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Allergic rhinitis (AR) is a chronic, non-infectious condition affecting the nasal mucosa, primarily mediated mainly by IgE. Recent studies reveal that AR is intricately associated not only with type 2 immunity but also with neuroimmunity. Nociceptive neurons, a subset of primary sensory neurons, are pivotal in detecting external nociceptive stimuli and modulating immune responses. This review examines nociceptive neuron receptors and elucidates how neuropeptides released by these neurons impact the immune system. Additionally, we summarize the role of immune cells and inflammatory mediators on nociceptive neurons. A comprehensive understanding of the dynamic interplay between nociceptive neurons and the immune system augments our understanding of the neuroimmune mechanisms underlying AR, thereby opening novel avenues for AR treatment modalities. [ABSTRACT FROM AUTHOR]

Background. The Peruvian Immunoblot panel, together with traditional skin prick tests (SPT), are widely used in vitro allergy tests in Peru. In addition to this, Peruvian allergists are increasingly adopting multiplex tests such as the ALEX‐2 (Macro Array Diagnostics). Previous studies have revealed limited agreement between Immunoblot and SPT results. Therefore, our study aimed to evaluate the concordance between these three tests in patients with allergic rhinitis (AR) in a private center in Arequipa, Peru. Materials and Methods. We enrolled 35 patients, including children over 3 years and adults, with AR. Clinical and demographic data were collected, and patients underwent allergic sensitization testing using the Immunoblot Peruvian panel (32 allergens), ALEX‐2 (295 allergens), and SPT (12 allergens). Concordance was calculated using Cohen's kappa coefficient and analyzed with IBM SPSS V26. Results. Among the patients, 34.3% exhibited moderate‐to‐severe persistent AR, and 14.3% had asthma. Additionally, 85.7% reported a family history of AR. Sensitization rates varied notably between the SPT and ALEX‐2, particularly for olive pollen (34.3% vs. 17.4%), Blomia tropicalis (11.4% vs. 17.1%), and grasses (11.4% vs. 28.5%). Remarkably, these allergens were not included in the Peruvian Immunoblot panel. Concordance analysis included seven allergens and showed significant concordance between ALEX‐2 and SPT for five allergens, between Immunoblot and SPT for two allergens, and between ALEX‐2 and Immunoblot for two allergens. Conclusion. This preliminary study shows us a better concordance between ALEX‐2 and SPT rather than between Immunoblot and SPT. [ABSTRACT FROM AUTHOR]

Allergic rhinitis (AR) is a series of allergic reactions to allergens in the nasal mucosa and is one of the most common allergic diseases that affect both children and adults. Shi-Bi-Lin (SBL) is the modified formula of Cang Er Zi San (CEZS), a traditional Chinese herbal formula used for treating AR. Our study aims to elucidate the anti-inflammatory effects and mechanisms of SBL in house dust mite-induced AR by regulating gut microflora metabolism. In vivo studies showed that nasal allergies and the infiltration of inflammatory cells in the nasal epithelium were significantly suppressed by SBL. Moreover, SBL restored the impaired nasal epithelial barrier function with an increased tight junction protein expression and reduced the endothelial nitric oxide synthase (eNOS). Interestingly, SBL significantly reconstituted the abundance and composition of gut microbiota in AR mice; it increased the relative abundance of potentially beneficial genera and decreased the relative abundance of harmful genera. SBL also restored immune-related metabolisms, which were significantly increased and correlated with suppressing inflammatory cytokines. Furthermore, a network analysis and molecular docking indicated IL-6 was a possible target drug candidate for the SBL treatment. SBL dramatically reduced the IL-6 level in the nasal lavage fluid (NALF), suppressing the IL-6 downstream Erk1/2 and AKT/PI3K signaling pathways. In conclusion, our study integrates 16S rRNA sequencing, microflora metabolism, and network pharmacology to explain the immune mechanism of SBL in alleviating HDM-induced allergic rhinitis. [ABSTRACT FROM AUTHOR]

Background: Nasal obstruction is a frequent problem amongst patients with sleep-disordered breathing (SDB). Radiofrequency of the inferior turbinates (RFIT) is commonly utilized for inferior turbinate (IT) reduction but its effectiveness in SDB patients remains unproven. We aim to evaluate long-term objective and subjective nasal, olfactory and sleep outcomes following RFIT in SDB patients. Methods: Patients were assessed at baseline (T0) and at 3 months (T1), 6 months (T2) and 12 months (T3) following RFIT. At T0, T1, T2 and T3, the patients underwent objective assessments of their nasal airways and smell function and an evaluation of their quality-of-life, sinonasal, olfactory and sleep symptoms. Sleep studies were carried out at T0 and T2. Results: Seventeen patients (with a median age of 42 years) underwent RFIT. A statistically significant objective and subjective improvement of the patients' nasal airways was demonstrated at T1. No other statistically significant changes were observed in the patients' nasal airways, smell, sleep study parameters or patient-reported outcomes at the other follow-ups. A multivariate analysis confirmed a statistically significant influence of age (older), sex (male), a higher BMI, the presence of septal deviation and the presence of allergic rhinitis in some of the studies' parameters. A statistically significant objective and subjective improvement of the patients' nasal airways was confirmed in the fitted model when considering the influence of the available variables. Conclusions: Our study confirms that the benefits of RFIT alone in SDB patients are limited and possibly only in the short-term period. Patient-related variables can potentially influence the final outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Asthma is associated with upper airway diseases and allergic diseases; however, the causal effects need to be investigated further. Thus, we performed this two-sample Mendelian randomization (MR) analysis to explore and measure the causal effects of asthma on allergic rhinitis (AR), vasomotor rhinitis (VMR), allergic conjunctivitis (AC), atopic dermatitis (AD), and allergic urticaria (AU). Methods: The data for asthma, AR, VMR, AC, AD, and AU were obtained from large-scale genome-wide association studies summarized recently. We defined single-nucleotide polymorphisms satisfying the MR assumptions as instrumental variables. Inverse-variance weighted (IVW) approach under random-effects was applied as the dominant method for causal estimation. The weighted median approach, MR-Egger regression analysis, MR pleiotropy residual sum and outlier test, and leave-one-out sensitivity analysis were performed as sensitivity analysis. Horizontal pleiotropy was measured using MR-Egger regression analysis. Significant causal effects were attempted for replication and meta-analysis. Results: We revealed that asthma had causal effects on AR (IVW, odds ratio [OR] = 1.93; 95% confidence interval [CI], 1.74−2.14; p < 0.001), VMR (IVW, OR = 1.40; 95% CI, 1.15−1.71; p < 0.001), AC (IVW, OR = 1.65; 95% CI, 1.49−1.82; p < 0.001), and AD (IVW, OR = 2.13; 95% CI, 1.82−2.49; p < 0.001). No causal effect of asthma on AU was observed. Sensitivity analysis further assured the robustness of these results. The evaluation of the replication stage and meta-analysis further confirmed the causal effect of asthma on AR (IVW OR = 1.81, 95% CI 1.62–2.02, p < 0.001), AC (IVW OR = 1.44, 95% CI 1.11–1.87, p < 0.001), and AD (IVW OR = 1.85, 95% CI 1.42–2.41, p < 0.001). Conclusions: We revealed and quantified the causal effects of asthma on AR, VMR, AC, and AD. These findings can provide powerful causal evidence of asthma on upper airway diseases and allergic diseases, suggesting that the treatment of asthma should be a preventive and therapeutic strategy for AR, VMR, AC, and AD. [ABSTRACT FROM AUTHOR]

Allergic diseases like asthma, allergic rhinitis and dermatitis pose a significant global health burden, driving the search for novel therapies. The NLRP3 inflammasome, a key component of the innate immune system, is implicated in various inflammatory diseases. Upon exposure to allergens, NLRP3 undergoes a two-step activation process (priming and assembly) to form active inflammasomes. These inflammasomes trigger caspase-1 activation, leading to the cleavage of pro-inflammatory cytokines (IL-1β and IL-18) and GSDMD. This process induces pyroptosis and amplifies inflammation. Recent studies in humans and mice strongly suggest a link between the NLRP3 inflammasome, IL-1β, and IL-18, and the development of allergic diseases. However, further research is needed to fully understand NLRP3's specific mechanisms in allergies. This review aims to summarize the latest advances in NLRP3 activation and regulation. We will discuss small molecule drugs and natural products targeting NLRP3 as potential therapeutic strategies for allergic diseases. [ABSTRACT FROM AUTHOR]

