Allergic Rhinitis Patients Research Articles

Validation of the Skin Prick Automated Test (SPAT) Cut-Off Value in Birch Pollen and House Dust Mite Allergic Rhinitis Patients.

A novel device, Skin Prick Automated Test (SPAT), previously showed reduced variability and more consistent test results compared to conventional skin prick test (SPT) to identify allergic sensitisation. This study aimed to clinically validate the adjusted SPAT cut-off in patients with confirmed birch or house dust mite (HDM) allergy. Seventy-five adults were included: 25 non-allergic subjects (confirmed by lack of allergy history and negative SPT), 25 birch and 25 HDM allergic rhinitis patients (both confirmed by positive SPT and nasal allergen challenge [NAC]). All subjects received a conventional SPT and an automated SPT for B ver, D pter, D far and control solutions. A cut-off of 4.2 and 4.1 mm, respectively, resulted in the highest accuracy to detect birch or HDM allergy using SPAT. Referring to previous study results suggesting a reliable cut-off value of 4.5 mm, it was decided to maintain 4.5 mm as SPAT cut-off indicating allergic sensitisation. Accuracy did not significantly differ between SPAT (96% using 4.5 mm) and conventional SPT (98% using 3.0 mm) to detect HDM allergy or to detect birch pollen allergy (100% for SPAT and SPT). SPAT wheal measurements performed through a ruler on the forearm or through digital measurement on a composite image did not significantly differ for any of the patient groups analysed. SPAT showed an equivalent accuracy to detect birch pollen or HDM allergy compared to conventional SPT, using the adjusted 4.5 mm SPAT cut-off in patients with confirmed allergic rhinitis. The SPAT web viewer can be used easily and effectively for digital wheal measurement on a composite image.

CREBBP stabilizes GNG3 protein through acetylation, thereby activating the NF-κB pathway and exacerbating airway inflammation in allergic rhinitis

Objective Allergic rhinitis (AR), an allergen-driven chronic inflammatory disorder of nasal mucosa, is characterized by airway inflammation as its cardinal pathological manifestation. While acetylation is known to regulate airway inflammation, its mechanistic involvement in AR-related inflammation remains elusive. This study aims to investigate the acetylation-dependent mechanisms governing airway inflammation in AR. Materials and methods RNA-seq analysis identified differentially expressed genes in peripheral blood of AR patients and healthy controls. Ovalbumin-sensitized BALB/c mice were performed as the AR mouse model. Airway inflammation was assessed by measuring inflammatory cytokine levels, inflammatory cell numbers, macrophage counts in whole lung lavage fluid (WLLF), and specific IgE levels in plasma using ELISA and Diff-Quick staining. The underlying mechanism was investigated through Western blotting, immunoprecipitation (IP), and Co-IP. Results GNG3 expression was significantly increased in AR patients and the AR mouse model. Knockdown of GNG3 significantly reduced airway inflammation and inhibited NF-κB pathway activation in the AR mouse model. CREBBP overexpression enhanced GNG3 protein stability, and CREBBP mRNA expression was significantly increased in patients with AR and positively correlated with GNG3 expression. Furthermore, GNG3 overexpression restored airway inflammation that was suppressed by CREBBP knockdown in the AR mouse model. Conclusion These results demonstrate that CREBBP aggravated airway inflammation in AR by activating the NF-κB pathway via GNG3 upregulation mediated by GNG3 acetylation.

Uncovering pleiotropic loci in allergic rhinitis and leukocyte traits through multi-trait GWAS

Allergic rhinitis (AR) is a nasal inflammation triggered by the immune system’s response to airborne allergens, with white blood cells playing a crucial role in the development of allergic symptoms. This study aimed to investigate the genetic correlations between AR and various blood traits in European and East Asian populations using linkage disequilibrium score regression (LDSC). By leveraging GWAS summary statistics, we identified significant genetic overlap between AR and eosinophil counts in both populations. Cross-trait analysis revealed 52 pleiotropic loci associated with AR and eosinophil counts in Europeans, while 12 novel loci were discovered in East Asians. Among these, five loci, including IL1RL1 and IL4R, were shared between Europeans and East Asians. Additionally, we identified a novel East Asian-specific locus near the CD28 gene. Differential gene expression analysis further showed that CD28 expression was significantly lower in AR patients compared to healthy controls, suggesting its potential involvement in AR pathogenesis. These findings underscore the utility of multi-trait GWAS in uncovering pleiotropic loci and provide new insights into the genetic architecture of AR, particularly emphasizing population-specific loci like CD28. This research opens avenues for understanding the genetic basis of AR and developing targeted therapies.

