Olivia Tellez-Jimenez, Christian Trejo-Jasso, Patricia Ramos-Ramirez, Maryana Tinoco-Cuellar, Diana García-Trejo, Angélica Flores-Flores, Rocío Chapela, José Luis Miguel-Reyes, Blanca Bazán-Perkins
<p>To the Editor,</p><p>Integrins are ubiquitous transmembrane glycoprotein receptors involved in bidirectional signaling across the cell membrane. Integrins are composed of a noncovalent complex that contains an α-subunit and a β-subunit, with 18 and 8 variations, respectively, forming a total of 24 distinct heterodimer.<span><sup>1</sup></span> The integrin β1 subunit can interact with 12 α subunits, from α1 to α11 and αv. β2 integrins, along with α4β1, are cell adhesion ligands of leukocyte receptors.<span><sup>2</sup></span> In asthma model, various polypeptides containing both cytosolic and extracellular β1 integrin subunits were detected in airway myocytes and connective tissue, suggesting the secretion of the β1 integrin subunit.<span><sup>3</sup></span> In the context of asthma patients, studies have documented the presence of soluble extracellular domain of α1 and α2 integrin subunits in serum.<span><sup>4</sup></span> However, it remains unclear whether cytosolic integrins domains are present in fluids, such as serum, within the context of the asthma.</p><p>In patients with asthma (Supporting Information S1: Table S1), the levels of the extracellular domain of α1 and β1 integrin subunits, as well as the intracellular domain of α1 and β2 integrin subunits, were similar to those of healthy subjects (Figure 1). However, in asthma patients, the levels of the extracellular domain of α2 and β2 integrin subunits, as well as the intracellular domain of α2 and β1 integrin, were higher than those observed in healthy subjects (<i>n</i> = 23, <i>p</i> < 0.0001). This data is consistent with observations in persistent asthma patients, where an increase in serum soluble α2 integrin (extracellular domain) was observed compared to non-persistent asthma patients, while α1 integrin remained unchanged.<span><sup>4</sup></span> Interestingly, the expression patterns of integrin β1, α1, and α2 subunits in asthma differed from those observed in scleroderma patients (Supporting Information S1: Figure S1). The integrins α1β1 and α2β1 act as receptors for various types of collagens (I, III, IV, and XIII), each with distinct functions.<span><sup>5</sup></span> Additionally, integrin fragments have the ability to form heterodimers while retaining identical antigenic and ligand-binding properties as the complete transmembrane integrin.<span><sup>6</sup></span> Therefore, the presence of functional soluble integrin heterodimers in serum is feasible.</p><p>The changes in the expression of the β1 integrin intracellular domain and both domains of the α2 integrin inversely correlate with FEV1 (Table 1), implying that the severity of asthma may be associated with an upregulation of these integrins. Conversely, the β2 integrin extracellular domain exhibited a direct correlation with FEV1. Supporting this finding, a recent study demonstrated that in asthma patients, this integrin subunit is predominantly released by metalloproteinase-9 (MMP-9) during asthma exacerbatio
{"title":"Identifying integrins secreted in serum: Unveiling their correlation with inflammation and asthma—A preliminary study","authors":"Olivia Tellez-Jimenez, Christian Trejo-Jasso, Patricia Ramos-Ramirez, Maryana Tinoco-Cuellar, Diana García-Trejo, Angélica Flores-Flores, Rocío Chapela, José Luis Miguel-Reyes, Blanca Bazán-Perkins","doi":"10.1002/clt2.70023","DOIUrl":"10.1002/clt2.70023","url":null,"abstract":"<p>To the Editor,</p><p>Integrins are ubiquitous transmembrane glycoprotein receptors involved in bidirectional signaling across the cell membrane. Integrins are composed of a noncovalent complex that contains an α-subunit and a β-subunit, with 18 and 8 variations, respectively, forming a total of 24 distinct heterodimer.<span><sup>1</sup></span> The integrin β1 subunit can interact with 12 α subunits, from α1 to α11 and αv. β2 integrins, along with α4β1, are cell adhesion ligands of leukocyte receptors.