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Objectives: Allergic rhinitis (AR) is a complex disorder with variable pathogenesis. Increasing evidence suggests that the LRRC8A is involved in maintaining cellular stability, regulating immune cell activation and function, and playing significant roles in inflammation. However, the involvement of LRRC8A in AR inflammation and its underlying mechanisms remain unclear. Methods: LRRC8A expression in AR patients, confirmed by qRT-PCR and Western blotting, was analyzed to investigate its relationship with the clinical characteristics of AR patients. In vitro, IL-13 stimulated HNEpCs to establish a Th2 inflammation model, with subsequent LRRC8A knockout or overexpression. NOX1/NOX4 inhibitor (GKT137831) and chloride channel inhibitor (DCPIB) were utilized to investigate AR development mechanisms during LRRC8A overexpression. An OVA-induced AR model with nasal mucosa LRRC8A knockdown confirmed LRRC8A's regulatory role in AR inflammation. Results: LRRC8A mRNA and protein levels were significantly elevated in AR patients, positively correlating with NADPH oxidase subunits and Th2 inflammatory markers. In vitro, IL-13 stimulation of HNEpCs resulted in upregulation of LRRC8A and increased expression of NOX1, NOX4, and p22phox, along with mitochondrial dysfunction and NF-κB pathway activation. The knockout of LRRC8A reversed these effects. In nasal mucosal epithelial cells, DCPIB and GKT137831 completely blocked mitochondrial dysfunction caused by the overexpression of LRRC8A, which led to up-regulation of NOX1, NOX4, and p22phox. In vivo, knocking down LRRC8A reduced eosinophil infiltration, downregulated the expression of NOX1, NOX4, p22phox IL-4, IL-5, and IL-13, and decreased NF-κB pathway activation. Conclusion: LRRC8A drives the upregulation of NOX1, NOX4, and p22phox, leading to ROS overproduction and mitochondrial dysfunction. It also activates NF-κB, ultimately leading to nasal mucosal epithelial inflammation. LRRC8A may be a potential target for the treatment of AR. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion Intranasal antihistamines (INAH), corticosteroids (INCS), and their fixed combinations (INAH+INCS) are one of the cornerstones of the treatment of allergic rhinitis (AR). We performed a systematic review and network‐meta‐analysis comparing the efficacy and safety of INAH, INCS, and INAH+INCS in patients with AR.We searched four electronic bibliographic databases and three clinical trial databases for randomised controlled trials assessing the use of INAH, INCS, and INAH+INCS in adults with seasonal or perennial AR. We performed a network meta‐analysis on the Total Nasal Symptom Score, Total Ocular Symptom Score, Rhinoconjunctivitis Quality‐of‐Life Questionnaire, development of adverse events, and withdrawals due to adverse events. Certainty of evidence was assessed using GRADE‐NMA.We included 167 primary studies, most of which assessed patients with seasonal AR. Among individual medications, azelastine‐fluticasone, and fluticasone furoate were the most frequently highest‐ranked interventions for efficacy outcomes, being regularly associated with clinically meaningful larger improvements when compared to other active treatments. Considering drug classes, INAH+INCS were the highest‐ranked interventions for all outcomes in which they were assessed, followed in most cases by INCS. In 105 out of 184 comparisons in seasonal AR, and 28 out of 97 comparisons in perennial AR, certainty of evidence was considered “high” or “moderate”.Intranasal medications for AR display clinically relevant differences in their efficacy, but all show a good safety profile. To our knowledge, this is the first network meta‐analysis comparing INAH, INCS, and INAH+INCS in AR, providing relevant evidence for guideline developers and practising physicians on the most efficacious treatments. [ABSTRACT FROM AUTHOR]

Background: Cerebrospinal fluid rhinorrhea is a rare condition characterized by the abnormal leakage of cerebrospinal fluid from the intracranial space into the sinonasal cavity. It includes various etiologies, including traumatic, iatrogenic, and spontaneous causes, each with distinct epidemiological and clinical characteristics. Case presentation: A 40-year-old Asian female presented with a three-month history of watery discharge from her left nostril and dull headaches localized to the left side of her head. Despite the initial diagnosis of allergic rhinitis, symptoms persisted, leading to further evaluation and eventual diagnosis of cerebrospinal fluid rhinorrhea. Detailed history, physical examination, and diagnostic tests including fluid analysis and imaging confirmed the diagnosis. The patient underwent a successful surgical repair after failed conservative management, highlighting the importance of timely intervention. Conclusion: Cerebrospinal fluid rhinorrhea poses significant risks if left untreated, including meningitis. Prompt recognition, accurate diagnosis, and individualized treatment strategies are crucial in mitigating complications and improving patient outcomes. A multidisciplinary approach, incorporating both conservative and surgical interventions tailored to the underlying cause, is essential for the successful management of cerebrospinal fluid rhinorrhea. [ABSTRACT FROM AUTHOR]

Background: Numerous studies have established that probiotics or prebiotics can relieve the symptoms of allergic rhinitis (AR), but their mechanism of action remain underexplored. This study aimed to observe the clinical efficacy of probiotics combined with prebiotics in seasonal AR patients and explore their underlying mechanisms. Methods: We conducted a prospective, randomized, double-blind, placebo-controlled clinical trial. The test group was given probiotics combined with prebiotics, whereas the placebo group was administered simulated preparation for 90 days. Outcome measures included total nasal symptom score (TNSS), visual analog scale, rhinitis quality of life questionnaire, fractional exhaled nitric oxide, and the rate and intensity of Loratadine use. Serum TNF-α, INF-γ, IL-4, IL-17, and IgE levels were measured by enzyme-linked immunosorbent assay. Intestinal microbiota was detected by 16S rRNA gene sequencing and quantitative PCR. Short-chain fatty acids were analyzed by gas chromatography-mass spectrometry. Results: 106 participants (N = 53 for both test group and placebo group) completed the study. From baseline to day 91, mean difference between groups (MDBG) in the reduction of TNSS was -1.1 (-2.2, -0.1) (P = 0.04); MDBG in the increment of TNF-α was 7.1 pg/ml (95% CI: 0.8, 13.4, P = 0.03); the INF-γ level was significantly increased (P = 0.01), whereas that of IL-17 (P = 0.005) was significantly decreased in the test group, whilst mean difference within groups was not statistically significant in the placebo group; MDBG in the increment of acetate was 12.4% (95% CI: 7.1%, 17.6%, P <0.001). After the administration of probiotics and prebiotics, the composition and metabolic function of the intestinal microbiota were significantly altered and positively related to the beneficial effect on seasonal AR patients. Conclusion: Probiotics combined with prebiotics administered for 90 days significantly attenuated the symptoms of seasonal AR patients, which may related to fluctuations in the composition and metabolic function of the intestinal microbiota and further ameliorating host immunity. [ABSTRACT FROM AUTHOR]

Background: Establishing the interaction between aeroallergens and air pollution in children with house dust mite induced allergic rhinitis (HDM-AR) remains challenging, especially in urban areas. The coronavirus disease 2019 (COVID-19) pandemic and the subsequent lockdown measures provided a valuable opportunity. Methods: We analyzed the clinical data of HDM-AR children between March and August in 2018–2020, and classified the children according to the type and the degree of HDM sensitization. The records of patients' hospital visits, allergic rhinitis symptoms assessments, and air pollution measurements in Shanghai were used to assess the differences before (2018–2019) and during the pandemic (2020), as well as during lockdown (March-June) and unlockdown (July-August) period in 2020. Results: The study included 1570 HDM-AR children aged 2 to 8 years old, 815 (51.9%) were monosensitized to HDM (mono-HDM-AR), and 755 (48.1%) were polysensitized to HDM (poly-HDM-AR). There was a significant increase in the rate of clinical visits among children with HDM-AR during the COVID-19 pandemic compared to pre-pandemic (P < 0.001), particularly among older children aged 7–8 years (P = 0.01). During the unlockdown period, there was a notable decrease in clinical visits for children with poly-HDM-AR (P < 0.001). Children with high levels of HDM sensitization exhibited significant symptom improvement in unlockdown period (P < 0.001). Although the air pollutants concentration had improved during the study, there was no effect on the improvement of HDM-AR children as expected. Conclusions: The COVID-19 pandemic and its associated lockdown measures provided a unique context to observe the dynamics of management in children with HDM-AR. The findings underscore the complexity of managing allergic conditions in pediatric populations, highlighting the influence of environmental and lifestyle changes on disease presentation and the need for tailored approaches to treatment during periods of societal disruption. [ABSTRACT FROM AUTHOR]

BackgroundMethodsResultsConclusionsTo evaluate the respiratory functions in children with cat sensitization accompanying allergic respiratory diseases and to compare these with those of healthy controls, as well as within themselves by classifying according to their diseases, domestic cat exposure, age groups’This prospective case-control study included 130 children aged 3-17 years with cat sensitization (CS group) accompanying respiratory allergic diseases and 70 age- and sex-matched healthy controls (HC group). The cases’ demographic parameters were recorded, and respiratory functions were analyzed using IOS and spirometry.At IOS evaluation, zR5, R5-20, Fres, and AX values ​​were higher in children in the CS group compared to the HC group (p = 0.029, p = 0.008, p = 0.001, and p < 0.001, respectively), while zX5 and zX20 values ​​were lower (p = 0.001 and p < 0.001). R5-20 and AX were higher in asthma compared to allergic rhinitis (p = 0.008, p = 0.015), but were insignificant compared to asthma and allergic rhinitis coexistent group (p > 0.05). R5-20, Fres, and AX were higher, and zX20 was lower in the pre-school age group (p < 0.001). No correlation was found between zFEV1, zFVC, zFEV1/FVC, zFEF25-75 and zR5 values in the CS group (p > 0.05).Pulmonary resistance was higher and reactance was lower in the entire and peripheral airways in children with cat sensitization accompanying respiratory allergic diseases compared to the healthy controls. Peripheral airway resistance and reactance were more impaired in asthma group compared to allergic rhinitis. However, peripheral airway resistance and main airway reactance were more impaired in the pre-school age group than the older ones. [ABSTRACT FROM AUTHOR]