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Introduction: Atopic diseases have been steadily increasing over the past decades and effective disease-modifying treatment options are urgently needed. These studies introduce a novel synthetic Toll-like receptor 4 (TLR4) agonist, INI-2004, with remarkable efficacy as a therapeutic intranasal treatment for seasonal allergic rhinitis. Methods: Using a murine airway allergic sensitization model, the impact of INI-2004 on allergic responses was assessed. Results: One or two intranasal doses of INI-2004 significantly reduced airway resistance, eosinophil influx, and Th2 cytokine production - providing strong evidence of allergic desensitization. Further investigations revealed that a liposomal formulation of INI-2004 exhibited better safety and efficacy profiles compared to aqueous formulations. Importantly, the liposomal formulation demonstrated a 1000-fold increase in the maximum tolerated intravenous dose in pigs. Pre-clinical GLP toxicology studies in rats and pigs confirmed the safety of liposomal INI-2004, supporting its selection for human clinical trials. Discussion: These findings lay the groundwork for the ongoing clinical evaluation of INI-2004 in allergic rhinitis as a stand-alone therapy for individuals poly-sensitized to multiple seasonal allergens. The study underscores the significance of innovative immunotherapy approaches in reshaping the landscape of allergic rhinitis management. [ABSTRACT FROM AUTHOR]

Objective To investigate the correlations between the expression levels of miR-149-5p and Notch1 mRNA in serum and the balance of regulatory T cells （Treg)/helper T cells （Th）17 in patients with allergic rhinitis (AR). Methods Ninety-eight AR patients （AR group） and 30 healthy volunteers (control group) were selected. According to the severity of the disease， the patients with AR were divided into the mild group （51 cases) and moderate and severe group （47 cases). Real-time fluorescence quantitative PCR was used to detect the expression of miR-149-5p and Notch1 mRNA in serum, and flow cytometry was used to detect Treg, Th17 and their cytokines in peripheral blood. Pearson correlation was used to analyze the correlations between serum miR-149-5p, Notch1 mRNA expression and peripheral blood Treg, Th17 and their cytokines, as well as the relationship between the miR-149-5p and Notch1 mRNA expression. Results Serum miR-149-5p expression, interleukin （IL）-10, transforming growth factor-β1（TGF-β1) level, peripheral blood Treg cells and Treg/Th17 ratio in the AR group were lower than those in the control group （all P<0. 05), and serum Notch1 mRNA ex‐ pression, IL-6, IL-17, IL-22, IL-23 and Th17 cells in peripheral blood were higher than those in the control group (all P<0. 05). The expression of miR-149-5p, the levels of IL-10, TGF-β1, Treg cells and Treg/Th17 ratio in peripheral blood were lower in the moderate and severe group than in the mild group (all P<0. 05), and the expression of Notch1 mRNA, the levels of IL-6, IL-17, IL-22, IL-23 and Th17 cells in peripheral blood were higher than those in the mild group （all P< 0. 05）. Serum miR-149-5p expression in the AR group was positively correlated with peripheral blood Treg cells, Treg/ Th17 ratio, serum IL-10, and TGF-β1 levels （r=0. 367, 0. 539, 0.265, 0.301, respectively; all P<0. 05), and was negatively correlated with the levels of serum IL-6, IL-17, IL-22, IL-23 and peripheral blood Th17 cells (r=-0. 289, -0. 213, -0. 336, -0. 243, -0. 221, respectively, all P<0. 05). Notch1 mRNA expression was negatively correlated with peripheral blood Treg cells, Treg/Th17 ratio, serum IL-10, and TGF-β1 level （r=-0. 346, -0. 508, -0. 281, -0. 293, respectively； all P<0. 05), and was positively correlated with serum IL-6, IL-17, IL-22, IL-23 levels and peripheral blood Th17 cells (r= 0. 326, 0. 241, 0. 302, 0. 285, 0. 237, respectively, all P<0. 05). Serum miR-149-5p was negatively correlated with Notch1 mRNA expression （r=-0. 550,P<0. 05). Conclusion The expression of miR-149-5p is down-regulated and Notch1 mRNA is up-regulated in AR patients, which are related to the imbalance of Treg/Th17 in AR patients. [ABSTRACT FROM AUTHOR]

Objective: Recognizing and effectively managing comorbidities in children with asthma is crucial for improving asthma outcomes. This study aimed to identify common comorbidities of asthma during childhood and compare the prevalences of selected comorbidities among children with and without asthma. Materials and Methods: Children (>5 years old) presenting to our hospital's pediatric immunology and allergy clinic between October 1, 2023, and October 31, 2024, were retrospectively and cross-sectionally evaluated in this study. The children were categorized into two groups based on the Global Initiative for Asthma guidelines criteria as those diagnosed with asthma and those without asthma. Comorbidities were evaluated according to the parents' reports and electronic hospital records and classified based on the involvement of the respiratory system and/or nonrespiratory manifestations. Results: A total of 452 patients (58% male) with a median age of 10.5 years (IQR:7.5-10.5) were included in this study, of which 79% exhibited at least one comorbidity. Of the total, 51.7% had asthma, while 48.2% did not. Respiratory comorbidity was more frequently observed in patients with asthma (84.6%) than in those without (72.9%). Comorbidities were more prevalent in patients with asthma with longer asthma duration, sensitization to any aeroallergen, and a higher body mass index. Multivariate logistic regression analysis identified atopic sensitization (OR: 5.5, 95%CI [2.16-14.02], p<0.001) as the sole predictor for the development of comorbidity in patients with asthma. Conclusion: Our study revealed that a significant proportion (84.6%) of children with asthma exhibited at least one comorbidity, and comorbidities were more frequent in children with asthma than in those without. The frequency of comorbidities increased with a longer asthma duration, the presence of atopic sensitization, and a higher body mass index. Atopic sensitization emerged as a predictor for comorbidity in children with asthma. Therefore, we recommend evaluating all patients with asthma, especially those with atopic sensitization, for other comorbid diseases. [ABSTRACT FROM AUTHOR]

Objective • To analyze the relationship between serum Toll-like receptor 4 (TLR4) and soluble intercellular adhesion molecule-1 (sICAM-1) levels and airway remodeling in children with severe bronchial asthma (BA) and their predictive value for recurrence. Methods • A retrospective study was conducted to select the clinical data of 120 children with severe BA who were admitted to Northern Jiangsu People’s Hospital from June 2022 to June 2023 and completed follow-up. Serum TLR4 and sICAM-1 were detected at admission. According to the recurrence during the follow-up period, the clinical data of the recurrent children were included in the recurrent group, and the clinical data of the non-recurrent children were included in the non-recurrent group. There were 55 children each in the recurrence group and the non-recurrence group. The baseline data of children with severe BA were statistically analyzed and compared. The correlation between serum TLR4 and sICAM-1 levels and airway remodeling in children with severe BA was analyzed by bivariate correlation Pearson (N). Binary logistic regression was used to analyze the relationship between serum TLR4, sICAM-1 levels, and recurrence in children with severe BA. Receiver operating characteristic curve (ROC) was used to analyze the predictive value of serum TLR4 and sICAM-1 for recurrence in children with severe BA; R4.1.0 statistical software was used to draw the decision curve of serum TLR4 and sICAM-1 levels to predict the recurrence of severe BA in children with a high-risk threshold as abscissa and net return rate as ordinate. Results • Among the 120 children with severe BA, 46 cases recurred during the 1-year follow-up period, with a recurrence rate of 38.33 %. The proportion of premature delivery and children with allergic rhinitis in the recurrent group was higher than that in the non-recurrent group, and the levels of eosinophil count, TLR4, and sICAM-1 were higher than those in the non-recurrent group (P < .001). The levels of T/D and WA% in the recurrent group were higher than those in the non-recurrent group (P < .001). The results of bivariate correlation Pearson (N) analysis showed that serum TLR4 and sICAM-1 levels were positively correlated with T/D and WA% in children with severe BA (r >0, P < .001); the results of ROC curve showed that the AUC of serum TLR4, sICAM-1 and combined detection in predicting the recurrence of children with severe BA were all > 0.70, which had certain predictive value, and the combined detection was the highest. The decision curve was drawn. The results showed that the net rate of return of serum TLR4 and sICAM-1 in predicting the recurrence of children with severe BA was better than that of a single net rate of return in the range of 0.217~0.284 and 0.296~0.492. In the range of high-risk threshold 0.000- 0.958, the net rate of return of serum TLR4 and sICAM-1 combined to predict the recurrence of severe BA children was > 0, which was of clinical significance. Conclusion • The serum TLR4 and sICAM-1 levels are closely related to airway remodeling and recurrence in children with severe BA, and their levels can effectively predict the risk of recurrence. [ABSTRACT FROM AUTHOR]

