Allergic Rhinitis In Children Research Articles

Clinical efficacy of Dermatophagoides farina drops on allergic rhinitis in children sensitized by dust mites combined with different allergens

ObjectiveThis study aimed to investigate the clinical efficacy and safety of sublingual immunotherapy (SLIT) using standardized dermatophagoides farina drops for the treatment of allergic rhinitis (AR) in children sensitized to dust mites combined with different allergens. The findings contribute to establishing a preliminary foundation for future in-depth studies on AR treatment. MethodsA total of 152 AR children undergoing SLIT were categorized into two groups based on serological test results: the inhalation group (dust mite combined with inhalation allergy) and the ingestion group (dust mite combined with ingestion allergy). The clinical efficacy and safety were evaluated by assessing the total nasal symptoms score (TNSS), total medication scores (TMS), visual analog scale scores (VAS scores), and the incidence of adverse reactions before treatment and after two years of treatment. ResultsAfter two years of treatment, TNSS, TMS, and VAS scores significantly improved compared to pre-treatment values in both the inhalation and ingestion groups (p < 0.05). However, there were no significant differences in efficacy between the two groups after two years of treatment (p > 0.05). During the treatment period, only 15 cases (10.9%, 9 cases in the inhalation group and 6 cases in the ingestion group) experienced mild adverse reactions. There was no significant difference in the incidence of adverse reactions between the two groups (p > 0.05). ConclusionSLIT using standardized dermatophagoides farina drops demonstrates long-term efficacy in children with AR, regardless of whether they belong to the inhalation or ingestion group, without significant differences in treatment outcomes.

Pilot study to determine asthma-like symptoms in the Sverdlovsk region

Introduction. Bronchial asthma (BA) occupies one of the leading places in the structure of chronic nonspecific lung diseases in children. At an early age it develops in a relationship between genetic and environmental factors and often does not have a characteristic clinical picture. Allergic rhinitis (AR) increases the risk of developing and severity of asthma. Assessing the risk of developing BA and AR in children is necessary for timely diagnosis. Purpose of the study. To identify the prevalence of symptoms of bronchial asthma in children in the Sverdlovsk region using the example of Yekaterinburg and Nizhny Tagil using Russian versions of the Asthma Prediction Tool and ISAAC questionnaires and analyze the data obtained. Materials and methods. 64 children aged 6-8 years who did not have chronic lung diseases were studied: 30 people - in the Children's Hospital No. 8 of Yekaterinburg and 34 - in kindergarten No. 201 of Nizhny Tagil using Russified versions of the “Asthma Prediction Tool” and ISAAC questionnaires, filled out official representatives of children after informed consent to conduct the study. 64 correctly completed questionnaires were analyzed. Results. The proportion of children with an average and high risk of developing asthma: in Yekaterinburg 26.67%, in Nizhny Tagil - 35.29%. Symptoms of AR were detected in 60% of children from Yekaterinburg and in 82.35% from Nizhny Tagil, which is 2.5 and 1.6 times more common than the established diagnosis of AR, respectively. In Yekaterinburg, a high risk of asthma is associated with an allergic phenotype based on the frequency of concomitant atopic dermatitis (16.67% compared with 10% in the low-risk group, p = 0.0159) or its absence (63.33% and 10%, respectively, p= 0.0159), in Nizhny Tagil this relationship was not confirmed when tested by a two-sided Fisher test. The frequency of cases of hereditary predisposition to allergic pathology does not have significant differences between high (medium) and low risk groups in both cities. Conclusion. In Russia, 4.8 additional cases of asthma and status asthmaticus per 100 thousand children are associated with air quality. In 2021, the Sverdlovsk region is noted as one of the priority subjects of the Russian Federation in terms of the number of asthma diseases associated with the aerogenic factor in the environment of children. Although the observed trend in the predominance of cumulative symptoms of asthma and AR in children in Nizhny Tagil, in comparison with Yekaterinburg, is not statistically significant, it correlates with a higher level of aerogenic air pollution, this indirectly confirms the absence of a statistically significant relationship with a family history of allergic pathology. However, the connection with man-made pollutants is not taken into account in the ISAAC questionnaires. To confirm that the prevalence of asthma and AR symptoms is higher than those obtained in multicenter studies among children of a similar age, a survey of at least 350 people will be required. In any case, it is necessary to study the role of priority pollutants in the formation of airway hyperresponsiveness, asthma and AR, in order to find effective preventive measures.

