Search

La rhinite allergique est une maladie inflammatoire touchant les muqueuses des voies aériennes supérieures. Essentiellement provoquée par des phénomènes de pollinose, elle est très souvent associée à la conjonctivite allergique et sa relation de cause à effet avec l'asthme n'est plus à démontrer. Le conseil du pharmacien est souvent sollicité. Allergic rhinitis is an inflammatory disease affecting the mucous membranes of the upper airways. Mainly caused by pollinosis, it is very often associated with allergic conjunctivitis and its causal relationship with asthma is well established. The advice of the pharmacist is often sought. [ABSTRACT FROM AUTHOR]

Copyright of Wiener Klinisches Magazin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Les allergènes préparés spécialement pour un seul individu (APSI) permettent le diagnostic et le traitement (immunothérapie allergénique [ITA]) des maladies allergiques respiratoires. Les APSI concernent 300 000 patients en France avec 100 000 nouveaux patients par an. Depuis 2 ans, ils ne sont disponibles que pour une administration par voie sublinguale (ITSL) gouttes et comprimés. L'ITA traite les symptômes de la maladie et prévient également l'évolution de la rhinite vers l'asthme allergique ainsi que l'apparition de nouvelles sensibilisations. De nombreuses études cliniques ont démontré la bonne tolérance de l'ITA et son efficacité dans la réduction des symptômes et du recours à l'utilisation de médicaments, dans l'amélioration de la qualité de vie, et la réduction de l'absentéisme et du présentéisme scolaire et au travail. L'ITA est toujours efficace après arrêt, contrairement aux traitements symptomatiques et peut entraîner des économies de santé. La communauté allergologique dans son ensemble a exprimé sa grande inquiétude quant au possible déremboursement des APSI : le décret n°2018-445 du 4 juin 2018 confirme la décision de l'HAS de dérembourser les APSI injectables, de passer à 30 % le remboursement des APSI sublinguaux, et d'augmenter à 30 % le remboursement des comprimés, avec une réévaluation dans 5 ans. Le groupe de travail APSI, mandaté par le nouveau Conseil national professionnel d'allergologie sous couvert de la Société française d'allergologie (SFA) a posé les bases des actions à mener avant la réévaluation programmée de l'ITA. Named-Patient Products (NPP) are used for both diagnosis and treatment (Allergen Immunotherapy, or AIT) of allergic respiratory diseases. Every year, 300,000 patients in France undergo AIT treatment, with 100,000 new patients per year. These products are available as sublingual (SLIT) drops and tablets. AIT not only treats disease symptoms but also prevents the progression of rhinitis to allergic asthma, as well as the appearance of further sensitizations. Several clinical studies have demonstrated the good safety of AIT as well as its efficacy in reducing symptoms and reducing recourse to relief therapies, and in enhancing quality of life, resulting in reduced absenteeism and presenteeism. Unlike symptomatic treatments, AIT remains effective after discontinuation and may thus be associated with reduced healthcare costs. The French allergy community expressed its great concern about the possible removal of reimbursable status for NPPs: French decree 2018-445 of June 4th, 2018 confirms the government's decision to withdraw reimbursement for injectable NPPs, to reimburse sublingual NPPs at a level of 30%, and to increase the reimbursement level for tablets to 30%, with reassessment scheduled in 5 years' time. The French NPP working group (Groupe APSI), mandated by the new National Professional College of Allergy and the French Allergy Society (SFA), has set out the basis for actions to be carried out before the scheduled reassessment of AIT. [ABSTRACT FROM AUTHOR]

