Cytokines in Allergic Rhinitis : Release due to Artificial and Natural Allergen Exposure

Bachert, Claus Korean Rhinologic Society 1999 Journal of rhinology Vol.6 No.1

Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines—2016 revision

Broż,ek, Jan L.,Bousquet, Jean,Agache, Ioana,Agarwal, Arnav,Bachert, Claus,Bosnic-Anticevich, Sinthia,Brignardello-Petersen, Romina,Canonica, G. Walter,Casale, Thomas,Chavannes, Niels H.,Correia Elsevier 2017 The journal of allergy and clinical immunology Vol.140 No.4

<P><B>Background</B></P> <P>Allergic rhinitis (AR) affects 10% to 40% of the population. It reduces quality of life and school and work performance and is a frequent reason for office visits in general practice. Medical costs are large, but avoidable costs associated with lost work productivity are even larger than those incurred by asthma. New evidence has accumulated since the last revision of the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines in 2010, prompting its update.</P> <P><B>Objective</B></P> <P>We sought to provide a targeted update of the ARIA guidelines.</P> <P><B>Methods</B></P> <P>The ARIA guideline panel identified new clinical questions and selected questions requiring an update. We performed systematic reviews of health effects and the evidence about patients' values and preferences and resource requirements (up to June 2016). We followed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) evidence-to-decision frameworks to develop recommendations.</P> <P><B>Results</B></P> <P>The 2016 revision of the ARIA guidelines provides both updated and new recommendations about the pharmacologic treatment of AR. Specifically, it addresses the relative merits of using oral H<SUB>1</SUB>-antihistamines, intranasal H<SUB>1</SUB>-antihistamines, intranasal corticosteroids, and leukotriene receptor antagonists either alone or in combination. The ARIA guideline panel provides specific recommendations for the choice of treatment and the rationale for the choice and discusses specific considerations that clinicians and patients might want to review to choose the management most appropriate for an individual patient.</P> <P><B>Conclusions</B></P> <P>Appropriate treatment of AR might improve patients' quality of life and school and work productivity. ARIA recommendations support patients, their caregivers, and health care providers in choosing the optimal treatment.</P>

Local Immunoglobulin E in the Nasal Mucosa: Clinical Implications

Els De Schryver,Lien Devuyst,Lara Derycke,Melissa Dullaers,Thibaut Van Zele,Claus Bachert,Philippe Gevaert 대한천식알레르기학회 2015 Allergy, Asthma & Immunology Research Vol.7 No.4

Immunoglobulin E (IgE) can be highly elevated in the airway mucosa independently of IgE serum levels and atopic status. Mostly, systemic markers are assessed to investigate inflammation in airway disease for research or clinical practice. A more accurate but more cumbersome approach to determine inflammation at the target organ would be to evaluate markers locally. We review evidence for local production of IgE in allergic rhinitis (AR) and chronic rhinosinusitis with nasal polyps (CRSwNP). Diagnostic and therapeutic consequences in clinical practice are discussed. We describe that the airway mucosa has the intrinsic capability to produce IgE. Moreover, not only do IgE-positive B cells reside within the mucosa, but all tools are present locally for affinity maturation by somatic hypermutation (SHM), clonal expansion, and class switch recombination to IgE. Recognizing local IgE in the absence of systemic IgE has diagnostic and therapeutic consequences. Therefore, we emphasize the importance of local IgE in patients with a history of AR or CRSwNP.

Prevalence of Allergic Rhinitis Among Adults in Urban and Rural Areas of China: A Population-Based Cross-Sectional Survey

Ming Zheng,Xiangdong Wang,Mingyu Bo,Kuiji Wang,Yan Zhao,Fei He,Feifei Cao,Luo Zhang,Claus Bachert 대한천식알레르기학회 2015 Allergy, Asthma & Immunology Research Vol.7 No.2

