Allergic Respiratory Diseases Research Articles

Real-world evidence of allergen immunotherapy.

The full understanding of the long-term effectiveness and safety of allergen immunotherapy (AIT) for allergic respiratory diseases cannot be achieved through randomized controlled trials (RCTs) alone. However, real-world studies designed as registries can complement RCTs. The significance of registries is highlighted by their potential to reassess contraindications and collect data on adult and pediatric patients with multiple comorbidities who are often excluded from RCTs. AIT is the sole disease-modifying therapeutic approach capable of inducing tolerance and offering a long-term response to allergens. AIT has been shown to play a role in arresting the 'allergic march' in young people, which reduces the risk of developing asthmatic clinical manifestations. Although RCTs are considered the gold standard for evaluating the efficacy and safety of AIT, their duration is usually too short (seldom lasting more than 1 year) to assess the long-term effects of AIT. Several long-term studies show that AIT's effect depends strongly on its use duration.

Study of the role of genes involved in the metabolism of histamine in the development of allergic respiratory diseases

The interaction of genetic, epigenetic and environmental factors underlies the pathogenesis of allergic diseases. Allergic rhinitis and atopic bronchial asthma are closely related and often concurrent respiratory allergic diseases. The chronic recurrent course of these diseases establishes the importance of further and more profound studies of the mechanisms underlying the development of these pathologies. Histamine is one of the most significant inflammatory mediators secreted during allergic reactions. The aim of the research was to study the role of polymorphic variants of AOC1, HRH2, HRH3, ALDH7A1, ADCYAP1, HNMT, PSAP, SCG3, genes involved in the histamine metabolism in the development of different endophenotypes of the allergic airway diseases in individuals living in the Republic of Bashkortostan. DNA samples of 358 individuals with allergic diseases of the respiratory tract of different ethnicity (Russians – 165, Tatars – 143, Bashkirs – 50) and 200 controls with unweighted heredity in allergic diseases (Russians – 75, Tatars – 83, Bashkirs – 42). Genotyping of polymorphic variants was performed by real-time PCR and PCR-RFLP analysis. It was revealed that the rs104979793*CC genotype and the rs104979793*C allele of the AOC1 gene were associated with allergic diseases of the respiratory tract and asthma with concomitant allergic rhinitis in Russians. A significant increase of total IgE level was revealed in Russian patients with allergic diseases of the respiratory tract with the rs1049793*CC genotype of the AOC1 gene compared to carriers of the rs1049793*CG and rs1049793*GG genotypes. The association of the C allele of the rs17525472 polymorphic variant localized near the SCG3 gene with allergic rhinitis in Russians was established. The results revealed that AOC1 and SCG3 genes involved in the metabolism of histamine are related to the development of different endophenotypes of airway diseases in children.

A Heuristic Approach to Analysis of the Genetic Susceptibility Profile in Patients Affected by Airway Allergies.

Allergic respiratory diseases such as asthma might be considered multifactorial diseases, having a complex pathogenesis that involves environmental factors and the activation of a large set of immune response pathways and mechanisms. In addition, variations in genetic background seem to play a central role. The method developed for the analysis of the complexities, as association rule mining, nowadays may be applied to different research areas including genetic and biological complexities such as atopic airway diseases to identify complex genetic or biological markers and enlighten new diagnostic and therapeutic targets. A total of 308 allergic patients and 205 controls were typed for 13 single nucleotide polymorphisms (SNPs) of cytokine and receptors genes involved in type 1 and type 2 inflammatory response (IL-4 rs2243250 C/T, IL-4R rs1801275A/G, IL-6 rs1800795 G/C, IL-10 rs1800872 A/C and rs1800896 A/G, IL-10RB rs2834167A/G, IL-13 rs1800925 C/T, IL-18 rs187238G/C, IFNγ rs 24030561A/T and IFNγR2 rs2834213G/A), the rs2228137C/T of CD23 receptor gene and rs577912C/T and rs564481C/T of Klotho genes, using KASPar SNP genotyping method. Clinical and laboratory data of patients were analyzed by formal statistic tools and by a data-mining technique-market basket analysis-selecting a minimum threshold of 90% of rule confidence. Formal statistical analyses show that IL-6 rs1800795GG, IL-10RB rs2834167G positive genotypes, IL-13 rs1800925CC, CD23 rs2228137TT Klotho rs564481TT, might be risk factors for allergy. Applying the association rule methodology, we identify 10 genotype combination patterns associated with susceptibility to allergies. Together these data necessitate being confirmed in further studies, indicating that the heuristic approach might be a straightforward and useful tool to find predictive and diagnostic molecular patterns that might be also considered potential therapeutic targets in allergy.