Stress granule assembly impairs macrophage efferocytosis to aggravate allergic rhinitis in mice

Cytoplasmic stress granules (SG) assemble in response to stress-induced translational arrest and are key signaling hubs orchestrating cell fate and regulating various physiological and pathological processes. However, the role of SG formation in the progression of allergic diseases is incompletely understood. Here, by analyzing the nasal tissues of allergic rhinitis (AR) mouse models and AR patients, we find that SGs assemble specifically in the macrophages within the nasal mucosa and promote AR progression by restraining the efferocytotic ability of macrophages, ultimately resulting in reduced Mres generation and IL-10 production. Mechanistically, intracellular m7G-modified Lrp1 mRNA, encoding for a typical efferocytosis receptor, is transported by the m7G reader QKI7 into stress-induced SGs, where Lrp1 mRNA is sequestered away from the translation machinery, ultimately resulting in reduced macrophage efferocytosis. Therefore, SG assembly impairs macrophage efferocytosis and aggravates AR, and the inhibition of SGs bears considerable potential in the targeted therapy.

Multicenter Investigation of Current Asthma Coexistence in Allergic Rhinitis Cases.

This study aimed to determine the prevalence of allergic rhinitis (AR) and asthma among the participants and assess the likelihood that any given participant would also have asthma. The study included 1200 patients with AR (599 men and 601 females) who met the inclusion criteria. These patients came from various locations across Turkey. All of the study's subjects had AR symptoms, such as stuffy nose, itching, sneezing, and runny nose. Whether the AR prick test is positive or negative is recorded as 0 for unavailable, 1 for negative, and 2 for positive. Following the GINA standards, they additionally assessed for asthma using the following survey questions: clinical asthma diagnosis, shortness of breath, wheezing, coughing, chest tightness, and asthma severity. The results show that 32.3% of the patients with AR have asthma. Asthma is significantly more common in elderly people with AR. Males with AR are more likely to have asthma (55.4%) than females with AR (9.2%). The rate of positive asthma tests rises in correlation with the reduction of nasal discharge and sneezing. However, as nasal itching and obstruction increased, asthma prevalence increased. The total nasal symptom scores of patients with asthma (13.17 ± 1.76) are significantly lower than those without asthma (15.88 ± 3.47). Asthma was seen in 32.3% of the AR patients. Patients with allergic rhinitis should be closely monitored for the onset of asthma, and prompt diagnosis and treatment are crucial. Collaboration among allergy clinics, pulmonology departments, and otorhinolaryngology practices is vital.

Metabolomic insights into variable antihistamine responses in allergic rhinitis: unveiling biomarkers for precision treatment