Background: Allergic rhinitis is an inflammatory disorder of the nasal membrane seen after allergen exposure and mediated by IgE type-1. It is characterized by one or more symptoms including rhinorrhea, nasal congestion, itching, and sneezing. Tissue eosinophilia is a characteristic feature of mucosal inflammation in allergic rhinitis. Aim: The present study aimed to assess eosinophil counts in peripheral blood and nasal smear in non-allergic and allergic rhinitis subjects. Methods: The present study assessed 180 subjects having allergic rhinitis against 180 gender and age-matched control subjects without allergic rhinitis. Smears were made from the nasal secretions and the peripheral blood of the study subjects. For both the groups, smears were fixed and staining was done to further study the samples under light microscopy. Results: In allergic rhinitis and non-allergic rhinitis, negative predictive value, positive predictive value, specificity, and sensitivity were 79%, 86.23%, 87.75, and 76.64 respectively. The study results showed a significant difference in the eosinophil counts from peripheral blood smear and nasal smear in subjects having allergic rhinitis in comparison to age and gender-matched non-rhinitis subjects. These results showed that nasal eosinophilia is the first information tool of point of contact in provisional diagnosis of allergic rhinitis. Conclusions: The present study concludes that nasal smear eosinophil cytology is a semiinvasive, economical, and simple procedure that can be used as a prognostic and diagnostic test in allergic rhinitis subjects. [ABSTRACT FROM AUTHOR]

Purpose: Even after allergic rhinitis is diagnosed and treated, various symptoms such as runny nose, sneezing, and itchy nose recur periodically due to various environmental factors. Methods: This randomized controlled trial was conducted to confirm the effectiveness of mask-based aromatherapy as a method of alleviating allergic rhinitis during the coronavirus disease 2019 (COVID-19) pandemic. The study participants were adults between the ages of 19 and 60 who were diagnosed with allergic rhinitis and had a Total Nasal Symptom Score (TNSS) of 2 or more. Participants were randomly assigned to an aromatherapy group that was provided aromatherapy essential oils and a control group that did not receive aromatherapy. Participants in the aromatherapy group were asked to drop an aromatherapy essential oil onto a disposable face mask and wear it twice a day for two weeks. Results: The aromatherapy group experience significant alleviation of allergic rhinitis symptoms (visual analogue scale, F = 11.22, p < .001; TNSS, F = 15.82, p < .001). The aromatherapy group also showed significantly higher improvements in fatigue (F = 8.28, p < .001), allergic rhinitis-specific quality of life (F = 11.12, p < . 001). Conclusion: The oils used in this study appeared to be effective in relieving the symptoms of allergic rhinitis. In particular, the mask drop inhalation method was applied in light of mandatory mask-wearing due to the global COVID-19 pandemic during this study period. Mask drop inhalation is a method of inhaling oil close to the nose and is considered an effective method for reducing the inconvenience of applying oil. [ABSTRACT FROM AUTHOR]

The minimal persistent inflammation （MPI） of allergic rhinitis （AR） is asymptomatic inflammation that occurs locally in the nasal mucosa after exposure to low doses of allergens. With the study of MPI, researchers have realized that this local subclinical inflammation in patients with AR not only causes chronic damage to the nasal mucosa, but also increases the hypersensitivity and hyperresponsiveness of allergic airway disease. The concept of MPI has changed our strategy for the treatment of AR, which requires that we should not only intervene in the symptomatic exacerbation period, but also intervene in the asymptomatic MPI period. This article systematically reviews the immunological mechanism, adverse effects, and treatment strategies of the MPI, to provide better treatment for the MPI of AR and reduce the recurrence of AR. [ABSTRACT FROM AUTHOR]

Allergic Rhinitis (AR), an inflammatory affliction impacting the upper respiratory tract, has been registering a substantial surge in incidence across the globe. We embarked on examination of differentially expressed genes (DEGs) and the Weighted Gene Co-Expression Network Analysis (WGCNA). With this armory of genes identified, we engaged the tools of Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG). Our study continued with the establishment of a protein-protein interaction (PPI) network and the application of LASSO regression. Finally, we leveraged a docking model to elucidate potential drug-gene interactions involving these key genes. Through WGCNA and different express genes screening, PPI network was performed, identifying top 20 key genes, including CD44, CD69, CD274. LASSO regression identified three independent factors, STARD5, CST1, and CHAC1, that were significantly associated with AR. A predictive model was developed with an AUC value over 0.75. Also, 105 potential therapeutic agents were discovered, including Fluorouracil, Cyclophosphamide, Doxorubicin, and Hydrocortisone, offering promising therapeutic strategies for AR. By fuzing DEGs with key genes derived from WGCNA, this study has illuminated a comprehensive network of gene interactions involved in the pathogenesis of AR, paving the way for future biomarker and therapeutic target discovery in AR. [ABSTRACT FROM AUTHOR]

Parental allergic diseases and smoking influence respiratory disease in the offspring but it is not known whether they influence fractional exhaled nitric oxide (FeNO) in the offspring. We investigated whether parental allergic diseases, parental smoking and FeNO levels in parents were associated with FeNO levels in their offspring. We studied 609 offspring aged 16–47 years from the Respiratory Health in Northern Europe, Spain and Australia generation (RHINESSA) study with parental information from the Respiratory Health in Northern Europe (RHINE) III study and the European Community Respiratory Health Survey (ECRHS) III. Linear regression models were used to assess the association between offspring FeNO and parental FeNO, allergic rhinitis, asthma and smoking, while adjusting for potential confounding factors. Parental allergic rhinitis was significantly associated with higher FeNO in the offspring, both on the paternal and maternal side (percent change: 20.3 % [95%CI 5.0–37.7], p = 0.008, and 13.8 % [0.4–28.9], p = 0.043, respectively). Parental allergic rhinitis with asthma in any parent was also significantly associated with higher offspring FeNO (16.2 % [0.9–33.9], p = 0.037). However, parental asthma alone and smoking were not associated with offspring FeNO. Parental FeNO was not associated with offspring FeNO after full adjustments for offspring and parental factors. Parental allergic rhinitis but not parental asthma was associated with higher levels of FeNO in offspring. These findings suggest that parental allergic rhinitis status should be considered when interpreting FeNO levels in offspring beyond childhood. • Parental allergic rhinitis but not parental asthma is associated with higher levels of FeNO in offspring beyond childhood. • Parental smoking is not associated with FeNO in offspring beyond childhood. • Parental FeNO levels do not relate to offspring FeNO levels after taking into account offspring allergic disease/status. [ABSTRACT FROM AUTHOR]

Local allergic rhinitis (LAR) represents a medical provocation for allergists and otorhinolaryngologists. LAR is considered to be a subtype of allergic rhinitis (AR) that affects a great percentage of patients who were, for decades, diagnosed as having chronic non-allergic rhinitis. The clinical picture is represented by rhinorrhea, sneezing, and nasal itching correlated with specific pollen season or dust, mold, or pet interior exposure. Usual assessment of AR (skin prick testing and serum IgE assessment) produces negative results. Specialized centers in allergology and ENT around the globe use a nasal allergen challenge, assessment of local IgE, basophil activation test (BAT), and nasal cytology in the diagnostic approach to the disease, taking into account their current limitations. The impact of LAR on quality-of-life indicators is the same as in AR. Treatment for LAR is similar to that for AR and is the same as for AR: allergen exposure avoidance, drug therapy, and allergen immunotherapy. This scoping review gathers the current up-to-date open access evidence available on PubMed on the subject of LAR. [ABSTRACT FROM AUTHOR]

The emergence of drug-resistant mycobacteria has rendered many clinical drugs and regimens ineffective, imposing significant economic and healthcare burden on individuals and society. Repurposing drugs intended for treating other diseases is a time-saving, cost-effective, and efficient approach for identifying excellent antimycobacterial candidates or lead compounds. This study is the first to demonstrate that rupatadine (RTD), a drug used to treat allergic rhinitis, possesses excellent activity against mycobacteria without detectable resistance, particularly Mycobacterium tuberculosis and Mycobacterium marinum, with a minimal inhibitory concentration as low as 3.13 µg/mL. Furthermore, RTD exhibited moderate activity against nonreplicating M. tuberculosis with minimal inhibitory concentrations lower than drugs targeting the cell wall, suggesting that RTD has great potential to be modified and used for the treatment of nonreplicating M. tuberculosis. Additionally, RTD exhibits partial synergistic effects when combined with clofazimine, pretomanid, and TB47 against M. tuberculosis, providing the theoretical foundation for the development of treatment regimens. Transcriptomic profiling leads us to speculate that eight essential genes may be the targets of RTD or may be closely associated with mycobacterial resistance to RTD. In summary, RTD may be a promising hit for further antimycobacterial drug or regimen optimization, especially in the case of nonreplicating mycobacteria. [ABSTRACT FROM AUTHOR]