Airborne pollen, a significant natural pollutant, restricts outdoor activities and impacts quality of life for sensitive individuals with pulmonary disorders. This study examines trends in airborne pollen concentrations and explores whether air pollution, pollen concentration, or both impact patient counts. The annual pollen trend in Jaipur shows peaks in pollen concentration in March (due to trees, 66%), September (due to weeds, 45%), and December (due to grass, 50%). Among the fifteen taxa examined, Holoptelea integrifolia is the largest pollen emitter in Jaipur, followed by Poaceae, among others. The count of patients arriving for clinical consultations in a hospital shows a strong and positive correlation with weed (Asteraceae spp. and Argemone mexicana) and grass pollen. A linear regression equation is developed (R2 value = 0.835) for forecasting consulting patient counts based on Cassia siamea pollen concentration. This can assist hospital administration in resource management, especially during peak allergy seasons. [ABSTRACT FROM AUTHOR]

Background: Allergy immunotherapy (AIT), a treatment approach for allergic rhinitis (AR), is recognized for its potential to modify the disease course beyond mere symptom relief. Interleukin‐36γ (IL‐36γ), a key player in immune responses, has been implicated in promoting eosinophilic inflammation in AR by activating eosinophils. We aimed to investigate the effect of IL‐36γ on group II lymphoid cell (ILC2) in AR patients who underwent sublingual immunotherapy (SLIT). Methods: Twenty‐four AR patients were enrolled and administered with SLIT. Serum proteins of IL‐36γ, interleukin‐5 (IL‐5), and interleukin‐13 (IL‐13) during SLIT were quantitatively assessed using enzyme‐linked immunosorbent assay (ELISA). The proportion of ILC2 was determined by flow cytometry. Sorted ILC2s were stimulated by IL‐36γ and ILC2 cell differentiation, and type II cytokines expression were examined. Results: SLIT treatment decreased the serum protein levels of IL‐36γ, IL‐5, IL‐13, and the proportion of ILC2 significantly. IL‐36γ suppressed the proliferation of ILC2 by inhibiting the levels of ILC2 transcription factor. IL‐36γ also inhibited IL‐5 and IL‐13 expression from ILC2. Conclusion: The changes of IL‐36γ during SLIT were related to the inhibited function of ILC2, implying that IL‐36γ may be used as a new biomarker for monitoring the efficacy of SLIT in AR. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodsResultsConclusionsThis study aimed to assess the causality of allergic diseases and celiac disease.We collected summary-level data from publicly available genome-wide association studies to conduct our bidirectional two-sample and multivariable Mendelian randomization analysis. Furthermore, a series of sensitivity analyses were applied to validate our findings.In bidirectional two-sample MR analyses, we found a significant causal effect of atopic dermatitis (AD) on CD (Inverse-variance weighted (IVW): odds ratio [OR] = 1.302, 95% confidence interval [CI] = 1.152–1.471, p < 0.001). We also found a significant causal effect of allergic rhinitis (AR) on CD (IVW: OR = 4.181, 95% CI = 1.495–11.697, p = 0.006). However, the MR-Egger method indicated a different causal effect direction compared to the IVW and weighted median method. After Bonferroni correction, the result of asthma on CD is suggestive of a causal effect (IVW: OR = 1.186, 95% CI = 1.021–1.378, p = 0.026). No causal effects were found when CD was considered as an exposure variable. In MVMR analyses, after separately and jointly adjusting for the influence of smoking and BMI, the causal effect of AD on CD remained robust.Our study suggests that AD is a risk factor for CD and it is considered suggestive of a causal relationship between asthma and CD. Further research is needed to explore the potential mechanisms underlying this causal effect. [ABSTRACT FROM AUTHOR]

Cetirizine is an antihistamine commonly used to treat allergic rhinitis and other allergic conditions. Cetirizine is often prescribed to breastfeeding mothers although there is limited information on infant exposure via breast milk. The aim of this study was to develop a popPK model based on data from a lactation study to predict cetirizine breast milk concentrations and estimate the relative infant dose (RID) in a breastfed infant. A popPK model was developed in NONMEM on data from a human lactation study including 35 women using cetirizine or levocetirizine while breastfeeding. Serial samples of breast milk were collected (n = 205) and the cetirizine concentrations quantified using a validated LC–MS/MS method. A one‐compartment model of cetirizine in breast milk was developed and employed to calculate the relative infant dose (RID). Covariates related to the maternal characteristics and breastfeeding patterns were evaluated in the model; only milk sampling pumping duration was found to be a significant covariate, with an increasing pumping duration leading to an increased apparent milk volume of distribution (Vm). The mean RID was 1.99% with the highest RID being 3.36% at Cmax. PopPK modelling could be used to estimate infant exposure to cetirizine via breast milk. The low predicted exposure in infants supports that cetirizine is compatible with breastfeeding. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusion Basophil activation test (BAT) might be an alternative to nasal allergen challenge (NAC) to identify the allergic etiology in rhinitis patients. Here, we investigate the diagnostic performance of BAT for allergic phenotypes of rhinitis.Rhinitis patients and healthy controls were subjected to NAC with Dermatophagoides pteronyssinus (DP), Alternaria alternata (AA), grass (GP) and olive (OP) pollens. Rhinitis subjects also underwent skin prick test (SPT) with relevant allergens. Patients were classified into allergic rhinitis (AR, positive NAC and SPT), local allergic rhinitis (LAR, positive NAC and negative SPT), dual allergic rhinitis (DAR, defined as AR for ≥1 allergen and LAR for ≥1 allergen), and non‐allergic rhinitis (NAR, negative NAC and SPT) phenotypes. BAT with DP, AA, GP and OP was conducted in study individuals and compared with NAC results.A total of 47 AR, 31 DAR, 26 LAR, 12 NAR and 21 control subjects were recruited. The best positivity cut‐offs of BAT for DP‐, AA‐, GP‐ and OP‐driven allergy (all phenotypes) were a %CD63 cells of 8.650, 14.250, 26.200, and 12.780, respectively (AUC 0.851, 0.701, 0.887, and 0.921, respectively).Sensitivity, specificity, negative and positive predictive values of BAT (all phenotypes) ranged 43.5%(AA)‐83.3%(OP), 88.9%(GP)‐100%(AA), 87%(GP)‐100%(AA), and 61.1%(DP)‐80.0%(pollens), respectively. BAT identified 79%–100% of SPT‐positive allergies (AR and DAR), and 25%–75% of SPT‐negative allergies (LAR and DAR), while ≤10% of NAR/HC subjects tested positive. BAT positivity correlated with rhinitis severity in LAR patients (p = 0.018), and associated with conjunctivitis (p = 0.015) in allergic subjects.BAT can replace NAC for AR confirmation, and limit the number of NAC required for LAR and DAR diagnosis. BAT can demonstrate sIgE in SPT‐negative allergies. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion Allergic rhinitis and/or conjunctivitis (AR/C) induced by tree pollen is common and negatively impacts quality of life in children and adolescents. This phase III trial investigated the efficacy and safety of the SQ tree SLIT‐tablet in a paediatric population (5–17 years) with moderate‐to‐severe AR/C induced by pollen from birch and trees in the birch homologous group.Nine hundred and fifty‐two subjects were randomized (1:1) to daily treatment with SQ tree SLIT‐tablet or placebo for up to 52 weeks and had free access to AR/C symptom‐relieving medications. The primary endpoint was the average total combined score (TCS); sum of average daily symptom score (DSS) and average daily medication score (DMS) during the birch pollen season (BPS). Key secondary endpoints included average DSS and DMS during BPS and average TCS, DSS and DMS during tree pollen season (TPS).SQ tree SLIT‐tablet demonstrated a statistically significant and clinically relevant treatment effect compared with placebo for the TCS during BPS with an absolute treatment difference of 1.29 (95% CI: 0.58, 2.00; p = .0004) and a relative reduction of 21.9% (95% CI: 10.6, 31.9). Results were substantiated by reductions in both DSS and DMS versus placebo during the BPS and in DSS, DMS and TCS during the TPS. Treatment was generally well tolerated. Most treatment‐related adverse events were mild or moderate local administration site reactions.This is the first paediatric trial to provide robust evidence of efficacy and safety of the SQ tree SLIT‐tablet in tree pollen‐induced AR/C in a paediatric population (5–17 years). [ABSTRACT FROM AUTHOR]