To Explore the Etiology, Pathogenesis, Diagnosis and Treatment Ideas of Allergic Rhinitis in Children based on the Triple Energizer Theory

To Explore the Etiology, Pathogenesis, Diagnosis and Treatment Ideas of Allergic Rhinitis in Children based on the Triple Energizer Theory

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.

The Associations of Prenatal Exposure to Fine Particulate Matter and Its Chemical Components with Allergic Rhinitis in Children and the Modification Effect of Polyunsaturated Fatty Acids: A Birth Cohort Study.

Polyunsaturated fatty acids (PUFAs) have been shown to protect against fine particulate matter in aerodynamic diameter ()-induced hazards. However, limited evidence is available for respiratory health, particularly in pregnant women and their offspring. We aimed to investigate the association of prenatal exposure to and its chemical components with allergic rhinitis (AR) in children and explore effect modification by maternal erythrocyte PUFAs. This prospective birth cohort study involved 657 mother-child pairs from Guangzhou, China. Prenatal exposure to residential mass and its components [black carbon (BC), organic matter (OM), sulfate (), nitrate (), and ammonium ()] were estimated by an established spatiotemporal model. Maternal erythrocyte PUFAs during pregnancy were measured using gas chromatography. The diagnosis of AR and report of AR symptoms in children were assessed up to 2 years of age. We used Cox regression with the quantile-based g-computation approach to assess the individual and joint effects of components and examine the modification effects of maternal PUFA levels. Approximately and 8.07% of children had AR and related symptoms, respectively. The average concentration of prenatal was . was positively associated with the risk of developing AR [hazard ratio ; 95% confidence interval (CI): 1.16, 2.96 per ] and its symptoms (; 95% CI: 1.22, 2.62 per ) after adjustment for confounders. Similar associations were observed between individual components and AR outcomes. Each quintile change in a mixture of components was associated with an adjusted HR of 3.73 (95% CI: 1.80, 7.73) and 2.69 (95% CI: 1.55, 4.67) for AR and AR symptoms, with BC accounting for the largest contribution. Higher levels of n-3 docosapentaenoic acid and lower levels of n-6 linoleic acid showed alleviating effects on AR symptoms risk associated with exposure to and its components. Prenatal exposure to and its chemical components, particularly BC, was associated with AR/symptoms in early childhood. We highlight that PUFA biomarkers could modify the adverse effects of on respiratory allergy. https://doi.org/10.1289/EHP13524.

Asthma-chronic obstructive pulmonary disease overlap: Results from a national-multicenter study.

Patients with asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) have a greater disease burden than those with COPD or asthma alone. In this study, it was aimed to determine the prevalence, risk factors, and clinical features of ACO because there are limited national data in Türkiye. The study was conducted in a cross-sectional design in nine tertiary-care hospitals. The patients followed with a diagnosis of asthma or COPD for at least one year were enrolled in the study. The frequency of ACO and the characteristics of the patients were evaluated in the asthma and COPD groups. The study included 408 subjects (F/M= 205/203, mean age= 56.24 ± 11.85 years). The overall prevalence of ACO in both groups was 20.8% (n= 85). The frequency was higher in the COPD group than in the asthma group (n= 55; 33.3% vs. n= 22; 9.8%), respectively (p= 0.001). Patients with ACO had similarities to patients with COPD in terms of advanced age, sex, smoking, exposure to biomass during childhood, being born in rural areas, and radiologic features. Characteristics such as a history of childhood asthma and allergic rhinitis, presence of chronic sinusitis, NSAID hypersensitivity, atopy, and high eosinophil counts were similar to those of patients with asthma (p<0.001). The annual decline in FEV1 was more prominent in the ACO group (mean= -250 mL) than in the asthma (mean change= -60 mL) and COPD (mean change= -230 mL) groups (p= 0.003). This study showed that ACO was common among patients with asthma and COPD in tertiary care clinics in our country. ACO should be considered in patients with asthma and COPD who exhibit the abovementioned symptoms.

