinical effects are currently affecting people all over the world in all age groups. As a result, people all around the world are looking for new therapies and medications with minimal or no side effects. Therefore, to conduct more research trials, scientists need an in vivo animal model and data obtained from previously published study findings. Understanding the clinical features of asthma makes it possible for us to better comprehend the pathophysiology of allergic illnesses in animals, which then enables us to apply some of this knowledge to humans. To achieve the goal of this review study, a literature search was conducted using PubMed ® (US National Library of Medicine, USA), Google Scholar, and Hilary. which is to give evidence-based recommendations for various animal models. The study covered the years 2000 through 2023. To widen the scope of this research area, information on about five animal models were gathered. Here, discusses the use of mice, rats, guinea pigs, dogs, and sheep as asthma animal models in earlier studies, and documented parameters were gathered.

Heterozygous CAPZA2 mutations cause global developmental delay, hypotonia with epilepsy: a case report and the literature review.

CAPZA2 encodes the α2 subunit of CAPZA, which is vital for actin polymerization and depolymerization in humans. However, understanding of diseases associated with CAPZA2 remains limited. To date, only three cases have been documented with neurodevelopmental abnormalities such as delayed motor development, speech delay, intellectual disability, hypotonia, and a history of seizures. In this study, we document a patient who exhibited seizures, mild intellectual disability, and impaired motor development yet did not demonstrate speech delay or hypotonia. The patient also suffered from recurrent instances of respiratory infections, gastrointestinal and allergic diseases. A novel de novo splicing variant c.219+1 G > A was detected in the CAPZA2 gene through whole-exome sequencing. This variant led to exon 4 skipping in mRNA splicing, confirmed by RT-PCR and Sanger sequencing. To our knowledge, this is the third study on human CAPZA2 defects, documenting the fourth unambiguously diagnosed case. Furthermore, this splicing mutation type is reported here for the first time. Our research offers additional support for the existence of a CAPZA2-related non-syndromic neurodevelopmental disorder. Our findings augment our understanding of the phenotypic range associated with CAPZA2 deficiency and enrich the knowledge of the mutational spectrum of the CAPZA2 gene.

Potential Predictors of Long COVID in Italian Children: A Cross-Sectional Survey.

Identifying predictive factors of long COVID syndrome (LCS) is essential to preventing and managing this condition. We investigated the prevalence, symptoms, and risk factors of LCS in a cohort of Italian children and adolescents. We carried out a cross-sectional survey on demographic characteristics and clinical data related to COVID-19 phase and LCS in a cohort of children and adolescents, sending a questionnaire by using the PEDIATOTEM platform. The prevalence of LCS was 25% (99/396). The most frequent symptoms of LCS included nasal congestion, diarrhea, headache, and fatigue. We found no association between demographic data (gender, age, and ethnicity) and LCS. Additionally, we showed that patients with concurrent allergic rhinitis, atopic dermatitis, respiratory disease, gastrointestinal disease, and rheumatologic disease had a higher risk of LCS than patients without those comorbidities. Patients experiencing fatigue, muscle, and abdominal pain in COVID-19 showed a higher risk of LCS than patients complaining of other symptoms. We found no association between vaccination and LCS. Specific comorbidities or symptoms during acute illness were identified as being risk factors for LCS. Understanding which are the risk factors for LCS could yield a clearer picture of its pathogenesis.

Tele-Monitoring Applications in Respiratory Allergy

Respiratory allergic diseases affect over 500 million people globally and pose a substantial burden in terms of morbidity, mortality, and healthcare costs. Restrictive factors such as geographical disparities, infectious pandemics, limitations in resources, and shortages of allergy specialists in underserved areas impede effective management. Telemedicine encompasses real-time visits, store-and-forward option triage, and computer-based technologies for establishing efficient doctor-patient communication. Recent advances in digital technology, including designated applications, informative materials, digital examination devices, wearables, digital inhalers, and integrated platforms, facilitate personalized and evidence-based care delivery. The integration of telemonitoring in respiratory allergy care has shown beneficial effects on disease control, adherence, and quality of life. While the COVID-19 pandemic accelerated the adoption of telemedicine, certain concerns regarding technical requirements, platform quality, safety, reimbursement, and regulatory considerations remain unresolved. The integration of artificial intelligence (AI) in telemonitoring applications holds promise for data analysis, pattern recognition, and personalized treatment plans. Striking the balance between AI-enabled insights and human expertise is crucial for optimizing the benefits of telemonitoring. While telemonitoring exhibits potential for enhancing patient care and healthcare delivery, critical considerations have to be addressed in order to ensure the successful integration of telemonitoring into the healthcare landscape.