Comparison of Olea pollen sampling between gravimetric and volumetric traps (NW of Morocco)

Olea pollen is considered one of the most critical causes of respiratory allergic disease in the Mediterranean region, contributing to different symptoms in allergic sufferers. Due to the high increase in the prevalence of olive pollen caused by the expansion of cultivated areas especially in the Mediterranean region, the aim of this study was to examine the Olea pollen sampling efficiency between gravimetric and volumetric pollen traps over the period 2018–2022. Our data demonstrated that Olea pollen season start-date was generally recorded earlier with volumetric trap than shown with gravimetric method. Moreover, the peak dates occurred mainly in May for the years studied. Across the entire period, the greatest pollen concentrations were reached in the week 11th and >60 % of the total Olea pollen were already reached after the ninth week of sampling in 2020. In general, the evolution of pollen sampling for both methods demonstrates similar temporal development. Variations in the seasonal pollen integral could be attributed to the elevation above ground level at which the traps were placed, exposure to regional winds, the influence of long-range transported pollen and the mode of pollen transport. The findings indicate that the gravimetric method was equally practical as the volumetric method in estimating airborne pollen.

Retrospective, Real Life Study on the Effectiveness and Safety of a Depigmented-Polymerized Subcutaneous Vaccine Containing a Mixture of Grasses and Olea europaea

Introduction: Allergen immunotherapy is the only modifying treatment of the natural course of respiratory allergic diseases; however, the lack of evidence leads to little inconclusive results. Real life studies are on the rise and are becoming a valuable tool to confirm and complement findings from clinical trials. The objective of this study was to evaluate the effectiveness and safety of a depigmented-polymerized undiluted subcutaneous extract of grass and olive pollen, under routine clinical practice conditions. Methods: This was an observational, retrospective, longitudinal, single-center study on the use of a 2-pollen (grass mix and Olea europaea) undiluted subcutaneous extract over at least 3 consecutive years. Data were collected from 76 patients (n = 44 female; median age: 12.5 years old) diagnosed with allergic rhinoconjunctivitis with/without allergic asthma due to sensitization to both grasses and O. europaea. Primary and secondary effectiveness endpoints were symptom severity, concomitant medication, and immunological profile before and after completing the immunotherapy. A 2-year follow-up of patients’ symptoms and medication history after completing the subcutaneous immunotherapy (SCIT) was performed. Results: There was a significant improvement of symptoms and medication consumption after 3 years of SCIT treatment, and a significant decrease in specific IgE levels for grasses and O. europaea was observed after finishing the treatment. Conclusion: Three years treatment of allergic patients using an undiluted mixture of two allergen extracts was shown to be safe and effective for rhinitis and asthma, with efficacy maintained for at least 2 years after finishing SCIT. These results reinforce the importance of real life clinical data in addition to those from clinical trials, helping to individualize allergic treatments.

Allergic Sensitization and Psychosomatic Involvement in Outdoor and Indoor Workers: A Preliminary and Explorative Survey of Motorway Toll Collectors and Office Employees.

The incidence of respiratory and cutaneous allergic disorders may be variable if we consider work activity. These disorders are reported in the current literature to have a relevant psychosomatic involvement. The aim of the study was to submit a survey on the self-reported occurrence of allergic respiratory and cutaneous diseases in outdoor and indoor workers to verify the onset or exacerbations of such pathologies, encourage surveillance, and suggest the need for further studies. Two groups of workers were compared when exposed and not exposed to air pollutants. An outdoor population of motorway toll collectors (153 workers; M: 58.03 years old, SD: 6.1; and female prevalence of 66.01%) and an indoor group of office employees (59 workers; mean age 54.44 years, SD: 8.50; and male prevalence of 61.02%) entered the study. The results of three multivariate analyses of the obtained data, investigating contributions of external factors, including age, sex, smoking habits, working type, and seniority, on allergic conditions were significant in both workers' groups. The findings highlighted that age and smoking habits were significant contributors to allergic conditions, both independently and in combination with other factors, such as sex and working type. The data suggest the presence of phenomena related to different etiological domains, as already reported in the literature. Through the collection of these data, it was possible to highlight the need to analyze clinical signs from different perspectives.