Association of factors with childhood asthma and allergic diseases using latent class analysis

We hypothesize that children characterized by deprived factors have poorer health outcomes. We aim to identify clustering of determinants and estimate risk of early childhood diseases. This 1993–2019 longitudinal cohort study combines three Canadian pediatric cohorts and their families. Mothers and children are clustered using latent class analysis (LCA) by 16 indicators in three domains (maternal and newborn; socioeconomic status [SES] and neighbourhood; environmental exposures). Hazard ratios (HR) of childhood asthma, allergic rhinitis (AR), and eczema are quantified with Cox proportional hazard (PH) regression. Rate ratios (RR) of children’s health services use (HSU) are estimated with Poisson regression. Here we report the inclusion of 15,724 mother–child pairs; our LCA identifies four mother-clusters. Classes 1 and 2 mothers are older (30–40 s), non-immigrants with university education, living in high SES neighbourhoods; Class 2 mothers have poorer air quality and less greenspace. Classes 3 and 4 mothers are younger (20–30 s), likely an immigrant/refugee, with high school-to-college education, living in lower SES neighborhoods with poorer air quality and less greenspace. Children’s outcomes differ by Class, in comparison to Class 1. Classes 3 and 4 children have higher risks of asthma (HR 1.24, 95% CI 1.11–1.37 and HR 1.39, 95% CI 1.22–1.59, respectively), and similar higher risks of AR and eczema. Children with AR in Class 3 have 20% higher all-cause physician visits (RR = 1.20, 95% CI 1.10–1.30) and those with eczema have 18% higher all-cause emergency department visits (RR = 1.18, 95% CI 1.09–1.28) and 14% higher all-cause physician visits (RR = 1.14, 95% CI 1.09–1.19). Multifactorial-LCA mother-clusters may characterize associations of children’s health outcomes and care, adjusting for interrelationships.

Greenness and its composition and configuration in association with allergic rhinitis in preschool children

BackgroundFew studies focus on the associations of green space composition and configuration with children's allergic rhinitis (AR). MethodsA multi-center population-based cross-sectional study was performed in 7 cities in mainland of China between 2019 and 2020, recruiting 36,867 preschool children. Information on the current AR symptoms and demographics were collected by questionnaire. Exposure to residential greenness was estimated by Normalized Difference Vegetation Index (NDVI, 1000 m buffer) around the residences. Greenness composition was estimated in 3 main categories: forest, grassland, shrubland. Configuration of each category and total greenness (a spatial resolution of 10 m × 10 m) was estimated by 6 landscape pattern metrics to quantify their area, shape complexity, aggregation, connectivity, and patch density. Exposure to daily ambient particulate matter (PM1, PM2.5 and PM10, a spatial resolution of 1 km × 1 km) was estimated. Multilevel logistic regression models were applied to analyze the associations of greenness and its composition and configuration with AR, and mediation effects by PMs were examined by mediation analysis models. ResultsThe prevalence of self-reported current AR in preschool children was 33.1%. Two indicators of forest, Aggregation Index of forest patches (AIforest) (odds ratio (OR):0.92, 95% Confidential Interval (CI): 0.88–0.97), and Patch Cohesion of forest (COHESIONforest) (OR: 0.93, 95% CI:0.89–0.98) showed significantly negative associations with AR symptoms. Mediation analyses found the associations were partially mediated by PMs. Age, exclusive breastfeed duration and season were the potential effect modifiers. The associations varied across seven cities. ConclusionOur findings suggest the inverse associations of the aggregation and connectivity of forest patches surrounding residence addresses with AR symptoms. Since the cross-sectional study only provides associations rather than causation, further studies are needed to confirm our results as well as the underlying mechanisms.