The association between breastfeeding and the occurrence of allergic rhinitis (AR) and food allergy (FA) in offspring remains inconclusive. This review aims to comprehensively explore the potential relationships between various patterns and durations of breastfeeding and allergic diseases in offspring. We systematically searched PubMed, EMBASE, Cochrane, WOS databases, and Google Scholar for observational studies published up to March 30, 2023, that investigated the link between breastfeeding and allergies in offspring. The quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS) and Joanna Briggs Institute (JBI). Pooled odds ratios (OR) and 95% confidence intervals (95% CI) were calculated employing an appropriate model based on the degree of heterogeneity. A total of 68 studies, encompassing 772,142 children, were ultimately included. The findings indicated that breastfeeding for more than 6 months was associated with a reduced risk of AR (OR = 0.88, 95% CI: 0.79 to 0.98) but posed a risk for FA (OR = 1.69, 95% CI: 1.27 to 2.25). Exclusive breastfeeding exhibited a protective effect against AR (OR = 0.94, 95% CI: 0.90 to 0.97), whereas non-breastfeeding was identified as a risk factor for AR (OR = 1.48; 95% CI: 1.03 to 2.12). No significant association was observed between breastfeeding patterns and FA. Conclusion: Breastfeeding for more than 6 months proves to be an effective preventive measure against AR. However, large prospective high-quality studies are needed to investigate the potential risk of FA in children with prolonged breastfeeding. What is Known: • The impact of breastfeeding on allergic rhinitis and food allergy in offspring is controversial. • Previous meta-analyses fail to prove the effect of breastfeeding on food allergy in offspring of all ages. What is New: • Breastfeeding for more than 6 months proves to be an effective preventive measure against AR. However, it potentially elevates the risk of FA in children. Non-breastfeeding is linked to an increased risk of AR in children, but there is no evidence of an association between breastfeeding patterns and FA in children. • The impact of breastfeeding on allergic rhinitis and food allergy in offspring may vary with the time and pattern of breastfeeding. [ABSTRACT FROM AUTHOR]

This article explores the emergence of lupin as a potential hidden food allergen. The true prevalence of lupin allergy is currently unknown, but the Allergy-Vigilance Network® (AVN) reported 62 cases of lupin-induced anaphylaxis out of 2,708 cases of food-induced anaphylaxis from 2002 to 2020. The study found that lupin-induced anaphylaxis was more common in females, adults, individuals with a peanut allergy, and after consuming prepacked food products. The research also revealed a significant degree of cross-reactivity between lupin and other legumes, particularly peanut. The authors recommend that allergists be aware of lupin cross-reactivity and that patients with a history of food anaphylaxis be tested for lupin. [Extracted from the article]

Background: Local allergic rhinitis (LAR) is defined by chronic nasal symptoms, absence of atopy, positive nasal allergen challenge (NAC) and a good response to subcutaneous allergen immunotherapy (SCIT). We sought to investigate SCIT capacity to induce local and systemic blocking antibodies in LAR patients. Methods: A RDBPC study of grass SCIT was performed, with participants receiving either SCIT (Group A; n = 10) or placebo (Group B; n = 14) in the first 6 months. Both groups subsequently received SCIT for 12 months at Year 2. Nasal and serum antibodies (IgG4, IgA1 and IgA2) and their inhibitory capacity were measured at multiple timepoints. Results: The allergen concentration tolerated increased significantly at 6 months (Group A; p =.047) and 24 months (Group B; p =.049) compared with baseline and persisted until the end of the study. Induction of serum sIgA1 to Phl p was seen in Groups A and B, albeit the former being induced earlier (1.71‐fold, p =.027). A significant induction in sIgG4 to Phl p 1 and 5 was observed in serum of Group A (p =.047 and p =.0039) and sIgA2 to Phl p in Group B (p =.032 and p =.0098) at 18 and 24 months, respectively. Both local and systemic blocking antibodies can inhibit allergen–IgE complexes binding to CD23 on B cells, and this correlated with level of allergen tolerated intra‐nasally in Group A (serum; 휌 = −.47, p =.0006, nasal; 휌 = −.38, p =.0294). Conclusions: Grass pollen SCIT induced functional systemic blocking antibodies that correlate with the concentration of allergen tolerated following NAC, highlighting their potential as a biomarker of SCIT in LAR. [ABSTRACT FROM AUTHOR]

Background: Subcutaneous immunotherapy (SCIT) can induce systemic reactions (SRs) in certain patients, but the underlying mechanisms remain to be fully elucidated. Methods: AR patients who were undergoing standardized HDM SCIT (Alutard, ALK) between 2018 and 2022 were screened. Those who experienced two consecutive SRs were included in the study group. A control group was established, matched 1:1 by gender, age, and disease duration with the study group, who did not experience SRs during SCIT. Clinical and immunological parameters were recorded and analyzed both before SCIT and after 1 year of treatment. Results: A total of 161 patients were included, with 79 (49.07%) in the study group. The study group had a higher proportion of AR combined asthma (26.8% vs. 51.8%, p < 0.001) and higher levels of sIgE to HDM and HDM components (all p <.001). Serum IL‐4 and IL‐13 levels in the study group were higher than those in the control group (p <.05). The study group received a lower maintenance dosage of HDM extracts injections than control group due to SRs (50000SQ vs. 100000SQ, p <.05). After 1 year of SCIT, the VAS score, the lung function parameters of asthmatic patients over 14 years old significantly improved in both groups (all p <.05). After a 7‐day exposure to 20 μg/mL HDM extracts, the percentages of Th1, Th17, Tfh10, and Th17.1 in PBMCs decreased, while the Tfh13 cells significantly increased in the study group (p <.05). Conclusion: The type 2 inflammatory response is augmented in HDM‐induced AR patients who experienced SRs during SCIT. Despite this, SCIT remains effective in these patients when administered with low‐dosage allergen extracts. [ABSTRACT FROM AUTHOR]

The chemoattractant Receptor23 (ChemR23) plays an essential role in triggering and resolving acute inflammation. This study aimed to evaluate the association between four potentially functional SNPs of the chemR23 gene (rs4373981 G > C, rs73201532 C > T, rs35121177 G > A, and rs4964676 G > A) with susceptibility to Allergic rhinitis (AR). 130 patients with allergic rhinitis and 130 healthy individuals were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR–RFLP) method. Our findings showed that genotypes and alleles frequencies were not significantly different between patient and control groups (p > 0.05). Furthermore, haplotype analysis (rs4373981, rs73201532, and rs4964676, respectively) revealed a protective effect of CTG, GTA, and GTG haplotypes against AR (p = 0.009, p = 0.0001, p = 0.001, respectively), and CCG, GCA, and GCG haplotypes of ChemR23 polymorphisms were associated with increased risk of AR (p = 0.03, p = 0.02, p = 0.0002, respectively). These findings suggested a possible role for ChemR23 in the pathogenesis of AR. [ABSTRACT FROM AUTHOR]

Allergic rhinitis (AR) is an allergic condition of the upper respiratory tract with a complex pathogenesis, including epithelial barrier disruption, immune regulation, and gut microbiota, which is not yet fully understood. Gut microbiota is closely linked to allergic diseases, including AR. Fecal microbiota transplantation (FMT) has recently been recognized as a potentially effective therapy for allergic diseases. However, the efficacy and mechanism of action of FMT in AR remain unknown. Herein, we aimed to observe the implications of gut microbiota on epithelial barrier function and T cell homeostasis, as well as the effect of FMT in AR, using the ovalbumin (OVA)-induced AR mice. The intestinal microbiota of recipient mice was cleared using an antibiotic cocktail; thereafter, FMT was performed. Subsequently, the nasal symptom scores and histopathological features of colon and nasal mucosa tissues of mice were monitored, and serum OVA-sIgE and cytokines of IL-4, IFNγ, IL-17A, and IL-10 cytokine concentrations were examined. Thereafter, tight junction protein and CD4+ T cell-related transcription factor and cytokine expressions were observed in the colon and nasal mucosa, and changes in the expression of PI3K/AKT/mTOR and NFκB signaling pathway were detected by WB assay in each group. Fecal DNA was extracted from the four mice groups for high-throughput 16S rRNA sequencing. FMT ameliorated nasal symptoms and reduced nasal mucosal inflammation in AR mice. Moreover, according to 16S rRNA sequencing, FMT restored the disordered gut microbiota in AR mice. Following FMT, ZO-1 and claudin-1 and Th1/Th2/Th17-related transcription factor and cytokine expressions were upregulated, whereas Treg cell-related Foxp3 and IL-10 expressions were downregulated. Mechanistic studies have revealed that FMT also inhibited PI3K/AKT/mTOR and NF-κB pathway protein phosphorylation in AR mouse tissues. FMT alleviates allergic inflammation in AR by repairing the epithelial barrier and modulating CD4+ T cell balance and exerts anti-inflammatory effects through the PI3K/AKT/mTOR and NF-κB signaling pathways. Moreover, gut microbiota disorders are involved in AR pathogenesis. Disturbed gut microbiota causes an altered immune-inflammatory state in mice and increases susceptibility to AR. This study suggested the regulatory role of the gut-nose axis in the pathogenesis of AR is an emerging field, which provides novel directions and ideas for the treatment of AR. [ABSTRACT FROM AUTHOR]

