Course Of Rhinitis Research Articles

Trajectory analysis of rhinitis in a birth cohort from lower-income New York City neighborhoods

Rhinitis is a prevalent, chronic nasal condition associated with asthma. However, its developmental trajectories remain poorly characterized. We sought to describe the course of rhinitis from infancy to adolescence and the association between identified phenotypes, asthma-related symptoms, and physician-diagnosed asthma. We collected rhinitis data from questionnaires repeated across 22 time points among 688 children from infancy to age 11 years and used latent class mixed modeling (LCMM) to identify phenotypes. Once children were between ages 5 and 12, a study physician determined asthma diagnosis. We collected information on the following asthma symptoms: any wheeze, exercise-induced wheeze, nighttime coughing, and emergency department visits. For each, we used LCMM to identify symptom phenotypes. Using logistic regression, we described the association between rhinitis phenotype and asthma diagnosis and each symptom overall and stratified by atopic predisposition and sex. LCMM identified 5 rhinitis trajectory groups: never/infrequent; transient; late onset, infrequent; late onset, frequent; and persistent. LCMM identified 2 trajectories for each symptom, classified as frequent and never/infrequent. Participants with persistent and late onset, frequent phenotypes were more likely to be diagnosed with asthma and to have the frequent phenotype for all symptoms (P< .01). We identified interaction between seroatopy and rhinitis phenotype for physician-diagnosed asthma (P= .04) and exercise-induced wheeze (P= .08). Severe seroatopy was more common among children with late onset, frequent and persistent rhinitis, with nearly 25% of these 2 groups exhibiting sensitivity to 4 or 5 of the 5 allergens tested. In this prospective, population-based birth cohort, persistent and late onset, frequent rhinitis phenotypes were associated with increased risk of asthma diagnosis and symptoms during adolescence.

Latent Class Growth Analysis of Rhinitis in an Inner-City Birth Cohort

Rhinitis is a chronic nasal condition associated with asthma and cough. However, its developmental trajectories, risk factors, and comorbid conditions remain poorly characterized. Here we describe (a) the natural course of rhinitis from infancy to adolescence and (b) the association between identified developmental trajectories of rhinitis and comorbid conditions.

This familiar diagnosis of “rhinitis”

The article highlights that rhinitis is the most common disease, it is divided into 3 main phenotypes: infectious (IR), allergic (AR) and non-infectious non-allergic (NAR). There are also combined forms. IR is a viral disease. Its clinical picture is described, the frequent failure of patients to consult a doctor for this disease is noted, which contributes to the development of complications and its chronization. The authors described the characteristic features of the AR clinic with “oral Allergy syndrome“. It is noted that NAR is a heterogeneous disease, which is divided into at least 6 subphenotypes: drug, taste, hormonal, atrophic, idiopathic and rhinitis of older people. The authors analyze the reasons for their occurrence. There is also a professional form of rhinitis. All these phenotypes are United by the symptom of difficult nasal breathing, which also occurs in chronic rhinosinusitis and “empty nose“ syndrome. Other causes of nasal breathing disorders are also mentioned. In the treatment of patients with almost any of the rhinitis phenotypes, the main ones are irrigation-elimination therapy and the appointment of topical decongestants (TD). An important role is played by avoiding the causes that activate the course of rhinitis, and educating the population to properly organize the individual treatment process. Topical vasoconstrictor drugs are the leading topical remedies that eliminate nasal breathing difficulties. They are sold in our country in the usual access and if used incorrectly can cause the development of medical rhinitis and many serious consequences. The methods of correct administration of the drug in the form of drops and spray, as well as its age-related dosages, are disclosed

Réactivités croisées et rhinoconjonctivite allergique : conséquences pratiques sur l’immunothérapie par le comprimé de pollen de fléole des prés

Specific immunotherapy (SIT) is currently the only causal treatment of allergic respiratory diseases. Sublingual immunotherapy (SLIT) is widely utilized for allergic rhinitis to grass pollen. Its effectiveness is due to the presence in the oral mucosa of immune cells with a regulatory phenotype, which is why SLIT is particularly suitable for inducing an antigen-specific tolerance with greater safety. Among the plants, it has been demonstrated in recent years many structural homologies. The existence of this high cross-reactivity can explain why allergens of timothy administered to a patient allergic to various grasses protect against all allergens in this family. Thus, recently, there appeared a new form of SLIT based on a tablet of allergen extract of timothy grass (Grazax®) used in order to “change the course of rhinitis and allergic conjunctivitis triggered by pollen Grasses in adults and children (from 5 years) with clinical symptoms due to an allergy to grass pollen”. The clinical development of this tablet has indeed demonstrated its effectiveness in reducing allergic symptoms and consumption of symptomatic treatments for patients. After 5 years of availability and more than 50,000 year-equivalent treatments, the systematic review of the safety profile of this tablet is very favorable with less than two serious incidents per 1000 treatments. While the prevalence of allergic rhinitis has doubled in 10 years and that it affects 18% of adults and 11 to 27% of children in France, how will be use this new form of desensitization?