BackgroundThe clinical response to antihistamine therapy exhibits substantial heterogeneity among individuals with allergic rhinitis (AR). While these medications represent a cornerstone in AR management, the molecular basis underlying differential treatment outcomes remains incompletely understood. This investigation sought to delineate specific metabolomic profiles that distinguish between AR patients who demonstrate favorable responses to antihistamine treatment and those who exhibit therapeutic resistance.MethodsThis investigation encompassed a cohort of 57 patients diagnosed with AR, stratified into antihistamine-effective (n=49) and antihistamine-ineffective (n=8) groups. The study protocol integrated multiple analytical approaches, including clinical phenotyping, serum vitamin D quantification, mRNA expression, and untargeted metabolomic analysis. Metabolomic profiling was conducted using a state-of-the-art liquid chromatography-mass spectrometry (LC-MS) platform, enabling comprehensive characterization of the serum metabolome.ResultsWhile demographic characteristics and vitamin D levels showed no significant differences between two groups, blood H1R mRNA expression was significantly higher in antihistamine-ineffective patients (P=0.046), and nasal TPSB mRNA expression was elevated (P=0.006). Nineteen metabolites showed significant differences (p<0.05, fold change>2.0, VIP>1.0) between groups. ROC curve analysis identified nine metabolites with high diagnostic potential (AUC>0.70), with Methotrexate (AUC=0.862), Pro-Val-Ala-Glu-Val (AUC=0.804), and TyrMe-Ile-OH (AUC=0.791) showing the strongest discriminatory power. Pathway analysis highlighted the involvement of caffeine metabolism and tryptophan metabolism pathways.ConclusionsThis study identified distinct metabolomic signatures between antihistamine-effective and antihistamine-ineffective AR patients, providing potential biomarkers for predicting treatment response and new insights into the metabolic mechanisms underlying treatment efficacy in AR.

Allergic rhinitis in college students at Dongguan: a cross-sectional survey on disease burden, knowledge, and self-management.

This study examined the prevalence, clinical characteristics, disease knowledge, and quality of life impact of allergic rhinitis (AR) among college students in Dongguan, China. Using a customized questionnaire, we surveyed 1,531 participants (response rate: 85.1%) and identified an AR prevalence of 18.68% (95% CI: 16.72-20.63%). The study identified significant gaps in AR management, including underutilization of allergen testing (only 44.21% of AR patients underwent skin prick testing) and limited medication knowledge among 73% of participants. Environmental control measures were often neglected, and health education was inconsistently delivered, with 72.03% of students relying on the internet for AR information. The findings underscore the need for enhanced health education, improved access to diagnostic testing, and patient-centered communication strategies. Digital platforms and peer-led interventions are recommended to address these gaps and improve AR self-management.

Do Skin Prick Tests Predict Nasal Provocation Test Outcomes in Allergic Rhinitis Patients?

In diagnosing allergic rhinitis (AR), conventional skin prick tests (SPTs) often fail to reflect allergen-induced nasal symptoms. Conversely, nasal provocation tests (NPTs) provide more definitive assessments but are less accessible. Therefore, we aimed to evaluate the correlation between SPT and NPT outcomes to assess SPT's predictive reliability for NPT results. A retrospective review was performed on 106 patients who underwent simultaneous SPT and NPT for suspected perennial AR. The SPT was assessed by measuring the mean wheal diameter of Dermatophagoides pteronyssinus (Dp). The NPT was performed by administering 100 µL of a 1000 AU/mL Dp solution into both nostrils, with responses assessed by changes in the five AR-related symptoms (total nasal symptom score, TNSS) at 15 min. Correlation and linear regression analyses were conducted to evaluate the relationship between SPT and NPT outcomes. TNSS changes at 15 min following intranasal Dp challenge showed a significant, moderately positive correlation with SPT Dp wheal diameter for all 106 subjects (ρ = 0.640, p<0.001). In patients positive for both SPT and NPT (n = 24, ρ = 0.510, p = 0.011) and those with monosensitization (n = 30, ρ = 0.644, p<0.001), a stronger and significant correlation was observed compared to the polysensitized group (n = 35, ρ = 0.372, p = 0.028), while no significant correlation was noted in patients negative for either test. Linear regression confirmed a significant linear relationship (R2 = 0.423, Y = 2.65X-0.59, p<0.001) between SPT wheal size and 15-min TNSS changes in NPT among all the subjects. Significant correlations and linear associations between SPT and NPT outcomes support SPT's predictive capability for NPT responses.

Clinical efficacy on acupuncture for perennial allergic rhinitis: a study protocol for a randomized clinical trial.