Introduction: Combined allergic rhinitis and asthma syndrome (CARAS) is a concurrent allergic symptom of diseases of allergic rhinitis and asthma. However, the mechanism of CARAS remains unclear. The study aimed to investigate the impact of microRNA-21 (miR-21) on CARAS via targeting poly (ADP-ribose) polymerase-1 (PARP-1) and phosphoinositide 3-kinase (PI3K)/AKT pathways. Methods: The levels of miR-21-5p and PARP-1 in CARAS patients were detected by quantitative reverse transcription polymerase chain reaction and enzyme-linked immunosorbent assay (ELISA). An ovalbumin-sensitized mouse model of CARAS was established. And knock down of miR-21-5p was constructed by intranasally administering with miR-21-5p shRNA-encoding adeno-associated virus vector. Airway resistance and airway inflammatory response were detected. ELISA was used to evaluate IL-4/IL-5/IL-13 levels in bronchoalveolar lavage fluid (BALF). Expression levels of E-cadherin, fibronectin, and α-SMA were determined using Western blotting. The levels of PARP-1 and the activation of PI3K/AKT were assayed. Results: Downregulation of miR-21-5p relieved pathophysiological symptoms of asthma including airway hyperreactivity and inflammatory cell infiltration. Downregulation of miR-21-5p significantly reduced the levels of IL4, IL-5, and IL-13 in BALF. Additionally, downregulation of miR-21-5p inhibited the epithelial-mesenchymal transition (EMT) process in CARAS mice. Furthermore, miR-21-5p regulated PARP-1 and was involved in PI3K/AKT activation in CARAS mice. Conclusion: Downregulation of miR-21-5p ameliorated CARAS-associated lung injury by alleviating airway inflammation, inhibiting the EMT process, and regulating PARP-1/PI3K/AKT in a mouse model of CARAS. [ABSTRACT FROM AUTHOR]

Introduction: Epithelial barrier disruption is the initial cause of various diseases. We previously reported that acupoint catgut embedding (AE) improves tight junction proteins (TJs) in rats with allergic rhinitis. However, whether AE improves the epithelial barrier in local allergic rhinitis (LAR) remains unknown. Methods: A total of 36 Sprague Dawley (SD) male rats aged 5–7 weeks were divided into 6 groups with 6 rats each: control group, LAR model group, false acupoint embedding + LAR group, acupoint embedding + LAR group, capsaicin + LAR group, and tunicamycin + acupoint embedding + LAR group. Behavioral observation, ELISA to detect inflammatory factors in nasal lavage fluid and serum IgE, nasal mucosal permeability test, hematoxylin-eosin staining, PCR to detect Substance P (SP), Western blot, and immunofluorescence to detect endoplasmic reticulum stress (ERS) index and TJs were used to investigate the mechanism of AE in LAR. Results: AE improved the symptoms and pathological features of nasal mucosa of LAR rats, reduced the inflammatory factors (IL4, IL5, IL13) of nasal lavage fluid, and showed no significant change in serum IgE levels in all groups. In addition, AE decreased the expression of SP in nasal mucosa of LAR rats, inhibited ERS, increased the expression of tight junction protein, reduced the permeability of nasal mucosa, and improved the function of nasal mucosal barrier. Conclusion: This study confirms that AE can improve the nasal mucosal barrier function of LAR by reducing the expression of SP, inhibiting ERS and increasing the expression of TJs, thus enhancing the nasal mucosal barrier function. [ABSTRACT FROM AUTHOR]

Background: Allergic rhinits is a prevalent condition, affecting a substantial proportion of the population. This study investigates the impact of ongoing biologic therapy, specifically with Dupilumab, on allergy diagnostics in patients with allergic rhinits. Methods: Various tests, including the Skin Prick Test, serum IgE levels and Allergy Screening Panels, were examined for their effectiveness in detecting sensitizations during biologic treatment. Results: The results indicate a significant decline in total IgE levels following biologic therapy initiation, aligning with previous findings on Dupilumab's inhibitory effects on IL-4 and IL-13. However, the specific IgE to total IgE ratio for major allergens was not significantly reduced. Comparing diagnostic tools, the Skin Prick Test demonstrates an impressive retention rate of sensitizations (98%) during Dupilumab treatment, outperforming the Allergy Screening Panel, which shows a 75% detection rate. Notably, the panel displays limitations in capturing lower sensitization levels. Conclusion: In summary, this study underscores that, despite the influence of biologic therapy on certain markers, standard allergy tests remain viable while emphasizing the importance of considering specific IgE levels rather than relying solely on CAP classes. The Skin Prick Test in particular proves to be a reliable tool for identifying sensitizations during Dupilumab treatment. The results offer valuable guidance for the diagnostic management of Allergic rhinits in individuals subjected to Dupilumab treatment. [ABSTRACT FROM AUTHOR]

To evaluate the association between three allergic diseases (allergic dermatitis, allergic rhinitis, and asthma) and the development of retinal vein occlusion (RVO), a major retinal disease that causes visual impairment. This study used data obtained from the Korean National Health Insurance Claims database between 2009 and 2018. The association between the three atopic triads (allergic dermatitis, allergic rhinitis, and asthma) and the occurrence of sight-threatening RVO, as determined by diagnostic and treatment codes, were analyzed. Multivariate adjusted Cox regression analysis was used to determine the hazard ratios (HRs) and 95% confidence intervals for RVO development in the presence of allergic disease. In this population-based study, 2,160,195 (54.6%) individuals were male, 1,794,968 (45.4%) were female, and 620,938 (15.7%) were diagnosed with allergic diseases. Patients with either asthma or allergic rhinitis had a greater risk of RVO (adjusted hazard ratio (aHR) = 1.101, 95% confidence interval [CI] = 1.029–1.178 for asthma; aHR = 1.181, 95% CI = 1.147–1.215 for allergic rhinitis) compared to those without asthma or allergic rhinitis; however, patients with atopic dermatitis did not show a significant association with RVO (aHR = 1.071, 95% CI = 0.889–1.290), after adjusting for other risk factors. Our study revealed that allergic rhinitis, asthma, and coexisting multiple allergic conditions were associated with an increased risk of RVO. Thus, it may be advisable to suggest an ophthalmological examination for patients with allergies due to the increased possibility of the occurrence of retinal vascular disease. [ABSTRACT FROM AUTHOR]

Allergic rhinitis is a common childhood disease. Although various drugs have been used to treat allergic rhinitis, including nasal corticosteroids, antileukotrienes, and antihistamines, there is still controversy about the optimal dose and the best combination with the highest efficacy. Higher doses of antihistamines are recommended for better control of urticaria, but there is insufficient evidence regarding the efficacy of increased doses of antihistamines in allergic rhinitis. The aim of the study was to evaluate the effectiveness of different drug combinations in the treatment of children with allergic rhinitis. Sixty-four children with persistent moderate to severe allergic rhinitis were enrolled and randomly divided into 4 groups. All children received mometasone furoate nasal spray once daily. In addition to mometasone, each group received one of the following drugs or drug combinations: daily desloratadine, twice daily desloratadine, montelukast, or a combination of desloratadine and montelukast. The severity of symptoms before and after the intervention was evaluated based on the total nasal symptoms score, including sneezing, nasal congestion, nasal itching, and rhinorrhea. Sixty patients completed the study. The reduction of nasal congestion score and total nasal symptoms score in the groups receiving desloratadine twice a day and desloratadine plus montelukast was superior to the daily desloratadine group and daily montelukast groups. According to this work, the treatment of allergic rhinitis with mometasone nasal spray with desloratadine twice a day or with the combination of desloratadine and montelukast was more effective than other treatment regimens. [ABSTRACT FROM AUTHOR]

Seasonal allergies have a negative impact on patients' quality of life. Nurses must be aware of the different treatment options and lifestyle modifications to help patients manage their symptoms. This article discusses the benefits and risks of over-the-counter medications for seasonal allergies and other implications for nurses. [ABSTRACT FROM AUTHOR]

Nearly a third of the world's population suffers from pollen‐induced respiratory allergies—and the number is rising. For those affected, the situation is becoming more stressful every year with climate change, rising atmospheric CO2 levels, and urbanization. These phenomena form a complex interface between human health and global change, yet the critical information needed to unravel it remains fragmented. A holistic big data approach, with close collaboration between Earth system scientists and health experts, is urgently needed to achieve meaningful insights that advance our understanding and management of increasing pollen‐induced respiratory allergies under global change. [ABSTRACT FROM AUTHOR]

