Types Of Allergic Diseases Research Articles

Six-year trend of subsequent allergic diseases following Kawasaki disease and its clinical implications: A population-based matched cohort study of 34,712 patients.

It has been suggested that allergic diseases may increase after Kawasaki disease (KD). We aimed to analyze the temporal patterns of allergic disease incidence after KD. A nationwide population-based matched cohort study was conducted using data from the Korean National Health Insurance claims database. Patients aged <5 years diagnosed with KD and their 1:3 propensity score-matched controls were included. Three cohorts were established: Cohort A, patients with allergies; Cohort B, patients without allergies; and Cohort C, patients without allergies, but excluding patients with birth history and underlying medical conditions. Cumulative incidence rates (%) and associated hospital visits for allergic rhinitis, atopic dermatitis, urticaria, and asthma were compared between the cases and controls during the 6-year follow-up period. The study population comprised 8678 patients diagnosed with KD and 26,034 controls. In Cohort A, although initially, there were intergroup differences in the number of hospital visits for certain allergic diseases, these differences were inconsistent and varied depending on the type of allergic disease. Over time, the differences narrowed, and by the sixth year, the gap had decreased significantly. In Cohorts B and C, the initial incidence rates of the four allergic diseases and associated hospital visits were lower in patients with KD as compared to controls. However, with a faster rate of increase, the incidence rates and number of hospital visits eventually surpassed those of the controls. The pattern of delayed increase in cumulative incidence rates and hospital visits for allergic diseases after KD suggests the possibility of a shared genetic or immunologic susceptibility between KD and allergic diseases, which becomes evident over time, rather than a direct influence of KD resulting in allergic diseases.

Immunotherapy approaches for managing allergic conditions in children – A narrative review

Allergic reactions in children are a major concern globally. The ever-changing environment, exposure to new and chemically altered compounds, genetically modified food products, variations in hygiene parameters, and most importantly, questionable immunity, together influence the pattern of allergic diseases in children. The most favorable and convenient mode of treatment sought is the use of over-the-counter drugs like antihistamines. However, they tend to lose their efficacy when used over a long period of time. Immunotherapy, for the management of allergic conditions, is considered a gold standard and is still a promising tool. Subcutaneous immunotherapy and sublingual immunotherapy together comprise the two modes of allergen-specific immunotherapy. Each method differs in its mode of administration and role in allergic diseases, in terms of, efficacy and safety measures. The choice between the two is dependent on the type of allergic disease and personal preferences opted either by the specific patient, or by the health-care professional involved in the treatment. The convenience of administration and compliance are also major grounds to consider while opting for the most appropriate mode of treatment. This review hence highlights new advancements in the field of immunotherapy, the efforts to achieve the goals envisioned and literature focusing on better outcomes in managing allergic reactions.

Sensitisation profile to pollen allergens of selected grass and tree species in Filipino communities

Pollen allergy remains insufficiently studied in the Philippines despite its global significance. This community-based, cross-sectional study thus determined the sensitisation profile of Filipino individuals to pollen allergens from selected grass species (Zea mays, Saccharum spontaneum, and Dichanthium spp.) and tree species (Mangifera indica, Delonix regia, and Peltophorum pterocarpum). Study subjects (n = 523), 2–70 years old, and residents of Bustos, Bulacan, Mayorga, Leyte, and Laoag, Ilocos Norte, were recruited from November 2018 to July 2019. Clinical history was evaluated through a self-directed questionnaire, while pollen sensitisation was assessed through skin prick test (SPT) and pollen-specific immunoglobulin E enzyme-linked immunosorbent assay (sIgE ELISA). Correlation and multiple logistic regression analyses were performed to identify significant relationships between pollen sensitisation and demographic characteristics. Of the 523 study subjects, 38.24% reported symptoms of allergic rhinitis, 32.70% reported atopic dermatitis, and 30.02% reported allergic asthma. Participants were mainly sensitised to M. indica (32.70%). More males were sensitised at earlier age groups than females. Alternatively, females had increased odds of reporting allergic rhinitis and more than one type of allergic disease. Sensitisation to tree pollen, age, smoking, and secondhand smoking status were also significant predictors (p ≥ 0.05). Smoking status, sex, age, family history, and sensitisation to tree pollen were significant risk factors associated with allergic diseases.