Background: Allergic rhinitis is an inflammatory disease dependent on immunoglobulin E and causes inflammation of the nasal mucosa, leading to decreased quality of life for affected patients. Since common treatments, including corticosteroids and antihistamines, have temporary therapeutic effects and numerous side effects, investigating natural compounds effective in improving allergic rhinitis with low complications and high efficacy can be significant and necessary. Purpose: This study aims to present a comprehensive and critical evaluation of the effect of natural compounds in improving allergic rhinitis. Methods: Studies were identified through systematic searches of ScienceDirect, PubMed, Scopus, and Web of Sciences databases. Eligibility checks were conducted based on predefined selection criteria. Forty-six articles were included in this study. Results and discussion: Phytochemicals, including flavonoids, alkaloids, terpenoids, and other compounds showed significant anti-inflammatory and antihistaminic effects. These compounds alleviate allergic rhinitis symptoms by inhibiting inflammatory mediators, oxidative stress, apoptosis, and key signaling pathways such as MAPK/NFκB and TLR4/MyD88/NF-κB. Conclusion: Phytochemicals exhibit anti-inflammatory and antioxidant properties, making them. [ABSTRACT FROM AUTHOR]

Background: Demonstrating the positive effects of Nigella sativa supplementation (Nigella spp) on Allergic Rhinitis (AR) treatment is challenging. To investigate the role of Nigella spp in managing AR, a comprehensive review through systematic reviews and meta-analyses was conducted. Purpose: To carry out a meta-analysis of clinical trials that used Nigella spp in treating AR based on current data. Study Design: A meta-analysis of randomized controlled trials (RCTs) was performed. Methods: Various databases, including PubMed, Web of Science, Embase, Science Direct, Springer Link and the Cochrane Library, were searched until October 2023 to obtain RCTs assessing impact of Nigella spp in the control of AR. The current meta-analysis was carried out with a random-effects model. Results: There were 8 studies enrolled, and our meta-analysis findings revealed that, relative to the control group, observation group exhibited the markedly increased total effective rate for allergic rhinitis treatment (odds ratio [OR] = 4.24, 95% confidence interval [CI] (2.57, 7.27), and p < 0.00001); three studies showed that the effect of Nigella spp for nasal symptoms treatment among patients with allergic rhinitis was superior in observation group to control group [mean difference = −2.60, 95% CI (−2.82, −2.38), p < 0.00001]; adverse effects occurred in five studies, all of which were transient, did not require medical intervention, and were not statistically significant between the two groups [OR = 1.01, 95% CI (0.59, 1.73), p = 0.98]. Conclusion: The observation group demonstrated relative safety and had an enhanced effect on allergic rhinitis treatment and total nasal symptom improvement than the control group. The inclusion of fewer studies and the lower quality of trial design might affect the stability of the results. However, the evidence-based findings that Nigella spp for allergic rhinitis treatment is more accurate should be validated in future large-scale, multicenter, and well-designed RCTs. [ABSTRACT FROM AUTHOR]

Background: Allergic rhinitis (AR) is the most common type of rhinitis, the treatment of which relies on relieving symptoms. Therefore, we aimed to assess the criteria that influence doctors' decision-making in the process of drug selection for the treatment of allergic rhinitis based on quantitative, qualitative, and cost analyses. Methods: We conducted a survey study with the participation of 300 allergologists. A self-developed questionnaire was presented during a computer-assisted telephone interview (CATI) according to standard procedures. The contingency table underwent statistical analysis using the chi-square test with Cramer's V. Results were considered statistically significant at p < 0.05. Results: Our analyses showed that doctors most often prescribe intranasal glucocorticoids and oral antihistamines to treat allergic rhinitis in patients of all ages. The most common factor that affects the decision-making related to AR treatment was the efficiency of the drug. We found a significant relationship between factors and the main workplace (X-squared = 122.81, df = 90, p -value = 0.0123, Cramer's V = 0.1787216), as well as voivodeship of the main workplace (X-squared = 440.75, df = 270, p -value = 2.378e-10, Cramer's V = 0.1954731). In our study, respondents claimed that patients are willing to pay 31–50 PLN (∼€7- €11) monthly for the treatment of mild and moderate forms of AR, while they were willing to pay 51–100 PLN (∼€11–€22) for treatment of the severe AR form. Conclusion: Our study confirms that the management of AR should be focused on the patient. One of the most important factors in choosing a drug is its effectiveness. Moreover, an important factor in the effective treatment of AR is the financial issue; as shown in our analysis, AR treatment costs can be a significant burden, especially for less wealthy citizens in Poland. [ABSTRACT FROM AUTHOR]

The allergic airway disease, such as allergic rhinitis, chronic rhinosinusitis, asthma, is a general term of a range of inflammatory disorders affecting the upper and lower airways and lung parenchyma. This study aimed to investigate the short-term effects of air pollutants and meteorological factors on AAD-related daily outpatient visits. An ecological study. Data on outpatient visits due to AAD (n = 4,554,404) were collected from the platform of the Ningbo Health Information from January 1, 2015 to December 31, 2021. A Quasi-Poisson generalized additive regression model was established to analyze the lag effects of air pollution on daily outpatient visits for AAD. Restricted cubic spline functions were used to explore the potential non-linear relationships between air pollutants and meteorological and daily outpatient visits for AAD. PM 2.5 , PM 10 , SO 2 , NO 2 , or CO were associated with daily outpatient visits for AAD, and there was a significant increasing trend in the cumulative lag effects. SO 2 had the largest effect at Lag07, with a 25.3% (95% CI: 21.6%–29.0%) increase in AAD for every 10 μg/m3 increase in exposure concentration. Subgroup analysis showed that the 0–18 years old age group had the strongest effects, especially for AR, and all effects were stronger in the cold season. Given that patients aged 0–18 are more susceptible to environmental changes, protective measures specifically for children should be taken during dry and cold weather conditions with poor air quality. [Display omitted] [ABSTRACT FROM AUTHOR]

Background/Objectives: Subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) are commonly used for allergic rhinitis (AR), yet limited research has directly compared their effects on quality of life (QoL). We aimed to assess QoL differences between SLIT and SCIT recipients. As both forms of immunotherapy have reported benefits, we hypothesize that patients undergoing SLIT and SCIT will have comparable QoL improvements. Methods: A cohort study included patients with AR treated with immunotherapy from 2018 to 2022. Patients with obstructive sleep apnea, primary ciliary dyskinesia, cystic fibrosis, vasculitis, rheumatoid arthritis, sarcoidosis, or lupus were excluded. QoL was evaluated using the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) at multiple time points. Demographics, additional therapies, and allergen sensitivities were recorded. Data were analyzed using SPSS Statistics. Results: A total of 41 participants were eligible for inclusion. Both SLIT and SCIT groups exhibited reductions from baseline RQLQ scores. Within SLIT recipients, 5/7 RQLQ domains significantly improved. SCIT recipients showed significant QoL enhancement in 3/7 domains. The mean difference between SLIT and SCIT cohorts was −0.18 (p = 0.57, d = −0.18, 95% CI [−0.79, 0.43] at a mean treatment time of 18 months. Conclusions: SLIT and SCIT showed comparable RQLQ score reductions after 18 months of therapy, suggesting similar QoL benefits between the two treatment paradigms. Further investigation is needed to explore SLIT vs. SCIT differences in long-term QoL improvements beyond two years. [ABSTRACT FROM AUTHOR]

Background: This study evaluated the relationship between aging and tympanometric changes, specifically the incidence of type C tympanograms, using data from the Korea National Health and Nutrition Examination Survey (KNHANES). Methods: We analyzed data from the 2019–2022 KNHANES, including 26,738 ears from individuals aged 40 and older. Tympanometry at 226 Hz identified type C tympanograms based on peak pressure below −100 daPa. Multiple logistic regression evaluated the association between age and type C tympanograms, adjusting for confounders such as sex, smoking status, allergic rhinitis, chronic sinusitis, and lifestyle disease markers. Results: The incidence of type C tympanograms increased significantly with age (R2 = 0.953, p < 0.001). Age was the most significant factor associated with type C tympanograms (p < 0.001, odds ratio 1.052), while other factors were not statistically significant. Ears with type C tympanograms had significantly poorer hearing thresholds compared to those with type A tympanograms (p < 0.001). Conclusions: Aging is significantly associated with an increased incidence of type C tympanograms, indicating possible middle ear dysfunction in older adults. The correlation between type C tympanograms and poorer hearing thresholds suggests that age-related changes in middle ear function may contribute to hearing impairment. Tympanometric screening in older adults may facilitate early detection and management of middle ear dysfunction, potentially improving hearing outcomes and quality of life. [ABSTRACT FROM AUTHOR]

The article compares two different methods of defining pollen seasons based on 10 years of birch and grass pollen data from Berlin, Germany, and Vienna, Austria. The study found that the European Academy of Allergy and Clinical Immunology (EAACI) definition correlated significantly with allergic rhinitis symptoms reported by users of electronic diaries. The analysis showed differences in the start, end, and duration of pollen seasons between the two cities, highlighting the importance of accurately defining pollen seasons for clinical trials and allergen immunotherapy. The study confirmed the applicability of both the EAACI and percentage analysis (PA) methods in describing pollen season characteristics for different regions. [Extracted from the article]

Background: Allergic rhinitis is a common inflammatory condition of the nasal mucosa that imposes a considerable health burden. Air pollution has been observed to increase the risk of developing allergic rhinitis. We addressed the hypotheses that early life exposure to air toxics is associated with developing allergic rhinitis, and that these effects are mediated by DNA methylation and gene expression in the nasal mucosa. Methods: In a case–control cohort of 505 participants, we geocoded participants' early life exposure to air toxics using data from the US Environmental Protection Agency, assessed physician diagnosis of allergic rhinitis by questionnaire, and collected nasal brushings for whole‐genome DNA methylation and transcriptome profiling. We then performed a series of analyses including differential expression, Mendelian randomization, and causal mediation analyses to characterize relationships between early life air toxics, nasal DNA methylation, nasal gene expression, and allergic rhinitis. Results: Among the 505 participants, 275 had allergic rhinitis. The mean age of the participants was 16.4 years (standard deviation = 9.5 years). Early life exposure to air toxics such as acrylic acid, phosphine, antimony compounds, and benzyl chloride was associated with developing allergic rhinitis. These air toxics exerted their effects by altering the nasal DNA methylation and nasal gene expression levels of genes involved in respiratory ciliary function, mast cell activation, pro‐inflammatory TGF‐β1 signaling, and the regulation of myeloid immune cell function. Conclusions: Our results expand the range of air pollutants implicated in allergic rhinitis and shed light on their underlying biological mechanisms in nasal mucosa. [ABSTRACT FROM AUTHOR]

