Treatment Of Allergic Rhinitis Research Articles

Hydrogel‐Based Intranasal Delivery Systems for The Treatment of Allergic Rhinitis

AbstractAllergic rhinitis, as the most common type of rhinitis, has become a global health problem. At present, oral/intranasal administration of H1‐antihistamines and corticosteroids is considered to be the main therapeutic method for allergic rhinitis. However, the local bioavailability of the drug is low due to the systemic effect of drugs and nasal mucociliary clearance. More recently, a hydrogel‐based intranasal delivery system (HIDS) is proposed and gradually developed as an emerging strategy for allergic rhinitis treatment by extending the residence time of drugs in a controlled manner. This review aims to highlight the advances in HIDS for allergic rhinitis treatment. The designs and therapeutic effect of the existing HIDS in the nasal microenvironment are described in detail. This review also provides a perspective on the future opportunities and developments of HIDS. Despite its nascent status, the future clinical and translational applications of HIDS can have a transformative impact on improving the treatment of chronic inflammation in the nasal cavity.

A Bioequivalence Study of Allergostin® Compared to Administration of Kestin® in Healthy Volunteers

Relevance. International non-proprietary name (INN) Ebastin is widely used in medical practice in the treatment of urticaria and allergic rhinitis. It is an antiallergic drug, which belongs to the second generation of H1-histamine receptor blocker, it is necessary to emphasize that Ebastin is effective when taken orally. As part of the registration of trade name Allergostin, a clinical study of its bioequivalence with Kestin was conducted with the participation of 26 healthy volunteers.
 Aim. The aim of this publication is summarize results of the clinical study of the comparative pharmacokinetics and bioequivalence, safety and tolerability of Allergostin, film-coated tablets, 20 mg (NTFF POLYSAN LLC, Russia), and Kestin, film-coated tablets, 20 mg (Almiral S.A., Spain), in healthy volunteers after a single oral dose on an empty stomach.
 Materials and methods. To confirm bioequivalence, an open, randomized, two-period, cross-over study of comparative pharmacokinetics and bioequivalence of drugs with a single oral intake on an empty stomach in adult healthy male and female volunteers was conducted. During the study, blood plasma samples were taken from volunteers. Each sample was tested by using a validated high performance liquid chromatography with tandem mass spectrometry method, the concentrations of ebastine and the active metabolite carabastin were determined. Based on obtained data , pharmacokinetic and statistical analysis was carried out, 90% confidence intervals (CI) were calculated for the ratio of the geometric mean values of the pharmacokinetic parameters Cmax and AUC0-72 for carabastin.
 Results. Based on results of statistical analysis, it was shown that the pharmacokinetic parameters of the test (Allergostin) and reference (Kestin) drug are characterized by high similarity. For the estimated pharmacokinetic parameters of carabastin, 90% CI ranged from 80-125% for AUC0-t and Cmax.
 Conclusion. Thus, according to the applied criteria, the drugs are recognized as bioequivalent.

ARIA Care Pathways 2019: Next-Generation Allergic Rhinitis Care and Allergen Immunotherapy in Malaysia.

An increase in the prevalence of allergic rhinitis (AR) worldwide presents a significant burden to the health care system. An initiative was started in Europe designated as Allergic Rhinitis and Its Impact on Asthma (ARIA) to develop internationally applicable guidelines by utilising an evidence-based approach to address this crucial issue. The efforts are directed at empowerment of patients for self-management, the use of digital mobile technology to complement and personalise treatment, and establishment of real-life integrated care pathways (ICPs). This guideline includes aspects of patients' and health care providers' management and covers the main areas of treatment for AR. The model provides better real-life health care than the previous traditional models. This review summarises the ARIA next-generation guideline in the context of the Malaysian health care system.