Common allergens in patients of allergic rhinitis in Gandaki province of Nepal

Introduction: Atopic disorder is very common globally and in Nepal which has affected quality of life resulting into loss of working and school days. Change in lifestyle is one of the important recommendations for fighting back with allergy, which suggests for avoidance of allergens developing allergic rhinitis. The objectives of the study were to find out common allergic conditions in Pokhara, Nepal and to identify the allergens, which induced IgE mediated disorder. Methods: A retrospective study was done among the patients with different allergic disorders who were referred from different specialist clinic attending Pokhara ENT Center at Pokhara from January 2011 to December 2017. The study sample included 1810 patients to find the distribution of various allergic disorders among them. Further, a sample of 430 patients of allergic rhinitis who had undergone skin prick test according to international guidelines were included in order to find out the common allergens among them. Set of allergens included in this study were mites, pollen, fungus, insects, dusts, epithelia-danders, feather &amp; fabric, non-juicy foods, and juicy foods. These nine allergen types further included several allergens. Data were analyzed using descriptive statistics using Stata 15.1. The study was done from after taking ethical clearance from the institutional ethical committee of Gandaki medical college. Results: Among various types of allergic diseases, allergic rhinitis accounted for one fourth (23.8%) of the cases. The patients with allergic rhinitis who underwent skin prick test against various allergens were evaluated. Skin prick test positive test result were seen for non-juicy foods (96%), pollens (95%) and then juicy foods (93%). On the contrary, least percentage (13.72%) of people were found positive against feather &amp; fabrics. Radish (7.7%) and snake gourd (6.99%) were only two juicy vegetables against which people were found positive in skin prick test. Among non-juicy foods, tobacco was the commonest allergens which was reported positive in skin prick test of 16% people. Pollen of Zea mays, Azadirachta indica, Mangifera indica and Prosopis juliflora were top allergens diagnosed positive among 12.65%, 10.95%, 7.79%, and 7.54% of people respectively. The mite Dermatophagoides pteronyssinus yielded highest prevalence (69.36%) of positive test. Conclusions: Based upon the findings of our study, allergic rhinitis is one of the most common allergic diseases in Gandaki province, Nepal. Patients of allergic rhinitis should be tested for certain allergens which are locally present and they need to modify lifestyle and avoid allergens which can induce IgE-mediated disorder. Further research is needed to establish causation.

Characteristics of IgG4-related disease complicated with allergic rhinitis or chronic rhinosinusitis: a large cross-sectional cohort study

In clinical practice, we found that IgG4-related disease (IgG4-RD) patients complicated with allergic rhinitis (AR)/chronic rhinosinusitis (CRS) seemed to have unique characteristics different from patients with IgG4-RD alone. In this study, demographic, clinical and laboratory characteristics of IgG4-RD patients complicated with AR/CRS were investigated. We retrospectively analyzed 756 IgG4-RD patients who were recruited in four medical centers from 2009 to 2021. We divided 756 IgG4-RD patients into 2 groups: the case group included IgG4-RD patients complicated with AR/CRS, and the control group included IgG4-RD patients without AR/CRS. 411 patients were complicated with AR/CRS among 756 IgG4-RD patients. Multiple organs involvement (≥ 3, p < 0.0001, OR 3.585 (95% CI 2.655–4.839)) and other types of allergic disease (p < 0.0001, OR 2.007 (95% CI 1.490–2.693)) were more common in the case group. Patients in the case group had a higher level of serum IgG4 (650 mg/dL vs 385 mg/dL, p < 0.0001), IgE (347 mg/dL vs 98 mg/dL, p < 0.0001) and ESR (14 mm/h vs 12 mm/h, p < 0.05). High IgE level (p < 0.01, OR 1.003 (95% CI 1.001–1.005)) and other types of allergic disease (p < 0.05, OR 3.196 (95% CI 1.146–8.908)) were risk factors for patients in the case group, in which most patients had nasal manifestations before the diagnosis of IgG4-RD. The median time interval from nasal symptoms appearance to IgG4-RD diagnosis was − 120 and − 90 months for patients complicated with AR and CRS, respectively. IgG4-RD patients are often complicated with AR/CRS and have distinct characteristics, which appear to be a subgroup of IgG4-RD. The data suggests a pathogenic association of IgG4-RD and AR/CRS.

Maternal bisphenol A and triclosan exposure and allergic diseases in childhood: a meta-analysis of cohort studies.