This article explores the effects of uncontrolled symptoms on the quality of life of patients with allergic rhinitis (AR). The study used a questionnaire to assess the impact of individual symptoms on quality of life. The results showed that poorly controlled eye, nose, and asthma symptoms were consistently associated with lower quality of life measures. The study emphasizes the importance of symptom control in improving the quality of life for patients with AR. However, it is important to note that the findings may not apply to all patients. [Extracted from the article]

There is insufficient systematized evidence on the effectiveness of individual intranasal medications in allergic rhinitis (AR). We sought to perform a systematic review to compare the efficacy of individual intranasal corticosteroids and antihistamines against placebo in improving the nasal and ocular symptoms and the rhinoconjunctivitis-related quality of life of patients with perennial or seasonal AR. The investigators searched 4 electronic bibliographic databases and 3 clinical trials databases for randomized controlled trials (1) assessing adult patients with seasonal or perennial AR and (2) comparing the use of intranasal corticosteroids or antihistamines versus placebo. Assessed outcomes included the Total Nasal Symptom Score, the Total Ocular Symptom Score, and the Rhinoconjunctivitis Quality-of-Life Questionnaire. The investigators performed random-effects meta-analyses of mean differences for each medication and outcome. The investigators assessed evidence certainty using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach. This review included 151 primary studies, most of which assessed patients with seasonal AR and displayed unclear or high risk of bias. Both in perennial and seasonal AR, most assessed treatments were more effective than placebo. In seasonal AR, azelastine-fluticasone, fluticasone furoate, and fluticasone propionate were the medications with the highest probability of resulting in moderate or large improvements in the Total Nasal Symptom Score and Rhinoconjunctivitis Quality-of-Life Questionnaire. Azelastine-fluticasone displayed the highest probability of resulting in moderate or large improvements of Total Ocular Symptom Score. Overall, evidence certainty was considered "high" in 6 of 46 analyses, "moderate" in 23 of 46 analyses, and "low"/"very low" in 17 of 46 analyses. Most intranasal medications are effective in improving rhinitis symptoms and quality of life. However, there are relevant differences in the associated evidence certainty. [ABSTRACT FROM AUTHOR]

Background Allergic rhinitis (AR) a common and complicated upper airway disease mediated by specific IgE antibodies. Our study aims to explore the pharmacological effects of astragalus polysaccharide (APS) on AR and elucidate the mechanisms involved. Methods RT-qPCR and Western blotting were used to analyze mRNA and protein expression. Interleukin (IL)-13-treated human nasal epithelial cells (hNECs) was employed as the AR cell model. Cell apoptosis and viability were evaluated by TUNEL staining and MTT assay, respectively. ROS level was examined by the DCFH-DA probe. Superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px) and malondialdehyde (MDA) levels were measured by the corresponding kits. FBXW7 m6A modification level was assessed by MeRIP assay. Methods Our results showed that APS treatment reduced cell apoptosis, ROS, and MDA levels while increasing SOD, CAT, and GSH-Px levels in IL-13-treated hNECs by activating the Nrf2/HO-1 pathway. Moreover, APS alleviated IL-13-induced oxidative stress injury in hNECs by downregulating WTAP. In addition, WTAP knockdown increased FBXW7 mRNA stability by regulating FBXW7 mRNA m6A modification. It also turned out that APS alleviated IL-13-induced oxidative stress injury in hNECs through the WTAP/FBXW7 axis. Conclusions Taken together, APS inhibited WTAP-mediated FBXW7 m6A modification to alleviate IL-13-induced oxidative stress injury in hNECs. [ABSTRACT FROM AUTHOR]

Allergic rhinitis (AR) is a prevalent upper airway chronic inflammatory disease in children worldwide. The role of bioactive lipids in the regulation of AR has been recognized, but the underlying serum lipidomic basis of its pathology remains unclear. We utilized ultra‐performance liquid chromatography (UPLC)‐Q‐Exactive Orbitrap/mass spectrometry (MS) to investigate the serum lipidomic profiles of children with AR. The lipidomic analysis identified 42 lipids that were differentially expressed (p < 0.05, fold change > 2) between the AR (n = 75) and normal control groups (n = 44). Specifically, the serum levels of diacylglycerol (DG), triacylglycerol (TG), fatty acid (FA), lysophosphatidylcholine (LPC), lysophosphatidylethanolamine, phosphatidyl‐ethanolamine, and cardiolipins were significantly higher in the AR group. The diagnostic potential of the identified lipids was further evaluated using receiver operating characteristic curve analysis. The analysis revealed that five lipids, including FA 30:7, LPC O‐18:1, LPC 18:0, LPC 16:0, and DG 34:0, had area under the curve values greater than 0.9 (p < 0.05). Furthermore, serum levels of IgE and IL‐33, markers of AR severity, were found to have a significant positive correlation (p < 0.05) with DGs, LPCs, TGs, and FAs in AR patients. This study revealed the lipid disorders associated with AR and its severity, providing new insights into the pathological process of AR. [ABSTRACT FROM AUTHOR]

Objective: Subcutaneous Immunotherapy (SCIT) is the long-lasting causal treatment of allergic rhinitis (AR). How to enhance the adherence of patients to maximize the benefit of allergen immunotherapy (AIT) plays a crucial role in the management of AIT. This study aims to leverage novel machine learning models to precisely predict the risk of non-adherence of AR patients and related local symptom scores in 3 years SCIT. Methods: The research develops and analyzes two models, sequential latentvariable model (SLVM) of Stochastic Latent Actor-Critic (SLAC) and Long Short-Term Memory (LSTM). SLVM is a probabilistic model that captures the dynamics of patient adherence, while LSTM is a type of recurrent neural network designed to handle time-series data by maintaining long-term dependencies. These models were evaluated based on scoring and adherence prediction capabilities. Results: Excluding the biased samples at the first time step, the predictive adherence accuracy of the SLAC models is from 60% to 72%, and for LSTM models, it is 66%-84%, varying according to the time steps. The range of Root Mean Square Error (RMSE) for SLAC models is between 0.93 and 2.22, while for LSTM models it is between 1.09 and 1.77. Notably, these RMSEs are significantly lower than the random prediction error of 4.55. Conclusion: We creatively apply sequential models in the long-term management of SCIT with promising accuracy in the prediction of SCIT nonadherence in AR patients. While LSTM outperforms SLAC in adherence prediction, SLAC excels in score prediction for patients undergoing SCIT for AR. The state-action-based SLAC adds flexibility, presenting a novel and effective approach for managing long-term AIT. [ABSTRACT FROM AUTHOR]

Phlomoides umbrosa Turczaninow (PU), a traditional Korean medicinal herb, exhibits osteogenic and anti-inflammatory effects. This research explored the effect of PU extracts on hyperimmune responses within the respiratory tract using lipopolysaccharide-stimulated RAW 264.7 cells and an ovalbumin-induced hyper-responsiveness model. The inflammatory cytokines, protein expression linked to airway inflammation, antioxidant enzyme activity, histopathological observation, and expectorant activity were measured. The results revealed that PU treatment led to a concentration-dependent reduction in Th2 cytokines and the expression of nuclear factor (NF)-κB, phosphatase-tensin homolog, mitogen-activated protein kinase (MAPK), and inducible nitric oxide synthase (iNOS). Simultaneously, antioxidant enzyme activity increased. Furthermore, PU exhibited substantial enhancements in lung tissue condition and expectorant activity relative to the allergic rhinitis-induced group. These findings indicate the potential of PU to mitigate airway inflammation and excessive mucus production by suppressing NF-κB, MAPK, and iNOS pathways. Consequently, PU emerges as a promising anti-inflammatory agent for respiratory tract applications. [ABSTRACT FROM AUTHOR]

Objective: This study aims to evaluate the accuracy of ChatGPT in answering allergic rhinitis (AR) and chronic rhinosinusitis (CRS) related questions. Study Design: This is a cross‐sectional study. Setting: Each question was inputted as a separate, independent prompt. Methods: Responses to AR (n = 189) and CRS (n = 242) related questions, generated by GPT‐3.5 and GPT‐4, were independently graded for accuracy by 2 senior rhinology professors, with disagreements adjudicated by a third reviewer. Results: Overall, ChatGPT demonstrated a satisfactory performance, accurately answering over 80% of questions across all categories. Specifically, GPT‐4.0's accuracy in responding to AR‐related questions significantly exceeded that of GPT‐3.5, but distinction not evident in CRS‐related questions. Patient‐originated questions had a significantly higher accuracy compared to doctor‐originated questions when utilizing GPT‐4.0 to respond to AR‐related questions. This discrepancy was not observed with GPT‐3.5 or in the context of CRS‐related questions. Across different types of content, ChatGPT excelled in covering basic knowledge, prevention, and emotion for AR and CRS. However, it experienced challenges when addressing questions about recent advancements, a trend consistent across both GPT‐3.5 and GPT‐4.0 iterations. Importantly, the accuracy of responses remained unaffected when questions were posed in Chinese. Conclusion: Our findings suggest ChatGPT's capability to convey accurate information for AR and CRS patients, and offer insights into its performance across various domains, guiding its utilization and improvement. [ABSTRACT FROM AUTHOR]

