Safety,tolerability and clinical efficacy of ultra-rush sublingual immunotherapy among patients suffering from allergic rhinitis

BackgroundConventional immunotherapy for allergy with 3–5 years of treatment period has poor compliance. Ultra-rush sublingual immunotherapy with a shorter period of treatment can have better compliance. There are very few studies on ultra-rush sublingual immunotherapy all over the world.Objectives(1) To determine allergen sensitivity among allergic rhinitis patients. (2) To assess safety, tolerability and clinical efficacy of ultra-rush sublingual immunotherapy.MethodsThe present study was conducted in Allergy clinic, KIMS Hospital & Research Centre, Bangalore, India from January 2010 to June 2011. After obtaining Institutional Ethics Committee approval, 40 allergic rhinitis patients (according to ARIA guidelines) in the 18–60 years age group who were positive for aeroallergens in skin prick test were recruited for ultra-rush sublingual immunotherapy (20 min initial phase and 4-month maintenance phase) and followed for 8 months with symptom and treatment diary.ResultsOut of 40 patients, the majority, 36 (90.00%) patients were sensitive to house dust mites. Six patients had seven immediate adverse reactions and seven patients had eight delayed adverse reactions. All subsided without medication or with symptomatic oral medications. All patients tolerated ultra-rush SLIT and there was significant decrease in both symptom-score and treatment received in these patients.ConclusionUltra-rush SLIT regimen has excellent safety, tolerability and clinical efficacy among allergic rhinitis patients.     

混合螨疫苗治疗儿童变应性鼻炎的疗效观察

目的评价阿罗格混合螨疫苗治疗儿童变应性鼻炎的疗效和安全性。方法对31例尘螨变应性鼻炎患儿进行特异性免疫治疗前及治疗后半年及1年半的症状、体征评分,比较其治疗效果。结果治疗后31例患者的症状、体征积分较治疗前均明显减少,差异有统计学意义（P〈0．01）,31例患者总计接受免疫治疗注射1209次,出现185次局部不良反应,3例出现全身不良反应,局部不良反应的发生率为15．30％（185／1 209）,全身不良反应的发生率为0．25％（3／1 209）,未出现致命性全身不良反应。结论标准化变应原脱敏治疗儿童变应性鼻炎是一种安全、有效的治疗方法。     

变应原疫苗免疫治疗对过敏性支气管哮喘合并鼻炎的疗效分析

目的评估标准化变应原疫苗免疫治疗（allergeni mmunotherapy,AIT）对过敏性哮喘合并鼻炎患者的近期疗效。方法设计调查问卷,对我院门诊接受标准化变应原疫苗-安脱达（Alutard（SQ）AIT治疗的39例过敏性哮喘合并鼻炎患者进行问卷调查,应用哮喘控制水平分级和哮喘控制测试（ACT）评分评价哮喘的疾病控制水平,应用鼻炎病情评分（RCT）评价过敏性鼻炎的控制情况。结果 39例患者治疗前后的哮喘控制水平分级（Z=-7.235,P〈0.05）、ACT评分（t=16.533,P〈0.05）、RCT评分（t=16.650,P〈0.05）、情绪（χ2=34.873,P〈0.05）等均有较大程度的改善。结论标准化AIT治疗能明显改善过敏性哮喘合并鼻炎患者的临床症状。     

变应原疫苗免疫治疗对过敏性支气管哮喘合并鼻炎的疗效分析

目的 评估标准化变应原疫苗免疫治疗(allergen immunotherapy,AIT)对过敏性哮喘合并鼻炎患者的近期疗效.方法设计调查问卷,对我院门诊接受标准化变应原疫苗-安脱达(Alutard(R)SQ)AIT治疗的39例过敏性哮喘合并鼻炎患者进行问卷调查,应用哮喘控制水平分级和哮喘控制测试(ACT)评分评价哮喘...     