The hydro-ethanolic extract of Scoparia dulcis Linn inhibits allergic airway inflammatory responses in murine asthma models

BackgroundInflammatory responses, including airway inflammation, hyper-responsiveness, mucus hyper-secretion, prostaglandins and Th2 cytokines infiltration in the airway submucosa, frequently occur in allergic respiratory disorders. This study sought to investigate the effects of the hydro-ethanolic extract of Scoparia dulcis (SDE) on allergic airway inflammation, airway hyper-responsiveness, goblet cell hyperplasia, mucus hypersecretion, Th2 cytokines and prostaglandin (PG)-D2 using murine asthma models. MethodsAllergic asthma was induced in healthy guinea-pigs, and mice, by exposing them to ovalbumin (OVA) sensitization and challenge, and treatment with either 2 ml/kg normal saline, 10 mg/kg salbutamol, 10 mg/kg prednisolone, 50, 100, or 250 mg/kg of SDE per os. The percentage protection against pre-convulsive dyspnoea after methacholine challenge in OVA-induced asthmatic guinea-pigs was determined for each treatment regime, and histopathological examinations thereafter conducted on the excised lungs. Periodic acid-Schiff staining was also performed to identify goblet cell hyperplasia and mucus hypersecretion in these lung tissues. Lung tissue homogenates and serum from OVA-induced asthmatic mice were also assayed for PGD2, interleukins (IL)-5 and -13 levels using monoclonal antibody-based mouse ELISA kits. ResultsSDE treatments prolonged the time taken for pre-convulsive dyspnoea to occur after methacholine challenge in OVA-induced asthmatic guinea-pigs; indicative of a positive activity against airway hyper-responsiveness. Histopathological studies also showed that SDE significantly inhibited (p ≤ 0.05) pulmonary infiltration of leukocytes, inflammatory cell accumulation, airway smooth muscle thickening and goblet cell hyperplasia. Serum and lung tissue concentrations of PGD2, IL-5 and IL-13, significantly elevated (p ≤ 0.001) following allergic asthma induction in mice, were significantly reduced (p ≤ 0.01) back to within normal levels after SDE treatments. ConclusionThe plant extract exhibited anti-asthmatic and anti-inflammatory properties, as it reduced the severity of allergic inflammation and hyper-reactivity, as well as PGD2 and Th2 cytokines infiltration in the airway; and these effects could be exploited for future management of asthma.

Efficacy and safety of subcutaneous immunotherapy with polymerized allergen mixtures in polyallergic patients – ARES observational study

ABSTRACT Background Administration of allergen mixtures of many components comprises the most common approach for American allergists regarding the management of polyallergic patients. European allergists, however, are more reluctant to this type of treatment due to the potential drawbacks of mixing extracts. Research design and methods To assess the efficacy and safety of subcutaneous immunotherapy (SCIT) with polymerized allergen mixtures without dilutional effect in polyallergic patients. This observational, prospective, multicenter study included patients (between 5 and 60 years) with respiratory allergic diseases that had been prescribed with SCIT with mixtures of two pollen or mite extracts. Changes in Symptoms and Medication Score (SMS) and in rhinitis quality of life questionnaire (RQLQ), subjective clinical improvement, treatment satisfaction and tolerability were assessed after the 1-year treatment. Results A total of 115 patients were included in the assessment. Mean global SMS decreased from 3.5 (SD = 1.1) to 1.6 (SD = 1.2) points, with a mean absolute reduction of 1.6 (SD = 1.3) points in the RQLQ score (p < 0.001, Wilcoxon test). General subjective clinical improvements and a good treatment satisfaction and tolerability were observed. Conclusion SCIT with polymerized allergen mixtures from either pollen or mite extracts proved to be an effective and safe treatment option for polyallergic patients suffering from allergic respiratory diseases.

Cognitive, Emotional, and Behavioral Disorders in Children with Respiratory Allergic Diseases: Causes and Solutions

The publication is devoted to the review of accumulated data on the relationship of respiratory allergopathology with neuropsychiatric disorders in childhood. The immediacy of the problem is due to the mutual influence of allergic and neuropsychiatric conditions combined in a child on the course of these diseases. According to research, the connection of respiratory allergic diseases with disorders of neurodevelopment, in particular with attention deficit and hyperactivity disorder and autism spectrum disorders, is clearly manifested, and the first publications on the connection with speech and other mild cognitive impairments have appeared. At the same time, the formation of depression, suicidal behavior, and anxiety disorders in respiratory allergopathology is being actively studied. It is assumed that the close relationship between nervous and immune regulation provides a high correlation of allergic and neuropsychiatric pathological conditions, although cause-and-effect relationships have not yet been precisely established. In this regard, it becomes relevant to introduce into clinical practice monitoring of cognitive status, neuropsychic development and possible symptoms of anxiety, depression and suicidal thoughts in the treatment of children with respiratory allergic diseases. Timely detection of violations will make it possible to provide specialized interventions at an early stage in order to achieve a favorable treatment result in the long term.