L'histoire naturelle de l'allergie montre que l'allergie pollinique dont la principale manifestation clinique est la rhinite ou la rhino-conjonctivite (RA/pollinose) peut débuter chez les enfants d'âge préscolaire. Certaines données de la littérature, encore éparses, suggèrent que la RA/pollinose pourrait débuter plus tôt, avant l'âge de 4 ans, voire avant l'âge de 2 ans chez certains nourrissons dans des situations d'exposition importante au pollen, de mode de vie, de contact avec les polluants (tabagisme passif), d'alimentation, ou de comorbidités particulières. L'étude de ces facteurs de risque n'est encore qu'à son début. Le diagnostic très précoce de la RA/pollinose est indispensable pour identifier les enfants atteints de RA isolée, sachant qu'il pourrait être possible de prévenir dans une certaine mesure la RA/pollinose et l'asthme associé à la RA. The natural history of allergy shows that pollen allergy, the main clinical manifestation of which is rhinitis or rhinoconjunctivitis (RA/pollinosis), can begin in preschool children. Some data in the literature, as yet limited, suggest that RA/pollinosis may begin earlier, before the age of 4 years, or even before the age of 2 years in certain infants as a result of significant pollen exposure, lifestyle, contact with pollutants (e.g. passive smoking), diet, or particular comorbidities. The study of these risk factors is still in its infancy. Very early diagnosis of RA/pollinosis is essential to identify children with isolated RA since RA/pollinosis and asthma associated with RA may be preventable to some extent. [ABSTRACT FROM AUTHOR]

Résumé Objectif Notre objectif était de déterminer la prévalence de la sensibilisation aux pollens de cyprès et d'olivier dans les 3 pays du Maghreb et de dresser le profil épidémio-clinique dans cette population. Patients et méthode Il s'agit d'une étude observationnelle, transversale, chez des patients consultant pour une symptomatologie évocatrice d'allergie respiratoire. Tous les patients ont bénéfice de prick-tests aux pneumallergènes dont l'olivier et le cyprès et dans un certain nombre de cas, du dosage des recombinants « rOle e1 » et « nCup a 1 ». Résultats Parmi les 975 fiches saisies, 932 patients ont été retenus. La rhinite était la manifestation la plus fréquente (95,3 %). La prévalence de la sensibilisation au cyprès et à l'olivier était respectivement de 18,7 % et 32,5 %. La prévalence de la sensibilisation au cyprès et à l'olivier était plus importante en cas de rhinite sévère, de conjonctivite ou d'allergies cutanées associées et d'asthme mal contrôlé ; p < 0,05. Conclusion La sensibilisation aux pollens d'olivier et de cyprès est fréquente aux pays du Maghreb. Les manifestations cliniques sont surtout en rapport avec des rhinites et sont souvent plus sévères. Abstract Objective We aimed to determine the prevalence of sensitization to cypress and olive pollens in the 3 Maghreb countries and to analyze the epidemiological-clinical profile of this population. Patients and methods We performed a cross-sectional observational study in patients with allergic symptoms. All subjects underwent standard skin-prick testing using a panel of common allergens, including olive and cypresses, and in some cases underwent recombinant assays using rOle e1 and nCup a 1. Results From 975 files examined, 932 patients were selected. Rhinitis was the most common manifestation (95.3%). The prevalence of cypress and olive tree sensitization was 18.7% and 32.5%, respectively. The prevalence of cypress and olive sensitization was higher in severe rhinitis, conjunctivitis or associated skin allergies and poorly controlled asthma; P < 0.05. Conclusion Sensitization to olive and cypress pollen is common in the Maghreb countries. Clinical manifestations are mainly related to rhinitis and are often more severe. [ABSTRACT FROM AUTHOR]