Efficacy of Antihistamine Nasal Spray Compared with Oral Antihistamine in Treatment of Allergic Rhinitis

Introduction: Allergic rhinitis is described as nasal membrane inflammation and is characterized by a symptom complex of sneezing, nasal congestion, itching, and rhinorrhea. These structures are also involved to some extent due to the continuity of the mucosal wall of the nose with the paranasal sinus and its communication with the ears through the Eustachian tube and with the eyes with the nasolacrimal duct. Objective: To determine the efficacy of antihistamine nasal spray compared with oral antihistamine in treatment of allergic rhinitis. Method: This Randomized control trial was conducted at the ENT department, Services Hospital, Lahore for 18 months from 01-02-2020 to 31-08-2022. Sample 450 patients of Allergic rhinitis of both sexes between the ages of 15-50 years were selected using simple random sampling technique. Patients were divided into 2 groups. Group A received oral antihistamine ebastine 10mg OD whereas Group B received nasal antihistamine spray olopatadine 0.6% (600mcg/100microlitre). Patients were then followed up every 2 weeks for 01 month. Data was enetered and analyzed in SPSS. Results: Total 450 patients were enrolled. The mean age was 24.5+ 3.0 years. There were 270(60%) male and 180(40%) female. In group A, there were 72(32%) patients 10 to 30 years of age group and 153(68%) were 30 to 50 years of age group. In group B, 65(28.8%) patients between 10 to 30 years and 160(71.1%) above 30 years of age group. Table: 2 In our study, sneezing was the most common 441(98%) followed by rhinorrhea 427(94.8%), nasal obstruction 338(75.1%), etc…In Group A, 153(68%) patients got relief and 72(32.0%) patients felt decrease in symptoms of Allergic rhinitis. In Group B, 144(64.0%) patients got relieved of symptoms, 81(36.0%) patients were partially relieved. Conclusion: The conclusion of the study that oral antihistamine and intranasal antihistamine nasal spray proved that treatment results of both treatment options were comparable in terms of reduction in the symptoms of allergic rhinitis. AIM: Our aim of the research is to determine the efficacy of antihistamine nasal spray compared with oral anti histamines in the treatment of allergic rhinitis. The sedating effects of oral antihistamines can totally be avoided in case nasal sprays have the same efficacy. Keywords: Allergic rhinitis, Antihistamine, Seasonal allergic rhinitis,

Fluticasone Propionate with Azelastine Versus Standalone Fluticasone Propionate as Nasal Spray in Allergic Rhinitis: A Prospective Comparative Study in a Rural Population of Northern India.

Allergic rhinitis (AR) is a symptomatic condition of the nose, caused by an IgE-mediated inflammation of the nasal membranes. Allergic rhinitis is further split into two categories, based on the duration of symptoms: intermittent (IAR) or persistent (PER) disease. Oral or topical antihistamines and topical nasal steroids are the most popular and efficient treatments for allergic rhinitis. The present prospective comparative study was done between December 2021 to November 2022, with 64 subjects of PER divided into groups A and B. Group A patients received Fluticasone propionate (50 mcg) combined with Azelastine (140 mcg) nasal spray, whereas Group B patients received standalone Fluticasone propionate (50 mcg) nasal spray. In both groups, the difference in mean TSS between the beginning and end of the 4-week study period was statistically significant (p for both < 0.05). After 4 weeks of treatment, Group A had a TSS of 2.02 ± 0.83 and Group B was at 3.80 ± 1.49; the difference between them was statistically significant (p < 0.05). According to results obtained from the current study, while both fluticasone propionate with azelastine nasal spray and standalone fluticasone propionate nasal spray are widely used for control of symptoms in PER, the former offers better results with significant reduction of symptoms when compared to the latter.

An integrated approach to the treatment of allergic rhinitis

Introduction. Аllergic rhinitis is characterized by IgE-mediated inflammation and widely distributed in both adult and pediatric populations. The contact between allergen and mucous membrane is followed by sneezing, rhinorrhea, nasal blockage. It may affect the quality of life and result in upper and lower airway diseases. The treatment aims to reduce or eliminate symptoms, prevent exacerbations and complications. The optimal treatment should maintain a habitual way of patient’s life. Intranasal corticosteroids in combination with selective antagonist of the leukotriene receptor drug – montelukast (Ektalust) have high efficiency and optimal dosing regimen.Aim. The study was to conduct a literature search for effectiveness of selective antagonist of the leukotriene receptor – montelukast (Ektalust) in treatment of allergic rhinitis.Materials and methods. The search was executed using RSCI and MEDLINE by keywords.Results and discussion. Patients with allergic rhinitis who received combination therapy with intranal glucocorticosteroids in combination with montelukast noted a better result in assessing the quality of life and reducing clinical manifestations, compared with patients who received monotherapy.Conclusions. Based on the available data it can be concluded that montelukast (Ektalust) in combination with intranasal corticosteroids may improve quality of life due to reduction of symptoms of allergic rhinitis, especially in conjunction with asthma.

