Exacerbation Of Allergic Rhinitis Research Articles

Evaluating the Serum Levels of CCL17, CCL22, and CCL28 Chemokines and the Gene Expression of α4β1 and α4β7 Integrins in Patients With Allergic Rhinitis

Allergic rhinitis (AR) is a chronic inflammatory disease involving the nasal mucosa. Leukocytes recruitment to the inflammation sites is controlled by chemokines, cytokines, and adhesion molecules. Retinoic acid (RA), a vitamin A metabolite, plays an essential role in mucosal immunity and the production of inflammatory cytokines and chemokines. This study intended to evaluate the serum levels of RA, CCL17, CCL22, CCL28, and the mRNA expression levels of α4, β1, and β7 integrins in AR patients compared to healthy subjects. Peripheral blood was collected from 37 patients with AR and 30 age- and gender-matched healthy individuals. Serum levels of RA, CCL17, CCL22, and CCL28 were measured by the enzyme-linked immunosorbent assay (ELISA) technique, and the mRNA expression levels for α4, β1, and β7 integrins were assessed using the quantitative real-time PCR method. Our results showed that the serum levels of CCL22 and CCL28 chemokines are significantly higher in the AR group compared to the healthy controls (P<0.01). However, the gene expression of the β1 integrin in the AR group was significantly lower than that of the control group (P<0.001). Besides, there was a positive association between serum RA and CCL17 levels in patients (P<0.0001, r=0.6). In conclusion, increased serum levels of CCL22 and CCL28 chemokines, as well as decreased gene expression of β1 integrin in AR patients, may contribute to the pathogenesis and/or exacerbation of AR.

Gastrointestinal manifestations, spectrum and frequency of sensitization to food allergens in Kyiv’s adult citizens with allergic rhinitis: a cross-sectional study

Background. Food allergy affects 1–3 % of adults worldwide. More than 160 foods can cause allergic reactions. Food allergy may precede and stimulate allergic rhinitis. Aim of the study was to assess the spectrum and frequency of sensitization to food allergens in patients with allergic rhinitis from Kyiv, Ukraine. Materials and me­thods. The investigation was conducted as a cross-sectional study. One hundred and seventy-five Kyiv adult patients with allergic rhinitis were enrolled in the trial. Sensitization to allergens and their components was determined by skin prick tests and in vitro detection of allergen specific IgE by ELISA in blood serum — a multicomponent Allergy Explorer2 ALEX2 test. Results. It was shown that sensitization to following inhalant allergens was predominant: to timothy grass — in 50.3 %, to ragweed — in 48.6 %, to birch — in 44 %, to wormwood — in 24 %, to Alternaria alternata mold — in 15.4 % of patients. One hundred and thirty-one (74.9 %) participants have co-sensitization to at least one food allergen, among them 77 (58.8 %) had gastrointestinal symptoms. Sensitization to following food allergens was predominant: to hazelnut — 27.5 %, apple — 26.3 %, peanut — 21.7 %, celery — 14.3 %, soy — 13.1 %, carp — 11.4 %, kiwi — 9.1 %, crab — 9.1 %, codfish — 8.6 %, oyster — 8.6 %, peach — 8 %, lobster — 8 %, carrot — 7.4 %, anisakis — 6.3 %, prawn — 6.3 %, tiger prawn — 5.7 %, to beef — 5.1 % of cases. It was found that the frequency of sensitization to cross-reactive proteins PR-10 was 20.5 % (95% confidence interval (CI); 9.7–33.9 %) in patients with allergic rhinitis without food co-sensitization comparing to 51.1 % (95% CI; 42.5–59.7 %) in participants with both allergic rhinitis and food co-sensitization, p < 0.001; to nsLTP — 2.3 % (95% CI; 0–8.9 %) and 19.8 % (95% CI; 13.4–27.2 %), respectively, p = 0.011. Conclusions. Among Kyiv adult patients with allergic rhinitis, approximately three quarters have food co-sensitization that may be the cause of gastrointestinal symptoms and exacerbations of allergic rhinitis after consuming vegetables, fruits and nuts due to cross-reactivity with inhalant allergens. This should be considered when manage such patients.

