CircCramp1l targets the miR-532-3p/HMGB1/Drp1 axis to regulate allergic rhinitis.

PLIN2 exacerbates Allergic Rhinitis by inhibiting PINK1/Parkin-mediated mitophagy.

Background: One worldwide health issue is allergic rhinitis (AR). It is an inflammatory disorder characterized by a failure in the regulation mechanism of the immune system. Interleukin 27 (IL-27) plays a critical function in immune-related illnesses and is a major mediator in controlling the differentiation of TCD4 + cells. Objectives: The goal of this study was to determine whether IL-27 Single Nucleotide Polymorphism (rs153109) correlates with the risk of AR in Egyptian population. Methodology: This study included 216 adult participants, consisted of 108 AR patients and 108 apparently healthy controls. Genotyping of the rs153109 SNP in the IL-27P28 gene promoter was executed by (PCR-RFLP) method. Results: The two study groups' demographic characteristics (gender and age) were matched. TT genotype was found to be significantly higher among AR patients compared to control group (65.7% versus 34.3% respectively) with OR of 3.65 at 95% CI. The CT and CC genotypes were protective factors, being more prevalent in controls and linked to a lower risk of AR. Conclusion: IL-27p28 SNP (rs153109) is associated with susceptibility to AR making it potentially valuable genetic biomarker for the Egyptian population's vulnerability to AR.

This review addresses the surgical management of pediatric nasal septal deviation. We discuss the challenges and considerations unique to children, including growth-related timing decisions, surgical techniques, and potential impacts on craniofacial development and quality of life. A narrative synthesis of recent literature was conducted. Key topics reviewed include the epidemiology of septal deviation in children, associations with complications (e.g. obstructive sleep apnea, sinusitis, cognitive or behavioral effects), timing of intervention in relation to septal growth, operative methods and preservation strategies, and complication rates and outcomes data. The prevalence of septal deviation in children is approximately 30%. Alone it rarely causes severe nasal obstruction, but in combination with conditions such as allergic rhinitis or adenoid hypertrophy it contributes significantly to symptomatology. Untreated nasal obstruction has been linked to craniofacial growth disturbances, sleep-disordered breathing, behavioral issues, and academic decline. Multiple authors now support that septal surgery can be safely performed in children aged six years and older without major detrimental effects on midface development. Critical technical principles include maximal conservation of cartilage and bone (especially in dorsal and caudal zones), avoidance of nasal floor mucosa dissection, and preservation of growth-center zones. Reported complications are low, but revision rates in pediatric septorhinoplasty remain higher than in adults (∼13.5%). Data accumulation suggests pediatric septal surgery is increasingly safe when performed with conservative technique. Surgical indication should be considered in children aged ≥6 who present with septal deviation resistant to medical therapy and who suffer complications such as snoring, OSA, recurrent sinusitis, or severely impaired quality of life. Meticulous operative planning with maximal structural preservation is paramount to optimize outcomes and minimize growth disruption.

Systemic exposure characteristics and pharmacokinetic studies of intranasally delivered qinhao nasal drops by UHPLC-Q/TOF-MS and UHPLC-MS/MS.

Allergic rhinitis (AR) is an increasingly common inflammatory disease mediated by immunoglobulin E in response to environmental allergens, substantially impacting the quality of life and healthcare systems worldwide. Recent research has drawn attention to the role of vitamin D, a corticosteroid hormone with immunomodulatory properties, in influencing the onset and severity of allergic diseases, including AR. Vitamin D exerts regulatory effects and inherent and tailored immunity, including suppressing pro-inflammatory cytokines and enhancing regulatory T cell function. A contrary connection among serum 25-hydroxyvitamin D levels has been suggested in observational studies of AR prevalence, particularly among children and male adults. However, interventional studies/ research into the therapeutic effects of vitamin D supplementation in AR have yielded mixed results, with benefits possibly dependent upon baseline vitamin D levels, gender, age, and concomitant therapies. Although emerging evidence implies a link between vitamin D shortage and augmented threat or severity of AR, definitive statements regarding its therapeutic role have not been made. Further high-quality randomized controlled trials are required to clarify the immunological mechanisms engaged and establish standardized clinical guidelines. This mini-review underscores the potential of vitamin D as an adjunctive approach in AR and highlights the need for individual strategies tailored to each patient's profile. This mini-review aims to synthesize evidence about the bond between vitamin D levels and AR, exploring epidemiological findings and underlying immunological mechanisms.