Introduction: Dogs are among the most commonly allergenic pets for children. Data on risk factors for the development of dog allergy are scarce. This study aimed to evaluate the characteristics of children with dog allergy and identify predictors of symptom development with dog exposure. Methods: The study included children with dog allergen sensitization demonstrated by skin prick test (SPT) between September 1, 2019, and December 1, 2022. Demographic, clinical, and laboratory data were collected from the patients' records and interviews with parents. Results: Dog allergen sensitization was detected by SPT in 548 (5.5%) of 9,907 patients. Of these, 507 patients had complete data and were included in the analysis. The patients' median age was 11 (IQR: 8–15) years, 55.8% were male, 97.6% exhibited polysensitization (pollen 75.1%, cat 69.6%), 83.6% had allergic rhinitis, and 46.2% had asthma. Acute dog exposure caused symptoms in 164 patients (32.3%), most commonly sneezing (n = 97) and nasal symptoms (n = 80). Predictors of acute symptoms in dog-sensitized children were male sex (OR: 0.584 [CI: 0.38–0.87]), dog exposure before 1 year of age (OR: 2.35 [CI: 1.18–4.66]), close contact with a dog owner (OR: 2.93 [CI: 1.78–4.8]), and cat allergy (OR: 2.75 [CI: 1.82–4.1]). Conclusion: Approximately one-third of children with dog sensitization developed symptoms after exposure to the dog. Male sex, direct dog exposure before the age of one, close contact with a dog owner, and cat allergy were identified as predictors of dog allergy. [ABSTRACT FROM AUTHOR]

Introduction: Allergic diseases remain of concern due to their increasing prevalence worldwide. Intrinsic and environmental risk factors have been implicated in the pathogenesis of allergic disease. Among the possible risk factors, migration has been associated with the manifestation of allergic diseases. We aimed to consolidate the existing evidence, review the hypotheses for the relationship between environmental factors and allergic disease, and provide a direction for future work. Methods: This systematic review and meta-analysis complied with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The Web of Science database was searched in September 2023 to retrieve publications investigating the relationship between allergic rhinitis (AR), atopic dermatitis (AD), or asthma and the following factors: (i) migrant status (i.e., migrants vs. natives) or (ii) duration since migration among migrants. Risk of bias was assessed using the JBI critical appraisal tool. Details and findings from the included studies were also summarized and meta-analyses were conducted where appropriate. Results: Fifty studies encompassing an estimated 3,755,248 individuals were reviewed. Articles investigated asthma (n = 46), AR (n = 16), and AD (n = 14). A variety of migration-related factors were also studied: movement of individuals across regions (n = 40), duration since immigration (n = 12), age at immigration (n = 9), and acculturation (n = 2). Migration status was not significantly associated with AD (pooled odds ratio [pOR] = 0.68, 95% confidence interval (CI) = 0.31, 1.49). Although AR prevalence was lower among immigrants than natives (pOR = 0.58, 95% CI = 0.45, 0.74), immigrants who had resided at least 10 years in the destination country had a higher risk of AR than immigrants with a duration of residence of less than 10 years (pOR = 8.36, 95% CI = 4.15, 16.81). Being an immigrant was also associated with a decreased risk of asthma (pOR = 0.56, 95% CI = 0.44, 0.72). Among immigrants, residing in the host country for at least 10 years was associated with increased asthma manifestation (pOR = 1.85, 95% CI = 1.25, 2.73). Immigrants who migrated aged 5 and below did not exhibit a significantly higher likelihood of asthma than migrants who immigrated older than 5 years (pOR = 1.01, 95% CI = 0.68, 1.50). Conclusion: This review was limited by the primarily cross-sectional nature of the included studies. Objective diagnoses of allergic disease, such as using the spirometry of bronchodilator reversibility test for asthma rather than questionnaire responses, could add to the reliability of the outcomes. Furthermore, immigrant groups were mostly nonspecific, with little distinction between their country of origin. Overall, migration appears to be a protective factor for allergic diseases, but the protection subsides over time and the prevalence of allergic diseases among the immigrant group approaches that of the host population. [ABSTRACT FROM AUTHOR]

Introduction:Artemisia species are widely spread in north hemisphere. Artemisia sieversiana pollen is one of the common pollen allergens in the north of China. At present, seven allergens were identified and had been listed officially from A. sieversiana pollen, but the remaining allergens are still insufficiently studied, which need to be found. Methods: Pectate lyase was purified from the extracts of A. sieversiana pollen by anion exchange, size exclusion, and HPLC-hydrophobic interaction chromatography. The gene of A. sieversiana pectate lyase (Art si pectate lyase) was cloned and expressed in Escherichia coli. The enzyme activity and circular dichroism (CD) spectrum of natural and recombinant proteins were analyzed. The allergenicity of Art si pectate lyase was characterized by enzyme-linked immunosorbent assay (ELISA), Western blot, inhibition ELISA, and basophil activation test. The allergen's physicochemical properties, three-dimensional structure, sequence profiles with homologous allergens and phylogenetic tree were analyzed by in silico methods. Results: Natural Art si pectate lyase (nArt si pectate lyase) was purified from A. sieversiana pollen extracts by three chromatographic strategies. The cDNA sequence of Art si pectate lyase had a 1191-bp open reading frame encoding 396 amino acids. Both natural and recombinant pectate lyase (rArt si pectate lyase) exhibited similar CD spectrum, and nArt si pectate lyase had higher enzymatic activity. Moreover, the specific immunoglobulin E (IgE) binding rate against nArt si pectate lyase and rArt si pectate lyase was determined as 40% (6/15) in patients' serum with Artemisia species pollen allergy by ELISA. The nArt si pectate lyase and rArt si pectate lyase could inhibit 76.11% and 47.26% of IgE binding activities to the pollen extracts, respectively. Art si pectate lyase was also confirmed to activate patients' basophils. Its structure contains a predominant motif of classic parallel helical core, consisting of three parallel β-sheets, and two highly conserved features (vWiDH, RxPxxR) which may contribute to pectate lyase activity. Moreover, Art si pectate lyase shared the highest sequence identity of 73.0% with Art v 6 among currently recognized pectate lyase allergen, both were clustered into the same branch in the phylogenetic tree. Conclusion: In this study, pectate lyase was identified and comprehensively characterized as a novel allergen in A. sieversiana pollen. The findings enriched the allergen information for this pollen and promoted the development of component-resolved diagnosis and molecular therapy of A. sieversiana pollen allergy. [ABSTRACT FROM AUTHOR]

Background: Allergic rhinitis (AR) is one of the most common respiratory noninfectious diseases and chronic inflammatory diseases, the incidence of which has been increasing in recent years. The main pathological characteristics of AR are repeated inflammation, airway hyperreactivity, mucus hypersecretion, and reversible airway obstruction due to inflammatory cell response. AR occurrence is associated with various factors, including those of genetic and environmental origins. Noncoding RNAs (ncRNAs) are a group of RNA molecules that cannot be converted into polypeptides. The three main categories of ncRNAs include microRNAs (miRNAs), long ncRNAs (lncRNAs), and circular RNAs (circRNAs). NcRNAs play a crucial role in controlling gene expression and contribute to the development of numerous human diseases. Methods: Articles are selected based on Pubmed's literature review and the author's personal knowledge. The largest and highest quality studies were included. The search selection is not standardized. Several recent studies have indicated the relationship of ncRNAs with the development of respiratory allergic diseases. NcRNAs, including miRNAs, lncRNAs, and circRNAs, are important gene expression regulatory factors. We review the expression and function of ncRNAs in AR, their role as disease biomarkers, and their prospective applicability in future research and clinically. We also discuss interactions between ncRNAs and their influence on AR comprehensively, these interactions are essential for determining the underlying pathological mechanisms further and discovering new drug therapeutic targets. Results: NcRNAs can be used as biomarkers for early AR diagnosis, disease surveillance and prognosis assessment. Various categories of ncRNAs play distinct yet interconnected roles and actively contribute to intricate gene regulatory networks. They are also therapeutic targets and biomarkers in other allergic diseases. Conclusion: This article demonstrates ncRNAs have a wide range of applications in AR treatment. The database covers three key areas: miRNAs, lncRNAs, and circRNAs. Additionally, potential avenues for future research to facilitate the practical application of ncRNAs as therapeutic targets and biomarkers will be explore. With further research and technological development, ncRNAs may provide additional innovative, effective solutions for AR treatment. [ABSTRACT FROM AUTHOR]

