Seasonal Allergic Rhinitis Patients Research Articles

Molecular sensitization profile to grass and olive pollens in Portugal.

Background. Grass and olive pollens have overlapping pollination periods and are common allergens in the Iberian Peninsula. The objective is to determine the sensitization pattern to major Phleum pratense and Olea europaea pollens in the Portuguese population with pollen allergic rhinitis (AR) using molecular allergen diagnosis (MAD). Methods. Seasonal AR patients (≥ 12 years), with positive skin prick tests (SPT) to Phleum and Olea were recruited from 16 centers. Using ALEX2, specific IgE to Phl p1, Phl p2, Phl p5, Phl p6, Phl p7, Phl p 12, Ole e1, Ole e7 and Ole e9 were determined. Immunoblotting of Olea allergic patients was performed. Results. Included 175 patients (55.4% female; mean age 31.6 ± 13.3 years; 85.7% adults; 40% asthmatic, Coast 28%/Inland 72% and North 29.1%/Centre 20.6%/South 50.3%). Considering Phleum MAD, 85.7% were sensitized to Phl p1, 45.7% to Phl p2, 50.3% to Phl p5, 45.7%, to Phl p6, 10.9% to Phl p7 and 22.9% to Phl p12. Sensitization to Ole e1 was found in 56.6%, to Ole e7 in 1.7% and Ole e9 in 3.4% patients. Sensitization to Phl p7 was more frequent in asthmatics (17.4% vs 6.6%; p = 0.044). Sensitization to Phl p5, Phl p6, Phl p12 and Ole e1 was more frequent in inland. Regarding sensitization patterns: 53.1% patients were sensitized to both species genuine´ sIgE, 38.3% to Phleum and 3.4% only to Olea species' sIgE. Immunoblotting of Olea allergic patients showed a high intensity band that may correspond to Ole e12. Conclusions. MAD showed "genuine" Grass and Olea sensitization in approximately 50% of our patients.

The effect of mask use on allergic rhinitis symptoms during COVID-19 pandemic

Aims: Inspiratory particle load including the allergens in the inhaled air is decreased by the use of the mask, which is one of the methods for COVID-19 protection. The aim of the study is to investigate the effect of masks used by seasonal allergic rhinitis patients with pollen allergy on the control of rhinitis symptoms.
 Methods: Mask usage characteristics of patients (mask type used, average number of days per week for mask usage, daily usage time),whether there was a change in the time spent outdoors during the pandemic compared to the pre-pandemic period, and rhinitis complaints and frequency of rhinitis-related drug use before the pandemic compared to the pandemic period were investigated.
 Results:The frequency of nasal discharge (6.62±1.69; 6.00±1.89: p

Comparative efficacy and acceptability of licensed dose intranasal corticosteroids for moderate-to-severe allergic rhinitis: a systematic review and network meta-analysis.

No evidence shows that one intranasal corticosteroid (INCS) is better than another for treating moderate-to-severe allergic rhinitis (AR). This network meta-analysis assessed the comparative efficacy and acceptability of licensed dose aqueous INCSs. PubMed/MEDLINE, Scopus, EMBASE, and the Cochrane Central Register of Controlled Trials were searched until 31 March 2022. Eligible studies included randomized controlled trials comparing INCSs with placebo or other types of INCSs in patients with moderate-to-severe allergic rhinitis. Two reviewers independently screened and extracted data following the Preferred Reporting Items in Systematic Reviews and Meta-analysis guideline. A random-effects model was used for data pooling. Continuous outcomes were expressed as standardized mean difference (SMD). The primary outcomes were the efficacy in improving total nasal symptom score (TNSS) and treatment acceptability (the study dropout). We included 26 studies, 13 with 5,134 seasonal AR patients and 13 with 4,393 perennial AR patients. Most placebo-controlled studies had a moderate quality of evidence. In seasonal AR, mometasone furoate (MF) was ranked the highest efficacy, followed by fluticasone furoate (FF), ciclesonide (CIC), fluticasone propionate and triamcinolone acetonide (TAA) (SMD -0.47, 95% CI: -0.63 to -0.31; -0.46, 95% CI: -0.59 to -0.33; -0.44, 95% CI: -0.75 to -0.13; -0.42, 95% CI: -0.67 to -0.17 and -0.41, 95% CI: -0.81 to -0.00), In perennial AR, budesonide was ranked the highest efficacy, followed by FF, TAA, CIC, and MF (SMD -0.43, 95% CI: -0.75 to -0.11; -0.36, 95% CI: -0.53 to -0.19; -0.32, 95% CI: -0.54 to -0.10; -0.29, 95% CI: -0.48 to -0.11; and -0.28, 95% CI: -0.55 to -0.01). The acceptability of all included INCSs was not inferior to the placebo. According to our indirect comparison, some INCSs have superior efficacy to others with moderate quality of evidence in most placebo-controlled studies for treating moderate-to-severe AR.

