Search

AbstractBackgroundAims/ObjectivesMaterial and MethodsResultsConclusions and SignificanceAllergen immunotherapy is the only treatment that can achieve remission for allergic diseases.To investigate the three-year adherence to sublingual immunotherapy for Japanese cedar pollinosis and house dust mite allergy at a clinic in Japan and identify factors that influence adherence and severe adverse reactions.In total, 174 patients aged 12 years or older who started sublingual immunotherapy for Japanese cedar pollinosis (n = 72), house dust mite allergy (n = 55), or both (n = 47) between May 2017 and June 2018. Patient age, sex, type of pharmacotherapy used, adverse reactions, blood test results, and duration of continuous treatment were investigated.The three-year treatment continuation rate was 40.8%. Adverse reaction rates were 12.6% for cedar pollinosis and 40.2% for house dust mite allergy. Patients with dose reductions due to severe reactions had lower first-year continuation rates. In the MITICURE® group, patients with severe reactions had significantly higher serum total IgE levels. Severe reactions were more common in MITICURE® patients with seven or more positive antigen types.Severe adverse reactions reduced early adherence. [ABSTRACT FROM AUTHOR]

Introduction: This study clarified the expression changes and clinical significance of CD44+CD62L− Treg and CD44−CD62L+ Treg subsets in the peripheral blood of patients with allergic rhinitis (AR). Methods: The peripheral blood of 39 patients with AR and 42 healthy controls was collected. Clinical data, such as sex, age, IgE titer, allergen screening information and visual analogue scale (VAS) score, were recorded. Changes in serum IL-2, IL-4, IL-6, IL-10, TNF-α, and IFN-γ were detected using the cytometric bead array method. Flow cytometry was used to detect the proportions of Th1, Th2, Th17, TFH, and Th9 cells and the proportions of CD44+CD62L− Treg and CD44−CD62L+ Treg subsets. Correlation analysis was performed between the CD44+CD62L− Treg subsets and the CD44−CD62L+ Treg subsets with clinical indicators (VAS score, total IgE titer), cytokines (IL-2, IL-4, IL-6, IL-10, TNF-α, IFN-γ), and Th1/Th2/Th17/TFH/Th9 cell proportions. Results: Compared to the control group, the proportion of total Treg cells and CD44+CD62L− Treg cells in the AR group decreased, and the proportion of CD44−CD62L+ Treg cells increased (p < 0.05). The proportions of CD44+CD62L− Treg cells significantly negatively correlated with Th2 cells (R = −0.5270, p < 0.05) and positively correlated with Treg cytokine IL-10 (R = 0.6447, p < 0.05). In addition, CD44+CD62L− Treg cells negatively correlated with the VAS score (R = −0.4956, p < 0.05), total IgE level (R = −0.4177, p < 0.05) and Th2 cytokine IL-6 level (R = −0.3034, p < 0.05) but positively correlated with the Th1 cytokine IL-2 (R = 0.4331, p < 0.05). In contrast, the proportion of CD44+CD62L− Treg cells significantly positively correlated with the Th2 cells (R = 0.6187, p < 0.05). Moreover, the proportion of CD44−CD62L+ Treg cells positively correlated with the VAS score (R = 0.4060, p < 0.05), total IgE level (R = 0.5224, p < 0.05) and Th2 cytokine IL-4 (R = 0.2647, p < 0.05) and IL-6 levels (R = 0.3824, p < 0.05) but negatively correlated with Th1 cytokine IL-2 (R = −0.3451, p < 0.05) and IL-10 (R = −0.3277, p < 0.05). Conclusion: A greater proportion of CD44+CD62L− Tregs correlated with better reversal of the Th1/Th2 imbalance and milder clinical symptoms in AR patients. The presence of more CD44−CD62L+ Tregs correlated with a weaker immunosuppressive effect on Th2 cells and more severe clinical symptoms in AR patients. These findings provide new perspectives for the treatment and disease monitoring of AR. [ABSTRACT FROM AUTHOR]