ABSTRACT Previous observational studies focused on the association of tea intake and allergic diseases. However, it is not known whether these associations are causal. We used a bidirectional Mendelian randomization (MR) study to assess the causal relationship of tea intake with the risk of allergic diseases, such as atopic dermatitis (AD), allergic rhinitis (AR), and allergic asthma (AA). Single‐nucleotide polymorphisms (SNPs) which had genetic statistical significance with tea intake were used as instrumental variables (IVs). We employed heritable IVs of tea intake from the UK Biobank, which included 447,485 samples. Sensitivity analyses were further performed using MR Egger and MR‐PRESSO. Inverse variance weighted (IVW) method was used as the main approach. In this MR study, 40 independent SNPs were selected for tea intake. The MR analysis revealed that an increase in genetically predicted tea intake was associated with a lower risk of AD (OR = 0.709, 95% CI = 0.546–0.919, p = 0.009). Furthermore, we observed a causal effect of genetically predicted tea intake on the risk of AA (OR = 0.498, 95% CI = 0.320–0.776, p = 0.002). However, no significant causal relationship was found between genetically predicted tea intake and AR (OR = 1.008, 95% CI = 0.998–1.017, p = 0.115). Our MR analysis suggested that increased tea intake may reduce the risk of AD and AA in European population. This suggests that tea intake is likely a trigger or a prevention strategy for AD and AA. [ABSTRACT FROM AUTHOR]

Long time series of vegetation monitoring can be carried out by remote sensing data, the level of urban greening is objectively described, and the spatial characteristics of plant pollen are indirectly understood. Pollen is the main allergen in patients with seasonal allergic rhinitis. Meteorological factors affect the release and diffusion of pollen. Therefore, studying of the complex relationship between meteorological factors and allergic rhinitis is essential for effective prevention and treatment of the disease. In this study, we leverage remote sensing data for a comprehensive decade-long analysis of urban greening in Tianjin, which exhibits an annual increase in vegetative cover of 0.51 per annum, focusing on its impact on allergic rhinitis through changes in pollen distribution. Utilizing high-resolution imagery, we quantify changes in urban Fractional Vegetation Coverage (FVC) and its correlation with pollen types and allergic rhinitis cases. Our analysis reveals a significant correlation between FVC trends and pollen concentrations, with a surprising value of 0.71, highlighting the influence of urban greenery on allergenic pollen levels. We establish a robust connection between the seasonal patterns of pollen outbreaks and allergic rhinitis consultations, with a noticeable increase in consultations during high pollen seasons. our findings indicate a higher allergenic potential of herbaceous compared to woody vegetation. This nuanced understanding underscores the importance of pollen sensitivity, alongside concentration, in driving allergic rhinitis incidents. Utilizing a Generalized Linear Model, significant features influencing the number of visits for allergic rhinitis (P < 0.05) were identified. Both GLM and LSTM models were employed to forecast the visitation volumes for rhinitis during the spring and summer-autumn of 2022. Upon validation, it was found that the R² values between the simulated and actual values for both GLM and LSTM models surpassed the 95% confidence threshold. Moreover, the R² values for the summer-autumn seasons (GLM: 0.56, LSTM: 0.72) were higher than those for spring (GLM: 0.22, LSTM: 0.47). Comparing the errors between the simulated and actual values of GLM and LSTM models, LSTM exhibited higher simulation precision in both spring and summer-autumn seasons, demonstrating superior simulation performance. Overall, our study pioneers the integration of remote sensing with meteorological and health data for allergic rhinitis forecasting. This integrative approach provides valuable insights for public health planning, particularly in urban settings, and lays the groundwork for advanced, location-specific allergenic pollen forecasting and mitigation strategies. Highlights: The incidence of allergic rhinitis is primarily determined by pollen allergenicity, followed by concentration. Utilizing high-resolution imagery, we quantify changes in urban Fractional Vegetation Coverage (FVC) and its correlation with pollen types and allergic rhinitis cases. Weaving together remote sensing, meteorological, and health data, we employed Generalized Linear Models and LSTM models to dissect the determinants of allergic rhinitis and to construct a daily predictive model for the incidence of allergic rhinitis consultations. [ABSTRACT FROM AUTHOR]

Objective: The daily lives of adolescents have changed significantly because of COVID-19 pandemic. We investigated the effects of changes in daily life attributed to COVID-19 on allergic diseases among Korean adolescents. Methods: Data from the 2021 Korea Youth Risk Behavior Survey were used. In total, 54,848 survey participants were included in the analysis. Allergic diseases included allergic rhinitis, atopic dermatitis, and asthma. Changes attributed to COVID-19 included family economic difficulties, physical activity, breakfast skipping frequency, alcohol consumption, smoking, and depressive moods. Chi-square tests and multiple logistic regression analyses were conducted to examine the impact of changes in daily life attributed to COVID-19 on allergic diseases. Results: Among the Korean adolescents surveyed, 29.8% experienced a deterioration in their economic status due to COVID-19, 49.1% reported decreased physical activity, 2.8% reported increased alcohol consumption, 1.0% reported an increase in their smoking behavior, and 36.9% reported an increase in depressive moods. Those diagnosed with atopic dermatitis, allergic rhinitis, or asthma within the previous 12 months accounted for 17.1%, 6.2%, and 1.0% of the population, respectively. Adolescents who were significantly affected by COVID-19 in their daily lives were frequently diagnosed with allergic diseases within the last 12 months. Conclusion: Changes in daily life due to COVID-19, including decreased physical activity and increased depressive mood, were common in adolescents and were associated with an increased prevalence of allergic diseases. Since changes in daily life due to the pandemic may increase the burden of allergic disease, additional interventions for disease management should be considered. [ABSTRACT FROM AUTHOR]

Atopic diseases, including atopic dermatitis (AD), food allergy (FA), asthma, and allergic rhinitis (AR) are closely related to inflammatory diseases involving different body sites (i.e. the skin, airway, and digestive tract) with characteristic features including specific IgE to allergens (so-called "atopy") and Th2 cell-mediated inflammation. It has been recognized that AD often precedes the development of other atopic diseases. The progression from AD during infancy to FA or asthma/AR in later childhood is referred to as the "atopic march" (AM). Clinical, genetic, and experimental studies have provided evidence that allergen sensitization occurring through AD skin could be the origin of the AM. Here, we provide an updated review focusing on the role of the skin in the AM, from genetic mutations and environmental factors associated with epidermal barrier dysfunction in AD and the AM to immunological mechanisms for skin sensitization, particularly recent progress on the function of key cytokines produced by epidermal keratinocytes or by immune cells infiltrating the skin during AD. We also highlight the importance of developing strategies that target AD skin to prevent and attenuate the AM. [ABSTRACT FROM AUTHOR]

Aim: To assess the relationship between systemic inflammation markers and ocular surface parameters in hazelnut harvesters. Material and Method: This prospective study included 30 patients presenting with moderate ocular surface diseases during the hazelnut harvesting season. A detailed ophthalmological examination was performed during the harvesting season and the first month after the end of treatment (control). Schirmer test, tear break-up time (TBUT), and ocular surface disease index (OSDI) scores were determined. In complete blood count analysis, in addition to the evaluation of inflammatory cells, the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) were calculated. Results: Eosinophil percentage had a high level of negative correlation with the TBUT and Schirmer values and a high level of positive correlation with the OSDI score during the hazelnut picking season (r = –0.727, r = –0.735, r = 0.750, respectively). During the hazelnut harvesting season, the NLR and SII parameters had a moderate level of negative correlation with the TBUT (r = –0.29 and r = −0.276) and Schirmer (r = –0.33 and r = −0.298) values and a moderate level of positive correlation with the OSDI score (r = 0.389 and r = 0.264). Conclusion: In hazelnut harvesters, ocular allergy and inflammation may be associated with systemic biomarkers. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD) is a genetically predisposed allergic inflammatory dermatosis with chronic, pruritic, and recurrent features. Patients with AD have dry and itchy skin, often accompanied by chronic eczematous lesions, allergic rhinitis, or asthma, which has a considerable impact on their daily lives. With advances in genome sequencing technology, it has been demonstrated that microorganisms are involved in this disease, and the microorganisms associated with AD are attracting considerable research attention. An increasing number of studies conducted in recent years have demonstrated that an imbalanced microbiome in AD patients has substantial impact on disease prognosis, and the causes are closely tied to various immune mechanisms. However, the involvement of microorganisms in the pathogenesis of AD remains poorly understood. In this paper, we review the advances in research on the immunological mechanisms of the skin microbiome, intestinal microbiome, and lung microbiome that are related to AD prognosis and immunotherapy protocols. It is hoped that this approach will lay the foundation for exploring the pathogenesis of and emerging treatments for AD. [ABSTRACT FROM AUTHOR]

Aim: Parental adverse childhood experiences (ACE) might affect the offspring health through intergenerational inheritance. The aim of this study was to investigate how paternal ACE associate with offspring sensitisation and allergic rhinitis (AR). Methods: The study included 590 Finnish father‐child dyads from the FinnBrain Birth Cohort Study. Outcomes were offspring sensitisation against allergens and AR at age 5.5 years. Paternal ACE up to 18 years were assessed using the Trauma and Distress Scale (TADS) with the lowest quarter as the reference group. Results: Of the children, 317 (54%) were males. Sensitisation occurred in 162/533 (30%) and AR in 122/590 (21%). Paternal TADS (median 17 points; interquartile range 11–27) was inversely associated with the risk of sensitisation. Children whose fathers scored the highest quarter had the lowest risk of sensitisation (adjusted odds ratio 0.42; 95% confidence interval 0.24–0.75), followed by those in the second highest quarter (0.58; 0.34–0.99). The association between the highest quarter and reduced risk of AR was similar. Conclusion: Paternal ACE were associated with a low risk of offspring sensitisation and AR, suggesting paternal childhood stress might influence immune responses in their offspring. [ABSTRACT FROM AUTHOR]