支气管哮喘和变应性鼻炎的舌下特异性免疫疗法进展

舌下特异性免疫疗法在支气管哮喘和变应性鼻炎的治疗方面发挥了重要作用,它提供了一种可以替代传统皮下免疫疗法的变应原免疫治疗方法.目前已经有两种制剂(滴剂和片剂)可以用于舌下特异性免疫疗法.研究表明舌下特异性免疫疗法是安全、有效的.     

支气管哮喘和变应性鼻炎的舌下特异性免疫疗法进展

舌下特异性免疫疗法在支气管哮喘和变应性鼻炎的治疗方面发挥了重要作用,它提供了一种可以替代传统皮下免疫疗法的变应原免疫治疗方法。目前已经有两种制剂（滴剂和片剂）可以用于舌下特异性免疫疗法。研究表明舌下特异性免疫疗法是安全、有效的。     

Office-based management of allergic rhinitis in adults

Allergic rhinitis (AR), the most common form of rhinitis, affects 10% to 30% of adults. However, the prevalence of AR actually may be underestimated. Rhinitis is caused by allergic, nonallergic, infectious, hormonal, occupational, and other factors. Proper management of AR requires that the correct diagnosis be made; the clinical history and physical examination are key. Controlled studies support the utility of several available treatments that produce fewer symptoms, improve quality of life, and prevent comorbidities.     

Role of nasal saline irrigation in the treatment of allergic rhinitis in children and adults: A systematic analysis

BackgroundThis meta-analysis aims to access the efficacy of nasal saline irrigation in the treatment of allergic rhinitis (AR) in adults and children.MethodsTwo authors independently searched databases up to December 2018. Differences in efficacy between saline irrigation and other treatments were compared. Subgroup analyses of discrepancy in effects between children and adults were performed.Results(1) Saline irrigation vs. no irrigation, in both children and adults groups, saline irrigation showed significant efficacy. (2) Saline + medication vs. medication, in children group, there was no statistical difference of efficacy between saline + medication and medication; in adults group, efficacy of saline + medicine was superior to that of medication. (3) Saline irrigation vs. medication, in children group, there was no statistical difference between efficacy of saline irrigation and medication; in adults group, efficacy of medication was superior to that of saline irrigation. (4) Hypertonic saline vs. isotonic saline, for children, efficacy of hypertonic saline was superior to that of isotonic saline. Additionally, no adults reported adverse events in all trials. Adverse effects were reported during the first nasal irrigation in 20 children, and one child withdrew due to adverse reactions.ConclusionsSaline irrigation can significantly improve symptoms of AR in children and adults. Saline irrigation can serve as a safe adjunctive treatment to medication of AR in adults. Saline irrigation can be an alternative therapy for children and pregnant women with AR. Efficacy of hypertonic saline may be better than that of isotonic saline in treating AR of children.     

变应性鼻炎与支气管哮喘患者的肺功能改变

目的 通过对变应性鼻炎(A组)与支气管哮喘患者(B组)及健康对照组(C组)进行肺功能检测,寻找两种疾病肺功能改变的意义.方法 采用美国Sensor-Medics6200体描箱对A、B、C组患者检测肺功能有关指标.结果 A、B两组V25％ 、V50％明显降低,与C组比较,差异显著(P＜0.01);A组V50％与B组比较,有意义地增高(P＜0.05);B组RV明显增高,与A、C组比较,差异显著(P＜0.01);A、B两组Raw与C组比较,有意义地增高(P ＜0.05);FVE1％:B组低于C组(P＜0.05),而A组与C组及A组与B组对照均无明显差异(P＞0.05);DLCO％:B组高于A及C两组(P＜0.05).结论 两组患者对肺功能影响相似,主要是小气道阻塞,只是哮喘组影响强.     