Effects of Particulate Matter on Allergic Rhinitis and Possible Mechanisms

Health impacts of particulate matter (PM) have become a global concern. PM tends to affect patients with allergic diseases, such as allergic rhinitis (AR), more severely. Many epidemiological studies have shown that PM increases outpatient clinic visits as well as the prevalence and severity of AR, while decreasing the quality of life of AR patients. However, the exact mechanisms underlying the effects of PM on the development and exacerbation of AR are still poorly understood. Various mechanisms are involved in the effects of PM on AR, including immunological response, oxidative stress, epithelial barrier dysfunction, allergic sensitization, and epigenetic modification. This article reviews epidemiological and clinical studies on the effects of PM on AR, and the mechanisms by which PM aggravates AR.

The Role of Environmental Risk Factors on the Development of Childhood Allergic Rhinitis.

Environmental factors play an important role in the development and exacerbation of allergic rhinitis (AR) in childhood. Indoor air pollution, such as house dust mites and secondhand smoke, can significantly increase the onset of AR, while pet dander may affect the exacerbation of AR symptoms in children. Furthermore, traffic related air pollution and pollen are outdoor air pollutants that can affect immune competency and airway responsiveness, increasing the risk of AR in children. Climate change has increased AR in children, as growth patterns of allergenic species have changed, resulting in longer pollen seasons. More extreme and frequent weather events also contribute to the deterioration of indoor air quality due to climate change. Additionally, viruses provoke respiratory tract infections, worsening the symptoms of AR, while viral infections alter the immune system. Although viruses and pollution influence development and exacerbation of AR, a variety of treatment and prevention options are available for AR patients. The protective influence of vegetation (greenness) is heavily associated with air pollution mitigation, relieving AR exacerbations, while the use of air filters can reduce allergic triggers. Oral antihistamines and intranasal corticosteroids are common pharmacotherapy for AR symptoms. In this review, we discuss the environmental risk factors for AR and summarize treatment strategies for preventing and managing AR in children.

Diesel exhaust particles increase nasal symptoms and IL-17A in house dust mite-induced allergic mice

Diesel exhaust particles (DEPs), traffic-related air pollutants, are considered environmental factors adversely affecting allergic diseases. However, the immunological basis for the adjuvant effects of DEP in allergic rhinitis (AR) remains unclear. Therefore, this study aimed to investigate the effect of DEP exposure on AR using a mouse model. BALB/c mice sensitized to house dust mite (HDM) were intranasally challenged with HDM in the presence and absence of DEP. Allergic symptom scores, serum total and HDM-specific immunoglobulins (Igs), eosinophil infiltration in the nasal mucosa, cytological profiles in bronchoalveolar lavage fluid (BALF), and cytokine levels in the nasal mucosa and spleen cell culture were analyzed. Mice co-exposed to HDM and DEP showed increased allergic symptom scores compared with mice exposed to HDM alone. Reduced total IgE and HDM-specific IgE and IgG1 levels, decreased eosinophil infiltration in the nasal mucosa, and increased proportion of neutrophils in BALF were found in mice co-exposed to HDM and DEP. Interleukin (IL)-17A level was found to be increased in the nasal mucosa of the co-exposure group compared with that in the HDM-exposed group. The levels of IL-4, IL-13, interferon-γ, IL-25, IL-33, and TSLP expression showed no difference between the groups with and without DEP treatment. Increased expression of IL-17A in the nasal mucosa may contribute to DEP-mediated exacerbation of AR in HDM-sensitized murine AR model.

Systemic reactions to subcutaneous allergen immunotherapy: real-world cause and effect modelling

BackgroundSubcutaneous immunotherapy (SCIT) is an effective treatment for allergic rhinoconjunctivitis. However, adverse events, including life-threatening systemic reactions, may occur. The purpose of this project is to identify risk factors for systemic reactions to SCIT and to provide practice-based solutions using a quality improvement (QI) framework.MethodsA QI initiative was performed in a hospital-based, Canadian Allergy clinic administering SCIT in a 12-month period.ResultsA total of 4242 injections of SCIT were performed over a period of 12 months. Of these, 10 injections resulted in a systemic reaction requiring epinephrine administration (i.e., an incidence of 1 in 424 injections, or 0.24%). Eight patients had at least one documented risk factor for a systemic reaction, and six had multiple risk factors. Major risk factors included seasonal exacerbation of allergic rhinitis, uncontrolled asthma, and an error in route of administration. All reactions occurred with the highest allergen extract concentration.ConclusionThis QI initiative highlights the need for improved patient and health care practitioner education and pre-administration screening. We suggest several considerations for SCIT administration: provide patients with written information on safety; screen patients before injections, including a review of treatment plan adherence and asthma control; adjust dosing to slow down buildup of the most concentrated immunotherapy extract, particularly in high risk patients; and apply additional safety measures in patients with multiple risk factors.