<span><sup>2</sup></span> In asthma model, various polypeptides containing both cytosolic and extracellular β1 integrin subunits were detected in airway myocytes and connective tissue, suggesting the secretion of the β1 integrin subunit.<span><sup>3</sup></span> In the context of asthma patients, studies have documented the presence of soluble extracellular domain of α1 and α2 integrin subunits in serum.<span><sup>4</sup></span> However, it remains unclear whether cytosolic integrins domains are present in fluids, such as serum, within the context of the asthma.</p><p>In patients with asthma (Supporting Information S1: Table S1), the levels of the extracellular domain of α1 and β1 integrin subunits, as well as the intracellular domain of α1 and β2 integrin subunits, were similar to those of healthy subjects (Figure 1). However, in asthma patients, the levels of the extracellular domain of α2 and β2 integrin subunits, as well as the intracellular domain of α2 and β1 integrin, were higher than those observed in healthy subjects (<i>n</i> = 23, <i>p</i> < 0.0001). This data is consistent with observations in persistent asthma patients, where an increase in serum soluble α2 integrin (extracellular domain) was observed compared to non-persistent asthma patients, while α1 integrin remained unchanged.<span><sup>4</sup></span> Interestingly, the expression patterns of integrin β1, α1, and α2 subunits in asthma differed from those observed in scleroderma patients (Supporting Information S1: Figure S1). The integrins α1β1 and α2β1 act as receptors for various types of collagens (I, III, IV, and XIII), each with distinct functions.<span><sup>5</sup></span> Additionally, integrin fragments have the ability to form heterodimers while retaining identical antigenic and ligand-binding properties as the complete transmembrane integrin.<span><sup>6</sup></span> Therefore, the presence of functional soluble integrin heterodimers in serum is feasible.</p><p>The changes in the expression of the β1 integrin intracellular domain and both domains of the α2 integrin inversely correlate with FEV1 (Table 1), implying that the severity of asthma may be associated with an upregulation of these integrins. Conversely, the β2 integrin extracellular domain exhibited a direct correlation with FEV1. Supporting this finding, a recent study demonstrated that in asthma patients, this integrin subunit is predominantly released by metalloproteinase-9 (MMP-9) during asthma exacerbatio","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 2","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11781838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Data on type 2 (T2)-low severe asthma (SA) frequency is scarce, resulting in an undefined unmet therapeutic need in this patient population. Our objective was to assess the frequency and characterize the profile and burden of T2-low SA in Greece.
Methods
PHOLLOW was a cross-sectional study of adult SA patients. Based on a novel proposed classification system, patients were classified as T2-low if blood eosinophil count (BEC; cells/μL) was <150, fractional exhaled nitric oxide (FeNO) < 25 ppb and any allergy status or BEC < 150/FeNO < 50 ppb/no allergy or BEC < 300/FeNO < 25 ppb/no allergy. For patients receiving biologics and/or oral corticosteroids, only those with BEC < 150/FeNO < 25 ppb/no allergy/no response to therapy were classified as T2-low. Secondary outcome measures were: Asthma Control Test (ACTTM), Mini-Asthma Quality of Life Questionnaire (Mini-AQLQ), hospital anxiety and depression scale (HADS), and Work Productivity and Activity Impairment:Respiratory Symptoms (WPAI:RS) questionnaire.
Results
From 22-Mar-2022 to 15-Mar-2023, 602 eligible SA patients were enrolled. The frequency of T2-low asthma was 20.1%. Of those, 71.1% had experienced ≥1 clinically significant exacerbations in the past year, 62.8% had ACT score <20 (uncontrolled asthma), and 22.3% were biologic-treated. Mini-AQLQ score was <6 (impairment) in 79.5% of patients, HADS-total score was ≥15 (clinically significant emotional distress) in 43.8%, while median percent activity impairment and work productivity loss were 30.0 for both domains. Clinical and patient-reported outcomes were worse among patients with ACT-defined uncontrolled asthma.