Cetirizine is widely used to treat children with allergic rhinitis and urticaria, yet optimal doses are undefined. Limited pharmacokinetic (PK) data and undefined renal P-glycoprotein (P-gp) ontogeny hinder the direct extrapolation of dosing from adults to children. This study aims to develop a paediatric cetirizine physiologically based pharmacokinetic (PBPK) model to explore renal P-gp ontogeny and guide optimal dosing strategies. An adult PBPK model for cetirizine was developed to determine drug-specific parameters. Combining the age-dependent physiological parameters embedded in SimCYP® and cetirizine PK from Caucasian children of varying ages to infer renal P-gp ontogeny, the paediatric cetirizine PBPK model was constructed. The ontogeny was validated using PK data from Chinese children across various age groups. The validated model was then employed to evaluate optimal dosing regimens for children in different age groups. The renal P-gp ontogeny equation was successfully inferred and incorporated into the PBPK model, capturing 100% and 87.8% of the observed PK data in Caucasian and Chinese children within the 90% prediction interval, respectively. Simulation results suggest that 5 mg twice daily (BID) for children aged 6-12 years and 0.25 mg/kg BID for children under 6 years are optimal, whereas fixed doses of 5 mg once-daily (QD) for children aged 2-6 years and 2.5 mg BID for children aged 0.5-2 years are also appropriate. Utilizing PBPK modelling and simulation, this study elucidated P-gp ontogeny and recommended the optimal cetirizine dosage regimen for children across all age groups.

Cockroach allergy is a common trigger of allergic reactions and may be a cause or a result of cross-reactions with other allergens. The aim of this study was to assess the pattern of sensitization to arthropod allergens in perennial allergic rhinitis (PAR) patients with positive skin prick test to cockroach. A group of PAR patients with positive skin prick test (SPT) result with cockroach extract (Blattella germanica) was selected. In addition to SPTs for other inhalant allergens, such as house dust mites (Dermatophagoides pteronyssinus and Dermatophagoides farinae), birch, grass, mugwort, cat, dog, and Alternaria, participants underwent the ALEX2 test which allowed for detection of sensitization to cockroach-specific and cross-reacting molecules. Forty-eight participants took part in the study, of whom forty-six underwent the ALEX2 test. Among PAR patients with positive SPT results to cockroach extract only 2 had elevated IgE levels to cockroach specific allergens (Bla g 1 and Bla g 4). However, in substantial number of patients sensitization to cross-reacting allergens was demonstrated. This was associated with frequent sensitization to other arthropod extracts. A correlation was observed between cockroach allergy and allergy to edible insects such as crickets, locusts, and mealworms; seafood; house dust mites and storage mites; and wasp species, depending on the cockroach species. In our population of PAR patients sensitization to cockroaches is associated with a broader spectrum of cross-reactive allergens. These findings deepen our understanding of potential cross-allergenicity and may form the basis for personalized risk assessment and allergy treatment in patients with AR.

Dual-action nasal spray with mussel protein and xylitol restores epithelial barrier and attenuates type 2 inflammation in allergic rhinitis.