Procena uticaja čađi u vazduhu na pogoršanje alergijskog rinitisa i astme u regionu Užica u Srbiji

Many epidemiological studies have shown a positive association between black carbon (BC) concentrations and exacerbation of allergic rhinitis and asthma. The aim of this study was to examine, for the first time in Serbia, the connection between visits to emergency services due to worsening of allergic rhinitis and allergic asthma and the concentration of BC in the air. Materials and methods: A time-stratified case crossover design was applied for emergency room visits due to allergic rhinitis and worsening asthma that occurred in the Užice region between 2012-2014. Data on visits were routinely collected at the Uzice Health Center. Results: A statistically significant association was observed between the worsening of allergic rhinitis and BC concentration two days before the visit to the emergency department (UO = 359, UO = 3.20 and UO = 3.24, depending on whether the analysis is not adjusted or adjusted for appropriate weather conditions). There was also a statistically significant association between worsening of allergic asthma and BC concentration two days before the emergency service visit (UO = 3.15, GP = 0.98-10.14) and three days before the emergency service visit (UO = 2.98; UO = 3.23 ; UO = 2.98). Conclusion: Exposure to soot, especially during the heating season, increases the risk of emergency services due to worsening of allergic rhinitis and asthma.

Аргументы в пользу применения современных блокаторов H1-гистаминовых рецепторов для лечения больных с аллергическим ринитом, протекающим на фоне острой респираторной вирусной инфекции

Allergic rhinitis is characterized by a significant prevalence among the adult population. Patients with allergic diseases have a higher sensitivity to pathogens of acute respiratory infection of the upper respiratory tract (ARVI). Inflammation of the mucous membrane of the nasal cavity and paranasal sinuses in such patients is characterized by more pronounced symptoms and greater resistance to therapy. An observational study was conducted at the Department of Otorhinolaryngology of the Moscow State Medical University named after A. I. Evdokimov, during which the effect of modern antihistamines on the severity of nasal and non-nasal symptoms of inflammation was evaluated in patients who were diagnosed with the development of acute respiratory viral infections against the background of seasonal exacerbation of allergic rhinitis. The data of 50 patients divided into two groups were analyzed. In the first group (n = 25), benzhydrylpiperazinylbutylmethylxanthine succinate (Theoritin) was included in the therapy regimen, in the second – cetirizine preparations (n = 5). During the follow-up, each patient underwent a clinical assessment of the severity of nasal and non-nasal symptoms three times (1st, 7th and 14th days of follow-up), and the severity of nasal obstruction was assessed using anterior active rhinomanometry. According to the data obtained, there was a pronounced positive dynamics in both groups, while the clinical efficacy was confirmed by instrumental evaluation data. However, by the 7th day of treatment, the positive dynamics was more pronounced in the group of patients receiving theoritin as part of therapy. The use of modern antihistamines in patients comorbid for allergic rhinitis and acute respiratory diseases has a significant therapeutic effect. Theoritin provides more pronounced therapeutic effects in the early stages, which makes its further study and use of the drug for the treatment of acute respiratory viral infections against the background of allergic rhinitis promising.