Introduction: Atopic dermatitis (AD) is a chronic inflammatory skin condition with increasing prevalence worldwide, significantly affecting quality of life. While dietary factors are suspected to influence the onset and severity of AD, the relationship between comprehensive dietary patterns and AD, particularly in conjunction with comorbidities such as asthma, allergic rhinitis, and food allergies, remains underexplored. This study aims to investigate the dietary patterns of adults and children with AD and their association with disease severity and the presence of comorbidities. Material and Methods: A cross-sectional study was conducted with 150 patients diagnosed with AD, recruited from the Department of Dermatology, Venereology, and Leprology (DVL). Dietary patterns were assessed using a validated food frequency questionnaire (FFQ), and AD severity was measured using the Scoring Atopic Dermatitis (SCORAD) index. The presence of comorbidities, including asthma, allergic rhinitis, and food allergies, was confirmed through patient history, clinical examination, and review of medical records. Data were analyzed using descriptive statistics, chi-square tests, t-tests, and multivariate logistic regression. Results: The study found that the mixed diet pattern had the highest adherence (mean ± SD: 7.1 ± 1.9), followed by vegetarian (5.8 ± 1.9) and non-vegetarian (5.1 ± 2.0) patterns. The mean SCORAD index was 43.8 ± 14.1, indicating moderate to severe AD. Pruritus and sleep loss scores were 5.1 ± 2.0 and 4.1 ± 1.9, respectively. The prevalence of comorbidities was 36.7% for asthma, 57.3% for allergic rhinitis, and 32.0% for food allergies. The study identified significant associations between dietary patterns and AD severity, as well as with the presence of comorbidities. Conclusions: This study highlights the potential impact of dietary patterns on AD severity and the high prevalence of comorbidities among individuals with AD. The findings suggest that a mixed dietary pattern may be commonly adhered to by AD patients and could play a role in managing the disease. The study emphasizes the need for a multidisciplinary approach in managing AD, considering both dietary interventions and the treatment of comorbid conditions. [ABSTRACT FROM AUTHOR]

Background: Severe allergic rhinitis has been associated with significant impairments in quality of life, sleep, and work performance. Recent evidence suggests that serum vitamin D3 has significantly correlated with the severity of allergic rhinitis (AR). Aim: The objective of the study was to evaluate whether vitamin D supplementation has any role to reduce the severity of disease spectrum among allergic rhinitis patients. Material & Methods: This prospective observational study was carried out in the department of otorhinolaryngology in a tertiary care hospital. 120 subjects with allergic rhinitis were evaluated for serum vitamin D levels. Pre-treatment total nasal symptom score (TNSS) were recorded for these patients. One group received anti-allergic while another group received vitamin D supplementation along with anti-allergic treatment. Post treatment TNSS scores and AR severity were calculated and analysed. Results: Majority of the patients (35%) were 31-40 years age group, predominantly female (55.8%). Most of them (51.7%) were vitamin D deficiency (<20 ng/dl). The vitamin D deficiency was more pronounced in the patients having severe allergic rhinitis with TNSS > 11 were having mean vitamin D level 17.2 ng/ml. TNSS were significantly improved after successful vitamin D supplementation among allergic rhinitis patients (p<0.05). Conclusion: patients with allergic rhinitis might be more vulnerable to have lower serum levels of vitamin D. Thus, significant reduction in the allergy symptom scores after vitamin D supplementation which alters the course of disease towards clinical improvement. [ABSTRACT FROM AUTHOR]

