Monthly Archives

October 2020

Null association between serum 25-hydroxyvitamin D levels with allergic rhinitis, allergic sensitization and non-allergic rhinitis: A Mendelian randomization study

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Qi Feng, Klaus Bønelykke, Weronica Ek, Bo CHawes, Shuai Yuan, Ching Cheung, Gloria Li, Raymond Leung, Bernard Cheung

Clin Exp Allergy. 2020 Sep 18. doi: 10.1111/cea.13739. Online ahead of print.

Allergic rhinitis and allergic sensitization are the most common and prevalent allergic conditions in the world. It has been suggested that serum 25-hydroxyvitamin D might have a role in immunomodulation and, consequently, in allergic rhinitis and allergic sensitization. This study aimed to assess a causal association between 25-hydroxyvitamin D levels and risk of allergic rhinitis or allergic sensitization, using two-sample Mendelian randomization (MR) approach.

Instrumental variables identified seven single nucleotide polymorphisms (SNPs) associated with serum 25-hydroxyvitamin D levels. The primary objective was allergic rhinitis, and the secondary objectives were allergic sensitization and non-allergic rhinitis. Two cohort studies provided the genome-wide association summary statistics of the outcomes. MR analysis with a random-effects inverse variance weighted method was performed as the primary analysis to estimate the overall effect size. Sensitivity analysis using the weighted median method and MR-Egger regression method was conducted. A subgroup analysis based on 25-hydroxyvitamin D synthesis-SNPs was also applied.

There wasn’t a causal association between serum 25-hydroxyvitamin D and risk of allergic rhinitis, and subgroup analysis also showed no relation between 25-hydroxyvitamin D synthesis-related SNPs and outcomes. The same results were obtained for sensitivity analysis.

In conclusion, this study did not find any evidence that supports a causal association between serum 25-hydroxyvitamin D levels and risk of allergic rhinitis, allergic sensitization, or non-allergic rhinitis in the European-ancestry population. This conclusion is against the use of vitamin D supplementation for the prevention of allergic diseases.

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para identificar personas con rinitis alérgica.

Can we identify allergic rhinitis from administrative data: A validation study

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Katja Biering Leth-Møller, Tea Skaaby, Flemming Madsen, Janne Petersen

Pharmacoepidemiol Drug Saf. 2020 Sep 23. doi: 10.1002/pds.5120. Online ahead of print.

The prevalence of allergic rhinitis has been increasing, with more than one in five people being affected. The objective of this study was to evaluate the validity of 13 different Danish prescription algorithms and hospital data to identify people with allergic rhinitis.

This study included 10 653 Danish adults in two time periods. Investigators used a positive serum-specific IgE and self-reported nasal symptoms as the primary gold-standard of allergic rhinitis. The secondary gold standard of allergic rhinitis was self-reported physician diagnosis. They calculated sensitivity, specificity, positive predictive value (PPV), negative predictive value, and corresponding 95 % confidence intervals for each register-based algorithm in the two periods.

All algorithms had a low sensitivity, irrespective of the definition of allergic rhinitis or period. The highest positive predictive values were achieved for algorithms that required antihistamines and intranasal corticosteroids, with a value of 0.69 (0.62 – 0.75) and a corresponding sensitivity of 0.10 (0.09 – 0.12) for the primary gold standard of allergic rhinitis.

In conclusion, due to the low use of prescription medication among those with allergic rhinitis, sensitivity was low (≤ 0.40) for all algorithms irrespectively of the definition of allergic rhinitis. Algorithms based on antihistamines and intranasal corticosteroids granted the highest PPVs. Nevertheless, PPVs were still moderate, due to low sensitivity, when applying a strict gold standard (sIgE and nasal symptoms). Studies using administrative data must consider how to reliably identify allergic rhinitis, for example, using different data sources, and how a potential misclassification will

impact their results.

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Positive effect of Helicobacter pylori treatment on outcome of patients with chronic spontaneous urticaria

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Mohammed Elhendawy, Maha Hagras, Shaimaa Soliman, Engi Seif Shaker

Am J Clin Pathol. 2020 Sep 17;aqaa134. doi: 10.1093/ajcp/aqaa134. Online ahead of print.