Purpose: To identify potential factors associated with keratoconus. Methods: This cross‐sectional study included data from Israel's largest healthcare provider for the years 2005–2020. Keratoconus patients and age‐matched controls were identified. Demographic factors and comorbid conditions, including smoking, diabetes mellitus, asthma, myalgia, mental retardation, Down syndrome, atopic dermatitis and allergy/allergic rhinitis, were compared between the two cohorts. The independent risk factors associated with keratoconus were determined using a multivariable conditional logistic regression model. Results: Overall, 145 508 subjects were reviewed of which 13 228 were keratoconus patients. A ten‐fold group (n = 132 280) of age‐matched control subjects served as controls for comparisons. In multivariable analysis, several factors were found to be significantly associated with keratoconus. Male gender (OR = 1.27, p < 0.001), Arab ethnicity (OR = 1.50, p < 0.001), diabetes (OR = 1.19, p < 0.001), asthma (OR = 1.50, p < 0.001), myalgia (OR = 1.09, p = 0.02), mental retardation (OR = 2.63, p < 0.001), atopic dermatitis (OR = 1.35, p < 0.001) and allergic rhinitis (OR = 1.21, p < 0.001) were significantly associated with keratoconus. Smoking was significantly protective of keratoconus (OR = 0.66, p < 0.001). Conclusions: This population‐based study reports male gender, Arab ethnicity, diabetes, asthma, myalgia, mental retardation/Down syndrome, atopic dermatitis and allergic rhinitis as factors associated with keratoconus while smoking demonstrates a protective effect. The results of this study could guide enhanced screening strategies and early interventions, particularly for high‐risk groups. [ABSTRACT FROM AUTHOR]

Asthma is a respiratory disorder caused by airway inflammation which may worsen after allergen exposure. Recent cohort studies demonstrate a positive association between skin cancer and asthma or hay fever (allergy to outdoor allergens such as pollen). Nationally-representative data for adults in the United States remains limited. We aimed to characterize skin cancer prevalence among individuals in the United States who have asthma or hay fever. To achieve this aim, we extracted nationwide cross-sectional data from 16,277 adult participants (total survey-weighted sample = 174,765,931) of the Third National Health and Nutrition Examination Survey from 1988 to 1994. This study uses survey-weighted regression to compare the nationwide prevalence of skin cancer among participants with or without a history of asthma or hay fever. Sensitivity analysis examined the influence of sex, 25-hydroxyvitamin D, chronic bronchitis or emphysema, geographical region, urban proximity, and oral glucocorticoid use. Of the included participants, the age-adjusted prevalence of skin cancer was 7.2%, similar to national estimates. Skin cancer prevalence was higher among participants who had asthma with hay fever (adjusted prevalence ratio, 1.79; 95% confidence interval, 1.16, 2.76), but not among participants with asthma only or hay fever only. Similarly, skin cancer prevalence was higher for those with asthma and positive pollen allergen skin prick testing (SPT), but not for those with hay fever and positive pollen SPT. No association was noted between skin cancer and wheezing triggered by pollen. Hay fever or immunoglobulin-E sensitization to pollen may increase skin cancer prevalence among individuals with a history of asthma. [ABSTRACT FROM AUTHOR]

Background: Malva sylvestris L. (commonly known as mallow) has been widely used in traditional Tibetan formulations to treat allergic rhinitis (AR), and malvidin is a key anti-inflammation constituent of this plant. Objective: The present study aimed to evaluate the potential therapeutic effect and mechanism of malvidin in an AR mouse model. Methods: Malvidin's efficacy was evaluated in an AR mouse model induced by ovalbumin (OVA) sensitization and challenge. The factors, such as nasal symptoms, serum OVA-specific immunoglobulin E (IgE) levels, histological changes in the nasal mucosa, and expressions of Th1, Th2, Th17, and Tregs and their cytokines, were assessed. Western blotting was used to analyze the effect of malvidin on signal transducer and activator of transcription 6 (STAT6) and GATA3 expression levels. Results: Malvidin reduced the allergic symptoms and serum levels of OVA-specific IgE in the AR model. Histological analysis indicated that malvidin alleviates nasal mucosal edema, eosinophil infiltration, and goblet cell proliferation. In addition, it altered the expression of Th1/Th2/Th17-related cytokines, enhanced the Treg population, and reduced Th2-mediated immunity by suppressing the phosphorylation of STAT6 and expression of the GATA3 protein. Conclusions: Malvidin significantly improved allergic symptoms in an OVA-induced AR mouse model by modulating Th1/Th2 immune responses and suppressing the STAT6/GATA3 pathway, indicating its potential as a naturally sourced agent for AR management. [ABSTRACT FROM AUTHOR]

Objectives: Studies suggest that transplant patients are at a higher risk of developing chronic rhinosinusitis (CRS). However, there is a dearth of studies describing the factors that may be linked to the development of CRS in this population. Our objective is to identify the risk factors associated with the development of CRS in transplant recipients. Study design: Retrospective cohort. Setting: Tertiary care center. Methods: This cohort included 3347 transplant recipients seen between 2017 and 2022. Of these, 2128 patients met the inclusion criteria and were grouped according to whether they were diagnosed with CRS during the post-transplant period. The analysis included both univariate and multivariate analysis to ascertain the odds ratio (OR) and predictive factors. Results: Of the 2128 patients, 649/2128 (30.4%) had CRS. CRS patients had an increased prevalence of previous endoscopic sinus surgery, allergic rhinitis, and recurrent acute rhinosinusitis in the pre-transplant period compared to the non-CRS group. According to the multivariate analysis, patients with primary immunodeficiency and additional transplant were 1.9 and 3.1 times more likely to develop CRS during the posttransplant period (95% CI: 1.3–2.6, p <.0001), (95% CI: 1.3 −7.3, p =.01), respectively. Sirolimus use was also associated with the development of CRS (OR = 1.4, 95% CI: 1.1–1.9, p =.01). Conclusion: This study is the largest cohort aimed at determining the predictive factors associated with the development of CRS. Patients with pretransplant rhinologic conditions, hematologic deficiencies, and the utilization of specific immunosuppressants were found to have a higher likelihood of developing CRS following transplantation. [ABSTRACT FROM AUTHOR]

Objective: Allergic rhinitis (AR) is a growing public health problem worldwide. Respecting the significance of the modified Lund-Kennedy (MLK) score in rhinitis assessment, we delved into its evaluation value on the sublingual immunotherapy (SLIT) efficacy in AR patients. Methods: Totally 100 AR patients were enrolled, with pre- and post-SLIT MLK score, total nasal symptoms score (TNSS), total medication score (TMS), visual analogue scale (VAS), inflammatory cytokines, and immune function-related parameters compared. The correlations of MLK score with TNSS/TMS/VAS, as well as with IL-4/INF-γ/eosinophil (EOS)/percentage/specific immunoglobulin (sIgE)/sIgG were assessed by Spearman correlation analysis. The value of MLK score on assessing SLIT efficacy in AR patients was analyzed. Results: SLIT treatment reduced MLK/TNSS/TMS/VAS scores, abated IL-4 level/EOS percentage/sIgE, and elevated INF-γ/sIgG levels. MLK score was positively correlated with pre- and post-SLIT TNSS score (rpre−treatment = 0.592, rpost−treatment = 0.756), TMS score (rpre−treatment = 0.385, rpost−treatment = 0.718), VAS score (rpre−treatment = 0.369, rpost−treatment = 0.704), IL-4 (rpre−treatment = 0.553, rpost−treatment = 0.639), EOS percentage (rpre−treatment = 0.511, rpost−treatment = 0.632), and sIgE (rpre−treatment = 0.472, rpost−treatment = 0.524), and negatively with INF-γ (rpre−treatment = −0.418, rpost−treatment = −0.578) and sIgG4 (rpre−treatment = −0.460, rpost−treatment = −0.613). The MLK score had an area under curve of 0.846 (77.01% sensitivity, 76.92% specificity, 4 cut-off value) and 0.944 (91.67% sensitivity, 92.11% specificity, 2 cut-off value) for assessing SLIT treatment as effective and markedly effective for the patients, respectively. Conclusion: The MLK score had good evaluation value on the efficacy of SLIT treatment in AR patients. [ABSTRACT FROM AUTHOR]

Allergic rhinitis is an inflammatory disorder affecting nasal mucosa in response to allergen exposure and is commonly assessed and managed in family medicine. In this article, we review new international guidelines on the diagnosis and management of allergic rhinitis and generate evidence‐informed recommendations for family medicine doctors. [ABSTRACT FROM AUTHOR]

Background Allergic rhinitis (AR) is a common condition that affects 19% of Australians in the community, accounting for approximately 0.6% of all general practitioner presentations. Recent years have seen the emergence of new treatment options, many of which can be delivered in the primary care setting. Objective The aim of this paper is to provide a contemporary and accessible framework for the clinical assessment, investigation and management of AR in the primary care setting, and to establish appropriate referral criteria for ear, nose and throat and/or allergist/immunologist referral. Discussion AR is common, and can have a significant effect on both quality of life and function. The diagnosis can be made based on history, examination and appropriate investigations, including serum specific allergen IgE (immunoglobulin E) and/or skin prick testing. Radiological imaging is not part of the work-up for AR. Management consists of four main aspects: allergen avoidance, pharmacotherapy, immunotherapy and procedural interventions. Biological pharmacotherapies are on the horizon. [ABSTRACT FROM AUTHOR]