Introduction: Allergic rhinitis (AR) is a common allergic disorder that impairs social and physical functioning as well as quality of life. It is characterized by sneezing, rhinorrhea, congestion, and itching which respond suboptimally to drug therapy. Low-level laser therapy (LLLT) has anti-inflammatory and immunosuppressive properties that have shown promise in some studies. We aimed to systematically review LLLT's effectiveness in treating AR and meta-analyze our findings. Methods: A systematic search of PubMed, Scopus, and Web of Science was conducted on November 24, 2023. All studies investigating LLLT on AR were included, and a pre-post meta-analysis of nasal symptoms (rhinorrhea, nasal congestion, nasal itching, and sneezing) in the LLLT-treated arm was conducted. Rhinoconjunctivitis quality of life questionnaire (RQLQ) scores before and after LLLT were also meta-analyzed alongside a pairwise meta-analysis of LLLT with placebo, acupuncture, steroids/antihistamines, and ultraviolet lasers. A random-effects model was used with a conservative pre-post correlation of 0.4 and standardized mean difference (SMD) as the effect size. Results: Sixteen studies were included in this review, and we found that nasal symptoms are alleviated post-LLLT in people with AR (SMD: −1.4, 95 CI: [−2.07 to −1.13], p value <0.001). RQLQ scores were also reduced after LLLT (SMD = −0.72, 95 CI: [−0.94 to −0.50], p value <0.001), and very few adverse events were reported. This meta-analysis, however, had significant publication bias and heterogeneity. When compared to a placebo, LLLT did not significantly improve nasal symptoms (SMD: −0.69, p value = 0.167), which might mean the post-LLLT nasal symptom alleviation is due to a placebo effect. Comparisons to other treatment modalities were too few to deduce anything meaningful, although it does appear that LLLT is less effective than UV lasers. Conclusion: LLLT is most likely effective at alleviating nasal symptomology and has a low likelihood of adverse event incidence, yet more high-quality studies with larger sample sizes are needed to compare LLLT to a placebo to ensure its superiority to the placebo effect, as well as non-inferiority clinical trials to compare it to standard treatments. [ABSTRACT FROM AUTHOR]

The prevalence of asthma is high and the incidence is increasing significantly in Africa. Cases of severe exacerbations of asthma are managed as inpatients and are often used as indicators of asthma care. There is a paucity of data regarding hospitalised paediatric asthma cases in low- and middle-income countries (LMICs). This retrospective study describes the clinical presentation of children admitted to Charlotte Maxeke Johannesburg Academic Hospital in Johannesburg, South Africa, with asthma, and the association, if any, with intensive care unit (ICU) admission. Medical records between the years 2015 and 2020 were reviewed, revealing 134 admissions, with eight children being admitted to the ICU. The median age was four years (IQR 3,7) and the median duration of stay was four days (IQR 4,6). 66% of the children admitted were aged 1-5 years; 52.5% of the admissions were male. Allergic rhinitis was the most common associated comorbidity, at 42.4%. Most children presented with subcostal retractions (88.8%) and hypoxia (74.2%). Two children died from asthma complications. Children who had a known asthma diagnosis at the time of admission were more likely to have been readmitted than those who did not have a prior asthma diagnosis (p = < 0.001). Previous asthma hospitalisation was associated with ICU admission (p = 0.041). Most admissions occurred during the summer months. The trend in hospitalised asthma cases declined over the study period and paediatric asthma mortalities were rare. Further studies are needed to assess risk factors for paediatric asthma hospitalisation, especially in LMICs. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to analyze the sensitization rate of different aeroallergens in children of different age, sex, and disease groups, describe the changing trend of different aeroallergens in different ages, and analyze the sensitization risk factors for asthma. Methods: Children (<18 years old) with suspected atopic diseases who visited the Department of Allergy of Children's Hospital Affiliated to Capital Institute of Pediatrics and underwent a skin prick test (SPT) were retrospectively enrolled from January 2019 to November 2021. Results: A total of 5465 patients (3514 boys, 1951 girls; mean age, 7 ± 3 years) were enrolled. Of them, 3703 patients (67.8%) were sensitized to at least one aeroallergen. Before 4 years of age, mold was the most prevalent aeroallergen (103/380 [27.1%]), whereas after 4 years of age, weed pollen was the most prevalent aeroallergen. After 6 years of age, tree pollen became the second most prevalent aeroallergen. After 12 years of age, the sensitization rate of indoor aeroallergens was lower than that of outdoor aeroallergens. Logistic regression showed that sensitization to mold (odds ratio [OR]:1.4, 95% confidence interval (CI): 1.2–1.7, p < 0.001), animal dander (OR: 1.6, 95% CI: 1.4–1.9, p < 0.001), and polysensitization (OR: 1.4, 95% CI: 1.0–1.8, p = 0.038) were potential sensitization risk factors for asthma. Conclusions: Mold is an important allergen in early life. Different kinds of allergens affect different age groups. Patients who are sensitized to mold or animal dander or experience polysensitization should be carefully monitored for asthma risk. [ABSTRACT FROM AUTHOR]