变应性鼻炎对支气管哮喘患者临床控制和肺通气功能的影响

目的 研究变应性鼻炎对支气管哮喘(简称哮喘)患者的临床控制和肺通气功能的影响.方法 分析39例哮喘合并变应性鼻炎患者的变应性鼻炎视觉模拟量表(VAS)评分与哮喘控制测试(ACT)评分、哮喘控制问卷(ACQ)评分和肺通气功能之间的相关性.结果 变应性鼻炎VAS评分与ACT评分呈负相关(r=-0.591,P＜0.05),与ACQ评分呈正相关(r=0.599,P＜0.05).变应性鼻炎VAS评分与FEV1％pred、PEF％ pred、FEF25％ pred、FEF50％ pred、FEF25％75％ pred均呈负相关(r=-0.473,-0.581,-0.591,-0.567,-0.494,P＜0.05).结论 在哮喘合并变应性鼻炎患者中,变应性鼻炎症状越重,哮喘控制越差,肺通气功能越低.     

Efficacy and safety of sublingual immunotherapy with Dermatophagoides farinae drops in pre-school and school-age children with allergic rhinitis

Background

The safety and efficacy of sublingual immunotherapy (SLIT) have been confirmed by many studies. However, in China, the research on efficacy and safety in young and older children with allergic rhinitis (AR) is still rare.

变应性鼻炎与支气管哮喘相关性研究进展

变应性鼻炎能够增加支气管哮喘（简称哮喘）患者的就诊率和用药剂量,不利于哮喘患者的临床控制并使其肺功能下降,但研究结果尚存在争论。变应性鼻炎在哮喘的发生和进展过程中扮演了重要角色,推测肺通气功能异常和气道高反应可能是部分变应性鼻炎患者的特征,该类人群可能更容易发展为哮喘。然而目前尚不明确变应性鼻炎患者的肺功能特点,针对此问题的研究较少。此外,关于治疗变应性鼻炎能否改善存在气道高反应的变应性鼻炎患者的肺功能并预防哮喘发生尚不清楚。这些问题对哮喘的预防具有重要意义,本文将讨论这方面问题的国内外研究进展,并提出可能的研究方向。     

Seasonal allergic rhinitis and the role of apitherapy

BackgroundApitherapy represents a certain form of complementary and alternative medicine that uses bee products in combination with other methods from this field. One of the basic concepts of this type of medicine is that all diseases can be treated using apitherapy. This study was performed to assess the recommendations from authors of books on apitherapy regarding the treatment of seasonal allergic rhinitis and compare them to findings from the scientific literature.MethodsOne hundred and twenty-nine books on apitherapy were analysed regarding recommendations for allergic seasonal rhinitis. Scientific evidence regarding the efficacy of using various bee products was searched via PubMed and JUSTfind.ResultsOnly 38.8% of the apitherapy books mentioned seasonal allergic rhinitis. Among these books, we found 29 different recommendations in favour of bee products and one against the use of honey. The most reasonable recommendation according to clinical studies on the subject, namely the use of a mix of honey and pollen, was only found once (0.8%).ConclusionsThe large discrepancies and number of different recommendations demonstrate that apitherapy is not a consistent type of medicine. The recommendations regarding seasonal allergic rhinitis in the vast majority of apitherapy books cannot be considered adequate when compared to the scientific findings.     

Syk inhibitors as treatment for allergic rhinitis

Allergic rhinitis is characterized by a hypersensitive immune response in the upper airways to seasonal or perennial allergens leading to episodes of sneezing, itching, runny nose and nasal congestion. These symptoms are mainly the manifestations of a large number of mediators released by mast cells and basophils localized in the nasal mucosa, following their activation via allergen-specific immunoglobulin E (IgE) receptors. Current medications antagonize the action of distinct mediators such as histamine and leukotrienes for symptom relief, or block the production of pro-inflammatory cytokines to suppress allergic inflammation. Notably, rather than neutralizing individual mediators, Syk kinase inhibitors can block the allergen-induced release of all mast cell mediators and the production of most eicosanoids and cytokines. Thus, Syk kinase represents an attractive therapeutic target for acute and chronic allergic inflammation. Syk kinase inhibitors are now entering clinical trials. Using cell-based structure-activity relationships with primary human mast cells, a series of 2,4-diaminopyrimidine Syk kinase inhibitors was developed. One of these compounds, referred to as R112, exhibited suitable characteristics for intranasal delivery and was tested for safety and efficacy in allergic rhinitis patients. In a park environment, R112 showed remarkable amelioration of acute allergic rhinitis symptoms with rapid onset of action. These results demonstrate the clinical significance of inhibiting Syk in allergic upper airway disorders.     