Clinical Relevance of Lepidoglyphus destructor Sensitisation in Allergic Rhinitis: Nasal Provocation Test as in vivo Assessment

Background: Dust mites are the leading cause of respiratory allergic diseases worldwide. Allergy to storage mites (SMs) has mostly been related to occupational exposures. However, recent studies have shown that sensitisation to SM, such as Lepidoglyphus destructor (Lep d), is of considerable importance also in urban populations, with high prevalence in dust samples of domestic environments. Co-sensitisation between house dust mites (HDMs) and SM is now regarded as very frequent in some regions, and cross-reactivity between them seems to be narrow. Therefore, SM allergenic capacity is increasingly a subject of study. The nasal provocation test (NPT), as an in vivo technique, could be considered the gold standard for the clinical relevance assessment of an allergen, in polysensitised rhinitis patients. Objective: The objective of this study was to analyse the clinical relevance of the SM Lep d, by assessing the relationship between in vivo sensitisation and expression of allergic respiratory disease in an urban setting. Patients and Methods: In our study, we enrolled a total of 32 allergic patients with rhinitis (with or without asthma) with proven sensitisation by skin prick test (SPT) and specific IgE (sIgE) to HDMs and/or SM. Patients underwent NPT with Lep d using subjective (Lebel Symptom Score Scale) and objective measurements (peak nasal inspiratory flow [PNIF]) for assessment of nasal response. Results: Most of the patients with positive SPT and sIgE to Lep d had a positive NPT (24/27; 89%). True Lep d allergy, assessed by a positive NPT, could be predicted by a SPT wheal size >9.7 mm and a sIgE >0.42 kUA/L, with 100%/95.7% sensitivity and 75.0%/83.3% specificity, respectively. Co-sensitisation between Lep d and Der p was high, 75.0%. Asthma was more frequent in the positive Lep d NPT group (54 vs. 12%, p < 0.05). Significantly more patients from this group reported physical exercise, nonspecific irritants, and respiratory infections as relevant triggers of respiratory symptoms (p < 0.01–p < 0.05). Conclusions: To our knowledge, this is the first study to show that sensitisation to Lep d may have clinical relevance in a non-occupational setting. In this group, there seems to be a relationship between allergy to Lep d and severity of respiratory disease, with more bronchial inflammation, when comparing with mite-allergic patients sensitised only to HDM. Therefore, the authors consider that sensitisation to Lep d should be considered when assessing and treating allergic respiratory disease in urban environments.

Assessment of environmental risk areas based on airborne pollen patterns as a response to land use and land cover distribution

Allergic respiratory diseases are considered to be among the most important public health concerns, and pollen is the main cause of allergic respiratory diseases worldwide. However, the biological component of air quality is largely underestimated, and there is an important gap in the legislation in this area. The aims of this study were to characterise the occurrence and incidence of pollen exposure in relation to potential pollen sources and to delineate the main areas of aerobiological risk in the Madrid Autonomous Region based on homogeneous patterns of pollen exposure. This study uses the historical aerobiological database of the Madrid Region Palynological Network (central Spain) from ten pollen stations from 1994 to 2022, and the land-use information from the Corine Land Cover. Multiple clustering approaches were followed to group the sampling stations and subsequently all the 1 × 1km pixels for the Madrid Autonomous Region. The clustering dendrogram for land-use distribution was compared to the dendrogram for historical airborne pollen data. The two dendrograms showed a good alignment with a very high correlation (0.95) and very low entanglement (0.15), which indicates a close correspondence between the distribution of the potential pollen sources and the airborne pollen dynamics. Based on this knowledge, the Madrid Autonomous Region was divided into six aerobiological risk areas following a clear anthropogenic gradient in terms of the potential pollen sources that determine pollen exposure in the Madrid Region. Spatial regionalisation is a common practice in environmental risk assessment to improve the application of management plans and optimise the air quality monitoring networks. The risk areas proposed by scientific criteria in the Madrid Autonomous Region can be adjusted to other operational criteria following a framework equivalent to other air quality networks.

Serum levels of specific IgE to cow's milk and its components as predictors of anaphylaxis in Chinese children with cow's milk allergy.