Epidemiological characterization and risk factors of rhinitis and rhinoconjunctivitis among preschool children in Shanghai, China

BackgroundPrevious studies have reported an increasing prevalence of childhood allergic rhinitis in developing countries. There is still a lack of the recent epidemiology of allergic rhinitis among Chinese preschool children. Therefore, this study explored the prevalence of rhinitis symptoms and identified their associations with potential risk factors among children at the age of 3–6 in Shanghai, China. MethodsValidated International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was adopted to collect information about rhinitis symptoms and potential risk factors. Univariate and multivariate logistic regression analyses were used to assess associations between risk factors and allergic rhinitis and rhinoconjunctivitis. ResultsA total of 6183 questionnaires were included in our study. The prevalence of rhinitis ever, current rhinitis, and physician-diagnosed rhinitis were 32.6%, 29.2%, and 14.3%, respectively, while the prevalence of current rhinoconjunctivitis was 11.3%. The higher prevalence was observed in boys than in girls in terms of rhinitis ever, current rhinitis, current rhinoconjunctivitis and doctor-diagnosed rhinitis. Autumn had the highest prevalence among four seasons. In our multivariate logistic regression analyses, history of allergic diseases and paracetamol use in the last year showed positive associations with the increased risk of both current rhinitis and rhinoconjunctivitis, and antibiotic use was an independent significant risk factor only for current rhinitis. Genetic factors, including maternal and paternal rhinitis, asthma, and eczema, were significantly associated with the prevalence of current rhinitis. Similar associations were seen between these factors and current rhinoconjunctivitis, except for paternal eczema. Among environmental factors, smoking exposure at home, heavy truck traffic in home's street, floor heating system were independent risk factors for both current rhinitis and rhinoconjunctivitis in the adjusted model, while cleaning the house less than once a week was only associated with current rhinitis. ConclusionThe prevalence of current rhinitis was 29.2% among children aged 3–6 in Shanghai, China. Sex differences and seasonal variations were observed in the prevalence of rhinitis symptoms. The identified risk factors would provide a basis for policy makers and medical experts to take intervention measures to prevent allergic rhinitis and rhinoconjunctivitis.

Multicenter study of seasonal and regional airborne allergens in Chinese preschoolers with allergic rhinitis

This study is nationwide multicenter epidemiological research, aimed at investigating the distribution changes and seasonal patterns of various airborne allergens among preschool children with allergic rhinitis (AR) in different regions of China, and analyzing the clinical correlation between sensitization to various airborne allergens and AR symptoms in children. Information on children was collected through standard questionnaires, and total IgE (tIgE) and specific IgE (sIgE) for 11 inhalant allergens were tested. The results showed that dust mites are the primary allergens for preschool AR children (39%). Among pollen allergens, Amb a had the highest positivity rate (8.1%), followed by Art v (7.8%). The sensitization rates for two mites peaked in May (46.9% and 40.6%). Art v peaked in August (21.5%), while Amb a had peaks in May (12.7%) and August (17.8%). The sensitization peaks for various tree pollens mainly occurred in August. In the Eastern monsoon region, the sensitization rate to mites was significantly higher than in the Northwest arid and semi-arid regions; whereas, for pollen allergens, the sensitization rates to Amb a, Pla a, Pin a, Pop d, and Bet v were significantly higher in the Northwest arid and semi-arid regions than in the Eastern monsoon region. The correlation among various tree pollens, specifically between Pla a, Pin r, Pop d, and Bet v was strong (0.63 ~ 0.79), with a cross-overlapping percentage of 53.9%. Children with multiple pollen sensitizations had higher cumulative nasal symptom scores than those negative for pollen (P < 0.01). Children with only pollen sensitization had higher cumulative rhinitis symptom scores than the all-negative group (P < 0.0001) and the mite-only sensitization group [P < 0.05], while the mite-only sensitization group also had higher scores than the all-negative group [P < 0.05], and the group sensitized to both pollen and mites had lower scores than the pollen-only group [P < 0.05]. This study indicates that sensitization to mites and grass pollens exhibits significant regional differences, with grass pollen allergies primarily occurring in autumn, sensitization to pollens in general exhibits a pronounced seasonal pattern. Moreover, pollen sensitization aggravates nasal and ocular symptoms in AR children.