Allergic rhinitis (AR) is a prevalent allergic disorder. Acupuncture has been widely utilized to alleviate allergic symptoms, and numerous studies have investigated its therapeutic effects on AR. However, due to the challenges associated with establishing appropriate placebo controls, few studies have directly compared acupuncture with sham acupuncture for AR treatment. This trial investigates the comparative effectiveness and tolerability of acupuncture vs. placebo needling for allergic rhinitis patients. This clinical trial features a stratified randomization scheme with 1:1 allocation, single-blind assessment, and a total sample size of 84 participants. After screening for inclusion, qualified subjects with perennial allergic rhinitis will be randomly allocated to treatment group(accepting acupuncture, n = 42) or control group (accepting sham acupuncture, n = 42). The intervention will last over a 4-week period. The main efficacy outcome is the change in main symptom severity assessed by the Visual Analogue Scale (VAS) after each week of treatment. Secondary outcomes include the Total Nasal Symptom Score (TNSS), Efficacy Index (%) after each treatment session, time to onset of effect, Rhinitis Quality of Life Questionnaire (RQLQ) scores after each week of treatment, and the additional use rate of anti-allergic medications. The findings of this study aims to evaluate the effectiveness and safety of acupuncture in treating perennial allergic rhinitis through comprehensive assessment of symptom relief, time-effect relationships, quality of life improvements, and reduction in anti-allergic medication use. Chinese Clinical Trial Registry (ChiCTR2400086227).

Increased Allergic Rhinitis Prevalence and Symptom Severity in Patients With Irritable Bowel Syndrome.

Patients with irritable bowel syndrome (IBS) have an increased risk of developing both airway and allergic diseases. However, the relationship between allergic rhinitis (AR), one of the most common chronic upper airway inflammatory diseases, and IBS remains poorly understood. The aim of this study is to provide a better understanding of airway complications in patients with IBS and to evaluate the presence of potential airborne and dietary antigen cross-reactivity in concomitant IBS and AR. A total of 287 participants, 54 healthy volunteers without gastrointestinal complaints and 232 patients with I fulfilling Rome IV criteria, were invited to complete self-administered questionnaires assessing the severity of upper airway symptoms and the prevalence of allergic rhinitis. Overall, patients with IBS had a threefold higher risk of questionnaire-based allergic rhinitis than control subjects (95% CI, 1.49-6.12). Furthermore, patients with IBS + AR showed reduced sleep quality, mood, and personal satisfaction associated with their upper airway complaints, compared to IBS patients without AR. Forty-seven (18/38) percent of IBS + AR patients reported IBS symptoms in response to ingestion of food items with molecular mimicry of the aeroallergen to which the patient is sensitized. Our study shows that patients with IBS have an increased frequency of concomitant allergic rhinitis, which contributes to a further reduction in quality of life. We also provide evidence of potential cross-reactive reactions between aeroallergens and dietary antigens in patients with concomitant IBS and AR.

Is there a bidirectional relationship between allergic rhinitis and irritable bowel syndrome? A meta-analysis

BackgroundSome studies suggest a link between allergic rhinitis (AR) and irritable bowel syndrome (IBS), but evidence is insufficient. This meta-analysis aimed to explore the relationship between AR and IBS.MethodsWe searched the relevant literature in six electronic databases. We included a total of nine articles, seven of which took AR as the research object, two of which took IBS as the research object. We performed a meta-analysis using random effects and estimated the resultant odds ratio (OR).ResultsA total of 10 627 patients with AR were included in seven studies, including 956 patients diagnosed with AR in the IBS population and 9671 patients diagnosed with AR in the non-IBS population. By heterogeneity test, X2 = 10.12, F-statistic (F) = 6, P = 0.12, I2 = 41%, OR = 2.88, and Z-score (Z) = 21.97 (P < 0.00001), the results were statistically significant. Patients with AR have an increased risk of developing IBS compared to patients without AR. A total of 1099 patients with IBS were included in two studies, including 384 patients with IBS in AR patients and 715 patients with IBS in the healthy population. After the heterogeneity test, X2 = 0.11, F = 1, P = 0.74, I2 = 0%, OR = 2.15, and Z = 11.81 (P < 0.00001), the results were statistically significant. Patients with IBS have an increased risk of developing AR compared to patients without IBS.ConclusionsThe bidirectional association between AR and IBS provides a basis for exploring potential new mechanisms between the two.RegistrationNo. INPLASY202440057.