Bisphenol A (BPA) and triclosan (TCS) are both endocrine-disrupting chemicals (EDCs), and pregnant women are usually exposed to them through daily consumption. This study aimed to explore the relationship between prenatal BPA and TCS exposure and allergic diseases in childhood by systematic review and meta-analysis. We searched the topic of prenatal BPA and TCS exposure and allergic diseases in childhood published before March 22, 2021, in four databases, including PubMed, Web of Science, Embase, and Cochrane. Statistical analysis was completed using Stata software (version 16.0). Seven papers on BPA and four papers on TCS were included in this meta-analysis. The association between prenatal exposure to BPA and total allergic diseases in childhood showed a pooled effect estimate of 1.13 (95% CI, 1.04, 1.23), with I2 = 0.0% (P = 0.615). The effect estimates between BPA exposure and each allergic disease were 1.18 (95% CI, 1.02, 1.36) for wheezing, 1.23 (95% CI, 1.01, 1.50) for asthma, 1.03 (95% CI, 0.89, 1.18) for eczema/rashes or hives, and 1.19 (95% CI, 0.91, 1.56) for aeroallergies. Prenatal exposure to TCS had no association with the four types of allergic disease in childhood. BPA exposure during the prenatal period was positively associated with allergic disease in childhood. Strengthening prenatal EDC exposure control is necessary for child health.

Pathogenesis of Children's Allergic Diseases: Refocusing the Role of the Gut Microbiota.

Allergic diseases comprise a genetically heterogeneous cluster of immunologically mediated diseases, including asthma, food allergy (FA), allergic rhinitis (AR) and eczema, that have become major worldwide health problems. Over the past few decades, the spread of allergic diseases has displayed an increasing trend, and it has been reported that 22% of 1.39 billion people in 30 countries have a type of allergic disease. Undoubtedly, allergic diseases, which can be chronic, with significant morbidity, mortality and dynamic progression, impose major economic burdens on society and families; thus, exploring the cause of allergic diseases and reducing their prevalence is a top priority. Recently, it has been reported that the gastrointestinal (GI) microbiota can provide vital signals for the development, function, and regulation of the immune system, and the above-mentioned contributions make the GI microbiota a key player in allergic diseases. Notably, the GI microbiota is highly influenced by the mode of delivery, infant diet, environment, antibiotic use and so on. Specifically, changes in the environment can result in the dysbiosis of the GI microbiota. The proper function of the GI microbiota depends on a stable cellular composition which in the case of the human microbiota consists mainly of bacteria. Large shifts in the ratio between these phyla or the expansion of new bacterial groups lead to a disease-promoting imbalance, which is often referred to as dysbiosis. And the dysbiosis can lead to alterations of the composition of the microbiota and subsequent changes in metabolism. Further, the GI microbiota can affect the physiological characteristics of the human host and modulate the immune response of the host. The objectives of this review are to evaluate the development of the GI microbiota, the main drivers of the colonization of the GI tract, and the potential role of the GI microbiota in allergic diseases and provide a theoretical basis as well as molecular strategies for clinical practice.

From Allergy to Cancer-Clinical Usefulness of Eotaxins.

Simple SummaryEotaxins are small proteins included in the group of chemokines. They act mainly on blood cells called eosinophils which are involved in the pathogenesis of inflammatory processes. This connection leads to involvement of eotaxins in the pathogenesis of all inflammatory related diseases, such as allergic diseases and cancer. This paper summarizes the current knowledge about eotaxins, showing their usefulness as markers that can be used not only in the detection of these diseases, but also to determine the effectiveness of treatment.Eotaxins are proteins which belong to the group of cytokines. These small molecules are secreted by cells that are mainly involved in immune-mediated reactions in the course of allergic diseases. Eotaxins were discovered in 1994 and their main role was considered to be the selective recruitment of eosinophils. As those blood cells are involved in the course of all inflammatory diseases, including cancer, we decided to perform an extensive search of the literature pertaining to our investigation via the MEDLINE/PubMed database. On the basis of available literature, we can assume that eotaxins can be used as markers for the detection and determination of origin or type of allergic disease. Many publications also confirm that eotaxins can be used in the determination of allergic disease treatment. Moreover, there are also studies indicating a connection between eotaxins and cancer. Some researchers revealed that CCL11 (C-C motif chemokine ligand 11, eotaxin-1) concentrations differed between the control and tested groups indicating their possible usefulness in cancer detection. Furthermore, some papers showed usefulness of eotaxins in determining the treatment efficacy as markers of decreasing inflammation. Therefore, in this paper we present the current knowledge on eotaxins in the course of allergic and cancerous diseases.