Особенности локального воспаления слизистой оболочки носа у детей с бронхиальной астмой

Bronchial asthma (BA) is often associated with chronic inflammatory processes in the nasal mucosa; these processes give rise to allergic rhinitis (AR), chronic rhinosinusitis, adenoiditis and polypous rhinosinusitis. Due to their multiple symptoms, these diseases of the upper respiratory tract, especially allergic rhinitis, are often difficult to verify in patients with asthma. The aim of the study was to assess the features of local inflammation of the nasal mucosa in patients with BA and AR. Patients and methods. 93 children with BA were examined. General clinical, allergological, functional examination, measurement of endonasal temperature and determination of IgE and IL4 content in nasal secretions were performed. Results. Children with BA have lower values of endonasal temperature than healthy ones. There was a tendency to decrease endonasal temperature as the symptoms of AR increased. In the acute stage of AR, the temperature values were lower than in the remission stage, р = 0,02. The addition of infectious inflammation of the nasal mucosa in children with AD was accompanied by an increase in endonasal temperature, р = 0,04. The increase of the content of nasal IgE in acute AR – 115,6 (49,9; 181,2) ME/mg, compared to the remission period to 24,9 (6,2; 43,7) ME/mg. Exacerbation of AR was associated with increased IL4 to 109,7 (54,2; 165,2) PG/mg, in the period of remission – 34,4 (12,0; 56,8) PG/mg. The increase of these biomarkers of allergic inflammation have a correlative relationship, R = 0,44, p = 0,002. The relationship of IL4 content with endonasal temperature, R = 0,44 р = 0,02 was established. Conclusion. Patients with BA and AR showed a decrease in endonasal temperature compared to healthy ones. Exacerbation of AR in children with BA characterized by an increase in the content of nasal IgE and IL4 and a decrease in endonasal temperature, which allows us to consider these indicators as biomarkers of activation of allergic inflammation.

A polycentric, randomized, parallel-group, study on Lertal\xae, a multicomponent nutraceutical, as preventive treatment in children with allergic rhinoconjunctivitis: phase II

BackgroundLertal®, an oral nutraceutical, contains extract of Perilla, quercetin, and Vitamin D3. The current polycentric, randomized, parallel-group, controlled study aimed in the Phase II to evaluate the efficacy and safety of Lertal® in preventing allergic rhinitis (AR) exacerbations in children after the end of the pharmacological treatment phase.Materials and methodsOne hundred twenty-eight children completed Phase II. Sixty-four children continued Lertal® treatment (Lertal® Group: LG) and 64 ones did not assume any medication (Observation Group: OG) for 4–12 weeks.The study endpoints were the number, intensity, and duration of AR exacerbations, and the length of symptom-free time.ResultsChildren of LG halved the risk (HR = 0.54) of having AR exacerbation. Children of LG had significantly (p = 0.039) less AR exacerbations than OG children. In children with AR exacerbations, the total number of days in which each patient took at least one rescue medication was significantly (p = 0.018) lesser in LG children than OG ones. In the global population, the cumulative days treated with rescue medication was significantly (p < 0.0001) higher in OG than in LG. There was no clinically relevant adverse event.ConclusionsThe present study documented that prolonged Lertal® assumption was safe and able to significantly reduce, such as halving, the risk of AR exacerbation, their duration and the use of rescue medications, after the suspension of the one-month antihistamine treatment. Therefore, Lertal® could be envisaged as an effective preventive treatment in AR children able to guarantee long symptom-free time.Trial registrationClinical trial registration: ClinicalTrials gov ID NCT03365648.

Evaluation of the Impact of Black Carbon on the Worsening of Allergic Respiratory Diseases in the Region of Western Serbia: A Time-Stratified Case-Crossover Study.

Background and Objectives: Many epidemiological studies have shown a positive association between black carbon (BC) and the exacerbation of allergic rhinitis and allergic asthma. However, none of the studies in Serbia examined this relationship yet. The aim of this study was to examine the associations between BC and emergency department (ED) visits for allergic rhinitis and allergic asthma in the Užice region of Serbia. Materials and Methods: A time-stratified case-crossover design was applied to 523 ED visits for allergic rhinitis and asthma exacerbation that occurred in the Užice region of Serbia between 2012–2014. Data regarding ED visits were routinely collected in the Health Center of Užice. The daily average concentrations of BC were measured by automatic ambient air quality monitoring stations. Odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were estimated using conditional logistic regression adjusted for the potential confounding influence of weather variables (temperature, humidity, and air pressure). Results: Statistically significant associations were observed between ED visits for allergic rhinitis and 2-day lagged exposure to BC (OR = 3.20; CI = 1.00–10.18; p = 0.049) and allergic asthma and 3-day lagged exposure to BC (OR = 3.23; CI = 1.05–9.95; p = 0.041). Conclusion: Exposure to BC in the Užice region increases the risk of ED visits for allergic rhinitis and asthma, particularly during the heating season.