Objective: Rhinosinusitis is a prevalent disease in children that can cause many substantial physical symptoms and have a detrimental influence on their quality of life. This study aims to evaluate the predisposing factors, and management of pediatric rhinosinusitis patients. Methods: A cross-sectional study using retrospective data from 324 pediatric rhinosinusitis patients was conducted. Demographics, predisposing factors, and management were recorded. Results: Many of the affected patients (50.3%) were between 6 and 11 years old. The predisposing factors were allergic rhinitis (97.2%), asthma (27.2%), upper respiratory tract infection (24.4%), adenoid hypertrophy (17.9%), and gastro-oesophageal reflux disease (0.6%). A significant association was found between the age group with upper respiratory infection as a predisposing factor in pediatric rhinosinusitis (P-value .000). Most of our patients (99.7%) responded well to medical treatment, and 8.6% of them underwent surgical therapy, mainly adenotonsillectomy. Conclusion: This study demonstrated that allergic rhinitis was the most established predisposing factor for pediatric rhinosinusitis, followed by asthma, upper respiratory tract infection, and adenoid hypertrophy. Medical therapy was the mainstay of treatment for pediatric rhinosinusitis patients. [ABSTRACT FROM AUTHOR]

Research on the therapeutic use of parasites has been ongoing since the development of the "hygiene hypothesis". Parasites can stimulate the Th2-dependent response and suppress the Th1-dependent response, which is intensified in many diseases, especially allergic and autoinflammatory ones. In this review, we present the types of parasites used in helminth therapy and the range of diseases in which they may be useful. We also present the results of clinical trials conducted so far, which confirm the safety of such therapy and provide promising outcomes. [ABSTRACT FROM AUTHOR]

Background: Xiaoqinglong Decoction (XQLD) is a traditional Chinese medicine formula used for the treatment of allergic rhinitis and asthma, including combined allergic rhinitis and asthma syndrome (CARAS), due to its anti-inflammatory and anti-seizure properties. However, the pharmacological activities and the underlying molecular mechanisms of XQLD remain to be elucidated. Hence, we investigated the effects of XQLD against inflammation in an ovalbumin (OVA)-induced CARAS model in BALB/c mice. Methods: BALB/c mice were sensitized by intraperitoneal injection and aerosol inhalation of OVA. XQLD or dexamethasone was administered by oral gavage prior to OVA challenge for 7 consecutive days. Specific airway resistance (sRAW) was evaluated 24 h after the final challenge with OVA. Enzyme-linked immunosorbent assay was used to measure the levels of serum inflammatory factors. The nasal mucosa and lung tissue were examined for general morphology and goblet hyperplasia using hematoxylin and eosin or periodic acid Schiff staining. Flow cytometry was employed to analyze the frequencies of helper T lymphocytes in peripheral blood. Immunohistochemistry was performed to determine the expression of transcription factors in helper T lymphocytes and γδ TCR. Results: XQLD significantly ameliorated the symptoms of CARAS model mice, suppressed serum levels of interferon-γ, interleukin (IL)-2, IL-4, IL-5, IL-17, while increasing levels of IL-10, transforming growth factor-β. Epithelium impairment, cilia loss, eosinophil infiltration, and goblet cell metaplasia were significantly reduced in the nasal mucosa and lung tissue sections. XQLD restored the balance of Th1/Th2 and Th17/Treg cell frequency in peripheral blood. Furthermore, XQLD down-modulated the expression of GATA-binding protein 3 (GATA3), retinoic acid receptor-related orphan receptor γt, and γδ T cell receptor (TCR) in the nasal mucosa, along with GATA3 and γδ TCR in the lung tissue. Conclusions: XQLD alleviated OVA-induced CARAS in BALB/c mice through its anti-allergic effects and modulation of the immune system. [ABSTRACT FROM AUTHOR]

Allergic Rhinitis (AR), a prevalent condition in otorhinolaryngology, is mediated by Type 1 hypersensitivity through IgE, characterized by Type 2 inflammatory response and eosinophil infiltration in the nasal mucosa. Since AR disease exhibits significant heterogeneity in symptom severity, an objective assessment of AR severity may facilitate better individualized treatment. To explore the changes in peripheral blood IL-9, Th9, and BAFF levels of allergic rhinitis (AR) in patients and the clinical significance associated with it. A retrospective study selected 80 AR patients admitted from January 2022 to October 2022 as the case group, dividing them into mild and moderate-to-severe groups based on symptom scores. Concurrently, 50 patients without AR, who were treated for nasal bone fractures or underwent septoplasty, were selected as the group for comparison. Alterations in the expression levels of peripheral blood IL-9, Th9, and BAFF were analyzed and compared among the different groups. The diagnostic value of serum BAFF for the severity of AR was analyzed using the receiver operating characteristic (ROC) curve. Noticeable variations were observed in clinical variables among the three groups such as, total IgE levels, peripheral blood eosinophil count and proportion, TNSS, and VAS (P< 0.05), while no statistically significant differences were observed in other variables (P> 0.05). The comparison of IL-9, Th9, and BAFF among the three groups revealed statistically significant differences (P< 0.05). Analysis using multivariate logistic regression revealed that IL-9 (OR = 2.365), Th9 (OR = 2.186), BAFF (OR = 2.307) were influencing factors of moderate-to-severe AR (P< 0.05). The ROC curve indicated that the AUC for the diagnosis of moderate-to-severe AR by IL-9, Th9, BAFF were 0.770, 0.734, 0.761, respectively, and the combined detection AUC was 0.888, an area under the curve higher than individual testing. Changes in peripheral blood IL-9, Th9, and BAFF levels in AR patients may function as indicators to assess the level of severity in diagnostic procedures. [ABSTRACT FROM AUTHOR]

Introduction: Allergic rhinitis (AR) is an upper airway inflammatory disease of the nasal mucosa. Conventional treatments such as symptomatic pharmacotherapy and allergen-specific immunotherapy have considerable limitations and drawbacks. As an emerging therapy with regenerative potential and immunomodulatory effect, mesenchymal stem cell-derived exosomes (MSC-Exos) have recently been trialed for the treatment of various inflammatory and autoimmune diseases. Methods: In order to achieve sustained and protected release of MSC-Exos for intranasal administration, we fabricated Poly(lactic-co-glycolic acid) (PLGA) micro and nanoparticles-encapsulated MSC-Exos (PLGA-Exos) using mechanical double emulsion for local treatment of AR. Preclinical in vivo imaging, ELISA, qPCR, flow cytometry, immunohistochemical staining, and multiomics sequencing were used for phenotypic and mechanistic evaluation of the therapeutic effect of PLGA-Exos in vitro and in vivo. Results: The results showed that our PLGA platform could efficiently encapsulate and release the exosomes in a sustained manner. At protein level, PLGA-Exos treatment upregulated IL-2, IL-10 and IFN-γ, and downregulated IL-4, IL-17 and antigen-specific IgE in ovalbumin (OVA)-induced AR mice. At cellular level, exosomes treatment reduced Th2 cells, increased Tregs, and reestablished Th1/Th2 balance. At tissue level, PLGA-Exos significantly attenuated the infiltration of immune cells (e.g., eosinophils and goblet cells) in nasal mucosa. Finally, multiomics analysis discovered several signaling cascades, e.g., peroxisome proliferator-activated receptor (PPAR) pathway and glycolysis pathway, that might mechanistically support the immunomodulatory effect of PLGA-Exos. Discussion: For the first time, we present a biomaterial-facilitated local delivery system for stem cell-derived exosomes as a novel and promising strategy for AR treatment. [ABSTRACT FROM AUTHOR]

Objective: To explore the role of different cells and molecules in the pathogenesis of allergic rhinitis (AR) with positive Artemisia allergen by detecting their expression levels. Methods: From January 2021 to December 2022,200 AR patients diagnosed in the Otolaryngology Clinic of Ordos Central Hospital were selected as the AR group, and 50 healthy people who underwent physical examination in the hospital during the same period were randomly selected as the healthy control (HC) group. The levels of GATA-3mRNA, RORγtmRNA and FoxP3mRNA in peripheral blood mononuclear cells were detected by real-time fluorescence quantitative PCR (qRT-PCR). The proportions of Th2, Th17 and Treg cells were detected by flow cytometry. The concentrations of IL-4, IL-5, IL-17 and IL-10 in serum were detected by enzyme-linked immunosorbent assay. The differences of transcription gene level, immune cell ratio and cytokine concentration between the two groups were analyzed. Results: There was no difference in age and gender between the two groups. The levels of GATA-3mRNA and RORγtmRNA transcription genes in peripheral blood mononuclear cells, the percentage of Th2, Th17 and Treg immune cells, the levels of eosinophils and basophils in peripheral blood, the concentrations of IL-4, IL-5, IL-17, IL-10 cytokines and IgE in serum of AR patients were significantly higher than those in HC group (P < 0.05). IL-4 and IL-17 were positively correlated with total IgE level. Conclusion: The secretion of immune cells and cytokines in peripheral blood of AR patients is abnormal. Th2, Th17, Treg specific transcription factors and related cells and cytokines are involved in the occurrence and development of allergic rhinitis. [ABSTRACT FROM AUTHOR]