People with chronic urticaria have chronic hives, itching, and wheels that come and go for long periods. Chronic spontaneous urticaria represents 80 – 90 % of chronic urticaria cases, and the release of histamine and other inflammatory mediators from mast cells and basophils may be immunoglobulin E (IgE)–mediated or non-IgE-mediated. Helicobacter pylori is a gram-negative bacterium with a high prevalence worldwide, and that persistently colonizes the stomach. Its presence is associated with an increased risk of peptic ulcer and gastric cancer. The association between Helicobacter pylori and chronic spontaneous urticaria is controversial. This study’s objective was to assess the relationship between Helicobacter pylori eradication therapy and chronic spontaneous urticaria remission.

This was a randomized, double-blind, placebo-controlled pilot study that included 72 patients with urticaria. From these, 27 were positive for Helicobacter pylori stool antigen and PCR in gastric biopsy and were randomly assigned to receive anti-Helicobacter pylori treatment or placebo.

Participants with Helicobacter pylori had significantly lower hemoglobin concentrations with microcytic hypochromic anemia and a significantly higher occurrence of dyspepsia symptoms. All Helicobacter pylori patients (except 2) had significant improvement of the urticaria itching and red wheals after two weeks of therapy compared to placebo.

This study showed an association between chronic spontaneous urticaria and the presence of Helicobacter pylori in the gastric tissue. Patients with urticaria who do not respond to usual chronic urticaria treatment should be tested for Helicobacter pylori as therapy of Helicobacter pylori showed to improve the symptoms of chronic spontaneous urticaria.

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Avances y desarrollos novedosos en la rinitis alérgica

Advances and novel developments in allergic rhinitis

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Yifan Meng, Chengshuo Wang, Luo Zhang

Allergy. 2020 Sep 9. doi: 10.1111/all.14586. Online ahead of print.

Allergic rhinitis is a condition of the upper airways, with a high prevalence worldwide, characterized by symptoms such as nasal obstruction, rhinorrhea, sneezing, and nasal pruritus. This is due to inhaled allergens and respective mucosal inflammation. This review’s objective was to highlight novel mechanisms and treatments of allergic rhinitis to optimize its management.

Proteins such as histone deacetylase (HDAC) and mucin 1 (MUC1) have a role in the epithelial tight junction barrier’s integrity. Inflammatory mediators, such as type 2 innate lymphoid cells (ILC2), myeloid dendritic cells (mDC), and plasmacytoid dendritic cells (pDC), are involved in the development of allergic rhinitis. Other risk factors include genetic susceptibility, age, intrauterine growth restriction, fetal oxidative balance, diet, environmental changes, and essential roles in allergic rhinitis.

Management of allergic rhinitis includes patient education, pharmacotherapy, allergen-specific immunotherapy, and biologics. Novel therapies include highly purified allergens, allergoids, peptides, and new adjuvants for use in specific allergen immunotherapy and specific monoclonal antibodies for blocking the effects of immune mediators.

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This study aimed to compare the gastrointestinal composition between adults and children suffering from allergic rhinitis.

Comparison of the gastrointestinal composition between adults and children suffering from allergic rhinitis

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Annabelle M Watts; Nicholas West; Ping Zhang; Peter Smith; Allan Cripps; Amanda Cox

Int Arch Allergy Immunol. 2020 Sep 24;1-12. doi: 10.1159/000510536. Online ahead of print.

The gut microbiota has an essential role in the development and regulation of local and systemic immunity. Allergic rhinitis, such as various immune-mediated conditions, has been associated with abnormal gut microbial colonization patterns in children; however, there is not enough data regarding adults. This study aimed to compare the gastrointestinal composition between adults and children who suffer from allergic rhinitis.

This was a cross-sectional study that included 57 adults with allergic rhinitis and 23 healthy controls. Investigators compared samples of their stools via next-generation sequencing of the V3-V4 hypervariable regions of the 16S rRNA gene. Investigators used a reference-based approach with the NCBI database to taxonomic classification and identity approach.

Participants with allergic rhinitis had a significant reduction in species richness. They also had declines in operational taxonomic unit counts and diversity indices. In contrast, they had significantly more Bacteroidetes than healthy controls, as well as an increased abundance of Parabacteroides and a reduced abundance of Oxalobacter and Clostriadiales.

Adults with allergic rhinitis have a different gut microbiome than healthy controls, with reduced microbial diversity and altered abundance of some microbes. Identifying the metabolites and mechanisms underlying the relationship microbiota-host will improve how the gut microbiome composition regulates immunity and may be of interest to potential therapeutic options for allergies.

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