Expression and correlation of SOCS3 and Eotaxin mRNA and proteins levels in nasal mucosal tissue of allergic rhinitis patients.

This study aims to investigate the expression and interaction mechanisms of Suppressor of Cytokine Signaling 3 (SOCS3) and Eotaxin in the nasal mucosal tissues of patients with Allergic Rhinitis (AR). In this retrospective study, we selected nasal mucosa tissues from 35 AR patients as the AR group, and nasal mucosa tissues from 22 patients with isolated nasal septum deviation as the control group. Utilizing reverse transcription polymerase chain reaction (RT-PCR) techniques, we measured the expression levels of SOCS3 mRNA and Eotaxin mRNA in both groups. Additionally, immunohistochemical methods were employed to assess the protein expression of SOCS3 and Eotaxin in these tissues. The average optical density value of SOCS3 protein in the AR group was 0.270 ± 0.05, significantly higher than 0.160 ± 0.04 in the control group (P<0.01); the average optical density value of Eotaxin protein in the AR group was 0.240 ± 0.04, also significantly higher than 0.164 ± 0.03 in the control group (P<0.01). At the mRNA level, the ratio of SOCS3 mRNA to GAPDH in the AR group was 0.83 ± 0.27, and the ratio of Eotaxin mRNA to GAPDH was 0.71 ± 0.21, both significantly higher than 0.32 ± 0.11 and 0.22 ± 0.08 in the control group. Besides, the expression levels of SOCS3 protein and mRNA in the nasal mucosal tissues of AR patients were positively correlated with the expression of Eotaxin protein and mRNA (r=0.927, P<0.01; r=0.854, P<0.01). The high expression of SOCS3 and Eotaxin in the nasal mucosal tissues of AR, as well as the positive correlation between them, suggest that they may play an important role in the pathogenesis of AR. This study provides new experimental evidence for in-depth understanding of the pathogenesis of AR and new potential targets for the treatment of AR.

A multicentre retrospective study of house dust mite allergen preparation treating multi-sensitized allergic rhinitis patients

Objective: To investigate, for multi-sensitized allergic rhinitis (AR) patients allergic to dust mites combined with other allergens (pollen, mold, animal dander, etc.), whether the single dust mite subcutaneous immunotherapy (SCIT) can improve the specific symptoms caused by other allergens in the patients, and to analyze the relationship between the effectiveness of symptom improvement in these patients and the type, quantity and severity of the allergens. Methods: A multicenter retrospective study was conducted to collect mul-sensitized AR patients from allergy or respiratory departments of 5 hospitals who received house dust mite allergen preparation SCIT for 12 to 36 months and met other inclusion and exclusion criteria from February to July 2024. General clinical data were collected and the perennial or seasonal symptoms before and after treatment were evaluated with visual analogue scale (VAS) to assess whether there was an perennial or allergen-specific symptom improvement (VAS score decrease ≥30%), by which the patients were divided into effective group and ineffective. R software was used to analyze the differences between groups by using Fisher's exact test and Mann-Whitney U test. Results: A total of 62 patients were enrolled, and the treatment were effective in 39 of them, with an effective rate of 62.9%. For allergen-specific symptoms, the median age of the effective group was higher than that of the ineffective group (12 years old vs. 8 years old, P=0.039), and the effective rate in dust mite specific immunoglobin E (sIgE) grade ≤5 group was higher than that in sIgE grade >5 group (81.6% vs. 45.5%, P=0.008), and the effective rate of mold sIgE grade ≤2 group was higher than that of sIgE grade >2 group (83.3% vs. 28.6%, P=0.045), and there was no statistically significant correlation between the other allergen grades and the effective rate (P>0.05). For perennial symptoms, the effective rate in the mold grade ≤2 group was higher than that in the sIgE grade >2 group (91.3% vs. 28.6%, P=0.010), and there was no statistically significant correlation between the other allergen grades and the effective rate (P>0.05). There was no significant correlation between the treatment effectiveness of perennial or allergen-specific symptoms and the number of combined allergens, the grade of skin test, and the difference between the grade of combined allergens and that of dust mites (P>0.05). Conclusion: Among the patients with multi-sensitized AR allergic to dust mites included in this study, single dust mite SCIT is effective in some of them, and for allergen-specific symptoms, the effective group was elder, and dust mite sIgE grade 6 and mold sIgE grade ≥2 was related to the low effective rate of SCIT. The present results are insufficient for selecting single or multiple AIT in any type of multi-sensitized patients.