Particulate matter pollution and allergic rhinitis

Summary Outdoor air pollution has become a major environmental health problem throughout the world. In particular, exposure to particulate matter(PM) has been associated with the development and exacerbation of allergic rhinitis（AR）. Although the adverse health effects of PM have been demonstrated for many years, the underlying mechanisms have not been fully identified. In this review, we refer to recently published literature to describe the composition of PM, the epidemiological evidence of PM-induced AR, and the possible immune mechanisms of PM-induced AR.

Effect of continuous positive airway pressure on allergic rhinitis in patients with obstructive sleep apnea-hypopnea syndrome.

BackgroundThe effect of continuous positive airway pressure (CPAP) on nasal symptoms in patients with obstructive sleep apnea–hypopnea syndrome (OSAHS) remains controversial. In addition, possible mechanism(s) remains unclear.ObjectiveTo examine whether CPAP contributes to the onset and exacerbation of allergic rhinitis (AR) in OSAHS patients based on patient-reported changes in nasal symptoms with and without CPAP therapy and the detection of house dust mites (HDMs) in CPAP filters and household environments.Materials and methodsIn a cohort of OSAHS patients, 350 patients who were undergoing CPAP therapy and 100 patients who declined CPAP therapy were retrospectively analyzed. These patients were contacted by telephone and asked to compare their nasal symptoms before and after CPAP therapy. HDMs in air conditioner and CPAP device filters and in household dust samples were detected using enzyme-linked immunosorbent assays.ResultsThe prevalence of AR was higher in the CPAP group vs the non-CPAP group (15.8% vs 7.0%, respectively; P = 0.025). The onset of AR among the OSAHS patients with no previous history of AR significantly increased within the first year of CPAP therapy compared with the control group (5.7% vs 0%, respectively; P = 0.031). Meanwhile, the patients with a history of AR were more likely to experience exacerbated rhinitis symptoms within the second year of treatment compared with the control group (7.5% vs 0%, respectively; P = 0.005). There was no significant difference in HDM concentrations between the CPAP and air conditioner filters, yet the concentrations in both the filters were higher than the concentrations in the bedroom dust samples (all P < 0.05).ConclusionCPAP is associated with the onset and exacerbation of AR in OSAHS patients. Long-term exposure to high concentrations of HDM allergens may be a significant factor.

Small-airway dysfunction precedes the development of asthma in children with allergic rhinitis

BackgroundEpidemiological evidence suggests the existence of a direct link between allergic rhinitis (AR) and asthma. Several studies also support the presence of small-airway dysfunction (SAD) in non-asthmatic children with AR. However, it remains unknown whether SAD can predict the progression of AR to asthma. Our objective was to explore the existence of SAD in non-asthmatic children with AR and to assessed its ability to predict the development of asthma. MethodsSeventy-three 6-year-old children with intermittent moderate-severe AR but without asthma symptoms/medication within the last two years, underwent spirometry and measurement of respiratory resistance (Rrs) and reactance (Xrs) before and after bronchodilation (BD) (300mcg salbutamol). Lung function measurements were performed in the absence of nasal symptoms and repeated at AR exacerbation. SAD was defined as >30% decrease in Rrs or >50% increase in Xrs at 6 or 8Hz post-BD. Participants were followed for five years. ResultsTwenty-three children (31.5%) developed asthma; this group presented significant post-BD changes in Rrs and Xrs, but only at AR exacerbation. The ability of these changes to predict the development of asthma was exceptional and superior to that of the spirometric parameters. SAD (22 children, 30.1%), emerged as the single most efficient predictor of asthma, independently of other risk factors such as parental asthma, personal history of eczema and type of allergic sensitisation. ConclusionSAD precedes the development of asthma in children with AR. Changes in respiratory impedance at AR exacerbation may assist in identifying those at risk to progress to asthma.

Effects of intranasal mometasone furoate on blood pressure in patients with allergic rhinitis.