Exploring the mechanism of Qianjin Yindan Jieji decoction in the treatment of allergic rhinitis based on network pharmacology and molecular docking.

Exploring the mechanism of Qianjin Yindan Jieji decoction in the treatment of allergic rhinitis based on network pharmacology and molecular docking.

Study on anti-inflammatory effect of peptides-conjugated alumina nanoparticle on allergic rhinitis mice model.

Allergic rhinitis (AR) is a common atopic problem in which immune response to the environmental factors leads to clinical symptoms. Helicobacter pylori neutrophil-activating protein (HP-NAP) as a peptide attenuates Th2 response and stimulates Th1 activation and mucus adhesion promoting protein (MapA) as a cell-surface protein binds to mucus. This study evaluated the effect of HP-NAP and MapA conjugated with alumina nanoparticle on AR. HP-NAP and HP-NAP with MapA were conjugated to alumina nanoparticle and two separate nanoparticles were produced. The AR mice were treated with these and HP-NAP in peptide form. The AR symptoms, gene expression of mucus, levels of IL-33 and IL-4, and total and ovalbumin (OVA)-specific IgE levels were evaluated. Nasal rubbing, sneezing, gene expression of mucus, and IL-33 and IL-4 levels, and OVA-specific and total IgE were decreased in three treated groups compared to AR, and there was a significant decrease in the symptoms in AR-H-M-A group (P < 0.05) when compared to the other treated groups. HP-NAP has a controlling effect on AR, and in nanoparticle-conjugated form it can strongly attach to the airway's mucus via MapA. Therefore, cooperation of HP-NAP-alumina with MapA can produce an effective and applicable treatment for AR.

MiR-223-3p regulates the eosinophil degranulation and enhances the inflammation in allergic rhinitis by targeting FBXW7.

MiR-223-3p is a multifunctional microRNA regulated by multiple transcription factors and plays a critical role in inflammation. This paper was designed to investigate the regulatory role and mechanism of miR-223-3p in eosinophils degranulation and allergic rhinitis (AR) inflammation. OVA sensitized AR mouse model and EOL-1 cells model were established. RT-qPCR and FISH were performed to detect the miR-223-3p expression. ELISA and WB were utilized to evaluate mRNA and protein expression. HE staining and transmission electron microscopy were applied to observe the morphological changes in nasal mucosa. Flow cytometry and immunofluorescence staining were performed to measure the proportion of eosinophils and eosinophilic major basic protein expression. The targeting relationship between miR-223-3p and FBXW7 was verified by bioinformatic analysis and dual-luciferase reporter gene assay. The expression of FBXW7 was detected by immunohistochemistry. The level of miR-223-3p in nasal mucosa was significantly up-regulated in AR group. The expression of miR-223-3p, ECP, MBP, and EPO were increased in EOL-1 cells, further increasing the miR-223-3p level could promote the ECP and EPO mRNA expression. Upregulation of miR-223-3p increased eosinophils granule protein expression, aggravated mucosal destruction and enhanced AR inflammation. Luciferase assay verified miR-223-3p directly target the 3'-UTR of FBXW7. In vitro, overexpression of FBXW7 could reverse the increase in MBP expression caused by the up-regulation of miR-223-3p. In vivo, knockdown of FBXW7 could reverse the down-regulation in granule protein level caused by the down-regulation of miR-223-3p, thereby aggravating AR inflammation. Collected evidence elucidated that miR-223-3p could regulate the eosinophil degranulation and enhances the inflammation in AR by targeting FBXW7. The miR-223-3p/FBXW7 axis may provide a novel approach for AR treatment.