Cow's milk allergy (CMA) is one of the most common food allergies in young children. As improved diagnostic tools, allergic tests are inconsistent and limited in predicting anaphylaxis. To explore risk factors for anaphylaxis and to determine practical cut-offs for allergic tests in predicting anaphylaxis. This is a prospective cohort study. Children with IgE-mediated CMA were enrolled and divided into three groups (Group 1: non-anaphylaxis; Group 2: GRADE I anaphylaxis; Group 3: GRADE II-IV anaphylaxis that warranted epinephrine). Prick-to-prick tests (PTPs) using fresh cow's milk (CM) were performed. Serum specific IgE (sIgE) against CM and its components, including casein, alpha-lactalbumin, beta-lactoglobulin, and bovine serum albumin were measured. The 90% and 95% positive predictive value (PPV) decision points for predicting anaphylaxis were determined. Potential predictors of anaphylaxis were evaluated in logistic regression models. This study included 134 CMA patients with a median age of 14.4 months. The sensitization rate to any CM component was 89%. Group 3 was more likely to be sensitized to multiple CM components and have higher sIgE levels. The 95% PPV diagnostic decision points of casein-sIgE in predicting anaphylaxis was 13.0 kUA/L. For GRADE II-IV anaphylaxis, casein-sIgE ≥ 54.9 kUA/L could provide a PPV of 88.9%. The elevated casein-sIgE level (OR 14.0, P=0.025) and complicating respiratory allergic diseases (OR 4.8, P=0.022) were independent risk factors for GRADE II-IV anaphylaxis. High casein-sIgE levels are strongly associated with CM anaphylaxis. Detection of casein-sIgE may offer an additional value for the prediction of CM anaphylaxis.

Environmental DNA analysis of airborne poaceae (grass) pollen reveals taxonomic diversity across seasons and climate zones

BackgroundGrasses populate most biogeographical zones, and their diversity influences allergic sensitisation to pollen. Previously, the contribution of different Poaceae subfamilies to airborne pollen has mostly been inferred from historical herbarium records. We recently applied environmental (e)DNA metabarcoding at one subtropical site revealing that successive airborne grass pollen peaks were derived from repeated flowering of Chloridoid and Panicoid grasses over a season. This study aimed to compare spatiotemporal patterns in grass pollen exposure across seasons and climate zones. MethodsAirborne pollen concentrations across two austral pollen seasons spanning 2017–2019 at subtropical (Mutdapilly and Rocklea, Queensland) and temperate (Macquarie Park and Richmond, New South Wales) sites, were determined with a routine volumetric impaction sampler and counting by light microscopy. Poaceae rbcL metabarcode sequences amplified from daily pollen samples collected once per week were assigned to subfamily and genus using a ribosomal classifier and compared with Atlas of Living Australia sighting records. ResultseDNA analysis revealed distinct dominance patterns of grass pollen at various sites: Panicoid grasses prevailed in both subtropical Mutdapilly and temperate Macquarie Park, whilst Chloridoid grasses dominated the subtropical Rocklea site. Overall, subtropical sites showed significantly higher proportion of pollen from Chloridoid grasses than temperate sites, whereas the temperate sites showed a significantly higher proportion of pollen from Pooideae grasses than subtropical sites. Timing of airborne Pooid (spring), Panicoid and Chloridoid (late spring to autumn), and Arundinoid (autumn) pollen were significantly related to number of days from mid-winter. Proportions of eDNA for subfamilies correlated with distributions grass sighting records between climate zones. ConclusionseDNA analysis enabled finer taxonomic discernment of Poaceae pollen records across seasons and climate zones with implications for understanding adaptation of grasslands to climate change, and the complexity of pollen exposure for patients with allergic respiratory diseases.

Clinical benefits with 300 IR HDM SLIT tablet in Europeans with house dust mite allergic rhinitis: Post hoc analysis of a large phase 3 trial