Institute of Allergy and Clinical Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China In recent years, the relationship between vitamin D and allergic diseases has received widespread attention. As a fat-soluble vitamin, vitamin D plays a crucial role in regulating the immune system and may influence the onset and progression of diseases such as atopic dermatitis, allergic rhinitis, and asthma. To understand the underlying mechanisms, we have summarized the current research on the association between vitamin D and allergic diseases. We also discuss the impact of vitamin D on the immune system and its role in the course of allergic diseases, particularly focusing on how vitamin D supplementation affects the treatment outcomes of these conditions. We aim to provide a theoretical basis and practical guidance for optimizing the management and treatment of allergic diseases by modulating vitamin D levels. [ABSTRACT FROM AUTHOR]

Background: Allergic rhinitis (AR) is a complex disease in which gene-environment interactions contribute to its pathogenesis. Epigenetic modifications, such as N6-methyladenosine (m6A) modification of mRNA, play important roles in regulating gene expression in multiple physiological and pathological processes. However, the function of m6A modification in AR and the inflammatory response is poorly understood. Methods: We used the ovalbumin (OVA) and aluminumhydroxide to induce an AR mouse model. Nasal symptoms, histopathology, and serum cytokines were examined. We performed combined m6A and RNA sequencing to analyze changes in m6A modification profiles. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and methylated RNA immunoprecipitation sequencing qPCR (MeRIP-qPCR) were used to verify differential methylation of mRNAs and them6A methylation level. Knockdown or inhibition of Alkbh5 in nasal mucosa of mice was mediated by lentiviral infection or IOX1 treatment. Results: We showed that m6A was enriched in a group of genes involved in MAPK signaling pathway. Moreover, we identified a MAPK pathway involving Map3k8, Erk2, and Nfκb1 that may play a role in the disrupted inflammatory response associated with nasal inflammation. The m6A eraser, Alkbh5, was highly expressed in the nasal mucosa of AR model mice. Furthermore, knockdown of Alkbh5 expression by lentiviral infection resulted in high MAPK pathway activity and a significant nasal mucosa inflammatory response. Our findings indicate that ALKBH5-mediated m6A dysregulation likely contributes to a nasal inflammatory response via the MAPK pathway. Conclusion: Together, our data show that m6A dysregulationmediated by ALKBH5, is likely to contribute to inflammation of the nasal mucosa via the MAPK signaling pathway, suggesting that ALKBH5 is a potential biomarker for AR treatment. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodsTo investigate the clinical efficacy and safety of Loratadine combined with Glucocorticoid nasal spray in the treatment of pediatric bronchial asthma with seasonal allergic rhinitis.A total of 100 pediatric patients with moderate to severe bronchial asthma and seasonal allergic rhinitis admitted to our hospital between January 2020 and January 2023 were included in this study. All patients met the complete inclusion and exclusion criteria. Based on different treatment interventions, they were divided into the control group (n = 50) and the observation group (n = 50). Patients in the control group received treatment with glucocorticoid nasal spray, while patients in the observation group received combined intervention with Loratadine in addition to the treatment received by the control group. The clinical treatment outcomes, incidence of adverse reactions, as well as the scores of nasal symptoms, asthma control, and peak expiratory flow rates at different treatment time points (baseline, T1: 30 days after treatment, T2: 60 days after treatment, T3: 90 days after treatment) were compared between the two groups. The combined treatment of Loratadine with Glucocorticoid nasal spray demonstrates significant clinical efficacy in the treatment of pediatric bronchial asthma with seasonal allergic rhinitis. It further promotes the recovery of peak expiratory flow rates, improves symptoms of rhinitis and asthma in pediatric patients. Importantly, the application of this combined treatment does not increase the risk of adverse reactions in pediatric patients, indicating its high safety profile. This treatment approach is worthy of clinical application and further promotion. [ABSTRACT FROM AUTHOR]

Background Objectives Search Strategy Selection Criteria Data Collection and Analysis Main Results Conclusions Clinical and preclinical evidence indicate that in utero maternal asthma exposure increases progeny asthma risk. Whether maternal asthma also increases the risks of progeny allergy is unclear.To synthesise the available evidence on the relationship between in utero exposure to maternal asthma and postnatal asthma, wheezing and allergic diseases (Prospero: CRD42020201538).We systematically searched MEDLINE [PubMed], Embase [Ovid], Web of Science, Informit Health, the Cochrane Library, CINAHL [EBSCOhost], MedNar [Deep Web Technologies], ProQuest Theses and Dissertations, Scopus [Elsevier] and Trove, to the end of 2023.Studies reporting asthma, wheeze and/or allergic disease in progeny of women with and without asthma or with asthma classified by control, exacerbation or severity.Double screening, selection, data extraction and quality assessment were performed, using Joanna Briggs Institute (JBI) scoring.Of 134 non‐overlapping studies, 127 were included in ≥1 meta‐analysis. Maternal asthma ever was associated with greater risks of asthma (65 studies, risk ratio [95% confidence interval] 1.76 [1.57–1.96]), wheeze (35 studies, 1.59 [1.52–1.66]), food allergy (5 studies, 1.32 [1.23–1.40]), allergic rhinitis (7 studies, 1.18 [1.06–1.31]) and allergic dermatitis (14 studies, 1.17 [1.11–1.23]) ever in progeny. Asthma during the pregnancy, more severe, and uncontrolled maternal asthma were each associated with greater risks of progeny asthma.Children of mothers with asthma are at increased risk for the development of allergic diseases. Whether improved maternal asthma control reduces risks of child allergy as well as asthma requires further investigation. [ABSTRACT FROM AUTHOR]

Allergic diseases, characterized by a broad spectrum of clinical manifestations and symptoms, encompass a significant category of IgE-mediated atopic disorders, including asthma, allergic rhinitis, atopic dermatitis, and food allergies. These complex conditions arise from the intricate interplay between genetic and environmental factors and are known to contribute to socioeconomic burdens globally. Recent advancements in the study of allergic diseases have illuminated the crucial role of DNA methylation (DNAm) in their pathogenesis. This review explores the factors influencing DNAm in allergic diseases and delves into their mechanisms, offering valuable perspectives for clinicians. Understanding these epigenetic modifications aims to lay the groundwork for improved early prevention strategies. Moreover, our analysis of DNAm mechanisms in these conditions seeks to enhance diagnostic and therapeutic approaches, paving the way for more effective management of allergic diseases in the future. [ABSTRACT FROM AUTHOR]

Objective To understand the distribution of allergens in different altitude areas of Yunnan Province and evaluate the impact of meteorological factors on the sensitization rate of allergens, providing a theoretical basis for formulating reasonable allergen screening programs in different regions of Yunnan Province. Methods A retrospective analysis was conducted in children with allergic rhinitis (AR) admitted to Department of Otolaryngology of Kunming Children’s Hospital from January 2022 to December 2023, and their permanent places of residence were Xishuangbanna prefecture, Dehong prefecture, Honghe prefecture, Zhaotong, Kunming, Dali prefecture, and Diqing prefecture. Skin prick tests (SPT) were performed, and the positive results of SPT and demographic data were analyzed. At the same time, the relationship between altitudes and meteorological factors and allergens was analyzed by considering the altitudes of these seven regions and meteorological data (average temperature, average annual relative humidity, average annual wind speed, and average annual precipitation) during the same period. Results A total of 8, 175 data sets were collected. Under different meteorological and altitude conditions, the positive rate of SPT for dust mites and partial pollen allergens showed significant differences (all P < 0.05), and dust mites remained the main allergen even at high altitudes. The positive rate of dust mite SPT was positively correlated with the average annual temperature and negatively correlated with the altitude (both P < 0.05); the positive rate of pollen SPT was negatively correlated with the average annual relative humidity (P < 0.05); the positive rate of dust mite SPT was increased with age (P < 0.05). Conclusion The distribution of allergens in different meteorological and altitude areas of Yunnan Province may vary, and personalized diagnosis, treatment, prevention programs need to be formulated. [ABSTRACT FROM AUTHOR]