Asthma and aspergillosis: Which One causes another

The respiratory system of the human body is always under exposure to a great number of fungal spores every day. Asexual spores of Aspergillus are the most frequent type occurring in various environments. Inhalation of these spores can lead to various undesirable effects in the airway. Infection in the form of aspergillosis is one type of harmful effect of inhaled spores, especially in immunocompromised patients, while sensitization is a second type after long-term exposure to Aspergillus spores. In some cases, sensitization can develop into a various types of allergic diseases such as asthma. Otherwise, aspergillosis can be initiated in many asthmatic patients, which make asthma a predisposing factor for aspergillosis. In conclusions: Asthma and aspergillosis have shared responsibility to form each other in reversible relationship.

Management of urticaria with Virechana: A case study

In the present era due to over-industrialization and increase in pollution as well as changed life style, one can constantly meets with various pollutants; which ultimately results in weaken immune system and increased sensitivity toward allergens. This causes various types of allergic diseases. Urticaria is one of the most common allergic skin diseases characterized by erythematous and pruritic rashes. It affects 15-20% of the people at some point of their life. Highest incidence occurs at third decade of life. The discomfort and stress caused by urticarial can lead to serious impairment of quality life. In classics sheetpitta has almost similar symptomatology and causative factors as urticaria. In sheetpitta, vata and kapha are primarily disturbed and in combination of pitta they cause redness, swelling and itching on the skin. Although the diseases is not life-threatening, it makes the patient troubled due to its appearance, severe itching, and disturb the daily routine. In contemporary science there is no permanent cure, but only remission of the disease can be achieved by medicine. But these treatments can cause reoccurrence of the disease. So an effort has been made with Ayurvedic intervention. A male patient from Panchkarma OPD was treated with Virechana along with internal medication and dietary protocol. Significant relief in the symptoms is observed in the patient after Virechana and oral medication. Virechana may be better line of treatment for urticaria as it works on correcting the underlying root cause along with symptoms of the diseases.

Immunoglobulins Levels in Iraqi Atopic patients (Asthma, Rhinitis and Urticaria)

One hundred ninety-two patients (82 males and 110 females) with three types of allergic diseases (allergic asthma 60, allergic rhinitis 54, and urticaria 78), and 45 control subjects were tested to determine the levels of IgG, IgM and IgA by using the single radial immunodiffusion technique, and the levels of IgE by the ELISA method. The results revealed an apparent increase in IgE levels and inversely significant decrement for both IgG and IgA in all the three types of the allergies. While there were no substantial differences between IgM levels in allergic asthma, urticaria, and control; only allergic rhinitis showed a significant decrease in the IgM level. The aim of this research is to investigate the relationship between serum level of IgG, IgM, IgA, and IgE in patients with allergic rhinitis, allergic asthma and urticaria. The decreasing level of IgG and IgA, as well as, increasing level of IgE, are associated with the three types of allergies and play an important role in developing the disease.

Identification of saprophytic and allergenic fungi in indoor and outdoor environments.

The airborne spores of some saprophytic and allergenic fungi such as Aspergillus, Alternaria, and Cladosporium are found throughout the world and exposure to these agents may result in various types of allergic diseases. The aim of this study, therefore, was to investigate the frequency of different saprophytic, allergenic, and pathogenic fungi in indoor and outdoor environments. During a 6-month period, 780 samples were obtained from a number of houses, mosques, parks, public restrooms, grocery stores, laboratories, and hospitals. An open-plate method was applied for air sampling by exposing 90-mm plates containing chloramphenicol/potato dextrose agar and malt extract agar were exposed to air for 30min. Alternatively, the sampling from surfaces was performed using sterile wet swab and tape-stripe method. All samples were then inoculated in media and incubated at 28°C for 2-3weeks. The isolated fungi were purified in order to detect the genus, and if possible, species level of the targeted fungi based on morphological and microscopic features using standard methods. The findings revealed that the dominant indoor and outdoor fungal species were Aspergillus, Penicillium, and Cladosporium whose frequency values were 16.42%, 16.17%, and 14.92% respectively. The lowest frequency was related to Acrophialophora and Madurella (0.25%). More notably, the results for air and surface were similar. It was also found out that the three dominant genera were Aspergillus (16.53%), Penicillium (15.50%), and Cladosporium (11.93%), with Basidiobolus and Acrophialophora having the lowest frequency. It was observed that different environmental spaces have a great bearing on the spreading of such allergic agents, especially in subtropical humid climates.

Birth order and paediatric allergic disease: A nationwide longitudinal survey.