Montelukast: results and prospects for applications in pediatric practice

The Centers for Disease Control and Prevention reports that more than 4 million children have been diagnosed with asthma. Currently, there is no treatment that could prevent the development of asthma or change its natural course over long-term follow-up. However, the disease can be controlled using treatments used in clinical practice. For persistent asthma in children aged 5 years and younger, low doses of inhaled glucocorticosteroids are recommended, as well as the administration of montelukast, a leukotriene receptor antagonist. In addition, montelukast is prescribed to patients with allergic rhinitis as an alternative to or in combination with oral antihistamines or nasal corticosteroids. Leukotrienes are lipid mediators that play a key role in acute and chronic inflammation and allergic diseases. They exhibit their biological effects by binding to specific G-protein-coupled receptors. Each subtype of the leukotriene receptor has unique functions and expression patterns. Leukotrienes play an important role in various allergic diseases, including bronchial asthma and allergic rhinitis. Montelukast is a cysteinyl leukotriene receptor-1 antagonist widely used to suppress the inflammatory response in asthma and allergic rhinitis. This review briefly summarizes the biology of leukotrienes and their receptors, recent developments in the field of antileukotriene drugs and the prospects for their different therapeutic applications. The role of antileukotriene drugs and key indications for the use of montelukast in the complex therapy of asthma and allergic rhinitis in children have been determined.

Investigation of the Comorbidity of Bronchial Asthma and Allergic Rhinitis in Children

Today there is an increasing tendency for all allergic diseases, including a high prevalence of bronchial asthma (BA), as well as an increasing number of patients with co-morbidities. Allergic rhinitis leads in frequency of occurrence with bronchial asthma. In the last decade, the term comorbidity has often been used to define the interrelation as well as the mutual influence of 2 or more syndromes, diseases in one patient. The aim of the research was to study the comorbidity of bronchial asthma and allergic rhinitis in children in the Department of Pulmonology. The retrospective study included an analysis of 51 case histories of children diagnosed with atopic bronchial asthma. Of the 51 patients, 28 children (54.9±7%) were diagnosed with allergic rhinitis after examination by an ENT specialist.

Research progress on influencing factors of allergic rhinitis in children

The incidence of allergic rhinitis (AR) is increasing year by year, especially in children. AR not only affects the growth, development, life and learning of children but also causes huge economic and social burdens. This study explores the impact of individual factors such as genetic polymorphisms, epigenetics, inflammatory response mechanisms, and microecological influence mechanisms on children's AR. It also reviews the impact of external factors such as allergenic factors, ambient air pollutants, infection and immunity factors, and climate and climate change on the disease, with the aim of improving understanding of AR in children and providing a basis for its prevention and treatment.

Combined Korean medicine therapies in children with allergic rhinitis: A prospective, multicenter, observational registry study at primary-care network clinics

IntroductionAllergic rhinitis (AR) causes symptoms such as hyper-rhinorrhea, sneezing, nasal congestion, itching, and pain by triggering inflammation in the nasal mucosa and an immune response caused by antigen-specific Immunoglobulin E (IgE). This prospective multicenter observational study aimed to evaluate the symptoms change and safety of combined Korean medicine (KM) therapy in patients with AR. MethodsThis study was conducted in HAMSOA Korean Medicine Clinics, a network specializing in treating pediatric patients in Korea, and 15 centers participated. The patients were divided into three groups (mild, moderate, and severe) according to their baseline total nasal symptom score. The patients were treated with herbal medicine, acupuncture, cupping therapy, and moxibustion therapy. ResultsThe study involved 72 subjects aged 6.47 ± 2.37 years. The average Numeric Rating Scale for allergic rhinitis symptoms at the baseline and final follow-up were 4.39 ± 2.14 to 3.47 ± 2.51, respectively, indicating a significant improvement over an average of 4 weeks. The Pediatric Allergic Disease Quality of Life Questionnaire scores at the final screening improved in all three groups. The mean difference was -10.44, with a 95 % confidence interval of -15.35 to -5.54 (p < 0.01.). Furthermore, no adverse events were reported in any patient in this study. ConclusionThe results provide preliminary evidence suggesting that KM treatment may be a safe and effective option for reducing symptoms associated with allergic rhinitis in children. Additional prospective studies are required to confirm the results of the present study.