Role of Montelukast on Vitamin D Levels in Asthma and Seasonal Allergic Rhinitis in Eastern India

Background: Allergic rhinitis and asthma are both chronic heterogeneous disorders, with an overlappingepidemiology of prevalence, health care and social costs in quality of life. Both are inflammatory disorders with asimilar pathophysiology and vitamin D has a significant role in the pathogenesis of the disease.Aims and Objective: The objective of this study was to evaluate the role of serum vitamin D in patients withsymptomatic allergic rhinitis and active asthma during the allergy season and observe the effect of montelukast10 mg daily as treatment.Materials and methods: This study included 130 asthmatic and seasonal allergic rhinitis patients following asingle-blind, placebo run-in period of 3 days–5 days, patients were randomized to oral montelukast 10 mg (n = 68)or placebo (n = 62) daily during the 2-week, double-blind, active-treatment period. The serum vitamin D was alsoevaluated in both the groups.Results: The serum vitamin D levels were found to be higher in patients taking monteleukast compared to placeboafter 2 weeks (p< 0.001). Montelukast reduced the Total Nasal symptoms score which includes Daytime nasalsymptoms and Nighttime symptoms compared to placebo after 2 weeks (p < 0.001). Conclusion: Montelukastprovides significant relief from symptoms of seasonal allergic rhinitis, while also conferring a benefit for asthma,in patients with both allergic rhinitis and asthma. Further, it has a beneficial role in improving vitamin D levels.

Clinical Efficacy and Safety of Artesimia annua-Sublingual Immunotherapy in Seasonal Allergic Rhinitis Patients Based on Different Intervention Time

Introduction: Artemisia is a major kind of grass pollen in Northern China that can cause multiple kinds of common allergic diseases, such as allergic rhinitis (AR), conjunctivitis, or asthma. Recently, Artemisia annua Allergens Sublingual Immunotherapy Drops have been proved effective and safe for treating seasonal AR (SAR) with or without allergic conjunctivitis patients and were available in China. We sought to further investigate the different intervention times of A. annua-sublingual immunotherapy (SLIT) for evaluating efficacy and safety in patients with SAR. Methods: A total of 88 subjects aged 18–52 years with SAR were enrolled and randomized into the SLIT group and control group. Forty-five patients received a course of SLIT with A. annua extracts along with pharmacotherapy as SLIT group and 43 patients only used symptomatic drugs as control group. Furthermore, SLIT group was randomly divided into 12–13 weeks’ pre-seasonal treatment group and 8–9 weeks’ pre-seasonal treatment group to receive different duration of SLIT before pollen season. Monosensitized and polysensitized groups were also the subgroups of SLIT group according to the sensitization status of patients. The combined symptom and medication score (CSMS), total nasal symptom score (TNSS), total medication score (TMS), visual analog score (VAS) were evaluated during the peak pollen phase in 2020 and 2021, respectively. Safety was assessed according to adverse events (AEs) reported. Results: Compared to control group, CSMS, TNSS, TMS, VAS were significantly improved during the course of SLIT (p < 0.001). Besides, clinical improvement in nasal symptoms and reduction of medication use was also observed in SLIT group, compared to the baseline value (p < 0.001). Meanwhile, we observed that there was no significant difference between monosensitized group (n = 8) and polysensitized group (n = 29), as well as 12–13 weeks’ preseasonal treatment group (n = 20) and 8–9 weeks’ pre-seasonal treatment group (n = 17) belonging to the SLIT group in clinical efficacy (p > 0.05). No severe systemic AEs were reported. Conclusions: This study proved that A. annua-SLIT can provide equivalent efficacy and safety for SAR patients under the circumstance of accepting the pre-seasonal treatment of 8–9 or 12–13 weeks, regardless of monosensitization or polysensitization.