Efficacy and safety of combined loratadine and mometasone furoate therapy in allergic rhinitis patients

ObjectiveThis study seeks to assess the effectiveness and safety of a combination treatment involving loratadine and mometasone furoate for patients suffering from allergic rhinitis (AR). Additionally, it explores the risk factors contributing to treatment failure, providing a theoretical basis for identifying safer and more effective AR treatments.MethodsA prospective study was carried out between January 1, 2021, and April 1, 2023, involving 116 patients with allergic rhinitis (AR) who were treated at our outpatient clinic. Participants were randomly divided into two groups: the control group (n=58), which received loratadine alone, and the study group (n=58), which received a combination of loratadine and mometasone furoate. Outcome measures included nasal symptom scores and serological markers, assessed before and after the treatment period. The effectiveness of the treatment was assessed using nasal symptom scores.ResultsPost-treatment assessments showed that both nasal symptom scores and serological markers were significantly lower in the study group compared to the control group (P<0.05). Additionally, the overall response rate was markedly higher in the study group (P<0.05). There were no significant differences in the total incidence of adverse reactions between the two groups (P>0.05).ConclusionThe combination of loratadine and mometasone furoate effectively alleviates clinical symptoms in patients with allergic rhinitis while demonstrating a favorable safety profile, making it a promising option for clinical use.

BDNF as a biomarker for evaluating clinical response in allergic rhinitis patients undergoing allergen-specific immunotherapy.

The present study aimed to compare the correlation between serum brain-derived neurotrophic factor (BDNF) level and clinical, immunological parameters in patients receiving allergen-specific subcutaneous immunotherapy (SCIT) for 3years duration. Comparing serum BDNF levels in AR patients and healthy controls, the correlation between serum BDNF level and clinical parameters in AR patients was analyzed further. Immunological parameters, including total IgE, d1 sIgE and d2 sIgE, serum BDNF levels, and the clinical parameters were evaluated at the 4-time points that including before immunotherapy, the end of the 1st, 2nd, and 3rd year during the SCIT treatment for AR patients who received immunotherapy. We found a significantly elevated expression level of serum BDNF levels in AR patients and it also showed a significant correlation with nasal symptom score that included itching score, nasal obstruction score, runny nose, total nasal symptom score, and peripheral parameters including eosinophil percent and eosinophil count. For AR patients who received immunotherapy, a good response was shown, the expression of serum BDNF levels showed a downward trend during 3years of SCIT, and it significantly positively correlated with the improvement of nasal symptoms including nasal obstruction, nasal itching, and medicine score. Serum BDNF level was associated with clinical severity in AR patients and clinical parameters in AR patients in SCIT duration, which should be considered as a response evaluation biomarker to monitor clinical efficacy in allergen-specific immunotherapy.

LP‐003, a novel high‐affinity anti‐IgE antibody for inadequately controlled seasonal allergic rhinitis: A multicenter, randomized, double‐blind, placebo‐controlled phase 2 clinical trial