A retrospective study conducted in Italy analyzed data from 116 patients with severe atopic dermatitis (AD) to determine if the drug upadacitinib could improve symptoms of concomitant allergic rhinitis (AR) or allergic asthma (AA). The study found that after 16 weeks of treatment with upadacitinib, 81.9% of patients achieved a reduction of at least 75% in their AD symptoms, and 56.03% achieved a reduction of at least 90%. Upadacitinib also showed a slight improvement in symptoms of AA and AR. The study suggests that upadacitinib may have a beneficial impact on AA and AR symptoms in patients with severe AD, but further research is needed. [Extracted from the article]

Background: Acupuncture has been shown for the treatment of allergic rhinitis in previous studies. Nevertheless, relevant evidence was lacked for paediatric patients with allergic rhinitis. We aim to validate the efficacy of acupuncture for allergic rhinitis in children by meta‐analysis and trial sequence analysis. Method: Comprehensive search of eight databases were conducted until August 27, 2023. Randomized controlled trials comparing acupuncture alone or in combination with drugs versus medication in children with AR were included. The primary outcome was total nasal symptom score (TNSS). The secondary outcomes were serum immunoglobulin E levels, and relapse rates. Results: Thirteen studies involving 1186 participants were included. In results, acupuncture group (AC group) versus medication group (Med group) shows no significant difference in the treatment of AR in children (risk ratio [RR] = 1.10, 95% CI = 0.97 to 1.24, p = 0.13), while TSA suggested the included sample size did not exceed required information size (RIS). Significant differences were found between the AC + Med group versus the Med group (RR = 1.29, 95% CI = 1.17 to 1.42, p < 0.00001), with sufficient sample size. Results in serum IgE after treatment which favored the Med group (MD = 51.94, 95% CI [22.24, 81.65], p = 0.0006). In terms of relapse rate, The AC group had a lower relapse rate than the Med group (RR = 0.40, 95% CI = 0.26–0.63, p < 0.0001). Conclusions: Acupuncture is an efficacious treatment for allergic rhinitis in children, but this conclusion might be limited by the generally low quality of evidence. TSA suggested additional high‐quality trials with larger sample sizes and longer treatment durations were needed. [ABSTRACT FROM AUTHOR]

Over the past few decades, allergic diseases have become more prevalent and impact around 20% of the global population. There is clinical significance of allergic march as it places a burden on the quality of life of children and their families. To assess the current situation of allergy conditions experienced by children attending elementary and junior high schools in Oyama and Tochigi cities, Japan. A letter was sent to parents informing them about an opt-in online survey concerning children's allergies along with a weblink and a QR code. A video explained the survey process and informed parents that their replies could not be retracted. Parents who had watched the explanation video and answered yes to participating were considered to have provided consent for the survey. A total of 2038 valid replies were gathered. Allergic Rhinitis was the most commonly diagnosed allergy, followed by Asthma, Food Allergy, and Atopic Dermatitis. Around 70% of the children were affected by the allergies, of whom half had been affected by multiple allergies. Most children affected by Atopic Dermatitis, Food Allergy or Asthma were affected by other allergies. Atopic Dermatitis and Food Allergy were mostly diagnosed before Asthma and Allergic Rhinitis. Children who are diagnosed with either Atopic Dermatitis or a Food Allergy will likely be affected by other allergies later in life. Allergic march perpetuated an earlier peak diagnosis incident rate for allergic rhinitis. Allergic Rhinitis can occur independently from other allergies compared to Atopic Dermatitis, Food Allergy and Asthma. [ABSTRACT FROM AUTHOR]

Dupilumab effectively treats atopic dermatitis (AD); however, its role in halting the atopic march remains uncertain. To investigate dupilumab's effect on atopic march in pediatric AD patients versus conventional immunomodulators. This retrospective cohort study utilized data from the TriNetX US Collaborative Network (2011-2024). Pediatric AD patients (≤18 years) were categorized into DUPI-cohort (newly prescribed dupilumab) or CONV-cohort (prescribed conventional immunomodulators without dupilumab). After 1:1 propensity-score matching, we analyzed atopic march progression, defined by the incident asthma or allergic rhinitis (AR). Cumulative incidence was plotted using Kaplan-Meier, with risk assessment via Cox regression. The study included 2192 patients in each cohort. The 3-year cumulative incidence of atopic march progression was lower in the DUPI-cohort than the CONV-cohort (20.09% vs 27.22%; P <.001). The DUPI-cohort demonstrated significant risk reduction in atopic march progression (hazard ratio [HR] 0.68, 95% CI 0.55-0.83), individual asthma (HR 0.60, 0.45-0.81), and individual AR (HR 0.69, 0.54-0.88). Younger patients on dupilumab exhibited a greater risk reduction for atopic march progression and individual asthma, contrasting with the opposite age-related pattern for individual AR. Observational study. Among pediatric AD patients, dupilumab was associated with reduced risk of atopic march progression compared with conventional therapies. [ABSTRACT FROM AUTHOR]