Bioinformatics analysis of nasal epithelial cell gene expression in seasonal and perennial allergic rhinitis

Objective: Transcriptome sequencing and bioinformatics analysis were performed on the gene expression of nasal epithelial cells in patients with seasonal allergic rhinitis (AR) and perennial AR, so as to obtain the differences in the gene expression of nasal epithelial cells between seasonal AR and perennial AR. Methods: The human nasal epithelial cell line(HNEpC) was cultured in vitro, treated with 100 μg/ml mugwort or house dust mite (HDM) extracts for 24 hours. Total cell RNA was extracted, and quantitative real-time polymerase chain reaction (qPCR) was used to detect the expression of cytokines, including IL-6, IL-8, IL-33 and thymic stromal lymphopoietin (TSLP). From November 2019 to November 2020, 3 seasonal AR patients, 3 perennial AR patients, and 3 healthy controls who attended the Department of Otolaryngology Head and Neck Surgery, China-Japan Union Hospital of Jilin University were analyzed. The patients' primary nasal epithelial cells were cultured in vitro, treated with corresponding allergens for 24 hours. Total RNA was extracted for transcriptome sequencing, and the sequencing results were analyzed by bioinformatics. Results: The qPCR results showed that the cytokines IL-6, IL-8, IL-33 and TSLP of HNEpC treated with mugworts extracts and HDM extracts had the same trend of change. After the nasal epithelial cells from patients with seasonal AR and perennial AR were treated with corresponding allergens, there were differences in biological processes and signal pathways between those and control. Gene ontology (GO) enrichment analysis showed that the differentially expressed genes (DEG) in AR patients allergic to mugwort were mainly enriched in the oxidation-reduction process, the negative regulation of apoptosis process, and the cell adhesion; the DEG in AR patients allergic to HDM were mainly enriched in cell adhesion, the negative regulation of cell proliferation and the response to drug. Enrichment analysis of Kyoto Encyclopedia of Genes and Genomes (KEGG) signaling pathway showed that the DEG of AR patients allergic to mugwort were significantly enriched in arachidonic acid metabolism, p53 signaling pathway and transforming growth factor β (TGF-β) signaling pathway, while the DEG of AR patients allergic to HDM were mainly enriched in cells cycle, Fanconi anemia pathway and DNA replication. Gene Set Enrichment Analysis (GSEA) showed that the inflammatory response, TNF-α/NF-κB signaling pathway and IL-2/STAT5 signaling pathway were significantly up-regulated in AR patients allergic to mugwort, indicating the promotion of inflammatory response; and AR patients allergic to HDM had significant down-regulation of G2M, E2F, and MYC, indicating the inhibition of cell proliferation. The protein-protein interaction network showed that TNF and CDK1 were the most interacting proteins in mugwort and HDM allergic AR patients, respectively. Conclusion: Seasonal AR and perennial AR may affect the different biological processes and signal pathways of nasal epithelial cells, leading to differences in the occurrence and development of AR.

Short-Term Subcutaneous Allergy Immunotherapy and Dupilumab are Well Tolerated in Allergic Rhinitis: A Randomized Trial.

BackgroundSubcutaneous immunotherapy (SCIT) has been proven as an effective therapy against some allergens for seasonal allergic rhinitis (SAR) patients unresponsive to intranasal corticosteroids and/or antihistamines but carries risk of systemic allergic reactions. Dupilumab blocks the shared receptor component for interleukin-4 and interleukin-13, key and central drivers of type 2 inflammation in multiple diseases.ObjectiveTo evaluate the efficacy and safety of SCIT+dupilumab vs SCIT alone.MethodsThis phase 2a, multicenter, double-blind, placebo-controlled parallel-group study conducted in 103 adults with grass pollen-induced SAR (NCT03558997) randomized patients 1:1:1:1 to SCIT, dupilumab (300 mg every 2 weeks), SCIT+dupilumab, or placebo. SCIT was administered using an 8-week cluster protocol followed by 8 weeks of maintenance injections. Primary endpoint was change from pre-treatment baseline in area under the curve (AUC) in total nasal symptom score (TNSS) 0–1 h following nasal allergen challenge (NAC) with timothy grass extract at Week 17.ResultsAlthough 16 weeks of treatment with SCIT+dupilumab did not significantly improve TNSS AUC (0–1 h) following NAC at Week 17 vs SCIT (least squares mean −56.76% vs −52.03%), a higher proportion of SCIT+dupilumab-treated patients (61.5%) achieved SCIT maintenance dose vs SCIT (46.2%). A lower proportion of SCIT+dupilumab-treated patients (7.7%) required epinephrine rescue treatment vs SCIT (19.2%). There were significantly fewer withdrawals in the SCIT+dupilumab group than in the SCIT group (n = 2 [7.7%] vs n = 8 [30.8%]; P = 0.0216); the majority of SCIT group withdrawals were due to SCIT-related intolerability, compared with no discontinuations from the SCIT+dupilumab group.ConclusionIn SAR patients, 16 weeks of SCIT+dupilumab may improve SCIT tolerability but did not incrementally reduce post-allergen challenge nasal symptoms compared with SCIT alone.Clinical Study NumberNCT03558997.