L'olivier (Olea europea L.) est une espèce caractéristique des pays du bassin méditerranéen, qui y est à l'origine de l'une des pollinoses les plus courantes. Cette allergie pollinique est influencée par le changement climatique qui peut anticiper les dates de floraison, augmenter la quantité de pollens produite, et allonger la saison pollinique. L'allergie à l'olivier est favorisée par deux principaux facteurs dont les gènes HLA classe II , de l' IL-13 et de l' IL-4RA ; et ceux liés à l'environnement notamment le statut socioéconomique et nutritionnel, l'activité physique et l'exposition à différents stimuli. Parmi les différents allergènes moléculaires impliqués dans la sensibilité à l'olivier, Ole e 1 étant l'allergène majeur, et la présence d'une homologie entre ces allergènes, et ceux d'autres espèces de la famille des Oléacées, ou même de différents taxons (Poacées ou graminées), est responsable des réactions croisées. Les polysensibilisations soulèvent d'importants défis diagnostiques que thérapeutiques. Ce qui souligne l'importance de recourir aux allergènes moléculaires dans l'approche diagnostique des pollinoses. D'autre part, l'allergie à l'olivier bénéficie de nos jours des progrès de l'immunothérapie spécifique, grâce notamment au développement de stratégie à base de peptides allergéniques comme alternative aux extraits de pollen d'olivier entier. The olive tree (Olea europea L.) is a characteristic tree of Mediterranean basin countries, responsible for the most frequent pollinosis. This pollinosis is influenced by climate change, which can anticipate flowering dates, increase the quantity of pollen produced, and the pollen season length. The occurrence of olive pollinosis mainly depends on HLA class II , IL-13 and IL-4RA genes; and environment factors, such as socioeconomic and nutritional status, physical activity and exposure to different stimuli. Among deferent categories of molecular allergens involved in olive pollinosis, Ole e 1 is the main allergen, and the presence of homology between these allergens, and those of other species from the Oleaceae family and other different taxons (Poaceae), is responsible for cross-reactions. Polysensitization is a major challenge in the diagnostic and therapeutic approach and highlights the importance of using molecular allergens in the pollinosis diagnostic. Furthermore, allergy to the olive tree has nowadays benefited from progress in specific immunotherapy, thanks in particular to the development of a strategy based on allergenic peptides as an alternative to whole olive tree pollen extracts. [ABSTRACT FROM AUTHOR]

Résumé Une étude en allergologie moléculaire n'est pas nécessaire dans la grande majorité des cas pour la prise en charge d'une pollinose lorsque l'interrogatoire et les tests cutanés sont bien corrélés à l'histoire clinique du patient. Le diagnostic positif ne repose pas sur la biologie. La sensibilisation à des composants allergéniques sans signification clinique augmente au fur et à mesure de l'exposition aux pollens de graminées. Ainsi, les recombinants n'apportent pas d'informations complémentaires utiles à la prescription d'une immunothérapie spécifique. Abstract Molecular allergy testing is not necessary in the vast majority of cases of pollinosis management where questioning and skin tests are well correlated to the patient's clinical history. Positive diagnosis is not based on laboratory tests. Sensitization to allergenic components without clinical significance increases with exposure to grass pollen. Thus, the recombinants do not provide any additional information useful for the prescription of specific immunotherapy. [ABSTRACT FROM AUTHOR]

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Pollinosis affects up to 20% of the Swiss population and increased substantially during the last century. Diagnosis of pollinosis is based on anamnesis, skin tests and determination of specific IgE in the serum. Treatment includes allergen avoidance, pharmacotherapy and allergen-specific immunotherapy (SIT). A proper patient and allergen extract selection, an ideally adapted application regimen and good patient-guidance are decisive for the success of the SIT. Under such conditions immunotherapy leads to a benefit in more than 80% of pollinosis-patients. Component-resolved diagnosis is an important step in more specific diagnosis. Several approaches studying changed application regimens and using molecular technologies to improve the efficacy of SIT are undergoing and will possibly substantially improve the efficacy, safety and acceptance of SIT. [ABSTRACT FROM AUTHOR]

Abstract: Allergic rhinitis has for a long time been considered to be a relatively minor allergic symptom, much less important than anaphylaxis and asthma. Its true frequency was unknown. Its management remained empiric. Its association with asthma was not clearly determined, although concerning adults, this association was rather well-known. A number of studies in children have now made more certain the association between asthma and allergic rhinitis, the impact of rhinitis on the child''s quality of life, and the significance of allergic rhinitis in the natural history of allergy and asthma. This review will cover some current aspects of allergic rhinitis: its association with asthma and food allergy, quantification of atopy, and its impact on daily life. It leads to recommendations for everyday practice of allergy in pediatrics. Given that allergic rhinitis probably begins earlier and earlier, children with this condition need to be followed closely and, if necessary, have their allergy tests repeated. Specific immunotherapy certainly merits to be used more frequently. [Copyright &y& Elsevier]