Modification of Food Allergy on the Associations between Early Life Exposure to Size-Specific Particulate Matter and Childhood Allergic Rhinitis.

Previous studies have reported the association between particulate matter (PM) and childhood allergic rhinitis (AR). However, it is unclear whether food allergy (FA) modifies the PM-AR association. We aimed at evaluating the effect of the modification of FA on PM-AR association in preschool children. We adopted a cross-sectional study and conducted a questionnaire survey among preschool children aged 3-6 years in 7 cities in China from June 2019 to June 2020 to collect information on AR and FA. We used a combination of multilevel logistic regression and restricted cubic spline functions to quantitatively assess whether FA modifies the associations between size-specific PM exposure (1 × 1 km) and the risk of AR. The adjusted odds ratios (ORs) for AR among the children with FA as per a 10 μg/m3 increase in early life PM1, PM2.5, and PM10 were significantly higher than the corresponding ORs among the children without FA [e.g., OR: 1.58, 95% CI: (1.32, 1.90) vs 1.29, 95% CI: (1.18, 1.41), per 10 μg/m3 increase in PM1]. The interactions between FA and size-specific PM exposure and their effects on AR were statistically significant (all p-int < 0.001). FA, as an important part of the allergic disease progression, may modify the PM-AR association in preschool children.

Intrauterine and early postnatal exposures to submicron particulate matter and childhood allergic rhinitis: A multicity cross-sectional study in China

BackgroundAirborne particulate matter pollution has been linked to occurrence of childhood allergic rhinitis (AR). However, the relationships between exposure to particulate matter with an aerodynamic diameter ≤1 μm (PM1) during early life (in utero and first year of life) and the onset of childhood AR remain largely unknown. This study aims to investigate potential associations of in utero and first-year exposures to size-segregated PMs, including PM1, PM1–2.5, PM2.5, PM2.5–10, and PM10, with childhood AR. MethodsWe investigated 29286 preschool children aged 3–6 years in 7 Chinese major cities during 2019–2020 as the Phase II of the China Children, Families, Health Study. Machine learning-based space-time models were utilized to estimate early-life residential exposure to PM1, PM2.5, and PM10 at 1 × 1-km resolutions. The concentrations of PM1–2.5 and PM2.5–10 were calculated by subtracting PM1 from PM2.5 and PM2.5 from PM10, respectively. Multiple mixed-effects logistic models were used to assess the odds ratios (ORs) and 95% confidence intervals (CIs) of childhood AR associated with per 10-μg/m3 increase in exposure to particulate air pollution during in utero period and the first year of life. ResultsAmong the 29286 children surveyed (mean ± standard deviation, 4.9 ± 0.9 years), 3652 (12.5%) were reported to be diagnosed with AR. Average PM1 concentrations during in utero period and the first year since birth were 36.3 ± 8.6 μg/m3 and 33.1 ± 6.9 μg/m3, respectively. Exposure to PM1 and PM2.5 during pregnancy and the first year of life was associated with an increased risk of AR in children, and the OR estimates were higher for each 10-μg/m3 increase in PM1 than for PM2.5 (e.g., 1.132 [95% CI: 1.022–1.254] vs. 1.079 [95% CI: 1.014–1.149] in pregnancy; 1.151 [95% CI: 1.014–1.306] vs. 1.095 [95% CI: 1.008–1.189] in the first year of life). No associations were observed between AR and both pre- and post-natal exposure to PM1–2.5, indicating that PM1 rather than PM1–2.5 contributed to the association between PM2.5 and childhood AR. In trimester-stratified analysis, childhood AR was only found to be associated with exposure to PM1 (OR = 1.077, 95% CI: 1.027–1.128), PM2.5 (OR = 1.048, 95% CI: 1.018–1.078), and PM10 (OR = 1.032, 95% CI: 1.007–1.058) during the third trimester of pregnancy. Subgroup analysis suggested stronger PM-AR associations among younger (<5 years old) and winter-born children. ConclusionsPrenatal and postnatal exposures to ambient PM1 and PM2.5 were associated with an increased risk of childhood AR, and PM2.5-related hazards could be predominantly attributed to PM1. These findings highlighted public health significance of formulating air quality guideline for ambient PM1 in mitigating children's AR burden caused by particulate air pollution.