Appropriate protocol of treatment modulation for seasonal allergic rhinitis caused by cypress pollens

Objective: To investigate appropriate protocol of treatment modulation for seasonal allergic rhinitis (AR) patients, in order to promote the implementation of personalized medicine. Methods: Total of 124 AR patients allergic to cypress pollens were recruited from January to February 2020 in Department of Allergy in Peking Union Medical College Hospital, 43 males and 81 females with an average age of (41±9) years. The patients were divided into two groups with block randomization method. In the first group, treatment was modulated every two days according to the average daily rhinoconjunctivitis symptom score of the last two days (short-term symptom-score group); while in the second group, therapy regimen was adjusted every week based on the Allergic Rhinitis Control Test (ARCT) score of the last week (long-term ARCT group). The treatment level was up-regulated when the cypress pollen count increased and stayed at a high level (step-up pharmacotherapy stage); and treatment was down-regulated while the pollen count decreased (step-down pharmacotherapy stage). Daily symptom scores, medicine scores, and ARCT scores of the two groups were recorded and compared. Results: During the whole cypress pollen season, the daily rhinoconjunctivitis symptom score of short-term symptom-score group was significantly lower than that in long-term ARCT group(2.4±1.0 vs 2.7±1.0, P<0.01), and the difference between the two groups was more pronounced in the step-up pharmacotherapy stage than that in the step-down pharmacotherapy stage, while there was no statistical difference between the daily medicine scores of the two groups (P>0.05). During the pollen rising period, the ARCT score of short-term symptom-score group was significantly better than that of long-term ARCT group (21(19, 22) vs 20 (17, 21), P=0.049); while in the pollen peak period and decreasing period, the ARCT scores of the two groups showed no statistical difference (P>0.05). The proportion of incompliance with doctor's advice was higher in long-term ARCT group compared to that in short-term symptom-score group (30.1% vs 6.7%, P<0.001). Conclusion: The protocol of treatment modulation for seasonal AR patients allergic to pollens should be developed flexibly according to the variation trend of pollen allergen exposure, so as to implement the idea of personalized medicine.

The effect on patient life quality of prophylactic treatment to seasonal allergic rhinitis and related transcriptomics research

Objective: The preseason prophylactic treatment of seasonal allergic rhinitis (AR) caused by pollens could alleviate AR symptoms during the pollen season. This study aimed to evaluate the effect of prophylaxis usage of suplatast tosilate on the life quality of AR patients in the pollen season, and investigate the potential mechanism of action through transcriptomic analysis. Methods: This is a randomized controlled study. AR patients allergic to weed pollens were recruited from Allergy Clinic of Peking Union Medical College Hospital from January 2020 to June 2020, and divided into prophylactic group who started to take suplatast tosilate as prophylaxis 2 weeks before the spread of weed pollens[n=10, 4 men and 6 women with age range of (34±6) years old] and control group who did not use any prophylactic treatment[n=24, 12 men and 12 women with age range of (33±9) years old]. The differences of age (t=0.381, P=0.706) and gender (χ²=0.595, P=0.715) distribution between the patients of two groups were not statistically significant. All the subjects filled in the rhinoconjunctivitis quality of life questionnaire (RQLQ) while onset of AR symptoms, and peripheral blood was drawn for transcriptomic analysis 1 month before and during the pollen season. Differences between groups were statistically analyzed through chi-square test and t test. Results: There was no significant difference in visual analogue scale of rhinitis symptom in the last pollen season between prophylactic group and control group[ 8.0 (6.4, 9.3) vs 7.3 (6.1, 8.0), Z=1.180, P=0.254]. The RQLQ score of prophylactic group was superior to that of control group in the weed pollen season (2.9±0.9 vs 3.7±0.9, t=-2.438, P=0.026). 210 differentially expressed genes of fold change ≥2 were identified, with 147 genes upregulated and 63 genes downregulated in the prophylactic group compared to the control group. Gene Ontology annotation showed that IL-12 and IL-23 related pathways were downregulated in prophylactic group (P=0.006 48). Polymerase Chain Reaction (PCR) verification of differentially expressed genes indicated that the relative expression level of HLA-G in prophylactic group was significantly lower than that in control group (0.23±0.19 vs 1.00±0.49,t=4.016, P=0.006). Conclusion: The prophylactic treatment of suplatast tosilate showed some benefit to the life quality of seasonal AR patients during the pollen season, and the potential mechanism might be related with the downregulation of IL-12 and IL-23 pathways and decreased expression of HLA-G.