Environmental factors seem to be related to the incidence of allergic disease. Children with a later birth order are often exposed to environments, where pathogens and endotoxins can be found, and thus have a higher risk of developing infectious diseases. Therefore, birth order is regarded as an indicator that reflects post-natal environment. However, longitudinal studies are limited on this subject. This study sought to elucidate the relationships between birth order and allergic disease. From a nationwide longitudinal study that followed children born in 2001 (n=47015), we selected doctors' visits for 3 types of allergic disease-bronchial asthma, food allergy and atopic dermatitis-from infancy to 12years of age and conducted binomial log-linear regression analysis to evaluate the associations between birth order and these diseases. We adjusted for the child and parental factors and estimated risk ratio (RR) and 95% confidence interval (CI) for each outcome. The associations between birth order and bronchial asthma were diverse; later birth order increased the risk in early childhood, but decreased the risks during school age. For example, the adjusted RR comparing third-born or higher and first-born children was 1.19 (95% CI, 1.05-1.35) between 30 and 42months of age, but was 0.76 (95% CI, 0.65-0.89) between 10 and 11years. Later birth order was generally protective for food allergy but increased the risk of atopic dermatitis. The influence of birth order depended on the type of allergic disease and the childhood period. Childhood is unique in terms of physical and immunological development, and the immune response to the post-natal environment in childhood appears to be heterogeneous.

The role of carotenoid intake in food allergy prevention.

Abstract Carotenoids are reported to play an important role in various physiological processes. Carotenoids quench reactive oxygen species and play a role in the prevention of development of chronic diseases and certain types of allergic diseases. The intake of β-carotene, which is one of the carotenoids, can improve allergic symptoms through inhibition of antigen-specific IgE antibody production, degranulation and the release of chemical mediators from mast cells or basophils. The retinoic acid derived from β-carotene is known to play an important role in inducing oral tolerance in gut-associated lymphoid tissue. The intake of β-carotene inhibits oral sensitization and the onset of IgE-dependent immediate type allergy. The intake of carotenoids has been reported to be important in the prevention of allergic symptoms, including allergic sensitization, asthma and eczema.

Factors Affecting Allergic Diseases in General High School Students

Objectives This study aimed to investigate the relevant factors of allergic disease in general high school students in Korea. It also aims to provide key data for the effective prevention and management of allergic diseases. Methods Study subjects were general high school students participating in the 11th (2015) Online Survey on Adolescents’ Health Behaviors. Participant demographics, lifestyle factors, and type of allergic disease were expressed in absolute values and percentages. The binominal logistic regression model was used for statistical analysis of characteristics and relevant factors of allergic disease. Analysis was performed by complex sample design using SPSS/WIN 18.0. The statistical significance was defined as p<0.05 with a two-sided test. Results Asthma was associated with sex, high school grade, body mass index (BMI), stress, smoking, breakfast, fast-food and vegetable consumption, milk, and walking. Allergic rhinitis correlated with sex, high school grade, residential area, economic statis, stress, vegetable consumption, and sleep satisfaction. Atopic dermatitis was associated with sex, BMI, residential area, economic status, stress, fast-food consumption, sleep satisfaction, and walking. Conclusions This study highlights the need for the development of strategies promoting a healthy lifestyle associated with allergic disease. Furthermore, a longitudinal study examining the association between medical and family history and allergic disease is required. This would contribute to the understanding of individual predisposition to allergic disease. Key words: General high school students, Allergy disease, Physical activity

No evidence for TSLP pathway activity in human breast cancer

ABSTRACTThymic stromal lymphopoietin (TSLP) is an epithelial cell-derived cytokine that primes dendritic cells for Th2 induction. It has been implicated in different types of allergic diseases. Recent work suggested that TSLP could play an important role in the tumor microenvironment and influence tumor progression, in particular in breast cancer. In this study we systematically assessed the production of TSLP at the mRNA and protein levels in several human breast cancer cell lines, large-scale public transcriptomics data sets, and primary human breast tumors. We found that TSLP production was marginal, and concerned less than 10% of the tumors, with very low mRNA and protein levels. In most cases TSLP was undetectable and found to be expressed at lower levels in breast cancer as compared to normal breast tissue. Last, we could not detect any functional TSLP receptor (TSLPR) expression neither on hematopoietic cells nor on stromal cells within the primary tumor microenvironment. We conclude that TSLP-TSLPR pathway activity is not significantly detected within human breast cancer. Taken together, these observations do not support TSLP targeting in breast cancer.