Clinical course of rhinitis and changes in vivo and in vitro of allergic parameters in elderly patients: a long-term follow-up study

Changes in rhinitis symptom severity tend to decrease with aging, but whether the decrease is associated with allergic skin test reactivity, serum total and specific IgE, and nasal eosinophils or determined only by aging is poorly understood. The aim of the study was to analyze sensitivity in vivo and in vitro some 15years after primary testing, skin prick test (SPT), serum total and specific IgE, ratio sIgE/tIgE, and nasal eosinophils in order to evaluate changes due to age and changes due to the severity of rhinitis symptoms. One hundred and eight rhinitis patients who had been investigated in 1995 were re-interviewed and their current allergy re-assessed after a follow-up of 15years. All patients were SPT with eight common allergens in the area of Palermo (Italy). Rhinitis symptoms tended, on average, to have become milder at the follow-up. All parameters examined showed a decreasing trend in older age groups over the period between the two investigations. Rhinitis symptoms tend to become milder and the allergic parameters both in vivo and in vitro usually decrease in the long run; however, the changes in rhinitis symptoms appear to be related to changes in the nasal eosinophils, independently of SPT and serum-specific IgE.

Allergen-specific immunotherapy of allergy and asthma: current and future trends

Allergen-specific immunotherapy is the only immunomodulatory and etiological therapy of allergy and asthma. Conventional specific immunotherapy (SIT) with whole-allergen extract is antigen specific, effective on multiple organs, efficient on asthma in defined conditions, provides long-lasting protection and is cost effective. Moreover, SIT is able to prevent the course of rhinitis to asthma. SIT has its drawbacks: the long duration of treatment, the unsatisfactory standardization of allergen extracts and a questionable safety level. Novel approaches are aimed at drastically reducing adverse anaphylactic events, shortening the duration of therapy and improving its efficacy. Novel promising approaches have based their formulation on a limited set of recombinant allergens or chimeric molecules as well as on hypoallergenic allergen fragments or peptides. The simultaneous use of adjuvants with immunomodulatory properties may contribute to improve both the safety and efficacy of allergen-SIT of allergy and asthma.

Variables affecting asthma course during pregnancy

The course of asthma is frequently altered by pregnancy, but the mechanisms remain undefined. The purpose of this study was to identify specific maternal or pregnancy characteristics that are related to the course of asthma during pregnancy. A secondary analysis of a previous prospective study identified 568 pregnant women whose patient-reported asthma course during pregnancy was compared with the women's usual disease course. Potential explanatory variables were compared between groups defined by their pregnancy versus usual course (better, worse, same). Improvement of asthma during pregnancy was noted in 33.6%, worsening was reported in 36.3%, no change was reported in 26.4%, and the course was uncertain in 3.7%. There was a significant concordance between asthma course and course of rhinitis during pregnancy. Rhinitis improved in 51.1% of patients whose asthma improved during pregnancy and worsened in 19.8% of these women. Rhinitis worsened in 55.9% of patients whose asthma worsened during pregnancy and improved in 2.1% of these women. No significant relationships were found between gestational asthma course and maternal demographic factors, panic-fear score, smoking, maternal weight, infant birth weight, or infant sex. The relationship of gestational asthma course to rhinitis symptoms may have clinical and mechanistic significance. Further studies will be necessary to test this hypothesis.

Changes in skin and nasal sensitivity to allergens and the course of rhinitis; a long-term follow-up study.

Allergic skin test reactivity tends to decrease with aging, but whether the decrease is associated with changes in symptom severity and duration of the disease or determined only by aging, is poorly understood. Our aim was to analyze skin test sensitivity some 20 years after primary testing and to relate possible changes in reactivity to aging, duration of rhinitis, and changes in severity of rhinitis symptoms. One hundred and seven rhinitis patients who had been investigated earlier were re-interviewed and their current allergy re-assessed after a follow-up of 23 years. All patients were skin prick tested with 22 to 26 common allergens. The allergic rhinitis status was verified with nasal allergen challenge. Skin test reactivity showed a significant trend decreasing towards older age groups over the period between the two investigations. Rhinitis symptoms tended, on average, to become milder during the follow-up, but an association between skin test reactivity and changes in symptom severity could not be verified. Rhinitis symptoms tend to become milder and the allergic skin reactivity usually decreases in the long run, but these changes may occur independently of each other. In this study, the change in rhinitis symptom severity seems not to be related to the decrease in skin test reactivity.