广东惠州地区成人支气管哮喘合并过敏性鼻炎的流行病学调查分析

目的了解惠州地区支气管哮喘（简称哮喘）患者合并过敏性鼻炎的情况,分析两者在临床表现方面的相关性及调查对过敏性鼻炎认知程度和治疗现状。方法问卷调查惠州地区280例哮喘患者,详细了解其哮喘病史、严重程度分级、哮喘控制测试（asthma control test,ACT）评分、鼻炎情况包括患病情况、认知程度、相关家族遗传史及治疗现状等。建立相应个人数据档案,对数据进行统计学分析。结果 280例哮喘患者中,203例（72.50%）合并过敏性鼻炎,哮喘合并过敏性鼻炎组和单纯哮喘组在年龄、性别、病程间的差异无统计学意义（P〉0.05）。哮喘合并过敏性鼻炎组、二级（轻度持续）、三级（中度持续）、四级（重度持续）例数均高于单纯哮喘组（P〈0.05）。ACT评分,完全控制、良好控制例数均低于单纯哮喘组（P〈0.05）,未控制哮喘高于单纯哮喘组（P〈0.05）。鼻炎情况过敏性鼻炎起病早于哮喘占59.61%,两者同时起病占17.24%,鼻炎诱因依次为冷空气（82.10%）,刺激性气体（61.58%）,25.62%患者做过过敏原测验,56.65%使用药物治疗鼻炎,27.10%直系三代有哮喘或过敏性鼻炎家族史。结论惠州地区哮喘合并过敏性鼻炎发生率高,认知程度较低,治疗现状不容乐观,为今后防治措施及相关研究提供依据。     

广东惠州地区成人支气管哮喘合并过敏性鼻炎的流行病学调查分析

目的 了解惠州地区支气管哮喘(简称哮喘)患者合并过敏性鼻炎的情况,分析两者在临床表现方面的相关性及调查对过敏性鼻炎认知程度和治疗现状.方法 问卷凋查惠州地区280例哮喘患者,详细了解其哮喘病史、严重程度分级、哮喘控制测试(asthma control test,ACT)评分、鼻炎情况包括患病情况、认知程度、相关家族遗传史及治疗现状等.建立相应个人数据档案,对数据进行统计学分析.结果 280例哮喘患者中,203例(72.50％)合并过敏性鼻炎,哮喘合并过敏性鼻炎组和单纯哮喘组在年龄、性别、病程间的差异无统计学意义(P＞0.05).哮喘合并过敏性鼻炎组、二级(轻度持续)、三级(中度持续)、四级(重度持续)例数均高于单纯哮喘组(P＜0.05).ACT评分,完全控制、良好控制例数均低于单纯哮喘组(P＜0.05),未控制哮喘高于单纯哮喘组(P＜0.05).鼻炎情况过敏性鼻炎起病早于哮喘占59.61％,两者同时起病占17.24％,鼻炎诱因依次为冷空气(82.10％),刺激性气体(61.58％),25.62％患者做过过敏原测验,56.65％使用药物治疗鼻炎,27.10％直系三代有哮喘或过敏性鼻炎家族史.结论 惠州地区哮喘合并过敏性鼻炎发生率高,认知程度较低,治疗现状不容乐观,为今后防治措施及相关研究提供依据.     