Ephedramine therapeutic effectiveness for allergic rhinitis treatment: a double blind placebo controlled trial

Background : Allergic rhinitis is a common allergic disease worldwide. To date therewas no curable treatment. Study design: Double blind placebo controlled clinicaltrial. Patients and Methods: Ephedramine was evaluated as treatment for allergicrhinitis. One hundred and twenty subjects were included in the study. The patientswas divided into two groups (A) and (B), given either placebo or ephedramine(acombination of pseudoephedrine HCl 60mg plus chlorpheneramine maleate 2.5mg). The drug was given twice daily for subsequent four weeks. Patients withallergic rhinitis and associated conditions were involved in the study. Results: Ourpatients demonstrate a very well response to ephedramine; 44.8% had completeremission from congestion at the end of trial while 78.8% had remission fromRhinorrhoea, 71.1% remitted from sneezing and 80.4% had complete remission frompruritus. The corresponding values in placebo group were 31.5%, 31.5%, 17.8% and31.4% respectively. Side effects of ephedramine include headache (32.7%), dizziness(27.7%), and dry mouth (21.8%). The same above side effects were reported inplacebo group, but with lower frequency. Conclusion: Ephedramine was effective astreatment for allergic rhinitis and associated conditions with non significant sideeffects and minimized antihistamine effect of chlorpheneramine maleate by -adrenergic effect of pseudoephedrine.

Fecal and serum metabolomic signatures and gut microbiota characteristics of allergic rhinitis mice model.

The etiology of allergic rhinitis (AR) is complicated. Traditional therapy of AR still has challenges, such as low long-term treatment compliance, unsatisfactory therapeutic outcomes, and a high financial burden. It is urgent to investigate the pathophysiology of allergic rhinitis from different perspectives and explore brand-new possible preventative or treatment initiatives. The aim is to apply a multi-group technique and correlation analysis to explore more about the pathogenesis of AR from the perspectives of gut microbiota, fecal metabolites, and serum metabolism. Thirty BALB/c mice were randomly divided into the AR and Con(control) groups. A standardized Ovalbumin (OVA)-induced AR mouse model was established by intraperitoneal OVA injection followed by nasal excitation. We detected the serum IL-4, IL-5, and IgE by enzyme-linked immunosorbent assay (ELISA), evaluated the histological characteristics of the nasal tissues by the hematoxylin and eosin (H&E) staining, and observed the nasal symptoms (rubs and sneezes) to evaluate the reliability of the AR mouse model. The colonic NF-κB protein was detected by Western Blot, and the colonic histological characteristics were observed by the H&E staining to evaluate inflammation of colon tissue. We analyzed the V3 and V4 regions of the 16S ribosomal DNA (rDNA) gene from the feces (colon contents) through 16S rDNA sequencing technology. Untargeted metabolomics was used to examine fecal and serum samples to find differential metabolites. Finally, through comparison and correlation analysis of differential gut microbiota, fecal metabolites, and serum metabolites, we further explore the overall impact of AR on gut microbiota, fecal metabolites, and host serum metabolism and its correlation. In the AR group, the IL-4, IL-5, IgE, eosinophil infiltration, and the times of rubs and sneezes were significantly higher than those in the Con group, indicating the successful establishment of the AR model. No differences in diversity were detected between the AR and Con groups. However, there were modifications in the microbiota's structure. At the phylum level, the proportion of Firmicutes and Proteobacteria in the AR group increased significantly, while the proportion of Bacteroides decreased significantly, and the ratio of Firmicutes/Bacteroides was higher. The key differential genera, such as Ruminococcus, were increased significantly in the AR group, while the other key differential genera, such as Lactobacillus, Bacteroides, and Prevotella, were significantly decreased in the Con group. Untargeted metabolomics analysis identified 28 upregulated and 4 downregulated differential metabolites in feces and 11 upregulated and 16 downregulated differential metabolites in serum under AR conditions. Interestingly, one of the significant difference metabolites, α-Linoleic acid (ALA), decreased consistently in feces and serum of AR. KEGG functional enrichment analysis and correlation analysis showed a close relationship between differential serum metabolites and fecal metabolites, and changes in fecal and serum metabolic patterns are associated with altered gut microbiota in AR. The NF-κB protein and inflammatory infiltration of the colon increased considerably in the AR group. Our study reveals that AR alters fecal and serum metabolomic signatures and gut microbiota characteristics, and there is a striking correlation between the three. The correlation analysis of the microbiome and metabolome provides a deeper understanding of AR's pathogenesis, which may provide a theoretical basis for AR's potential prevention and treatment strategies.