Background: Nasal congestion as the main symptom in patients with allergic rhinitis can impair nasal breathing. It causes hypoxia and concomitant sympathetic system activation, which may also lead to increased blood pressure levels in these patients. Objective: We postulated that appropriate therapy, including intranasal steroids, decreases blood pressure levels in patients with allergic rhinitis. Methods: In our study, we investigated the effect of intranasal steroid (4 weeks of mometasone furoate) on blood pressure changes in 45 patients with allergic rhinitis whose main complaint was nasal congestion. We used ambulatory monitoring for determining blood pressure levels before and after intranasal steroid therapy. None of the patients had any other systemic diseases. Results: We found a significant decrease of daytime systolic and diastolic blood pressures and mean blood pressure values (daytime systolic blood pressure: 120 vs. 117 mmHg, p = 0.024; daytime diastolic blood pressure: 73 vs. 71 mmHg, p = 0.027; daytime mean blood pressure: 86 vs. 83 mmHg, p = 0.007). Although insignificant, we also found lower night-time systolic and mean blood pressure values (nighttime systolic blood pressure: 109 vs. 107 mmHg, p = 0.182; nighttime mean blood pressure 77 vs. 73 mmHg, p = 0.116). Conclusions: We found that post-treatment daytime average systolic, diastolic, and mean arterial blood pressure levels were significantly lower compared to values obtained during exacerbation of allergic rhinitis. Decrease in blood pressure with treatment of allergic rhinitis and nasal congestion suggests that nasal congestion and impaired nasal respiration may affect blood pressure and potentially cause serious problems in hypertensive patients with allergic rhinitis.

T-helper type 1-T-helper type 2 shift and nasal remodeling after fine particulate matter exposure in a rat model of allergic rhinitis.

Exposure to fine particulate matter (particulate matter ≤2.5 μm [PM2.5]) increases the risk of allergic rhinitis (AR), but the underlying mechanisms remains unclear. Thus, we investigated the roles of T-helper (Th)1-Th2 cytokines and nasal remodeling after ambient PM2.5 exposure in a rat model of AR. Female Sprague-Dawley rats were randomized into six groups: a negative control group, a group of healthy rats exposed to 3000 μg/m3 PM2.5, an ovalbumin (OVA) induced AR model, and three PM2.5-exacerbated AR groups exposed to three different concentrations (200, 1000, and 3000 μg/m3) of PM2.5 for 30 days via inhalation. Nasal symptoms, levels of Th1-Th2 cytokines, the degree of eosinophilia in nasal lavage fluid (NLF), and the messenger RNA (mRNA) expressions of transcription factors GATA-3 and T-bet in the nasal mucosa were measured in each individual rat. Hyperplasia of globet cells and collagen deposition were examined by histology. PM2.5 significantly increased the number of sneezes and nasal rubs in rats with AR. PM2.5 also significantly decreased interferon gamma and increased interleukin (IL) 4 and IL-13 expressions as well as the number of eosinophils in NLF. The mRNA expression of GATA-3 in the nasal mucosa of rats with AR was upregulated by PM2.5, whereas T-bet was significantly downregulated. Statistically significant differences in OVA-specific serum immunoglobulin E, goblet cell hyperplasia, collagen deposition, and transforming growth factor beta 1 levels were observed between the PM2.5-exacerbated AR groups and the AR model group. Analysis of our data indicated that an increase in the immune response with Th2 polarization and the development of nasal remodeling may be the immunotoxic mechanisms behind the exacerbation of AR after exposure to PM2.5.

A Review of Spatial Variation of Allergenic Tree Pollen Within Cities

Urban trees provide a range of environmental and public health benefits. However, urban trees may also have an adverse effect on human health by increasing exposure to pollen. Many types of tree pollen are considered to be allergens and have been linked to various manifestations of allergic disease, including allergic sensitization, exacerbation of allergic rhinitis, and exacerbation of allergic asthma. An emerging body of literature suggests that the amount of pollen deposited annually varies widely over small spatial scales. While the health impacts of spatial variation in tree pollen within metropolitan areas could be large, the current literature has not been systematically reviewed. To fill this gap in knowledge, this review synthesizes existing evidence on how tree pollen is distributed on an intra-urban spatial scale. A better understanding of the spatial distribution of allergenic tree pollen within urban environments and its relation to health could inform increasingly common urban tree planting programs.