Angiotensin-converting enzyme gene insertion/deletion polymorphisms and the susceptibility to allergic rhinitis

BackgroundAngiotensin-converting enzyme (ACE) gene I/D polymorphism might be linked to the risk of the allergic rhinitis (AR).ObjectiveIn the present study, we assessed the association of ACE gene I/D polymorphisms with AR susceptibility using a meta-analysis.Materials and methodsWe carried out a retrieval of studies and included the eligible studies if they met the criteria. After the data extraction, the Stata software was used to analyse the genotype frequencies.ResultsIn total, five studies with 561 patients and 603 controls were included. However, the genotype distribution among the control of one study was not consistent with the Hardy–Weinberg equilibrium. After pooling all studies, the results indicated an association between ACE gene I/D polymorphism and AR risk in the overall analysis (II vs. others: OR = 0.70, 95% CI = 0.54–0.92, P = 0.010; D vs. I: OR = 1.29, 95% CI = 1.08–1.54, P = 0.005). In the further analysis of the East Asians, no association between ACE gene I/D polymorphism and AR risk was observed.ConclusionACE gene I/D polymorphisms were not associated with the risk of AR in East Asians. These results need to be confirmed in the following studies.     

The efficacy and safety of sublingual immunotherapy in children and adult patients with allergic rhinitis

BackgroundClinical research has shown that sublingual immunotherapy (SLIT) is effective and safe in moderate-severe allergic rhinitis (AR) induced by house dust mite (HDM). However, the sample size in many studies is small. Meanwhile, the controversy on the efficacy and safety in the very young children younger than four years old still existed.ObjectiveThe aim of this retrospective study is to evaluate the efficacy and safety of SLIT with Dermatophagoides farinae (Der.f) extracts in children and adult patients with allergic rhinitis, particularly in the very young children.MethodA total of 573 subjects aged 3–69 with AR received a three-year course of sublingual immunotherapy with Der.f extracts along with pharmacotherapy. The total nasal symptoms score (TNSS), total medication score (TMS), visual analogue score (VAS) and adverse events (AEs) were evaluated at each visit.ResultTNSS, TMS, VAS were significantly improved during the three-year course of treatment in comparison to the baseline values (P < 0.01). Besides, significant improvement in nasal symptoms and reduction of medication use were also observed in young children aged 3–6 years (P < 0.01). No severe systemic adverse events (AEs) were reported.ConclusionSLIT with Der.f drops is clinically effective and safe in children and adult patients with HDM-induced AR, including the very young children less than four years old.     

Prevalence of asthma,allergic rhinitis and pollinosis in a city of Brazil: A monitoring study

BackgroundAllergic respiratory diseases such as asthma and allergic rhinitis have increased considerably in the last decades.ObjectiveThe present study estimates prevalence trends of asthma, allergic rhinitis and pollinosis in the population of a city of Southern Brazil, without restriction of age, from 2011 to 2018, using the ISAAC standardized questionnaire.MethodsData was collected from March to June of 2011 and during the same months in 2018, in order to verify trends in the prevalence of these allergic conditions. The total sample consisted of 3132 individuals of both sexes living in the municipality of Santo Ângelo, in the state of Rio Grande do Sul, Brazil.ResultsNo differences were observed in the prevalence of asthma diagnosis (15.1% in 2011 and 13.8% in 2018), however the prevalence of current wheeze was significantly reduced from 24.7% in 2011 to 21.2% in 2018 (p < 0.05). Regarding allergic conditions in 2011 and in 2018, a significant reduction was observed (p < 0.001) in reported current rhinitis (63.3% vs. 50.5%), rhinoconjunctivitis (48.9% vs. 38.8%), hay fever (52.0% vs. 43.3%), and pollinosis (29.0% vs 17.0%). Moreover, we observed an inverse relation between age and rhinoconjunctivitis and hay fever, and all symptoms were more frequent in females. Rhinoconjunctivitis and hay fever, as well as current rhinitis and pollinosis were highly prevalent among 30–39 years-old individuals, whereas current wheeze affected mainly the age group 10–19 years-old.ConclusionWhile the prevalence of asthma remained similar after seven years, allergic rhinitis and pollinosis declined between 2011 and 2018.