Microbial characterization of the nasal cavity in patients with allergic rhinitis and non-allergic rhinitis.

Although recent studies have shown that the human microbiome is involved in the pathogenesis of allergic diseases, the impact of microbiota on allergic rhinitis (AR) and non-allergic rhinitis (nAR) has not been elucidated. The aim of this study was to investigate the differences in the composition of the nasal flora in patients with AR and nAR and their role in the pathogenesis. From February to September 2022, 35 AR patients and 35 nAR patients admitted to Harbin Medical University's Second Affiliated Hospital, as well as 20 healthy subjects who underwent physical examination during the same period, were subjected to 16SrDNA and metagenomic sequencing of nasal flora. The microbiota composition of the three groups of study subjects differs significantly. The relative abundance of Vibrio vulnificus and Acinetobacter baumanni in the nasal cavity of AR patients was significantly higher when compared to nAR patients, while the relative abundance of Lactobacillus murinus, Lactobacillus iners, Proteobacteria, Pseudomonadales, and Escherichia coli was lower. In addition, Lactobacillus murinus and Lacttobacillus kunkeei were also negatively correlated with IgE, while Lacttobacillus kunkeei was positively correlated with age. The relative distribution of Faecalibacterium was higher in moderate than in severe AR patients. According to KEGG functional enrichment annotation, ICMT(protein-S-isoprenylcysteine O-methyltransferase,ICMT) is an AR microbiota-specific enzyme that plays a role, while glycan biosynthesis and metabolism are more active in AR microbiota. For AR, the model containing Parabacteroides goldstemii, Sutterella-SP-6FBBBBH3, Pseudoalteromonas luteoviolacea, Lachnospiraceae bacterium-615, and Bacteroides coprocola had the highest the area under the curve (AUC), which was 0.9733(95%CI:0.926-1.000) in the constructed random forest prediction model. The largest AUC for nAR is 0.984(95%CI:0.949-1.000) for the model containing Pseudomonas-SP-LTJR-52, Lachnospiraceae bacterium-615, Prevotella corporis, Anaerococcus vaginalis, and Roseburia inulinivorans. In conclusion, patients with AR and nAR had significantly different microbiota profiles compared to healthy controls. The results suggest that the nasal microbiota may play a key role in the pathogenesis and symptoms of AR and nAR, providing us with new ideas for the treatment of AR and nAR.

Intranasal corticosteroid and antihistamine combinations in the treatment of allergic rhinitis: the role of the novel formulation olopatadine/mometasone furoate

ABSTRACT Introduction Allergic rhinitis (AR) is a common disease with an important impact on the quality of life and very high management costs. In many patients, the poor control of rhinitis symptoms often requires the use of different drugs, and polytherapy tends to reduce therapeutic adherence. According to the latest version of ARIA guidelines, the currently recommended drugs for the treatment of moderate-to-severe AR are second-generation antihistamines, intranasal corticosteroids, and their combination, even in a single nasal spray device. A single medication with a rapid onset of action, acting on breakthrough symptoms too, would be advantageous, also in terms of patient compliance. Areas covered GSP301 (olopatadine 600 µg – mometasone furoate 25 µg) is a novel intranasal formulation, combining the second-generation antihistamine olopatadine hydrochloride with mometasone furoate. Here, we review the evidence for GSP301, especially concerning the efficacy and safety profile of this intranasal combination in the treatment of AR. Expert opinion The evidence provided in the current review clearly supports the use of GSP301 as a novel intranasal corticosteroid/antihistamine combination with a well-documented efficacy and safety profile in terms of rapid symptom relief and good tolerability.