Allergic rhinitis, a common chronic inflammatory condition characterized by T-cell imbalance and mast cell hyperactivity, had not been investigated for the role of Lyn kinase within mast cells and its effects on T helper cell differentiation. α-Linolenic acid (ALA), a dietary supplement, exerts anti-allergic and anti-inflammatory effects. This study investigated the function of Lyn kinase in mediating mast cell-promoted Th17 cell differentiation during ALA treatment for allergic rhinitis. Behavioural symptoms, serum inflammatory factors, nasal pathological damage and splenic T cell differentiation were assessed in models of allergic rhinitis, using wild type and Cpa3-cre;Lynfl/+ mice. Effects of ALA and mast cells on Th17 differentiation were evaluated in co-culture assays. Binding characteristics of ALA to Lyn were analysed via surface plasmon resonance, molecular docking and co-immunoprecipitation. Phosphorylation of Lyn and lipid raft assembly were investigated by immunofluorescence and western blot in vitro. ALA administration alleviated allergic rhinitis symptoms and inflammation, restored Th17/Treg balance and produced comparable therapeutic results in Cpa3-cre;Lynfl/+ mice. In vitro, Th17 cell differentiation was increased by Ag/IgE-activated mast cells and this increase was inhibited by ALA. Functionally, ALA acted as a Lyn kinase inhibitor, blocking Ag/IgE-induced mast cell degranulation. By binding to Lyn, ALA disrupted the FcεRIβ-Lyn interaction and inhibited lipid raft assembly. Lyn kinase in mast cells plays a critical role in the pathogenesis of allergic rhinitis. ALA represents a novel Lyn-targeting agent, restoring immune balance by modulating mast cell-promoted Th17 differentiation, highlighting its potential for allergic rhinitis treatment.

Effects of Environmental Factors on Incidence of Allergic Rhinitis and Chronic Rhinosinusitis: A Comparative Study.

Atopic dermatitis (AD) affects 15%-20% of children worldwide, with most treatment in primary care. Initial management of new-onset infantile AD remains poorly characterized. This retrospective cohort study included 3053 patients aged 0-2 years diagnosed with AD at pediatric and family medicine clinics at a single institution. Demographic, comorbidities, and treatment information were collected. The mean age was 0.6 years at initial diagnosis; 54.4% were male. Of 3053 patients, 1015 (33.2%) had ≥ 1 additional atopic comorbidity or complication, most commonly asthma (28.8%), allergy (33.4%), allergic rhinitis (34.7%), conjunctivitis (41.8%), and bacterial infection (6.7%). At diagnosis, 66.8% (2038/3053) received prescription therapy, mostly topical (57.3%, 1743/3043 initial prescriptions). Common treatments at visit 1 (V1) included topical corticosteroid (TCS, 48.4%, 1472/3043 prescriptions), topical antifungal (4.4%, 134/3043), oral antihistamine (4.0%, 121/3043), while only 0.2% (7/3043) received topical calcineurin inhibitors. TCS potency was predominantly low (71.5%, 1053/1472), with medium (27.3%, 402/1472) and high (1.2%, 17/1472) less frequent. 78/1261 children (6.2%) changed potency of TCS between V1 and visit 2 (V2), with 5.2% escalating and 1.0% de-escalating therapy. Escalation was significantly associated with existing atopic comorbidities/complications (OR 3.15, p < 0.001). Fewer than half of children received anti-inflammatory prescriptions at their initial AD visit. More research is needed to investigate whether this finding represents mild cases or undertreatment. Children with allergic comorbidities were more likely to require escalation to stronger TCS, warranting future exploration of the relationship between initial therapies and disease severity or comorbidity development.

Atopic dermatitis (AD) is a common inflammatory skin condition characterized by epidermal barrier dysfunction and immune dysregulation, affecting both children and adults. This study aimed to determine the prevalence of common allergen sensitizations in patients with AD, compared with controls without allergic diseases, and to identify those associated with an increased risk of asthma or allergic rhinitis. We conducted a cross-sectional study including patients with atopic dermatitis and age- and sex-matched controls selected by propensity score matching from the Center of Allergy and Clinical Immunology, Vinmec Times City Hospital. Total IgE levels and specific IgE sensitization to common allergens were documented using an extract-based multiplex assay. Both the AD and control groups each comprised 452 patients and were comparable in age, median (IQR, range): 7 (1-29, 0-84) and sex distribution (51.11% female). Sensitization to at least one allergen was observed in 59.51% of patients, with a mono-sensitization rate of 11.73% and a poly-sensitization rate of 47.79%. House dust mites had the highest sensitization rates among AD patients in our study, with sensitization rates for Dermatophagoides pteronyssinus, Dermatophagoides farinae, and Blomia tropicalis at 29.65%, 26.99%, and 11.5%, respectively. Eggs and milk were the most common food allergens, with sensitizations rates of 20.58% and 12.61%, respectively. Although sensitization rates were high, the prevalence of true clinical allergy was much lower, underscoring the need for cautious interpretation of test results in conjunction with clinical symptoms. Age-related differences were evident: younger children were more often sensitized to food allergens, older children and adolescents to respiratory allergens, and elderly patients to cockroach, and Candida albicans. Additionally, sensitization to C. albicans, D. pteronyssinus, D. farinae, cat dander, dog dander, rice grain, barley flour, and rye flour was significantly more frequent in patients with AD compared to individuals with no allergic diseases. Such sensitization was also associated with a higher risk of respiratory allergic comorbidities, suggesting the potential role of these allergens as distinctive markers of atopy. This study highlights the importance of understanding allergen sensitization in patients with AD to optimize management strategies, particularly in Vietnam, where house dust mite sensitization is highly prevalent. Allergen avoidance and allergen-specific immunotherapy could be beneficial as add-on therapies for AD.