BackgroundAnti‐IgE therapy can serve as an option for inadequately controlled seasonal allergic rhinitis (SAR) patients. LP‐003, a novel anti‐IgE antibody, is being tested as an add‐on treatment for SAR. This trial aimed to evaluate whether LP‐003 is effective and safe for SAR.MethodsThis placebo‐controlled double‐blind phase 2 randomized clinical trial was conducted in 17 hospitals in China. SAR patients whose symptoms were inadequately controlled despite first‐line treatment (nasal corticosteroids with or without oral antihistamine) in the previous two seasons were enrolled between July 6, 2023 and August 7, 2023. Participants were randomized in a ratio of 2:4:3 to receive subcutaneous injections of 100 mg LP‐003, 200 mg LP‐003 or placebo every 4 weeks for 2 doses. All patients received fluticasone propionate as standard‐of‐care (SoC). The main outcome was the mean total nasal symptom score (TNSS) during the peak pollen period (PPP). Secondary endpoints included a series of symptom and medication scores, quality of life assessments during PPP and pollen period (PP), immunogenicity and safety.ResultsA total of 180 participants were randomly assigned. The LP‐003 + SoC treatment achieved a significantly lower TNSS compared with placebo + SoC (3.31 vs. 4.06, intergroup difference = −0.74, p = 0.0464). For key secondary outcomes, the LP‐003 group also achieved significantly lower daily nasal symptom and rescue medication use scores (3.54 vs. 4.42, intergroup difference = −0.88, p = 0.0352), and daily ocular symptom and rescue medication use scores (1.66 vs. 2.19, intergroup difference = −0.54, p = 0.0245) compared to the placebo group. The suppression of free IgE was prevalent and persistent. There was no statistically significant difference in adverse events and severe adverse events between LP‐003 and placebo groups.ConclusionsThese findings support LP‐003 as a promising add‐on option to the SoC for patients with moderate to severe SAR. Fixed dosage regimen and extensive suppression of free‐IgE render it a cutting‐edge advantage.

Bifidobacterium animalis subsp. lactis A6 alleviates perennial allergic rhinitis in adults by inhibiting serum total IgE and IL‐13: A randomized, double‐blind, placebo‐controlled trial

ObjectivesThe evidence regarding the efficacy of probiotics in improving allergic rhinitis (AR) remains inconsistent. This study aimed to evaluate the potential effects of Bifidobacterium animalis subsp. lactis A6 (A6) on perennial AR.MethodsA randomized, double‐blind, placebo‐controlled trial was conducted involving 70 adults with perennial AR receiving either probiotic (A6, 5 × 1010 CFU/sachet per day) or placebo intervention for 8 weeks. Nasal symptoms and quality of life (QoL) were recorded using total nasal symptom scores (TNSS) and the rhinitis quality of life questionnaire (RQLQ). Blood eosinophil count, total immunoglobulin E (IgE), allergen‐specific IgE, and immunological parameters were also assessed.ResultsAfter 8 weeks of intervention, the probiotic group showed a statistically significant greater reduction in TNSS total score compared with the placebo group [−3.11 (3.53) vs. −1.29 (3.34), p = 0.029, Cohen's d = 0.68]. Similar results were noted for serum total IgE and interleukin‐13 (IL‐13). Comparable findings were seen for RQLQ score only at week 4 but not at week 8.ConclusionsIn conclusion, A6 could statistically significantly alleviate rhinitis symptoms and improve QoL in adults with perennial AR. The effect size, as measured by Cohen's d, suggests that A6 may provide clinically meaningful benefits for AR patients to a certain degree.Clinical Trial RegistrationChictr.org.cn Identifier no. ChiCTR2200064158.

A comparative study of efficacy and tolerability of cetirizine and bilastine in patients of allergic rhinitis: An open-label, randomized, parallel-group study