Therapeutic effects of Pulsatilla koreana Nakai extract on ovalbumin-induced allergic rhinitis by inhibition of Th2 cell activation and differentiation via the IL-4/STAT6/GATA3 pathway

Allergic rhinitis (AR), caused by immunoglobulin E (IgE)-mediated inflammation, generally occurs in the upper respiratory tract. T helper type 2 (Th2) cell-mediated cytokines, including interleukin (IL)-4, IL-5, and IL-13, are important factors in AR pathogenesis. Despite various treatment options, the difficulty in alleviating AR and pharmacological side effects necessitate development of new therapies. The root of Pulsatilla koreana Nakai (P. koreana), a pasque flower, has been used as a herbal medicine. However, its effects on AR remain unclear; therefore, we aimed to explore this subject in the current study. The therapeutic effects of P. koreana water extract (PKN) on the pathophysiological functions of the nasal mucosa was examined in ovalbumin (OVA)-induced AR mice. The effect of PKN on Th2 activation and differentiation was evaluated using concanavalin A-induced splenocytes and differentiated Th2 cells from naïve CD4+ T cells. We also investigated the effect of changes in JAK/STAT6/GATA3 signaling on IL-4-induced Th2 cells. In OVA-induced AR mice, PKN administration alleviated allergic nasal symptoms and decreased the total number of immune cells, lymphocytes, neutrophils, and eosinophils in nasal lavage fluid; serum levels of OVA-specific IgE, histamine, and IL-13 were also significantly reduced. PKN also ameliorated OVA-induced nasal mucosal tissue thickening by inhibiting inflammation and goblet cell hyperplasia. PKN treatment significantly inhibited Th2 activity and differentiation through the IL-4/STAT-6/GATA3 pathway in Th2 cells. PKN is an effective AR treatment with the potential to improve patients' daily lives by regulating the allergic inflammatory response induced by Th2 cells.

IL-1β and Allergy: Focusing on Its Role in Allergic Rhinitis.

Allergic rhinitis (AR) is a chronic upper airway immune-inflammation response mediated by immunoglobulin E (IgE) to allergens and can seriously affect the quality of life and work efficiency. Previous studies have shown that interleukin-1β (IL-1β) acts as a key cytokine to participate in and promote the occurrence and development of allergic diseases. It has been proposed that IL-1β may be a potential biomarker of AR. However, its definitive role and potential mechanism in AR have not been fully elucidated, and the clinical sample collection and detection methods were inconsistent among different studies, which have limited the use of IL-1β as a clinical diagnosis and treatment marker for AR. This article systematically summarizes the research advances in the roles of IL-1β in allergic diseases, focusing on the changes of IL-1β in AR and the possible interventions. In addition, based on the findings by our team, we provided new insights into the use of IL-1β in AR diagnosis and treatment, in an attempt to further promote the clinical application of IL-1β in AR and other allergic diseases.

Comparing The Effects of Botulinum toxin-A and multiple surgical parasympathectomy on treatment of allergic rhinitis

ObjectiveAllergic rhinitis (AR) is a common disease with a recent increasing in prevalence. Traditional treatment strategies of AR, sometimes, show limited effectiveness and side effects. Intranasal injection of Botulinum toxin type A (BTX-A) and multiple postganglionic parasympathectomy of pterygopalatine ganglion (PPG) are among the increasingly used alternative treatment options of AR. In this study, we compared the early efficacy of BTX-A and multiple surgical parasympathectomy (MSP) on treatment of uncontrolled AR. MethodsSixty patients who were diagnosed with uncontrolled AR, were recruited to the study. Participants randomly underwent either intranasal injection of BTX-A (45 IU in each nostril) (Group A) or bilateral MSP (Group B). All patients were evaluated in terms of nasal hypersecretions, congestion and sneezing with visual analogue scale prior to treatment and at weeks 1, 2, 4, 8, 12 and 6 months during the follow-up period. ResultsA significant difference in the degree of nasal hypersecretions and sneezing could be identified in both groups before and after the interventions. Although the significant efficacy on sneezing was documented in group A and B only in the first 4 and 8 weeks, respectively, such efficacy on nasal hypersecretions extended for 12 weeks in group A and throughout the follow-up period in group B. Nasal congestion did not differ significantly in both groups. ConclusionBoth BTX-A and MSP, in patients with uncontrolled AR, may be a long-lasting therapeutic option for the treatment of nasal hypersecretions, but not as effective as for sneezing and nasal congestion.

Abies holophylla Leaf Essential Oil Alleviates Allergic Rhinitis Based on Network Pharmacology.