Magnolia kobus (M. kobus) has long been used to treat nasal congestion, allergic rhinitis, and sinusitis. In the current study, we demonstrate the effects and underlying mechanisms of M. kobus flower water extract (ME) and ME-derived constituent magnolin on in vitro osteoblastogenic and anti-osteoclastogenic responses. Treatment with ME or magnolin markedly enhanced the osteoblast differentiation and mineralization in MC3T3-E1 pre-osteoblasts. This osteoblastogenic activity of ME or magnolin was closely associated with upregulation of osteoblast-specific molecules, including RUNX2, DLX5, OSX, alkaline phosphatase, collagen type I, and osteopontin, as well as the activation of mitogen-activated protein kinase (MAPK) signaling pathways. Concurrently, magnolin inhibited osteoclast differentiation through inactivating MAPK pathways and downregulating NFATc1, c-Fos, tartrate-resistant acid phosphatase, and cathepsin K in RANKL-treated RAW264.7 cells. These observations suggest that ME and magnolin have pharmacological potential for the treatment and prevention of metabolic bone disorders, including osteoporosis.

To investigate the direct effects of Upper Respiratory Tract Infection and Adenoid Hypertrophy on Allergic Rhinitis, and to examine the mediating role of a harsh environment in these relationships, a quantitative cross-sectional study was conducted. Data were collected from 387 valid respondents using standardized questionnaires. Descriptive and correlation analyses were performed with SPSS 26.0, while AMOS 24.0 was used to construct a structural equation model to test both direct and mediating effects. Results showed that Upper Respiratory Tract Infection, Adenoid Hypertrophy, and a harsh environment each had significant direct positive effects on Allergic Rhinitis. Importantly, the harsh environment partially mediated the relationships between the two pathological factors (infection and hypertrophy) and Allergic Rhinitis. This suggests that these factors not only directly worsen the condition but also indirectly exacerbate it by increasing susceptibility or exposure in poor environmental conditions. The study confirms an interaction between individual pathological status and environmental factors in Allergic Rhinitis, establishing a combined pathway that amplifies disease severity. Prevention and treatment strategies should adopt an integrated medical and environmental approach. Clinically, proactive management of infections and hypertrophy is essential. At the public health level, improving environmental quality is fundamental to controlling the disease at its source.