[Display omitted] The integrity of the airway epithelium is guarded by the airway basal cells that serve as progenitor cells and restore wounds in case of injury. Basal cells are a heterogenous population, and specific changes in their behavior are associated with chronic barrier disruption—mechanisms that have not been studied in detail in allergic rhinitis (AR). We aimed to study basal cell subtypes in AR and healthy controls. Single-cell RNA sequencing (scRNA-Seq) of the nasal epithelium was performed on nonallergic and house dust mite–allergic AR patients to reveal basal cell diversity and to identify allergy-related alterations. Flow cytometry, immunofluorescence staining, and in vitro experiments using primary basal cells were performed to confirm phenotypic findings at the protein level and functionally. The scRNA-Seq, flow cytometry, and immunofluorescence staining revealed that basal cells are abundantly and heterogeneously present in the nasal epithelium, suggesting specialized subtypes. The total basal cell fraction within the epithelium in AR is increased compared to controls. scRNA-Seq demonstrated that potentially beneficial basal cells are missing in AR epithelium, while an activated population of allergy-associated basal cells is more dominantly present. Furthermore, our in vitro proliferation, wound healing assay and air–liquid interface cultures show that AR-associated basal cells have altered progenitor capacity compared to nonallergic basal cells. The nasal basal cell population is abundant and diverse, and it shifts toward a diseased state in AR. The absence of potentially protective subtypes and the rise of a proinflammatory population suggest that basal cells are important players in maintaining epithelial barrier defects in AR. [ABSTRACT FROM AUTHOR]

While the daily rhythm of allergic rhinitis (AR) has long been recognized, the molecular mechanism underlying this phenomenon remains enigmatic. We aimed to investigate the role of circadian clock in AR development and to clarify the mechanism by which the daily rhythm of AR is generated. AR was induced in mice with ovalbumin. Toluidine blue staining, liquid chromatography–tandem mass spectrometry analysis, real-time quantitative PCR, and immunoblotting were performed with AR and control mice. Ovalbumin-induced AR is diurnally rhythmic and associated with clock gene disruption in nasal mucosa. In particular, Rev-erbα is generally downregulated and its rhythm retained, but with a near-12-hour phase shift. Furthermore, global knockout of core clock gene Bmal1 or Rev-erbα increases the susceptibility of mice to AR and blunts AR rhythmicity. Importantly, nasal solitary chemosensory cells (SCCs) are rhythmically activated, and inhibition of the SCC pathway leads to attenuated AR and a loss of its rhythm. Moreover, rhythmic activation of SCCs is accounted for by diurnal expression of ChAT (an enzyme responsible for the synthesis of acetylcholine) and temporal generation of the neurotransmitter acetylcholine. Mechanistically, Rev-erbα trans-represses Ch at through direct binding to a specific response element, generating a diurnal oscillation in this target gene. SCCs, under the control of Rev-erbα , are a driver of AR rhythmicity; targeting SCCs should be considered as a new avenue for AR management. [ABSTRACT FROM AUTHOR]

Background: Respiratory allergies mostly allergic rhinitis and asthma represent an important and increasing public health problem and one of the priorities for the European health systems. There is an increasing public concern regarding the persistence and severity of allergic diseases and many difficulties of health systems in providing prompt specialized medical assistance. Our study aims to highlight the main results of the Alliance 4Life project focused on the evaluation of the burden and management of respiratory allergies in primary care from Romania and comparative health-related data from four Central and Eastern European countries. Method: We developed a questionnaire focused on patients with allergic rhinitis and asthma directly addressed to general practitioner (GP) specialists from Romania who attended the annual national conference in Bucharest. Results: The main results showed that patients with respiratory allergies are frequently encountered in primary care practice, only a few patients are evaluated by allergists and there is a clear need for education in this field. Conclusions: This preliminary study confirms that respiratory allergies represent a considerable burden in primary care and the questionnaire may be a useful tool in further studies considering the experience of other healthcare systems. More advanced studies integrating epidemiology with data on air pollution and environmental conditions should be envisaged. [ABSTRACT FROM AUTHOR]