Conclusions
One-fifth of SA patients present with a T2-low endotype. These patients frequently have uncontrolled disease and experience impairments in their quality of life, emotions and work ability.
{"title":"T2-low severe asthma clinical spectrum and impact: The Greek PHOLLOW cross-sectional study","authors":"Konstantinos Porpodis, Nikolaos Zias, Konstantinos Kostikas, Argyris Tzouvelekis, Michael Makris, George N. Konstantinou, Eleftherios Zervas, Stelios Loukides, Paschalis Steiropoulos, Konstantinos Katsoulis, Anastasios Palamidas, Aikaterini Syrigou, Maria Gangadi, Antonios Christopoulos, Dimosthenis Papapetrou, Fotios Psarros, Konstantinos Gourgoulianis, Eleni Tzortzaki, Stylianos K. Vittorakis, Ioannis Paraskevopoulos, Ilias Papanikolaou, Georgios Krommidas, Dimitrios Latsios, Nikolaos Tzanakis, Miltiadis Markatos, Angeliki Damianaki, Argyrios Manikas, Alexia Chatzipetrou, Dimitrios Vourdas, Ioanna Tsiouprou, Christina Papista, Marina Bartsakoulia, Nikolas Mathioudakis, Petros Galanakis, Petros Bakakos","doi":"10.1002/clt2.70035","DOIUrl":"10.1002/clt2.70035","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Data on type 2 (T2)-low severe asthma (SA) frequency is scarce, resulting in an undefined unmet therapeutic need in this patient population. Our objective was to assess the frequency and characterize the profile and burden of T2-low SA in Greece.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PHOLLOW was a cross-sectional study of adult SA patients. Based on a novel proposed classification system, patients were classified as T2-low if blood eosinophil count (BEC; cells/μL) was <150, fractional exhaled nitric oxide (FeNO) < 25 ppb and any allergy status or BEC < 150/FeNO < 50 ppb/no allergy or BEC < 300/FeNO < 25 ppb/no allergy. For patients receiving biologics and/or oral corticosteroids, only those with BEC < 150/FeNO < 25 ppb/no allergy/no response to therapy were classified as T2-low. Secondary outcome measures were: Asthma Control Test (ACT<sup>TM</sup>), Mini-Asthma Quality of Life Questionnaire (Mini-AQLQ), hospital anxiety and depression scale (HADS), and Work Productivity and Activity Impairment:Respiratory Symptoms (WPAI:RS) questionnaire.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 22-Mar-2022 to 15-Mar-2023, 602 eligible SA patients were enrolled. The frequency of T2-low asthma was 20.1%. Of those, 71.1% had experienced ≥1 clinically significant exacerbations in the past year, 62.8% had ACT score <20 (uncontrolled asthma), and 22.3% were biologic-treated. Mini-AQLQ score was <6 (impairment) in 79.5% of patients, HADS-total score was ≥15 (clinically significant emotional distress) in 43.8%, while median percent activity impairment and work productivity loss were 30.0 for both domains. Clinical and patient-reported outcomes were worse among patients with ACT-defined uncontrolled asthma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>One-fifth of SA patients present with a T2-low endotype. These patients frequently have uncontrolled disease and experience impairments in their quality of life, emotions and work ability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 2","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sanna Toppila-Salmi, Annina Lyly, Johanna Simin, Juhani Aakko, Helga Haugom Olsen, Lauri Lehtimäki
Background
Although patients with chronic rhinosinusitis with nasal polyps (CRSwNP) may benefit from endoscopic sinus surgery (ESS), some patients will experience polyp recurrence, adding to the overall disease burden of CRSwNP. We aimed to investigate predictors of revision ESS in patients with CRSwNP.