Epidemiological profile of allergic respiratory disease in Mexican children

Objective: Report the prevalence and severity of the most common allergic diseases in children living in Monterrey, México. Methods: Cross-sectional multi-center survey on the most common allergic diseases, completed by parents of 6-7-year-old children and by 13-14- year-old adolescents in the Monterrey metropolitan area, between January 2018 and December 2019. Results: A total of 3,044 questionnaires were eligible for the analysis. Among children between 6-7 years old, 30.2% (n = 143/473) presented wheezing at any time in their life; with a higher prevalence in the male population. In the adolescent group, 26.4% reported having experienced wheezing at some point in their life, with a slight predominance in the female group (54.9%). Conclusions: Knowing the prevalence of allergic diseases in our population gives us tools to generate strategies that allow us to provide the best quality healthcare to our patients. Keywords: Asthma; Rhinitis; Eczema; Wheezing; Allergy And Immunology; Child.

Epidemiological profile of allergic respiratory disease in Mexican children

Report the prevalence and severity of the most common allergic diseases in children living in Monterrey, México. Cross-sectional multi-center survey on the most common allergic diseases, completed by parents of 6-7-year-old children and by 13-14- year-old adolescents in the Monterrey metropolitan area, between January 2018 and December 2019. A total of 3,044 questionnaires were eligible for the analysis. Among children between 6-7 years old, 30.2% (n = 143/473) presented wheezing at any time in their life; with a higher prevalence in the male population. In the adolescent group, 26.4% reported having experienced wheezing at some point in their life, with a slight predominance in the female group (54.9%). Knowing the prevalence of allergic diseases in our population gives us tools to generate strategies that allow us to provide the best quality healthcare to our patients.

The Skin Sebum and Moisture Levels of Children with Allergic Diseases: How Predictive Are They for House Dust Mite Allergy?

The aim was to evaluate the prediction of house dust mite allergy in children diagnosed with allergic disease based on their skin moisture and sebum levels. This is a case-control study including children with asthma, allergic rhinitis (AR), and atopic dermatitis (AD) and a healthy control group. The participants' skin moisture and sebum levels were measured non-invasively using a digital device. A total of 421 patients and 143 healthy children were included. The median value of skin moisture percentage was statistically significantly lower in asthma, AR, and AD patients compared to the control group (p < 0.001 for each). The median value of skin sebum percentage was significantly lower in asthma and AD patients compared to the control group (p = 0.002 and p = 0.003, respectively). ROC analysis was performed to assess the predictive value of skin moisture percentage for house dust mite allergy in respiratory allergic diseases (asthma and AR) and AD separately. Using a cut-off point of 35.5% for skin moisture in asthma and AR patients, the sensitivity and specificity were 81.3% and 56.5%, respectively. Although the specificity is low, the high sensitivity value is promising. The non-invasive measurement of skin sebum and moisture could provide convenience to clinicians in the diagnosis and management of allergic diseases.

Use of omalizumab and allergen-specific immunotherapy for the treatment of respiratory allergic diseases in children and adults

Allergen-specific immunotherapy is a method of treatment and prevention of respiratory allergic diseases. Carrying it out changes and improves the course of allergic diseases. One of the promising and new approaches is the combination of allergen-specific immunotherapy with one of the biological drugs, omalizumab. Currently, few such studies have been carried out in the world. 14 works were selected from international databases (eLibrary.ru, PubMed, Embase, Cochrane, Web of Science). Their results were analyzed and summarized. The characteristics of these studies and their design are given. The results of the safety and effectiveness of the combined use of allergen-specific treatment and anti-IgE therapy are described. It was shown that in most cases (13 out of 14), omalizumab therapy precedes allergen-specific immunotherapy. However, the duration of combination treatment, drug regimens, and patient monitoring vary significantly. All studies have established a variety of positive effects of the combined use of omalizumab and allergen-specific immunotherapy (improvement of the course of diseases, increased possibility of treatment with allergens, good tolerability of drugs, etc.). These studies are very promising. Their continuation is required. It is necessary to clarify the most rational schemes for the combined use of anti-IgE and allergen-specific immunotherapy.