Abstract: Cupressaceae pollen allergy has increased in the Mediterranean region in recent decades. This allergy constitutes one of the few causes of respiratory allergy of winter. With regards to its clinical manifestations, rhinitis and conjunctivitis are more frequent than asthma. There has been a progressive increase in the total and annual concentration of Cupressaceae pollen, the reasons for which are the parallel increase in the planting of these trees and the global hothouse effect with the resulting climate change, both of which increase the production of pollen and their concentration in the ambient air. The effectiveness and safety of specific immunotherapy for Cupressaceae allergy were demonstrated some years ago in double-blind, controlled studies in which either traditional subcutaneous therapy or sublingual therapy were used. [Copyright &y& Elsevier]

Abstract: Allergic rhinitis grew up by threefold in French population in the last 25 years. In this context, we conduced a review on the relationships between pollens and health effects. Three fields are discussed: assessment of exposure in epidemiological studies, relationships between pollens and health effects, finally the results of the retained studies are presented. In epidemiological studies, population exposure to pollens is always done by outdoor stationary measurement. Relationships between aeroallergen concentrations and clinical effects are difficult to study because some factors as individual susceptibility, differences in the potential noxious effect of each allergen; lag between pollen and clinical effects, concentration limit that start up clinical effects and concentration limit for maximal effect; the successive productions and emissions of the different kinds of pollens; and multi-sensibility. Studying these relationship needs also to take into account several confounding factors such as: meteorological parameters, fungal aeroallergens concentrations; chemical air pollutants concentrations. Most of the epidemiological studies analyse the relationship between daily variations in pollen counts and daily variations in health effects quantified at individual levels in specific populations (panel study) or quantified at population levels (time-series). A review was already realised on studies published between 1978 and 1995 that examined the relationship between pollens and allergic rhinoconjunctivitis. Only 16 of the published studies had been retained (15 panels and one time-series). The conclusion of this work was that these studies showed associations between pollen counts and allergic rhinoconjunctivitis. But these associations could not be quantified and the dose–response curves could not be characterised because of inappropriate statistical methods and not taking into account confounding factors. In our review, nine studies that examined the short-term effect of pollen were retained for their good methodology (two of them are panels). Their results confirm associations between pollen counts and health effects and some of them succeed in quantifying the short-term effect of pollens on allergic rhinitis, allergic conjunctivitis and also asthma. [Copyright &y& Elsevier]

Abstract: It has been estimated that one person in five has a respiratory allergy. It has likewise been estimated that 45 million Europeans will become allergic to grass pollen. Sponsored by the WHO, ARIA (Allergic Rhinitis and its Impact on Asthma) proposed guidelines for the treatment of allergic rhinitis in which specific immunotherapy (SIT) occupies a central place because it is the only therapy capable of modifying the immune status of the allergic individual. The efficacy of SIT is fully supported by results of clinical studies reviewed in several meta-analyses, covering both injection and sublingual administration. In recent years, sublingual immunotherapy (SLIT) has been shown to be efficacious and well-tolerated, with more than 500 million doses having been administered to date without undesirable systemic side effects where the rules of good clinical practice have been followed. This form of immunotherapy is now available in the form of rapidly-dissolving sublingual tablets. This review will analyze clinical studies dealing with this new form of immunotherapy, its efficacy, tolerance and cost/efficacy ratio. [Copyright &y& Elsevier]

Abstract: The frequency of cutaneous sensitization to ash tree pollen (Fraxinus excelsior) reported over the past years is a source of many diagnostic difficulties for allergists, all the more so as this sensitization often occurs in patients who are sensitized to numerous pollens. As knowledge of cross reactivities among closely related or taxonomically distant botanical species has progressed, the diagnosis of this pollinosis has become particularly difficult. In the present study, special attention is given to botanical aspects and geographical distribution of the ash tree, as well as to characteristics of its pollen. We then present an up-to-date review of the allergenic components of ash pollen, based on the latest scientific reports. [Copyright &y& Elsevier]

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The medical treatment of allergic rhino-conjunctivitis involves different classes of drugs administered locally or by general route. They belong to three main classes, antihistamines, steroids and mast cell stabilizers. Since it is a relatively benign and also highly common disease, treatment options are limited by possible, even mild, side effects and by cost efficacy restriction. In the more severe forms of the condition, treatment efficacy remains unsatisfactory., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)