Objective: Patient‐reported outcome measures, while valuable, may not correlate with diagnostic test results. To better understand this potential discrepancy, our objective was to determine whether psychological health is an effect modifier of the association between patient‐reported allergy outcome scores and allergy test results. Study Design: Prospective outcomes study. Setting: Tertiary care hospital and community‐based clinic. Methods: This study included 600 patients at least 18 years of age who presented for symptoms related to allergic rhinitis and completed the related sinonasal outcome test (SNOT), which includes validated nasal, allergy, and psychological domains. Stratified analyses of odds ratios and Spearman correlation coefficients were utilized to assess for effect modification by psychological status. Results: Worse patient‐reported allergic rhinitis symptoms were significantly associated with positive allergy test results (odds ratio [OR] 1.69, 95% confidence interval [CI] 1.22‐2.34, P =.002) in patients with better psychological health. In contrast, there was no association in patients with worse psychological health (OR 1.06, 95% CI 0.36‐3.10, P =.92). These findings were corroborated by assessments of correlation: allergy domain scores were positively correlated with allergy testing scores (Spearman rho 0.18, 95% CI 0.10‐0.25, P <.001) in patients with better psychological health, while there was no correlation in patients with worse psychological health (−0.02, 95% CI −0.16‐0.12, P =.77). Conclusions: Psychological status was an effect modifier of the association between allergy domain and allergy testing data. When assessing the relationship between subjective measures, such as sinonasal validated instruments, and objective measures, such as allergy test results, accounting for effect modifiers such as psychological state can provide clinical and research‐related insights. [ABSTRACT FROM AUTHOR]

Objective: To identify predictors of chronic rhinosinusitis (CRS) in patients presenting with the chief complaint of nasal allergies. Study Design: Cross‐sectional study. Setting: Tertiary care, academic center. Methods: Clinical and demographic characteristics were collected from participants who were patients presenting with the chief complaint of nasal allergies. From all participants, a 22‐item Sinonasal Outcome Test (SNOT‐22) was collected, and a modified Lund‐Kennedy endoscopy score was calculated from nasal endoscopy. Association was sought between having CRS and variables of clinical and demographic characteristics, SNOT‐22, and endoscopy score. Results: A total of 219 patients were recruited and 91.3% were diagnosed with allergic rhinitis; 45.2% were also diagnosed with CRS. Approximately half of the patients with CRS reported no intranasal corticosteroid usage. Having CRS was associated with male sex (odds ratio [OR] = 2.29, 95% confidence interval [CI]: 1.30‐4.04, P =.004), endoscopy score (OR = 1.96, 95% CI: 1.59‐2.42, P <.001), and the SNOT‐22 nasal subdomain score (OR = 1.07, 95% CI: 1.03‐1.11, P =.001) related to SNOT‐22 items: "need to blow nose," "thick nasal discharge," "sense of taste/smell," and "blockage/congestion of nose." At least moderate (item score ≥3) "blockage/congestion of nose" or "thick nasal discharge," mild "need to blow nose" (item score ≥2) or very mild decreased "sense of taste/smell" (item score ≥1), and any nasal endoscopy findings (endoscopy score ≥1) were statistically significant predictors of CRS. Conclusion: Moderate or more severe nasal obstruction or discharge symptoms, any decreased sense of smell/taste, or positive nasal endoscopy findings in patients believing they have allergic rhinitis should prompt further evaluation of CRS to avoid delays in treatment. [ABSTRACT FROM AUTHOR]

Key points The evidence regarding the open‐label placebo effect on allergic rhinitis symptoms remains uncertain. Open‐label placebo significantly reduced the frequency of symptoms in allergic rhinitis patients with similar safety profiles; however, there was no effect on the severity of symptoms and impairment due to symptoms. The statistically significant impact on symptom frequency can be considered not clinically significant. [ABSTRACT FROM AUTHOR]