Local and systemic reactions to subcutaneous allergen immunotherapy: Ten years' experience in a pediatric clinic

BackgroundLocal and especially systemic reactions are important problems in subcutaneous immunotherapy (SCIT). Local and systemic reactions develop in 0.7% to 4% and 0.2% of all injections, respectively. ObjectiveTo evaluate the frequency of and risk factors for reactions developing in pediatric patients undergoing SCIT. MethodsLocal and systemic reactions developing after 14,308 injections between 2003 and 2013 were retrospectively evaluated in the current study using the Subcutaneous Immunotherapy Systemic Reaction Grading System, as recommended by the World Allergy Organization. The type of allergic disease, allergens producing a sensitivity, allergen immunotherapy content, adjuvant content, and the effects of treatment phase on the frequency of adverse effects were investigated. ResultsOf 319 patients, local reactions occurred in 11.9%, wide local reactions occurred in 5%, and systemic reactions occurred in 4.7%. A local reaction was observed in 0.38% of all injections, whereas a systemic reaction was observed in 0.1% of all injections. Local reactions were most frequent in the build-up phase, and systemic reactions were most frequent in the maintenance phase (P = .01). Side reactions were more common in patients undergoing SCIT with multiple allergens (P = .002) and house dust mite (P = .001). No statistically significant difference was found between adjuvant content and adverse effect frequency (P = .32). ConclusionsThe frequencies of local and wide local reactions during SCIT were lower than expected. Although systemic reactions were frequently seen, no fatal reaction was observed in the current study. House dust mite SCIT and multiple allergen use increased the risk of reaction.

GIS-based Association Between PM10 and Allergic Diseases in Seoul: Implications for Health and Environmental Policy.

PurposeThe role of PM10 in the development of allergic diseases remains controversial among epidemiological studies, partly due to the inability to control for spatial variations in large-scale risk factors. This study aims to investigate spatial correspondence between the level of PM10 and allergic diseases at the sub-district level in Seoul, Korea, in order to evaluate whether the impact of PM10 is observable and spatially varies across the subdistricts.MethodsPM10 measurements at 25 monitoring stations in the city were interpolated to 424 sub-districts where annual inpatient and outpatient count data for 3 types of allergic diseases (atopic dermatitis, asthma, and allergic rhinitis) were collected. We estimated multiple ordinary least square regression models to examine the association of the PM10 level with each of the allergic diseases, controlling for various sub-district level covariates. Geographically weighted regression (GWR) models were conducted to evaluate how the impact of PM10 varies across the sub-districts.ResultsPM10 was found to be a significant predictor of atopic dermatitis patient count (P<0.01), with greater association when spatially interpolated at the sub-district level. No significant effect of PM10 was observed on allergic rhinitis and asthma when socioeconomic factors were controlled for. GWR models revealed spatial variation of PM10 effects on atopic dermatitis across the sub-districts in Seoul. The relationship of PM10 levels to atopic dermatitis patient counts is found to be significant only in the Gangbuk region (P<0.01), along with other covariates including average land value, poverty rate, level of education and apartment rate (P<0.01).ConclusionsOur findings imply that PM10 effects on allergic diseases might not be consistent throughout Seoul. GIS-based spatial modeling techniques could play a role in evaluating spatial variation of air pollution impacts on allergic diseases at the sub-district level, which could provide valuable guidelines for environmental and public health policymakers.

Dropouts in sublingual allergen immunotherapy trials – a systematic review

Participant dropouts can reduce the power of allergen immunotherapy clinical trials. Evaluation of the dropout rate and reasons for dropout are important not only in the planning of clinical studies but are also relevant for adherence to immunotherapy in daily clinical practice. A systematic review was carried out in order to establish the overall dropout rate among published double-blind, placebo-controlled randomized clinical trials of sublingual immunotherapy for respiratory allergic diseases. Dropouts were analysed in regards to allergen, formulation, treatment schedule, participant age, study size, number of centres and type of allergic disease. Relative dropout rates in placebo and active groups as well as reasons for dropout were also assessed. A total of 81 studies, comprising 9998 patients, were included. Dropout rates in sublingual immunotherapy controlled studies do not appear to be a major problem with a composite dropout percentage of 14% (95% CI:11.9-16). Furthermore, they are not different for active compared to placebo-treated participants. This lends support to the positive clinical outcomes seen in meta-analyses of these trials.

The expression of cannabinoid receptor 1 is significantly increased in atopic patients

The expression of cannabinoid receptor 1 is significantly increased in atopic patients