Methods
A nationwide population-based study including all adults diagnosed with CRSwNP who had surgical procedure codes for ESS (N = 3506), followed up between January 2012 and December 2019. Logistic regression models provided adjusted odds ratios (OR) with 95% confidence intervals (CIs) for the odds of revision surgery within one and 3 years post-index surgery.
Results
559 (15.9%) of the patients had at least one revision surgery during the follow-up. Median time to revision of ESS was 425 days (interquartile range: 213–898). Baseline asthma (OR = 1.58, 95% CI 1.17–2.12) and antibiotic use (OR = 1.61, 95% CI 1.27–2.04) were associated with higher odds of revision ESS, particularly within 3 years post-index surgery, whereas Increasing age was inversely associated with the odds of ESS revision (OR = 0.82, 95% CI 0.76–0.88). The highest odds of revision ESS were observed within 3 years post-index surgery in patients who had undergone extensive surgery at index (OR = 14.13, 95% CI 3.41–95.64) compared with those who had undergone limited surgery. OCS use was frequent among CRSwNP patients, with a higher cumulative dose in patients undergoing multiple ESS revisions (63%, n = 97, median daily dose 3.29 mg, IQR: 1.64–3.70) compared with patients without revisions (49%, n = 1361 and 1.64 mg, IQR: 1.64–3.29, respectively. p-value <0.001).
Conclusions
A small proportion of CRSwNP patients require revision ESS with associated high cumulative OCS doses, highlighting the need for additional therapies to achieve disease control and reduce the corticosteroid burden. A few simple baseline characteristics can predict the need for recurrent surgery among the patients with CRSwNP.
{"title":"Predictors of revision endoscopic sinus surgery in Finnish patients with chronic rhinosinusitis with nasal polyps","authors":"Sanna Toppila-Salmi, Annina Lyly, Johanna Simin, Juhani Aakko, Helga Haugom Olsen, Lauri Lehtimäki","doi":"10.1002/clt2.70032","DOIUrl":"10.1002/clt2.70032","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although patients with chronic rhinosinusitis with nasal polyps (CRSwNP) may benefit from endoscopic sinus surgery (ESS), some patients will experience polyp recurrence, adding to the overall disease burden of CRSwNP. We aimed to investigate predictors of revision ESS in patients with CRSwNP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A nationwide population-based study including all adults diagnosed with CRSwNP who had surgical procedure codes for ESS (<i>N</i> = 3506), followed up between January 2012 and December 2019. Logistic regression models provided adjusted odds ratios (OR) with 95% confidence intervals (CIs) for the odds of revision surgery within one and 3 years post-index surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>559 (15.9%) of the patients had at least one revision surgery during the follow-up. Median time to revision of ESS was 425 days (interquartile range: 213–898). Baseline asthma (OR = 1.58, 95% CI 1.17–2.12) and antibiotic use (OR = 1.61, 95% CI 1.27–2.04) were associated with higher odds of revision ESS, particularly within 3 years post-index surgery, whereas Increasing age was inversely associated with the odds of ESS revision (OR = 0.82, 95% CI 0.76–0.88). The highest odds of revision ESS were observed within 3 years post-index surgery in patients who had undergone extensive surgery at index (OR = 14.13, 95% CI 3.41–95.64) compared with those who had undergone limited surgery. OCS use was frequent among CRSwNP patients, with a higher cumulative dose in patients undergoing multiple ESS revisions (63%, <i>n</i> = 97, median daily dose 3.29 