Abstract Purpose: Allergic rhinitis (AR) is a type 1 allergic disease of the nasal mucosa, characterized by paroxysmal repetitive sneezing, watery rhinorrhea, and nasal blockage with the prevalence of 25% worldwide. Bilastine is a newer second-generation H1 antihistaminic approved for the symptomatic treatment of AR and chronic urticaria in patients older than 12 years. To date, there are very few studies in the Indian population comparing the efficacy, safety, and its effect on cognition of bilastine with second-generation antihistaminics. Hence, the study was planned to assess and compare the efficacy, tolerability, and the effect on cognition of cetirizine and bilastine in patients of AR. Aim: The aim is to assess and compare the efficacy and tolerability of cetirizine and bilastine in patients with AR. Materials and Methods: It was a randomized, open-label, parallel-group, comparative study conducted on 80 patients of AR attending the ENT outpatient department of a tertiary care teaching hospital. Patients were divided into two groups of 40 each. They received either cetirizine 10 mg or bilastine 20 mg once daily for 2 weeks, and efficacy and tolerability were assessed at 2 weeks follow-up visits. Results: The difference in mean total symptom score was significant in bilastine as well as cetirizine, which showed that bilastine was equally efficacious as cetirizine. Adverse events were reported more in the cetirizine group. Conclusion: Bilastine is equally efficacious as cetirizine and a favorable tolerability profile may make it a more tolerable H1-antihistaminic than cetirizine.

Allergic Rhinitis is Associated with Increased Suicidality: A Systematic Review and Meta-Analysis.

Allergic rhinitis (AR) is a common inflammatory condition affecting millions globally. Emerging evidence suggests a potential link between AR and suicidality; however, this association remains underexplored compared to other atopic diseases. This systematic review and meta-analysis aimed to investigate the association between AR and the risks of suicidal ideation, attempts, and death. Following PRISMA guidelines, we conducted a systematic search across PubMed, Embase, PsycINFO, Cochrane databases, Web of Science, Scopus, CINAHL, and Google Scholar. A total of 590 studies were screened, with 9 eligible cross-sectional studies involving 1,604,962 participants included. Data on suicidal ideation, suicide attempts, and death were synthesized using random-effects meta-analyses. Odds ratios (ORs) were calculated with 95% confidence intervals (CIs). The risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist, and evidence was graded using the GRADE framework. AR was not significantly associated with suicidal ideation (OR: 1.12, 95% CI: 0.97-1.30; 1,101,819 participants from 7 studies). However, AR patients demonstrated an elevated risk of suicide attempts (OR: 1.25, 95% CI: 1.00-1.57; 1,554,297 participants from 5 studies) and suicide death (OR: 1.65, 95% CI: 1.46-1.86; 478,244 participants from 2 studies). This meta-analysis highlights an association between allergic rhinitis and increased risk of suicide attempts and death. However, due to the cross-sectional nature of included studies, causality cannot be inferred.

Interleukin-37 Suppresses the Function of Type 2 Follicular Helper T in Allergic Rhinitis.

Background: Allergic rhinitis (AR) is triggered by immunoglobulin E (IgE)-mediated immune responses to airborne allergens. Recent studies highlight the pivotal role of T follicular helper 2 (Tfh2) cells in IgE production. Interleukin-37 (IL-37) has emerged as an intrinsic modulator of innate immunity and inflammatory processes. We aimed to investigate the regulatory effect of IL-37 on Tfh2 cells in the pathogenesis of AR. Methods: Blood samples were collected from AR patients and controls. The IL-37 levels and the frequency of Tfh2 cells were detected by enzyme-linked immunosorbent assay (ELISA) and flow cytometry, respectively. The isolated Tfh2 cells were cultured or cocultured with naive B cells. The regulatory effects of IL-37 on Tfh2/B cells were assessed using ELISA, quantitative real-time polymerase chain reaction (qRT-PCR). Mouse models of ovalbumin (OVA)-induced AR were established to explore the effect of IL-37 in vivo. Results: IL-37 suppressed the production of IL-4 and IL-21 by Tfh2 cells and downregulated C-X-C chemokine receptor type 5 (CXCR5) and B-cell lymphoma 6 protein (Bcl6) mRNA expression while upregulating B lymphocyte-induced maturation protein 1 (Blimp1) and signal transducers and activators of transduction5 (STAT5) mRNA. IL-37 decreased IgE production by B cells significantly, and the addition of anti-IL-18 receptor α alleviated this effect. In mouse models, IL-37 reduced nasal rubbing, sneezing, eosinophil counts, OVA-specific IgE, and Tfh2 proportions. Conclusions: IL-37 plays a crucial role in modulating Tfh2 cell responses in AR, suggesting a potential therapeutic target for this condition.