Allergic diseases are common chronic inflammatory conditions, which can affect multiple organs in severe cases, resulting in complex and varied clinical manifestations. Therefore, their management requires a more comprehensive and long-term strategy. A well-balanced diet is crucial in this context, as it regulates the immune system and improves atopic constitution, making it a key measure in preventing and controlling allergic diseases. Unlike observational studies prone to confounding and reverse causality, Mendelian randomization uses genetic variants as instrumental variables for stronger causal inference. This study employed the two-sample Mendelian randomization to investigate the potential causal relationships between 22 dietary factors and allergic diseases. The primary methods used were the weighted median method, MR-Egger regression, and inverse-variance weighted. To ensure the robustness and accuracy of the results, a series of sensitivity analyses, heterogeneity tests, and pleiotropy assessments were conducted. The study identified 7 dietary factors associated with allergic asthma, atopic dermatitis, and allergic rhinitis. The oily fish (OR: 0.666; 95% CI: 0.468–0.949; P = .024), dried fruit (OR: 0.463; 95% CI: 0.307–0.697; P = .00023), and cereal intake (OR: 0.595; 95% CI: 0.355–0.998; P = .049) was found to have a protective effect against asthma. The fresh fruit (OR: 0.592; 95% CI: 0.384–0.913; P = .018), tea (OR: 0.774; 95% CI: 0.603–0.995; P = .046), cereal (OR: 0.635; 95% CI: 0.430–0.939; P = .023), and processed meat intake (OR: 0.481; 95% CI: 0.294–0.787; P = .0036) were protective factors against atopic dermatitis. No significant causal relationships were observed between other dietary factors and these 3 diseases. These findings underscore the critical role of a balanced diet in the prevention and management of allergic diseases and highlight the potential of nutritional interventions in the future control and treatment of these conditions.

Endoscopic posterior nasal nerve (PNN) neurectomy and temperature-controlled radiofrequency ablation are validated interventions for medication-refractory allergic rhinitis (AR), but direct comparisons of their long-term efficacy, safety, and mechanisms remain lacking. In this prospective, multicenter, randomized, patient-blinded study, 174 adults with moderate-to-severe persistent AR were allocated to PNN neurectomy (n=89) or ablation (n=85). The primary endpoint was the percentage of participants achieving the minimal clinically important difference (MCID) for the 24-h reflective total nasal symptom score (rTNSS) at 24 months. The rTNSS MCID responder rate at 24 months was 86.5% (95% confidence interval [CI], 80.0-95.0%) in the neurectomy group and 84.9% (95% CI, 78.0-94.0%) in the ablation group, with no significant between-group difference (p=0.453). Both groups demonstrated substantial and parallel improvements in quality of life. Neurectomy provided greater and more durable control of rhinorrhea (1-24 months, all p<0.05), nasal congestion (24 months, p<0.001), and nasal itching (24 months, p=0.046), alongside a greater reduction in unilateral nasal resistance (right side, p = 0.014). Both groups showed convergent systemic neuroimmune reprogramming at 1 year, with suppression of substance P, interleukin (IL)-31, IL-33, IL-4, IL-13, and IL-6, and increased transforming growth factor-β (TGF-β)and immunoglobulin G4 (IgG4). No serious adverse events occurred; mild transitory events were reported only with neurectomy (3.4%). Both techniques are effective and safe for refractory AR over 2 years. Although overall outcomes are comparable, neurectomy offers superior and sustained control of rhinorrhea, nasal congestion, and nasal itching. Treatment can be individualized based on symptom profile.

The gut microbiota plays a crucial role in modulating mucosal immunity and allergic responses, yet its predictive value for sublingual immunotherapy (SLIT) outcomes remains underexplored in Artemisia pollen-induced allergic rhinitis (AR). In this single-center prospective cohort study, 204 adults with Artemisia pollen-induced AR underwent baseline stool collection before initiating standardized SLIT. Gut microbiota was analyzed using 16S rRNA sequencing of the V3-V4 region, with prespecified features including Shannon diversity index, composite abundance of butyrate-producing bacteria (Faecalibacterium, Roseburia, Eubacterium rectale group), and Prevotella-to-Bacteroides (P/B) ratio. Clinical response was defined as ≥30% reduction in combined symptom-medication score (CSMS) during the peak pollen season. We developed three prediction models: Model A (clinical variables only), Model B (clinical variables plus microbiota features), and Model C (parsimonious model via L1 regularization). The response rate was 54.41% (111/204). In multivariable analysis, all three microbiota features independently predicted treatment response: butyrate-producing bacteria (OR = 1.59, q = 0.006), P/B ratio (OR = 1.43, q = 0.020), and Shannon diversity (OR = 1.33, q = 0.046). Model B demonstrated superior discrimination compared to Model A (AUC 0.79 vs 0.71, ΔAUC = 0.08, P = 0.021), with improved calibration (intercept α = -0.03, slope β = 0.98) and significant net reclassification improvement (NRI = 0.36, P = 0.002). Decision curve analysis confirmed greater net benefit across clinically relevant threshold probabilities. The parsimonious Model C maintained good performance (optimism-corrected AUC = 0.78) with 77.48% sensitivity and 72.04% specificity. Baseline gut microbiota characteristics, particularly butyrate-producing bacterial abundance, microbial diversity, and Prevotella/Bacteroides community structure, significantly predict SLIT response in Artemisia pollen-induced AR and provide substantial incremental value over conventional clinical parameters. These findings support the integration of gut microbiota assessment into pretreatment stratification algorithms for allergen immunotherapy.