Tic disorder in allergic rhinitis children and adolescents: a case-control study

BackgroundAllergic rhinitis is the most common allergic disease. It can accompany psychological disorders such as tic disorders due to the prolonged course of the symptoms of allergic rhinitis. This pioneer case-control study aims to investigate tic disorders in children and adolescents under 18 years of age diagnosed with allergic rhinitis.MethodThe case group in this study consisted of patients who had both allergic rhinitis and tic disorders. Patients with allergic rhinitis without tic disorders were also enrolled as the control group with matched gender and age. Demographic characteristics, tic classifications, and contributing factors for allergic rhinitis and tic disorders were studied among the cases. Tic disorders were evaluated using DSM-5 criteria for the classification of tic disorders.Results47 patients in the case group and 47 patients in the control group were included in this study. 53.2% and 46.8% were males and females in the case group, respectively. The mean age of the patients was 10.46 ± 3.97 years old. Sound tics were more common among the patients compared to motor tics. Patients with concomitant AR and tic disorders had more days per week with AR symptoms (P-value ≤ 0.001; OR (every day vs. three days a week = 11.02(2.98, 40.76))). Most patients with sound tick were women (p: 0.026), and most patients with motion tic were in the Provisional tic disorder group (p: 0.001). The history of infantile eczema was seen more in patients without sound tic (p: 0.025), and otitis media was significantly less common among patients with sound tics (p: 0.026). Provisional tic disorder was the most common class among the patients. In the case group (coexistence between allergic rhinitis and tic) compared to the control group, patients had significantly more days with AR symptoms per week.ConclusionThis preliminary study indicates that Provisional tic disorder was the most common classification of tic among patients with allergic rhinitis, especially in patients with motor tics. Asthma in motor tics, a history of food allergy in infancy, and a history of infantile eczema were also common among patients with vocal tics. Also, patients with allergic rhinitis and tic had more severe disease (more symptoms per week) than those with rhinitis alone. These findings emphasize the association of tic disorders with immunological pathways.

IL-1β and iNOS can drive the asthmatic comorbidities and decrease of lung function in perennial allergic rhinitis children.

Allergic asthma and rhinitis (AR) are closely linked, with a significant proportion of AR patients developing asthma. Identification of the early signs of comorbidity of AR and asthma can enable prompt treatment and prevent asthma progression. This study investigated the role of interleukin-1β (IL-1β), a pro-inflammatory cytokine, and inducible nitric oxide synthase (iNOS) in the comorbidity of AR and asthma and lung function in Korean children with perennial AR (PAR). A cohort of 240 subjects (6 to 10 years old) with PAR (PAR alone: 113 children, PAR and asthma: 127 children) was analyzed for various biomarkers, including IL-1β, iNOS, and epithelial-mesenchymal transition (EMT) markers in serum. The blood levels of eosinophils and immunoglobulin E (IgE) were examined. IL-1β, CCL-24, E-cadherin, and vimentin were measured by enzyme-linked immunosorbent assay (ELISA). Epithelial iNOS was measured by the NOS kit. Elevated levels of IL-1β, iNOS, and vimentin in the serum were identified as significant indicators of the likelihood of comorbidity of PAR and asthma in children. Furthermore, higher concentrations of IL-1β, iNOS, and vimentin have been linked to reduced lung function in PAR children. Notably, IL-1β expression shows a relationship with the levels of E-cadherin, vimentin, and CCL-24. However, no correlation was found between IL-1β and iNOS expressions. This study suggests that IL-1β and iNOS can be biomarkers in the progression of PAR and asthma and decreased lung function, suggesting potential targets for early intervention and treatment.