Introduction: FOXO1 plays an important role in regulating immune processes that contribute to allergic inflammation; however, genetic variants influencing FOXO1 expression in AR pathogenesis remains unclear. This study aimed to investigate the functional effect of FOXO1 single nucleotide polymorphisms (SNPs) on AR development by performing genetic association and functional analysis studies. Methods: This study belongs to a part of an ongoing Singapore/Malaysia cross-sectional genetics and epidemiological study (SMCSGES). We assessed the associations of FOXO1 transcript expression levels in peripheral blood mononuclear cells (PBMC) with AR phenotype, total nasal symptom score (TNSS), and SNP genotype in a sub-cohort of n = 658 individuals from the SMCSGES population. Associations of FOXO1 SNPs with AR were assessed in a cohort of n = 5,072 individuals from the SMCSGES population. In vitro promoter luciferase assay was used to evaluate the effect of AR-associated SNPs on FOXO1 promoter activity. Results: FOXO1 transcript expression in PBMC was significantly associated with the risk of AR (p < 0.05) and TNSS among AR patients (p < 0.0001). We identified a significant association between tag-SNPs rs9549246 and FOXO1 transcript expression in PBMC from the SMCSGES sub-cohort and the multiethnic eQTLGen consortium (false discovery rate-adjusted p < 0.05). The minor allele “A” of tag-SNP rs9549246 was significantly associated with a higher risk of AR (p = 0.04422, odds ratio = 1.21, 95% confidence interval = 1.01–1.45) in the SMCSGES genotyping cohort (n = 5,072). In vitro luciferase assay showed the minor allele “A” of rs35594717 (tagged by rs9549246) was significantly associated with a higher FOXO1 promoter activity (p < 0.05). Conclusion: FOXO1 transcript expression in PBMC has a strong association with the risk and symptom severity of AR. Genetic variants tagged by rs9549246 were shown to affect the expression of FOXO1 and contribute to the development of AR in the SMCSGES population. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Studies of childhood diet diversity and allergic disease have not examined additional associations with an offspring allergy‐linked maternal diet index during pregnancy. We studied both associations in a pre‐birth cohort.Offspring allergic disease diagnoses were obtained from electronic medical records. Maternal and infant diet were self‐reported. Adjusted parametric Weibull time‐to‐event models assessed associations between maternal diet index, infant diet diversity and time to development of allergic rhinitis, atopic dermatitis, asthma, wheeze, IgE‐mediated food allergy, and a combined outcome of any allergic disease except for wheeze.Infant diet diversity at 1 year was associated with the risk of the combined outcome between 1 and 4 years of age (p = .002). While both maternal diet index and infant diet diversity at 1 year were associated with the risk of the combined outcome between 1 and 4 years of age (both p < .05), infant diet diversity at 1 year did not modify the association between maternal diet index and the risk of the combined outcome between 1 and 4 years of age (p = .5). The group with the lowest risk of the combined allergy outcome had higher maternal diet index and higher infant diet diversity.The novel finding that both maternal diet index during pregnancy and infant diet diversity at 12 months are associated with the risk of a combined allergic disease outcome points to two targets for preventive interventions: maternal diet index scores during pregnancy and offspring diet diversity during infancy. [ABSTRACT FROM AUTHOR]

The incidence of allergic rhinitis in children is high across the world, as well as in China. Allergic rhinitis in children has serious impact on physical and mental health of the children. At the same time, the caregivers of allergic rhinitis children have heavy burden of care, and their mental problems are severe. It is necessary to implement timely psychological intervention for the caregivers of allergic rhinitis children. Mindfulness-Based Cognitive Therapy (MBCT) is a safe and effective psychological therapy, and the effect of online intervention can be comparable to the traditional face-to-face intervention program. This study focused on the mental health status in the main caregivers of children with allergic rhinitis, and conducted a modified online MBCT intervention on the caregivers, in order to improve their adverse mental state, meanwhile, improve the quality of care they provide. The results show that online MBCT intervention is applicable to the main caregivers of children with allergic rhinitis, and can effectively reduce caregiver burden, relieve anxiety and depression, and improve the level of mindfulness in the caregivers. [ABSTRACT FROM AUTHOR]