Background: This study aims to provide a comprehensive bibliometric analysis of research trends, hotspots, and future directions in the immunoregulatory mechanisms of allergic rhinitis (AR) from 2014 to 2024. Methods: Data were sourced from the Web of Science Core Collection (WoSCC), covering articles and reviews published between April 1, 2014, and March 31, 2024. The search terms included "Allergic Rhinitis," "AR," and related terms along with specific keywords related to immune cells and inflammatory mediators. Bibliometric tools such as CiteSpace, VOSviewer, and SCImago Graphica were used to analyze institutional cooperation networks, keyword co-occurrence, citation bursts, and research topic evolution. Microsoft Excel 2019 was employed to display annual publication trends. Results: A total of 2200 papers met the inclusion and exclusion criteria. The number of publications showed an upward trend over the past decade, with a significant peak in 2021. China (583 papers) and the United States (454 papers) were the major contributing countries. Imperial College London emerged as the leading institution. Key research frontiers identified include the roles of NF kappa B and air pollution in AR. Keyword burst analysis revealed emerging topics such as respiratory allergy and personalized treatment strategies. Notable limitations include the exclusive use of the WoSCC database and the restriction to English-language publications. Conclusion: The field of immunoregulatory mechanisms in allergic rhinitis has seen significant growth, with China and the United States leading the research. Future research should focus on developing personalized treatment plans and understanding the comprehensive impact of environmental factors. Continued interdisciplinary collaboration and international cooperation will be essential for advancing therapeutic strategies in AR. [ABSTRACT FROM AUTHOR]

Objective: To determine risk factors of medical adherence and describe strategies to increase adherence in patients with chronic rhinologic disease. Data Sources: PubMED, SCOPUS, CINAHL, and Cochrane. Review Methods: Systematic review of 4 databases (PubMED, SCOPUS, CINAHL, Cochrane) from inception of databases to September 1, 2022 to identify studies that evaluated factors related to and affected by medical adherence in patients with chronic rhinologic disease. Results: Of 1491 studies screened, 25 studies met inclusion criteria. Of these, 7 studies described how sensory attributes of intranasal sprays affect adherence, including odor, taste, aftertaste, and side effects. Five studies described record keeping diaries/notification systems to improve adherence, with demonstration of web‐based platforms to send reminders as well as keep record of medication usage to improve adherence. Eight studies described patient‐specific risk factors to nonadherence, with demonstration of increased age and conscientious personalities correlating with medical adherence. Five studies looked at pediatric patients specifically, with adherence rates in children parallelling that of adults. Additionally, nonadherence in children may have greater implications for school performance. Conclusion: Overall, adherence to topical medical therapy in patients with chronic rhinologic disease is affected by patient‐related and medication‐specific factors which should be considered when counseling patients. Web‐based diary or notification systems may help increase adherence. Additionally, children are equally adherent to topical medical therapy as adults and nonadherence may have negative implications for school performance. [ABSTRACT FROM AUTHOR]

Objective: We review the prevalence of allergic diseases in children across prenatal exposures to heavy metals. Methods: This systematic review and meta-analysis is registered in the PROSPERO database (CRD42023478471). A comprehensive search of PubMed, Web of Science, Medline and Cochrane library was conducted from the database inception until 31 October 2023. The Newcastle-Ottawa Quality Assessment Scale (NOS) was used to assess the quality of included studies. We used a random-effects model to summarize the effects from the studies. Results: A total of 16 studies were included, 120,065 mother-child pairs enrolled. The NOS scores indicated that the quality of the literature included in the study was of a high standard. Conclusion: The final results indicate that prenatal exposure to Pb increased the incidence of wheeze and Eczema in infants, and exposure to Ni and CD increased the incidence of AD in infants. [ABSTRACT FROM AUTHOR]

Background: T lymphocyte helper (Th) 2 plays the main role in pathogenesis of allergic airway diseases (AAD). Recent studies showed that interleukin (IL) 33, Th17 and Th22 also may be involved in allergic inflammation. The aim is to evaluate cytokine level before and after nasal challenge with Dermatophagoides pteronyssinus in patients with AAD. Methods: Patients with persistent allergic rhinitis (AR) with or without allergic asthma (AA) allergic to house dust mite and healthy individuals underwent nasal challenge with Dermatophagoides pteronyssinus. Measurements of IL-13, IL-17, IL-22 and IL-33 in serum and nasal lavage were performed before, 2 and 22 h after nasal challenge by ELISA. Results:. Ten patients with AR only, 6 patients with AR and AA and 7 healthy individuals were involved in the study. Serum IL-22 level significantly increased in patients with AR and AA and nasal lavage IL-22 tended to increase in patients with AAD after nasal challenge. Serum IL-13 level tended to increase in patients with AR and AA. IL-13 level in nasal lavage fluid decreased at 22 h after nasal challenge in patients with AR only. IL-17 level in serum and nasal lavage decreased in patients with AAD. Serum IL-33 tended to increase after nasal challenge whereas IL-33 in nasal lavage significantly decreased. Conclusion: Cytokine profile differs between local and systemic compartments and between patients with allergic rhinitis only and patients with allergic rhinitis and asthma after nasal challenge. [ABSTRACT FROM AUTHOR]

Introduction: Allergic rhinitis (AR) is a widespread upper airway disorder characterized by inflammation of the nasal passages. It is immunologically mediated via the hypersensitivity type I mechanism, which is primarily elicited by the immunoglobulin E (IgE)-linking allergen-induced imbalance of the Th2/ Th1 immune response. Owing to the limited efficacy of current medications, probiotics have received attention for their potential in preventing and ameliorating AR. Methods: In this study, a Lacticaseibacillus paracasei strain, GOLDGUTLpc969 (Lpc969), isolated from the feces of healthy adults, was proven to be effective in preventing AR by LPA-induced RBL-2H3 in-vitro and OVA-induced AR mice invivo evaluation. Results: The strain significantly attenuated the release of histamine and degranulation in LPS-induced RBL-2H3 cells. In the OVA-induced AR mice, L. paracasei GOLDGUT-Lpc969 also exhibited a significant decrease in disease indicators such as the disease activity index (DAI score), serum IgE, and serum histamine. Treatment with L. paracasei GOLDGUT-Lpc969 led to significant suppression of the Th2-related cytokines IL-4, IL-5, IL-6, IL-13, and TNF-a in the serum of mice. Discussion: Furthermore, a comparison of the genomes of three previously reported AR-effective L. paracasei strains (including GOLDGUTLpc969) and one non-effective L. paracasei strain revealed that the gene K03671 may play a key role in alleviating AR symptoms. In conclusion, this study highlights the efficacy of L. paracasei GOLDGUT-Lpc969 in AR prevention by suppressing the Th2 immune response and proposes the potential involvement of the functional gene K03671 in ameliorating AR symptoms. Therefore, L. paracasei GOLDGUTLpc969 shows promise as a probiotic for preventing AR. [ABSTRACT FROM AUTHOR]

\nIntroduction: Allergic rhinitis (AR) is a chronic condition caused by an immunoglobulin E-mediated response to environmental allergens, which affects 10–40% of the global population. AR symptoms, such as nasal congestion and rhinorrhea, significantly reduce quality of life and are associated with sleep disturbances, further exacerbating the condition’s burden. Despite the known impact of AR on sleep, the effects of intranasal corticosteroids on sleep quality have not been comprehensively reviewed. Therefore, this systematic review and meta-analysis aimed to investigate the efficacy of intranasal corticosteroids in improving sleep quality among patients with AR. Methods: This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The study protocol was registered with PROSPERO (CRD42023460698). A comprehensive search was conducted on PubMed, Cochrane Central Register of Controlled Trials, and Ichushi-Web. Randomized controlled trials (RCTs) comparing intranasal corticosteroids with placebos in patients with AR were included. Data extraction and risk of bias assessment were independently performed by two authors. The primary outcome was the improvement in sleep quality measured by standardized questionnaires. Meta-analyses were performed using a random-effects model. The risk of bias was assessed using the RoB2 tool. Results: Eighteen RCTs involving 6,019 participants were included. The meta-analysis of 12 comparisons from eight studies for the Rhinoconjunctivitis Quality of Life Questionnaire sleep domain showed significant improvement in sleep quality with a standardized mean difference (SMD) of 0.292 (95% confidence interval [CI]: 0.235–0.350, p < 0.0001, I2 = 0.0%). The Nocturnal Rhinoconjunctivitis Quality of Life Questionnaire also showed improvement with an SMD of 0.284 (95% CI: 0.164–0.404, p < 0.0001) based on two comparisons from one study. However, the Epworth Sleepiness Scale did not show significant results (SMD: 0.027, 95% CI: −0.429 to 0.483, p = 0.907) based on two comparisons from two studies. Sensitivity analysis, excluding two studies with high risk of bias according to RoB2, confirmed the robustness of these results. Subgroup analyses for patients with seasonal or perennial AR showed significant improvements in both groups. Conclusion: This study demonstrates that intranasal corticosteroids significantly improve sleep quality in patients with AR. These findings support the use of intranasal corticosteroids as a first-line treatment for AR, not only for managing daytime symptoms but also for enhancing sleep quality. Future research should focus on sleep quality changes as a primary outcome and incorporate both subjective and objective measures to better understand the relationship between sleep and AR symptoms. Allergic rhinitis (AR) is a chronic condition caused by an immunoglobulin E-mediated response to environmental allergens, which affects 10–40% of the global population. AR symptoms, such as nasal congestion and rhinorrhea, significantly reduce quality of life and are associated with sleep disturbances, further exacerbating the condition’s burden. Despite the known impact of AR on sleep, the effects of intranasal corticosteroids on sleep quality have not been comprehensively reviewed. We performed a systematic review and meta-analysis to investigate the efficacy of intranasal corticosteroids in improving sleep quality among patients with AR. A comprehensive search was conducted on PubMed, Cochrane Central Register of Controlled Trials, and Ichushi-Web. Randomized controlled trials (RCTs) comparing intranasal corticosteroids with placebos in patients with AR were included. Meta-analyses were performed using a random-effects model. We included 18 RCTs involving 6,019 participants. The meta-analysis of 12 comparisons from eight studies for the Rhinoconjunctivitis Quality of Life Questionnaire sleep domain showed significant improvement in sleep quality with a standardized mean difference (SMD) of 0.292 (95% confidence interval: 0.235–0.350, p < 0.0001). The Nocturnal Rhinoconjunctivitis Quality of Life Questionnaire also showed improvement with an SMD of 0.284 (95% confidence interval: 0.164–0.404, p < 0.0001) based on two comparisons from one study. In conclusion, this study demonstrates that intranasal corticosteroids significantly improve sleep quality in patients with AR. These findings support the use of intranasal corticosteroids as a first-line treatment for AR, not only for managing daytime symptoms but also for enhancing sleep quality. [ABSTRACT FROM AUTHOR]