Effect of rhinophototherapy on nasal congestion in patients with seasonal allergic rhinitis.

SUMMARYObjectiveThe aim of the present study was to objectively and subjectively evaluate the effects of adding rhinophototherapy to intranasal beclomethasone dipropionate to treat nasal congestion in patients with seasonal allergic rhinitis.MethodSeventy-five seasonal allergic rhinitis patients were randomly divided into two groups. Patients in Group 1 received intranasal beclomethasone dipropionate for two weeks and patients in Group 2 had rhinophototherapy added to the same medical therapy as Group 1. The effectiveness of treatments was evaluated with the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), Nasal Obstruction Symptom Evaluation scale (NOSE) questionnaires and active anterior rhinomanometry.ResultsAfter treatment, significant improvement was observed in Group 2 vs Group 1 in terms of RQLQ (p = 0.011) and NOSE (p = 0.001) scores. In Group 2, significant differences were observed between before and after treatment for inspiratory total nasal resistance (p = 0.004). However, no significant differences vs. baseline were observed in Group 1.ConclusionOur study shows that adding intranasal phototherapy with a combination of UVA, UVB and visible light therapy to nasal beclomethasone dipropionate treatment objectively improves nasal patency in patients with seasonal allergic rhinitis.

Evaluation of efficacy and safety of montelukast and levocetirizine FDC tablet compared to montelukast and levocetirizine tablet in patients with seasonal allergic rhinitis: a randomized, double blind, multicentre, phase III trial

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; To evaluate efficacy, safety and tolerability of Montelukast 10 mg+levocetirizine 5 mg FDC compared to either montelukast 10 mg or levocetirizine 5 mg given alone in seasonal allergic rhinitis (SAR) patients.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; Phase III, multicentre, randomized, double blind, parallel group, active controlled study was conducted in 279 SAR patients at 16 sites across India. Efficacy was assessed using daytime nasal symptoms score (Primary efficacy outcome), night-time symptoms score, daytime eye symptom score, patient's global evaluation, physician's global evaluation, rhino-conjunctivitis quality-of-life score. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; At end of treatment there was statistically significant evidence from the per protocol analysis that patients on FDC had a greater improvement in change from baseline in daytime nasal symptoms score than patients who received Montelukast (p=0.0266) or Levocetirizine (p=0.0409). These results were consistent with the Intent to treat analysis. Analysis of the secondary efficacy endpoints provided numerically greater improvement in the nighttime symptoms score, daytime eye symptoms score, and rhinoconjunctivitis quality-of-life scores in the FDC group as compared to the Montelukast group or Levocetirizine group. The FDC of Montelukast and Levocetirizine was found to be safe and generally well tolerated. The majority of adverse events were mild in severity, resolved without treatment and were unrelated to study medication.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Fixed dose combination of Montelukast and Levocetirizine was safe, generally well tolerated and superior on efficacy compared to Montelukast or Levocetirizine in patients of seasonal allergic rhinitis.&lt;/p&gt;

Levels of nasal exhaled hydrogen sulfide in the general population and allergic rhinitis patients.

BackgroundObjective measures used for the differential diagnosis and severity assessment of allergic rhinitis (AR) are still lacking. The involvement of hydrogen sulfide (H2S) in the development of AR indicates that nasal exhaled H2S (NeH2S) has potential as a biomarker to be used in AR patients. This study aimed to evaluate the application value of NeH2S measurement in the diagnosis and assessment of AR.MethodsThis study was a multi‐center cross‐sectional survey conducted in Northwestern China. Demographic information collection and rhinitis assessment were completed through questionnaires. The level of NeH2S and serum immunoglobulin E were measured.ResultsThe level of NeH2S in general population ranged from 0 to 35 ppb, with a median value of 2 ppb. The NeH2S levels in seasonal allergic rhinitis (SAR) patients were significantly lower than those in general population (2 [1, 2.75] vs. 2 [2, 3] ppb; p = .023), and the NeH2S value of the SAR group tended to be lower than that of the non‐allergic rhinitis (NAR) group (2 [1, 2.75] vs. 2 [2, 3] ppb; p = .094). The subgroup of AR patients with symptoms lasting longer than 2 weeks per month had a lower NeH2S level compared with the subgroup of patients with symptoms lasting less than 2 weeks per month (2 [1, 2] vs. 2 [2, 3] ppb; p = .015).ConclusionThis study described the distribution range of NeH2S levels in the general population. Further study with larger sample size was needed to clarify the relationship between NeH2S level and AR.