Purpose: The aim of the present study was to compare the prevalence of self-reported and confirmable allergic rhinitis (AR) with positive skin pricktest (SPT) results among adults living in urban and rural areas of China. Methods: Adults from a community in Beijing and a village in Baoding wereselected as representative urban and rural dwellers, respectively. All eligible residents were enrolled from the population register and received aface-to-face interview using modified validated questionnaires. Equal sets of randomly selected self-reporting AR-positive and AR-negative participantswho responded to the questionnaires were also investigated using skin prick tests. Results: A total of 803 participants in the rural area and atotal of 1,499 participants in the urban area completed the questionnaires, with response rates being 75.9% and 81.5% respectively. The prevalenceof self-reported AR of the rural area (19.1%) was significantly higher than that of the urban area (13.5%). The elementary school of educational levelincreased the risk of having AR (adjusted OR=2.198, 95% CI=1.072-2.236) .The positive SPT rates among subjects with self-reported AR in therural and urban areas were 32.5% and 53.3%, respectively; the confirmable AR prevalence of 6.2% and 7.2% among the rural and urban adults, respectively. Conclusions: The prevalence of confirmable AR is similar between rural and urban areas in China, although there is a higher prevalenceof self-reported AR in the former. Purpose: The aim of the present study was to compare the prevalence of self-reported and confirmable allergic rhinitis (AR) with positive skin prick test (SPT) results among adults living in urban and rural areas of China. Methods: Adults from a community in Beijing and a village in Baoding were selected as representative urban and rural dwellers, respectively. All eligible residents were enrolled from the population register and received a face-to-face interview using modified validated questionnaires. Equal sets of randomly selected self-reporting AR-positive and AR-negative participants who responded to the questionnaires were also investigated using skin prick tests. Results: A total of 803 participants in the rural area and a total of 1,499 participants in the urban area completed the questionnaires, with response rates being 75.9% and 81.5% respectively. The prevalence of self-reported AR of the rural area (19.1%) was significantly higher than that of the urban area (13.5%). The elementary school of educational level increased the risk of having AR (adjusted OR=2.198, 95% CI=1.072-2.236) .The positive SPT rates among subjects with self-reported AR in the rural and urban areas were 32.5% and 53.3%, respectively; the confirmable AR prevalence of 6.2% and 7.2% among the rural and urban adults, respectively. Conclusions: The prevalence of confirmable AR is similar between rural and urban areas in China, although there is a higher prevalence of self-reported AR in the former.

Staphylococcal Enterotoxin-Specific IgE Sensitization: A Potential Predictor of Fixed Airflow Obstruction in Elderly Asthma

Won Ha-Kyeong,Song Woo-Jung,Moon Sung do,Sohn Kyoung-Hee,Kim Ju-Young,Kim Byung-Keun,Park Heung-Woo,Bachert Claus,Cho Sang Heon 대한천식알레르기학회 2023 Allergy, Asthma & Immunology Research Vol.15 No.2

Purpose: Staphylococcus aureus enterotoxin-specific immunoglobulin E (SE-sIgE) sensitization tends to increase with age and is known to be associated with asthma and severity in older adults. However, the long-term impact of SE-sIgE in the elderly remains unknown. This study aimed to examine the relationships between SE-sIgE and fixed airflow obstruction (FAO) in a cohort of elderly asthmatics. Methods: A total of 223 elderly asthmatics and 89 controls were analyzed. Patients were assessed for demographics, history of chronic rhinosinusitis (CRS), asthma duration, acute exacerbation frequency, and lung function at baseline and then were prospectively followed up for 2 years. Serum total IgE and SE-sIgE levels were measured at baseline. Airflow obstruction was defined as forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) ratio < 0.7 at baseline and FAO was defined as FEV1/FVC ratio < 0.7 over the 2-year follow-up. Results: At baseline, the prevalence of airflow obstruction was 29.1%. Patients with airflow obstruction were significantly more likely to be male, and have a positive smoking history, comorbid CRS, and higher levels of SE-sIgE than those without airflow obstruction. Multivariate logistic regression analysis showed that airflow obstruction was significantly associated with current smoking and SE-sIgE sensitization at baseline. After the 2-year follow-up, baseline SE-sIgE sensitization was consistently related to FAO. Meanwhile, the number of exacerbations per year was significantly correlated with SE-sIgE levels. Conclusions: Baseline SE-sIgE sensitization was significantly associated with the number of asthma exacerbations and FAO after the 2-year follow-up in elderly asthmatics. These findings warrant further investigation of the direct and mediating roles of SE-sIgE sensitization on airway remodeling.