BackgroundHouse dust mite (HDM)-induced allergic rhinitis (AR) is a major cause of allergic respiratory disease. The efficacy and safety of the 300 IR HDM sublingual immunotherapy (SLIT) tablet in patients with moderate-to-severe HDM-AR was confirmed in a large, international, phase 3 randomized controlled trials (RCTs). Here, we analyzed the results in the European population. MethodsData from 91 European centers that participated in the international, double-blind, RCT (EudraCT 2014-004223-46, NCT02443805) with the 300 IR HDM SLIT tablet versus placebo over 12 months were analyzed post hoc. The treatment effect in European adults and adolescents was notably assessed through the European Academy of Allergy and Clinical Immunology (EAACI)-recommended combined symptom and medication score (CSMS0-6, pre-defined endpoint) and the total combined rhinitis score (TCRS0-24, post hoc endpoint, also balanced) during the primary evaluation period (4 weeks at the end of treatment period) using analysis of covariance (ANCOVA). ResultsThere were 818 patients who comprised the modified full analysis set in Europe. Over the primary period, the differences in CSMS0-6 and TCRS0-24 between the 300 IR and placebo groups were statistically significant (p < 0.0001): −0.32 (95%CI [-0.46; −0.17]) and −1.28 (95%CI [-1.63; −0.94]), respectively, with relative differences of −20.9% and −21.2%. All post hoc and the rhinoconjunctivitis quality of life endpoints were significantly improved with 300 IR versus placebo. The 300 IR HDM tablet was generally well tolerated. ConclusionThis RCT sub-analysis confirmed the 300 IR HDM SLIT tablet is an effective and safe treatment for European adults and adolescents with HDM-AR with clinically meaningful benefits from the patients' perspective. Trial registrationNCT02443805. Registered on April 29, 2015./EudraCT 2014-004223-46. Registered on September 16, 2015.

[Study on the distribution pattern of allergen sIgE in patients with respiratory allergic diseases in a hospital in Shanxi Province].

To explore the allergen sensitization status of patients with respiratory allergic diseases in Shanxi Province, and to provide a basis for the diagnosis, treatment and prevention of allergic diseases. It is a cross-sectional study, a total of 1 680 patients with allergic rhinitis and/or asthma diagnosed at the Department of Allergic Reaction of Shanxi Bethune Hospital from July 2021 to June 2023 who underwent allergen sIgE testing and/or skin prick test were retrospectively enrolled.There were 772 males and 908 females.The age range was 3 to 88 years. The median age was 35 years.There were 108 cases in the child group (≤12 years old), 102 cases in the adolescent group (13-17 years old), 819 cases in the youth group (18-40 years old), 498 cases in the middle-aged group (41-65 years old), and 153 cases in the elderly group (>65 years old). There were 333 cases in the allergic rhinitis group, 827 cases in the allergic asthma group, and 520 cases in the allergic rhinitis with asthma group. There were 1 254 urban patients and 426 rural patients.There were 253 cases in the northern Shanxi region, 1 195 cases in the central Shanxi region, and 232 cases in the southern Shanxi region. Statistical analyses were performed using the χ 2 test or Fisher's exact probability method to compare the differences in allergen sIgE positivity rates by sex, age, disease, living environment, and geography. The results showed that 1 027 patients (61.1%) were positive for at least one allergen sIgE, with Artemisia having the highest rate of positivity (603/1 680, 35.9%), followed by ragweed (302/1 680, 18.0%) and dust mite combinations (245/1 680, 14.6%). The number of individuals with single-allergen sIgE positivity was 357 (357/1 027, 34.8%), with the highest number of single-allergen sIgE positive results associated with Artemisia (114/357, 31.9%). The number of multiple-allergen sIgE positive results was 670 cases (670/1 027, 65.2%), with the highest number of patients having 2 allergen sIgE positive results (243/670, 36.3%). The overall positivity rate for allergen sIgE was significantly higher among males than among females (65.7% vs. 57.3%, χ2=12.405, P<0.001). Overall positivity for inhalant allergen sIgE was higher in the child and adolescent groups (88.0% vs. 88.2% vs. 59.8% vs. 40.2% vs. 19.0%, χ2=223.372, P<0.001), and food allergen sIgE positivity was highest in the child group (54.6% vs. 36.3% vs. 26.0% vs. 18.9% vs. 21.6%,χ2=66.383,P<0.001). The sIgE positivity rate of inhalant allergens was significantly higher in the allergic rhinitis group and the allergic rhinitis with asthma group than in the allergic asthma group, except for cockroaches and molds (P<0.05). The overall positive rate of allergen sIgE was significantly higher among urban patients than among rural patients (66.2% vs. 46.2%, χ2=53.230, P<0.001). The difference in the overall positive rate of allergen sIgE among patients from different regions was not statistically significant (56.1% vs. 62.0% vs. 62.1%, χ2=3.140, P=0.208). The sIgE positivity of dust mite combinations was significantly higher in the central Shanxi region and the southern Shanxi region than in the northern Shanxi region (15.5% vs. 18.1% vs. 7.1%,χ2=14.411, P=0.001). In conclusion, artemisia was the most important sensitizer for respiratory allergic diseases in Shanxi Province. The types of allergens and positivity rates were different for different sexes, ages, diseases, living environments, and regions. Therefore, patients with allergic diseases should be tested for allergens to help with the diagnosis, treatment and prevention of allergic diseases.