The features of the pollen sensitization in seasonal allergic rhinitis patients with gastrointestinal tract inflammatory diseases comorbidity

BACKGROUND:Allergic diseases and gastrointestinal tract diseases can influence on the natural course of each other.&#x0D; AIM:To study the sensitization profile in patients with comorbidity of seasonal allergic rhinitis (SAR) and upper gastrointestinal tract inflammatory diseases (UGITID).&#x0D; MATERIALS AND METHODS:112 adult residents of Volgograd city suffering from SAR but without perennial symptoms and sensitization to indoor allergens have been included in the study. 31/112 patients hadH. pylori-negative and 38/112 H. pylori-positive UGITID. Control group consisted of 43/112 patients without gastrointestinal diseases. Skin prick-testing with 3 groups of pollen allergens have been carried out.&#x0D; RESULTS:75.9% of patients were sensitized to weed pollen; sensitization to grass pollen was in 1.53 times less, and 10.5% of patients (4/38) had positive tests with birch pollen. The sensitization to quinoa and ragweed in SAR and H. pylori-UGITID patients was comparable with control group but less common with wormwood, sumpfweed allergens. The sensitization in SAR patients andH. pylori+-UGITID was similar to the control group, but positive SPT with sunflower and corn allergens were rare then in control group.&#x0D; CONCLUSION:Weed pollen allergens prevail in sensitization spectrum of adult Volgograd residents with SAR. Sensitization to goose-foot and ragweed is common less in SAR patients andH. pylori-UGITID but to graminea grass and birch pollen is more often. It may be supposed that the UGITID are predisposing factors to the sensitization to cross-reacting plant food allergens. At the same time supposed immunomodulating action ofH. pylorimake the differences between AR patients withH. pylori+-UGITID orH. pylori-UGITID minor.

Seasonal allergic rhinitis and its control with antihistamines in an outpatient practice.

Allergic rhinitis (AR) is a significant social and medical problem of modern healthcare. The treatment of patients with AR is based on a stepwise approach, the purpose of which is to fully control the symptoms. The first stage drugs of choice are oral non-sedative antihistamines of the second generation. A study was conducted to evaluate the effectiveness of Allerway and drugs containing cetirizine to control the symptoms of seasonal AR (SAR) in an outpatient practice. The data obtained in the framework of a multicenter prospective noninterventional study (the short name of the study is LEVADA) were analyzed. Data were collected at 5 centers using scales for assessement of the symptoms of allergic rhinitis: rTNSS, miniRQLQ, visual analog scale and the Epworth sleepiness scale. The dynamics of SAR symptoms was assessed using the rTNSS scale (24 hours) after 7 and 14 days of treatment. A total of 100 patients were included in the study; 97 patients completed the study. Of these, 46 (47.42%) were women and 51 (52.57%) were men aged 18 years. The average duration of the diagnosis of SAR in patients before inclusion in the study in the Allerway group was 97.485.51 months (about 8 years), in the cetirizine group 107.0114.62 months (about 8.9 years), p=0.641. The efficacy of regressing the intensity of SAR symptoms on the rTNSS scale was demonstrated to be (average and average error) 2.920.11 points in the group of patients taking Allerway and 2.930.11 points in the group of patients taking cetirizine. After 7 days, there was an increase in the proportion of patients with a complete absence of the main symptoms of SAR: nasal congestion, rhinorrhea, itching in the nose. In the group of patients taking Allerway in 44 out of 49 patients (89.8%), it was noted that on average, after 39.414.35 minutes, symptom relief was observed in 42 of 48 (87.5%) patients, and in patients taking cetirizine, relief of rhinitis symptoms was noted during 44.013.76 minutes. An improvement in the quality of life was noted by reducing the severity of symptoms on the miniRQLQ scale by 44.315.29 points in the Allerway group and by 45.013.03 in the group receiving cetirizine. It was shown that the use of Allerway (at a dose of 5 mg, once a day) and preparations containing cetirizine (at a dose of 10 mg, with a single dose per day), allows to achieve a positive clinical effect in the treatment of patients with SAR (seasonal allergic rhinitis) in outpatient practice within 7 and 14 days with a high level of safety and compliance.