Local allergic rhinitis in children: identification and characterization in a specialty outpatient clinic.

Background. Local Allergic Rhinitis (LAR) is a phenotype defined by rhinitis symptoms with negative responses to systemic sensitization tests but with an exclusively nasal allergic inflammatory response. Data on the pediatric age group is scarce, and no Latin American data has been published so far. Methods. Nasal Allergen Challenge (NAC) was performed with Dermatophagoides pteronyssinus and Blomia tropicalis in six- to 18-year-old patients diagnosed with rhinitis and no systemic sensitization. NAC was monitored using subjective parameters and acoustic rhinometry. The study aimed to identify LAR in child and adolescent subjects previously diagnosed with non-allergic rhinitis (NAR) in a Brazilian specialty outpatient clinic (Allergy and Immunology). Results. During the study period, we analyzed 758 skin prick tests (SPT). Of those, 517 (68.2%) were diagnosed with rhinitis. Among those, 18.4% (95/517) had a negative SPT, meeting the criteria for inclusion in the study. Twenty-five patients underwent NAC, and 40% (10/25) of them, previously considered to have NAR, had a positive test and were reclassified as having LAR. Based on the analyzed characteristics, clinically differentiating LAR from NAR was impossible. Conclusions. This study represents the first investigation of LAR in child and adolescent subjects in Latin America, contributing significantly to the understanding of its prevalence and characteristics in this geographic area. Among a subgroup of patients lacking systemic sensitization submitted to NAC, 40% (10/25) demonstrated a positive NAC with Dermatophagoides pteronyssinus and Blomia tropicalis, warranting their reclassification to LAR. NAC with multiple allergens has been proven safe and viable in pediatric populations, affirming its critical role in the accurate diagnosis of LAR.

Оцінка сироваткового загального та специфічного імуноглобуліну Е в дітей з персистуючим алергічним ринітом і поєднаним із бронхіальною астмою при сенсибілізації до алергенів кліщів

Allergic rhinitis (AR) is a common immunoglobulin E (IgE) dependent disease among allergic patients worldwide. At the same time, the determination of specific IgE in the blood serum allows characterizing the relevant sensitizing allergens. Despite the existence of conditional thresholds for normal and elevated levels of total and specific IgE, there is no consensus in the literature on which IgE value unequivocally confirms the presence of atopy and what is the relationship between these levels and the severity of clinical manifestations. Purpose - to evaluate the levels of serum total and specific IgE and their relationship with severity and age in children with persistent AR and combined with bronchial asthma (BA) during sensitization to house dust mite (HDM) allergens. Materials and methods. A clinical, anamnestic and laboratory examination of 259 children aged 5 to 17 years with AR and combined AR with BA, who were sensitized to HDM allergens, was conducted. Results. In AR in children with sensitization to HDM, there is a dependence of serum total IgE level on the severity of AR and age of children. With increasing severity of AR manifestations, a significant (p&lt;0.05) increase in total IgE levels was noted. It was found that the content of sIgE also increased with increasing severity of AR. Thus, statistically significantly (p&lt;0.05) higher levels of sIgE were determined in sensitization to the major HDM molecules Der f 1, Der p 1, Der p 2, Der p 23 in children with severe AR. Sensitization to the tropomyosin Der p10 molecule, which usually has no effect on the clinical manifestations of respiratory allergy but indicates cross-reactivity to seafood, was significantly more common (p&lt;0.05) in children aged 3-7 years compared to children aged 13-17 years. Conclusions. The data obtained partially define the pathogenetic features in the formation of sensitization to HDM and their individual molecules, confirming that this process begins at an early age, which may indicate the need to start allergen-specific immunotherapy in such children if clinically necessary. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.