Mesenchymal stem cell‐derived extracellular vesicles (MSC‐EVs) have shown promising immunomodulatory capabilities for a variety of clinical conditions. However, the potential regulatory mechanisms of MSC‐EVs in allergic rhinitis (AR) remain unexplored. The present study was designed to investigate the immunomodulatory effect of MSC‐EVs in patients with AR. Peripheral blood mononuclear cells (PBMCs) were isolated from AR patients. The number of peripheral CD4+Foxp3+IL‐17+, CD4+Foxp3+IL‐17− and CD4+Foxp3−IL‐17+ T cells in healthy controls and AR patients were evaluated using flow cytometry. Therapeutic effect of MSC‐EVs was determined by detecting IFN‐γ, IL‐4, IL‐17 and IL‐10 cytokines in supernatant by ELISA and flow cytometry. The mean fluorescence intensity (MFI) was calculated in PBMCs for IL‐10, IL‐17 and TGF‐β on T cells after MSC‐EVs treatment. Bioinformatic analysis of microRNA was performed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis. CD4+Foxp3+IL‐17+ T cells expression in PBMCs was higher in the AR group and the balance of Treg/Th17 was tilted towards Th17 cells. Supernatant from AR patients revealed that MSC‐EVs treatment upregulated IL‐10 and IFN‐γ, and downregulated IL‐4 and IL‐17. EVs treatment effectively re‐established Th1(CD4+IFN‐γ+cells)/Th2(CD4+IL‐4+cells) balance, reduced CD4+IL‐17+ and increased CD4+IL‐10+ and CD4+TGF‐β+ cells. The MFI of IL‐10 and TGF‐β in CD4+CD25+CD127− T cells were higher, whereas lower levels of IL‐17 were observed. Bioinformatic analysis revealed that the TGF‐β, Wnt signalling pathways and STAT5 transcription factor might mechanistically support the immunomodulatory effect of MSC‐EVs. This study presents the immunomodulatory effect of MSC‐EVs in PBMCs from AR patients. The results provide a new therapeutic strategy for AR. [ABSTRACT FROM AUTHOR]

ABSTRACT Allergic rhinitis (AR) is one of the most frequently observed diseases in otorhinolaryngology, a global issue that alters the quality of life of patients. Both B cells and follicular helper T cells (Tfhs) have important roles in allergic diseases. However, how Tfhs and B cells interact to modulate allergic rhinitis pathogenesis remains unclear. In this study, two models of allergic rhinitis were examined, including the co‐culture of follicular helper T cells (Tfhs) isolated from mouse spleen with B cells. To further define the mechanism, exosomes from Tfh cells were isolated and added to B cells. Bulk RNA sequencing (RNA‐seq) analysis was used to compare exosomes derived from Tfhs cells in a mouse model of allergic rhinitis and exosomes derived from Tfhs cells in wild‐type mice. Among them, miR‐149‐5p was observed to be lowly expressed in the allergic rhinitis group, which was confirmed using qPCR. miR‐149‐5p mimics or inhibitors were utilised to overexpress or knock down miR‐149‐5p in Tfhs, which were then co‐cultured with B cells, demonstrating that miR‐149‐5p is negatively correlated with B cell proliferation and maturation. The function of WNT3A, a target gene of miR‐149‐5p, and the downstream effector AXIN2 on the proliferation and maturation of B cells were predicted and verified. We show that miR‐149‐5p packaged in Tfhs‐derived exosomes induces B cell proliferation and maturation through the WNT3A/AXIN2 axis. The discovery will contribute to new ideas for the treatment of allergic rhinitis. [ABSTRACT FROM AUTHOR]

The prevalence of allergic diseases such as Allergic Rhinitis and Asthma is steadily increasing globally, with pollen allergy being one of the most significant sensitizing factors. However, the cross-reactivity of different pollen allergies remains unclear, posing challenges in the diagnosis and treatment of individuals with multiple sensitivities. In this study, the Component Resolved Diagnosis technique was performed to simultaneously measure the specific IgE concentrations of 52 patients against Art v and its components (Art v 1), Phl p and its components (Phl p 1, Phl p 4, Phl p 5, Phl p 6, Phl p 7, Phl p 12), Bet v and its components (Bet v 1, Bet v 2), Amb a and its component (Amb a 1), and Amb p. Additionally, sIgE inhibition tests were conducted by Art v, Phl p, and Bet v extracts. Among Art v-positive patients, 64.6% showed positivity for Art v 1. In Phl p-positive patients, Phl p 12 had the highest positivity rate (75.0%). Among Bet v-positive patients, 75.6% exhibited positivity for Bet v 2, whereas for Amb a and Amb p-positive patients, 23.7% and 29.0% respectively showed positivity for Amb a 1. The sIgE inhibition assays results revealed that Art v extract had inhibition rates greater than 73.2% against Phl p and its component Phl p 12, as well as Bet v and its component Bet v 2. Simultaneously, Phl p extract showed inhibition rates of 80.70–89.87% against Phl p 12, Bet v and Bet v 2. Bet v extract showed inhibition rates ranging from 21.9 to 59.8% against Phl p and Bet v 2, with a better inhibition rate (76.80%) against Phl p 12. In conclusion, Art v 1 is identified as the principal component of Art v. The profilin proteins of Phl p and Bet v (Phl p 12 and Bet v 2), are implicated as potential cross-reactive elements contributing to polysensitization in patients with respiratory allergies in the Northwest region of China. This cross-reactivity leads to a shared sensitization mechanism among pollen allergens such as Art v, Phl p, and Bet v. [ABSTRACT FROM AUTHOR]

This article presents a study on the seasonal patterns of airborne fungal spores in central England over a 13-year period. The study identifies 23 fungal spores, with Alternaria, Cladosporium, and Aspergillus/Penicillium being known allergens. The research highlights the impact of temperature and precipitation on fungal spore concentrations and suggests a potential increase in aeroallergen exposure due to climate change. The findings provide valuable insights for understanding the distribution of airborne spores and their potential health implications. [Extracted from the article]

OX40/OX40L are costimulatory molecules in the tumor necrosis factor superfamily. Numerous studies have shown that OX40/OX40L are involved in immune regulation, especially in the proliferation and differentiation of T cells and the generation of memory T cells, which play important roles in allergic diseases. In recent years, the use of OX40/OX40L as therapeutic targets for treating T‐cell‐mediated diseases has attracted the interest of scholars. This paper reviews the role of OX40/OX40L in allergic diseases and the progress in clinical treatments targeting this signaling pathway. [ABSTRACT FROM AUTHOR]

Abstract:ObjectiveData SourcesStudy SelectionsResultsConclusionThis meta-analysis aims to evaluate the efficacy and safety of montelukast combined with levocetirizine in the treatment of allergic rhinitis with asthma, and to provide objective and effective evidence-based medical evidence for clinical use.Pubmed, Web of Science, Cochrane Library, WANFANG DATA, CNKI, and Chinese BioMedical Literature Database were retrieved to identify records related to Montelukast combined with levocetirizine in the treatment of allergic rhinitis with asthma.First, the eligibility criteria were employed to screen search results. Then, two investigators independently assessed titles, abstracts, and the full text of all retrieved references to identify potentially eligible studies.As of 2024-02-03, a total of 6 articles were included in this meta-analysis, covering 2950 patients with allergic rhinitis with asthma. The meta-analysis results exhibited a pooled NSS of -1.28 (95%CI: -1.64 to -0.92), suggesting that the combination of montelukast and levocetirizine was effective in the treatment of nasal symptoms of allergic rhinitis complicated with asthma. The meta-analysis of controlled trials showed that the SMD of NSS in the group of Montelukast combined with levocetirizine was -2.56 (95%CI: -2.77 to -2.35). The result indicated that compared with the control group, the combination of montelukast with levocetirizine significantly improved the symptoms of allergic rhinitis.In summary, this meta-analysis demonstrated the efficacy of montelukast combined with levocetirizine in the treatment of nasal symptoms in AR with asthma, indicating that the combination of montelukast with levocetirizine is more effective in improving symptoms of allergic rhinitis than monotherapy and has good safety. [ABSTRACT FROM AUTHOR]