Frequency and clinical features of pollen-food syndrome in children

BackgroundPollen-food syndrome (PFS) is an allergic reaction to fresh fruits, vegetables and/or nuts that can occur in patients who are allergic to pollen. The prevalence of PFS in children is not clearly known. ObjectiveThe objective of this study was to determine the frequency and clinical features of PFS in pediatric patients with pollen-induced allergic rhinitis (AR). MethodThis study was conducted in the pediatric allergy outpatient clinic of our hospital. Pollen-induced seasonal AR patients who were evaluated for any symptoms appearing after consuming any fresh fruits and vegetables. ResultsSix hundred and seventy-two pollen-sensitized patients were included in this study. The symptoms related to PFS were reported in 22 (3.3%) patients. The median age of the patients was 12.3 years and 59% (n=13) were female. Peach was the most common culprit (22%). There were isolated oropharyngeal symptoms in 20 (91%) patients and anaphylaxis in two (9%) patients with the suspected food. The multiple logistic regression analysis revealed that female gender, history of atopic dermatitis and allergic diseases in the family were the potential risk factors for PFS [Odds ratio 95%CI: 3.367 (1.344–8.435), 5.120 (1.935–13.550), 3.046 (1.239–7.492), respectively]. ConclusionPFS can be seen in children who are followed up for pollen-induced AR. The symptoms of PFS are usually mild and transient. However, comprehensive evaluation of patients is important since serious systemic reactions such as anaphylaxis can also be observed.

Mometasone Furoate Aqueous Nasal Spray vs Placebo and Flonase® in Seasonal Allergic Rhinitis Patients (I94-001)

Mometasone Furoate Aqueous Nasal Spray vs Placebo and Flonase® in Seasonal Allergic Rhinitis Patients (I94-001)

Efficacy of a Novel Intranasal Formulation of Azelastine Hydrochloride and Fluticasone Propionate, Delivered in a Single Spray, for the Treatment of Seasonal Allergic Rhinitis: Results from Russia

Background: The novel intranasal formulation of azelastine hydrochloride (AZE) and fluticasone propionate (FP) in a single spray (MP-AzeFlu) was compared with a first-line intranasal antihistamine spray (AZE) in Russian seasonal allergic rhinitis (SAR) patients. Methods: Moderate-to-severe SAR/rhinoconjunctivitis patients (n = 149; aged 18–65 years) were randomized to receive MP-AzeFlu (137/50 μg AZE/FP per spray) or AZE (137 μg/spray), both as 1 spray/nostril twice daily, in a multicenter, open-label, 14-day, parallel-group trial. The primary outcome was change from baseline in morning and evening reflective total nasal symptom score (rTNSS). Secondary end points included: change from baseline in reflective total ocular symptom score (rTOSS), reflective total of 7 symptom scores (rT7SS), 28-item Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) overall score, and EuroQol-5D (EQ-5D) questionnaire score. Results: When compared with AZE-treated patients, those treated with MP-AzeFlu experienced significantly greater reductions in rTNSS (difference: –2.47; 95% confidence interval [CI] –3.65 to –1.30; p < 0.001), rTOSS (difference: –1.62; 95% CI –2.32 to –0.92; p < 0.001), and rT7SS (difference: –4.34; 95% CI –5.98 to –2.70; p < 0.001). Superior relief observed on day 2 with MP-AzeFlu versus AZE was sustained throughout the study. MP-AzeFlu-treated patients experienced a greater improvement in QoL than AZE-treated patients as measured by overall RQLQ score (mean ± SD 2.91 ± 1.08 vs. 2.05 ± 1.15) and EQ-5D score (mean ± SD 87.4 ± 10.3 vs. 83.0 ± 12.8). MP-AzeFlu was well tolerated. Conclusions: MP-AzeFlu was superior to AZE in reducing moderate-to-severe SAR symptoms, providing earlier and more complete symptom relief.

Serum levels of interleukin 33 and its receptor ST2 in patients treated with subcutaneous allergen immunotherapy in intermittent allergic rhinitis.