Allergic rhinitis (AR) is an inflammatory disorder of the nasal mucosa caused by immune hypersensitivity to airborne allergens. AR pathophysiology involves pro-inflammatory mediators-, such as tumor necrosis factor alpha (TNF-α), nuclear factor-kappa B (NF-κB), interleukin-6 (IL-6), interleukin-8 (IL-8), and malondialdehyde (MDA). Modulating these mediators is a potential therapeutic strategy. This study evaluated the anti-inflammatory potential of apple polyphenols, specifically procyanidin and quercetin, using in silico molecular docking against key inflammatory proteins related to AR. High-resolution three-dimensional structures of TNF-α, NF-κB, IL-6, IL-8, and MDA were obtained from the Protein Data Bank, and ligand structures were prepared and optimized in AutoDock. Docking validation was performed by redocking native ligands, and the best poses were assessed for binding affinity and interaction profiles. Procyanidin and quercetin exhibited moderate to strong binding affinities toward all targets, with binding energies ranging from −1.34 to −7.63 kcal/mol, and inhibition constants suggesting potential biological relevance. Both ligands formed stable hydrogen bonds and hydrophobic interactions with residues involved in cytokine activity and transcriptional regulation. Quercetin displayed higher affinity for TNF-α and NF-κB, whereas procyanidin showed strong interactions with MDA, suggesting additional antioxidant effects. These findings suggest that procyanidin and quercetin from apple extract may modulate multiple inflammatory and oxidative pathways in AR, warranting further biological evaluation as potential therapeutic agents.

Allergic diseases, particularly allergic rhinitis and asthma are highly prevalent among children and adolescents and frequently associated with sensitization to inhalant allergens. However, recent data on sensitization profiles in the Portuguese pediatric population are scarce, especially regarding regional and demographic variability. In this context, we aimed to characterize the clinical and allergen sensitization profiles of children and adolescents with allergic diseases in Portugal, through a multicenter approach. We conducted a retrospective, cross-sectional study across 14 Portuguese hospitals between January 2021 and June 2023. Children and adolescents (< 18 years) with a clinical diagnosis of allergic diseases and at least one positive skin prick test to inhalant allergens were included. Demographic, clinical, and environmental data were collected from electronic medical records. Skin prick tests followed European Academy of Allergy & Clinical Immunology recommendations. Statistical analysis was performed using IBM® SPSS® Statistics version 29. A total of 3456 patients were included (60.5% male; median age 10 years). Allergic rhinitis (78.1%) and asthma (54.5%) were the most common diagnoses and 43.1% presented with both conditions. Sensitization was most frequent to Dermatophagoides pteronyssinus (84.3%) and Dermatophagoides farinae (74.3%), followed by Lepidoglyphus destructor (57.8%), grass pollens (60.4%), and Blomia tropicalis (23.5%). Polysensitization occurred in 58.4% of patients. Sensitization patterns varied with age. Geographic differences were noted: house dust mites sensitization predominated in coastal regions, whereas sensitization to pollens, molds, and animal epithelia was more frequent inland. Migrant children (14.2%) showed lower sensitization rates to most allergens, despite a comparable disease burden. To the best of our knowledge, this is the first multicenter study to describe pediatric allergen sensitization patterns in Portugal. The high rates of polysensitization and the regional variability underscore the importance of tailored diagnostic strategies. Skin prick test remains a key tool in the initial assessment of allergic diseases.