Therapeutic effect of an Ayurvedic drug in the management of Respiratory Allergic Disorders in children - A comprehensive review

Background: Respiratory allergic disorders (RAD) are the most common allergy symptom seen in children. Respiratory allergies are primarily caused by hyper responsiveness of the respiratory mucosa, which results in histamine release and mast cell activation. In Ayurvedic words, this could be viewed as an abnormality of the body's immune system or Ojus induced by disrupted Vata, Kapha, and Pitta. The prevalence of respiratory allergies in school-aged children in India varies widely, ranging from 5-20%. Methods: This study was completed by gathering the knowledge from classical Ayurvedic literature, research articles, guidelines and PubMed and MedLine databases. Results and Discussion: Dashmoola Katutrayadi drug is mentioned in Sahastra Yogam under Swasa Kasahara Kashaya have Shwas-Kasahar, anti-inflammatory, anti-histaminic and anti-asthmatic effects individually and in combinations. Conclusion: Present review reveals that these drugs have potential to alleviate the severity and frequency of RAD and can be used for the management of the same.

Allergen Sensitization of Parents and Children With Respiratory Allergic Diseases

Allergen Sensitization of Parents and Children With Respiratory Allergic Diseases

Efficacy and safety study of standardized mite allergen specific immunotherapy with no reduction during maintenance in children with respiratory allergic disease

Efficacy and safety study of standardized mite allergen specific immunotherapy with no reduction during maintenance in children with respiratory allergic disease

Satisfaction, Qol and adherence of patients allergic to dust mites and/or pollens undergoing sublingual immunotherapy.

Aim: Sublingual immunotherapy (SLIT) changes history of allergic respiratory disease (ARD). However, adherence is a barrier for optimal outcomes.Patients & methods: In the QUALI study, 859 patients with house-dust mite (HDM) and/or pollen induced ARD uncontrolled with symptomatic treatment and undergoing SLIT for at least 6 months or including one pre-coseason (pollen) were collected.Results & conclusion: SLIT significantly improved allergic rhinoconjunctivitis (ARC) and asthma symptom control, leading to reduced medication, meaningful health-related quality of life gain, improved nasal, ocular and bronchial symptoms and everyday life activities. Patients were highly satisfied and most of them adhered to SLIT, being forgetfulness the main non-adherence motive. SLIT is a quick effective treatment against persistent moderate-to-severe symptoms in ARC and asthma but it should been improve forgetfulness, as non-adherence reason.

The effectiveness of subcutaneous immunotherapy in allergic diseases of children and adults

ObjectivesImmunotherapy is the gradual administration of increasing doses of allergens to reduce or eliminate the patient's adverse clinical response following exposure to these allergens. The goal of the current study was to evaluate the effectiveness of subcutaneous immunotherapy in patients with allergic diseases referred to the Bushehr Asthma and Allergy Clinic, Iran. Materials and methodsPatients with respiratory allergic diseases, who had positive skin prick test, randomly enrolled in this observational study and underwent immunotherapy for one year. To evaluate the efficacy of immunotherapy, two questionnaires were completed for all the patients before and one year after the start of immunotherapy, including the Total Nasal Symptom Score (TNSS) and Asthma Control Test (ACT). ResultsA total of 878 patients with asthma or allergic rhinitis disorder [53.6% (n=471) male and 46.4% (n=407) female] with a median (IQR) age of 28.0 (12.0–35.0) years were randomly enrolled in this observational study. Five hundred forty-nine patients (64.8%) were over 18 years old and 298 patients (33.9%) were under 18 years old, the age of the other patients was not known. The median (IQR) duration of disease was 84.0 (36.0–138.0) months. Rinithis allergy had most frequent than asthma [39.9% (n=350) vs. 22.2% (n=195), respectively] and 218 patients (24.8%) have both of them. After the treatment, 234 patients (54.5%) completely stop and 26.3% patient (n=113) used less than half of the drugs. The mean TNSS (n=259) and ACT (n=186) scores for patients had significant difference before and after immunotherapy [13.64 vs. 5.68, P<0.001; 7.91 vs. 17.43, P<0.001, respectively]. ConclusionThe mean TNSS and ACT score before and after the treatment significantly improved the patients’ symptoms. To conclude, standard immunotherapy can be effective in patients with moderate to severe allergic rhinitis and mild to moderate persistent allergic asthma to reduce clinical symptoms.

Intestinal microflora in children with secondary hyperoxaluria and allergic respiratory diseases

Intestinal microflora in children with secondary hyperoxaluria and allergic respiratory diseases

The distribution of allergen sensitization and screening panel for respiratory allergic diseases in seven geographical regions of China: A multicenter study

The distribution of allergen sensitization and screening panel for respiratory allergic diseases in seven geographical regions of China: A multicenter study