IntroductionInterleukin 33 (IL-33) is a pleiotropic cytokine involved in pathological processes in seasonal allergic rhinitis. IL-33 binds to ST2 receptor, which is highly expressed on mast cells and selectively on Th2 cells. Information is lacking on the role of IL-33/ST2 axis in allergen subcutaneous immunotherapy.Aim of the studyTo determine if allergen immunotherapy changes the IL-33/ST2l axis in seasonal allergic rhinitis patients.Material and methods40 patients with intermittent allergic rhinitis sensitive to grass and/or tree pollen were studied. Among these, 10 patients were longitudinally assessed in the follow-up visit after completing the first course of immunotherapy. Twenty-two healthy subjects were included as controls. Immunotherapy was applied according to a perennial schedule comprising up-building and maintenance phases. Serum levels of ST2/IL-33 R and IL-33 were measured by ELISA (R&D Systems).ResultsSerum levels of IL-33 significantly rose after the first course of immunotherapy and reached the controls levels. Serum levels of ST2 were comparable before the pollen season and after the first course of immunotherapy.ConclusionsIncrease in serum levels of IL-33 after the first course of immunotherapy may suggest it is too short period to prevent the expected raise in serum IL-33 levels in the pollen season, and longer treatment is required to observe significant changes of this cytokine. ST2 serum levels are independent of immunotherapy and pollen season.

Evaluation of positive results for autologous serum skin testing in patients with seasonal allergic rhinitis compared with healthy controls

p { margin-bottom: 0.08in; direction: ltr; color: rgb(0, 0, 0); }p.western { font-family: Times New Roman, serif; font-size: 12pt; }p.cjk { font-family: Times New Roman, serif; font-size: 12pt; }p.ctl { font-family: Times New Roman, serif; font-size: 12pt; }a.cjk:visited { }a:link { color: rgb(0, 0, 255); } Objective: Autologous serum skin testing is a practical test for basophil histamine release which is used in the diagnosis of chronic autoimmune urticaria. Although the exact autoimmune pathogenesis of allergic diseases of the upper respiratory tract remains a matter of debate, recent studies have reported positive autologous serum skin tests in both allergic and non-allergic rhinitis, asthma sufferers, and even in healthy controls. In this study, we aim to evaluate positive results from autologous serum testing in hayfever sufferers and to compare the results with those from healthy controls. Materials and methods The study included 76 seasonal allergic rhinitis patients aged between 18-65 years and 51 healthy volunteers who underwent autologous serum skin testing. The Chi-squared test was used for comparisons between the two groups. Result Autologous serum testing proved positive in 29 of the patients with allergic rhinitis and in 10 of the healthy controls. The number of positive results from autologous serum testing was found to be significantly higher in patients with allergic rhinitis than in the control group. Conclusion From the results of this research and the information found in the literature, it appears that autologous serum skin testing has uses beyond merely detecting chronic urticaria. There may be an advantage in evaluating the common features and serum factor in patients with allergic rhinitis and urticaria who show positivity to autologous serum skin testing.

SERUM IGE REACTIVITY TO CROSS-REACTING MOLECULES IN POLLEN ALLERGIC PATIENTS FROM NORTH EASTERN POLAND

Introduction Presence of IgE which cross-react with allergen components such as profilins, polcalcins and cross-reacting carbohydrate determinants (CCD) creates a problem in selection of patients for allergen immunotherapy. This study assesses the prevalence of sensitization to profilins, polcalcins and CCDs in seasonal allergic rhinitis patients (ARs). Methods 112 allergic rhinitis (AR) patients age 14 to 55 years with sensitization to at least one seasonal allergen (IgE>0.7 KU/l) were studied. IgE sensitization to recombinant(r) Bet v 2, rPhl p 12, rBet v 4, rPhl p 7 and CCDs in addition to rBet v 1, rPhl p 1, rPhl p 5 was evaluated using a multiplex immunoblot (Euroimmun, Germany). Results 64.3%, 80.4% and 41.1% of AR patients were sensitized to birch, timothy grass and mugwort pollen, respectively. Sensitization to rBet v 2/Phl p 12 occured in 26.8%, to Bet v 4/Phl p 7 in 8.9%, and to CCDs in 25%. In 29.3% of AR patients serum IgE reactivity to any of the cross-reactive component could be demonstrated. Serum IgE reactivity to rBet v 2 was always accompanied by reactivity to rPhl p 12 and reactivity to rBet v 4 was always accompanied by reactivity to rPhl p 7. Conclusions Evaluation of serum IgE reactivity to cross-reactive components may be useful in assessment of AR patients qualified for allergen immunotherapy.