Abies holophylla is an evergreen coniferous species that has been widely used for treating pulmonary diseases and colds. Previous research has demonstrated the anti-inflammatory effect of Abies species and the anti-asthmatic activities of Abies holophylla leaf essential oil (AEO). As asthma and allergic rhinitis (AR) share pathophysiology and pharmacotherapeutic interventions, AEO inhalation can also ameliorate upper respiratory allergic diseases. This study explored the protective effects of AEO on AR with network pharmacological pathway prediction. The potential target pathways of AEO were analyzed by a network pharmacological approach. The BALB/c mice were sensitized by ovalbumin (OVA) and 10 μm particular matter (PM10) to induce allergic rhinitis. Aerosolized AEO 0.0003% and 0.03% were delivered by nebulizer for 5 min a day, 3 times a week for 7 weeks. Nasal symptoms (sneezing and rubbing), histopathological changes in nasal tissues, serum IgE, and zonula occludens-1 (ZO-1) expressions on nasal tissues were analyzed. After AR induction with OVA+PM10 and inhalation of AEO 0.0003% and 0.03% treatment, AEO significantly decreased allergic symptoms (sneezing and rubbing), hyperplasia of nasal epithelial thickness, goblet cell counts, and serum IgE level. The network analysis demonstrated that the possible molecular mechanism of AEO is highly associated with the IL-17 signaling pathway and tight junction. The target pathway of AEO was investigated in RPMI 2650 nasal epithelial cells. Treatment of AEO on PM10-treated nasal epithelial cells significantly reduced the production of inflammatory mediators related to the IL-17 signaling pathway, NF-κB, and the MAPK signaling pathway and prevented the reduction in TJ-related factors. When taken together, AEO inhalation may be considered as a potential treatment for AR by alleviating nasal inflammation and recovering the tight junction.

Probiotic treatment (Enterococcus faecalis) improves symptoms of seasonal allergic rhinitis: A randomized controlled trial.

Probiotic treatment (Enterococcus faecalis) improves symptoms of seasonal allergic rhinitis: A randomized controlled trial.

ARUNDO DONAX L.: A SCIENTIFIC UPDATE

Arundo donax L. belongs to the family Poaceae. It has been found in the Mediterranean, North Africa, India and Pakistan. It grows in hilly locations in India. It grows up to 2100-2440 m in the Himalayas. Commonly, A. donax L. is known as Giant Reed in English and Narakata in Hindi. Traditionally it is used in the treatment of dropsy and cancer. It is the active ingredient of an Ayurveda formulation, “Virataradi Kashaya,” which is used in the treatment of urinary calculi, retention of urine and abdominal pain in homeopathy A. donax L. is used for the treatment of allergic rhinitis. A. donax L. contains many beneficial phytoconstituents such as protein, fat, total carbohydrate, fibers, lignin, α-cellulose, hemicelluloses, alkaloids (tryptamine, bufotenidine, gramine and arundamine), etc. A. donax L. has been found to possess many pharmacological properties like antibacterial and antifungal effects, anthelmintic effects, antifeedant activity, antiproliferative effect, effect on milk production and fattening performance, central nervous effect, hypotensive effect, antispasmodic effect, anti-acetylcholine effect, uterine stimulant effect and neuromuscular blocking activity. It is an essential ingredient of herbal expectorants. This review might be a vital tool for researchers who seek to work in this area.

Therapeutic management of allergic rhinitis: a survey of otolaryngology and allergology specialists.

To describe the current management of allergic rhinitis (AR) in Spain's specialized care according to the next-generation ARIA guidelines. An ad hoc online survey was distributed to AR specialists to appraise their perceptions of pathology management, knowledge of next-generation ARIA guidelines (including four case clinics), and their views on the principal barriers and the actions to proper AR management. one hundred nine specialists (38.5% allergists and 61.5% otolaryngologists) completed the study survey. Most respondents (87.2%) had read all or part of the Next-Generation ARIA Guidelines, and 81.6% stated that they considered the patient's treatment choice preferences. However, only 20.2% of specialists answered according to the recommendations in at least three of the four case clinics. Most participants failed to fulfill the treatment duration according to the guidelines. They regarded the lack of multidisciplinary teams (21.7%) and the lack of patients' AR treatment adherence (30.6%) as the most critical healthcare system- and patient-related barriers to the correct management of AR, respectively. Promoting patients' education was considered the most crucial action to improve it. Despite specialists' awareness, there is a gap between the evidence-based guidelines' recommendations and their implementation in clinical practice.