Influence of gender and sexual reproductive state in concentration of CAN f 1 in the fur of dogs (Canis lupus familiaris)

Background The allergens from cats and dogs have been implicated as extrinsic factors involved in sensitization, precipitation and exacerbation of allergic rhinitis and asthma in susceptible children and adults, at rates ranging from 10 to 25%. The major allergen from the epithelium of dogs is the Can f 1, responsible for the majority of sensitivity reactions to these. The Can f 1 is a lipocalin, which confers adhesive properties, derived from the sebaceous glands and found in fur, scales and saliva of dogs. The aim of this study is to assess the influence of gender and sexual reproductive state on concentrations of Can f 1 in the fur of dogs.

Clinical Control in the Dual Diagnosis of Obstructive Sleep Apnea Syndrome and Rhinitis: A Prospective Analysis

Obstructive sleep apnea syndrome (OSAS) and allergic rhinitis (AR) are common coexisting disorders. Upper airway, specifically nasal resistance, is thought to increase during exacerbations of AR and nonallergic rhinitis (NAR), as well as in OSAS. The study objective was to determine if a correlation exists between clinical control of rhinitis and OSAS. This prospective study followed 43 patients with concurrent OSAS and AR or NAR. OSAS was diagnosed by polysomnography, and AR or NAR was diagnosed by history, skin testing, serum-specific IgE, and total IgE levels. Measurements of control of OSAS included the Epworth Sleepiness Scale (ESS) survey and compliance with continuous positive airway pressure (CPAP) device. Measurements of rhinitis control included Assessment of Nasal Symptom Severity and Assessment of Nonnasal Symptom Severity (NSS refers to both) and Global Assessment of Nasal and Nonnasal Symptom Severity surveys (GSS). Higher NSS scores correlate with more rhinitis symptoms, whereas higher GSS scores correlate with less symptoms. All patients completed the study. There was a positive correlation between ESS and NSS scores (p < 0.001), inverse correlation between ESS and GSS scores (p < 0.001), inverse correlation between CPAP compliance and NSS scores (p < 0.001), and positive correlation between CPAP compliance and GSS scores (p < 0.001). There was no statistically significant difference between the AR, NAR, and AR/NAR groups. Our study showed a statistically significant positive correlation between clinical control of rhinitis symptoms and clinical control of OSAS. This study emphasizes the importance of achieving concurrent optimal control of both OSAS and AR/NAR.

Sublingual Immunotherapy for Allergic Rhinitis: A Prospective Study Based on AAOA Consensus Dosing Protocol

Objectives: Study the efficacy and safety of sublingual immunotherapy (SLIT) based on the original American Academy of Otolaryngologic Allergy (AAOA) Consensus dosing protocol for treatment of allergic rhinitis (AR). Methods: Patients undergoing SLIT for more than 12 months between 2007-2010 were prescribed escalation (over 3 months) and maintenance doses as recommended by AAOA. Sinonasal-Outcome-Test-20 (SNOT-20) questionnaire scores were used for calculations of repeated measures analysis of variance (ANOVA) with contrast testing to define trends. Results: Data from fifteen males and six females with a mean follow-up duration of 17.57 months were analyzed. Fourteen patients had minor side effects, including AR exacerbation (5 cases), itching (8), rash (2), diarrhea (1), and palatal ulcer (1). None required admission or treatment discontinuation. ANOVA testing revealed a significant linear decreasing trend in rhinological (F1,13 = 11.2), ear/facial (F1,13 = 5.4), sleep (F1,13 = 6.9), psychological (F1,13 = 13.1), and overall SNOT-20 (F1,13 = 14.5) scores. Our results show overall SNOT-20 scores improving by 31% from baseline within 3 months initiation of therapy, and continued to improve progressively during the maintenance phase up to 69%. Domain scores analyzed showed greatest improvements in ear/facial symptoms (up to 86%) and psychological function (up to 77%). Rhinologic and sleep function scores also showed impactful improvements of up to 56% and 61% respectively. Conclusions: This is the first published paper to study and demonstrate the safety and efficacy of SLIT based on AAOA consensus dosing protocol. A standardized regime will allow more meaningful comparison between studies.