mg, IQR: 1.64–3.70) compared with patients without revisions (49%, <i>n</i> = 1361 and 1.64 mg, IQR: 1.64–3.29, respectively. <i>p</i>-value <0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A small proportion of CRSwNP patients require revision ESS with associated high cumulative OCS doses, highlighting the need for additional therapies to achieve disease control and reduce the corticosteroid burden. A few simple baseline characteristics can predict the need for recurrent surgery among the patients with CRSwNP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 2","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bahar Arslan, Murat Türk, Serhat Hayme, Ömür Aydin, Derya Gokmen, Gozde Koycu Buhari, Zeynep Celebi Sozener, Bilun Gemicioglu, Ismet Bulut, Sengul Beyaz, Cihan Orcen, Secil Kepil Ozdemir, Metin Keren, Ebru Damadoglu, Tugce Yakut, Ayse Fusun Kalpaklioglu, Ayse Baccioglu, Sumeyra Alan Yalim, Insu Yilmaz, Ilkay Koca Kalkan, Elif Yelda Ozgun Niksarlioglu, Ali Fuat Kalyoncu, Gul Karakaya, Muge Erbay, Sibel Nayci, Fatma Merve Tepetam, Asli Akkor Gelincik, Hulya Dirol, Ozlem Goksel, Selen Karaoglanoglu, Ferda Oner Erkekol, Sacide Rana Isik, Fusun Yildiz, Yasemin Yavuz, Dilek Karadogan, Nurgul Bozkurt, Ummuhan Seker, Ipek Kivilcim Oguzulgen, Ilknur Basyigit, Serap Argun Baris, Elif Yilmazel Ucar, Tuba Erdogan, Mehmet Polatli, Dane Ediger, Fatma Esra Gunaydin, Leyla Pur, Zeynep Yegin Katran, Yonca Sekibag, Enes Furkan Aykac, Dilsad Mungan, Ozcan Gul, Ali Cengiz, Bulent Akkurt, Seyma Ozden, Semra Demir, Derya Unal, Ayse Feyza Aslan, Ali Can, Reyhan Gumusburun, Gulhan Bogatekin, Hatice Serpil Akten, Sinem Inan, Munevver Erdinc, Aliye Candan Ogus, Murat Kavas, Demet Polat Yulug, Mehmet Erdem Cakmak, Saltuk Bugra Kaya, Gulistan Alpagat, Eylem Sercan Ozgur, Oguz Uzun, Sule Tas Gulen, Gulseren Pekbak, Deniz Kizilirmak, Yavuz Havlucu, Halil Donmez, Gulden Pacaci Cetin, Sadan Soyyigit, Bilge Yilmaz Kara, Gulden Pasaoglu Karakis, Adile Berna Dursun, Resat Kendirlinan, Ayse Bilge Ozturk, Can Sevinc, Gokcen Omeroglu Simsek, Oznur Abadoglu, Pamir Cerci, Taskin Yucel, Irfan Yorulmaz, Zahide Ciler Tezcaner, Emel Cadalli Tatar, Ahmet Emre Suslu, Serdar Ozer, Engin Dursun, Arzu Yorgancioglu, Gulfem Elif Celik, Mehmet Atilla Uysal
Background
Asthma is one of the most common causes of chronic respiratory disease, and countries with low socioeconomic status have both a high prevalence of asthma and asthma-related death.
Objective
In this study, we aimed to determine socioeconomic levels of asthmatic patients according to a national database and investigate the effects of social markers on disease control in our region.
Methods
This is an analysis of data from 2053 adult asthma patients from a multicentre chart study in Turkey. Socioeconomic status (SES) data were collected from questionnaires and this form was sent to the patients via e-mail. Parameters related to social status and poor disease control were analyzed.
Results
Illiteracy (OR:2.687 [95% CI: 1.235–5.848]; p = 0.013) and lower household income (OR:1,76 [95% CI: 1.002–3.09]; p = 0.049) were found as independent risk factors for hospitalization in the multivariate logistic regression analysis. Therewithal, being aged between 40 and 60 (OR: 1.435 [95% CI: 1.074–1.917]; p = 0.015), illiteracy (OR: 2.188 [95% CI: 1.262–3.795]; p = 0.005) and being employed (OR: 1.466 [95% CI: 1.085–1.847]; p = 0.011) were considered as independent risk factors for systemic corticosteroid use at least 3 days within last 1 year.
Conclusion
As a result of our national database, education level, household income and working status briefly socioeconomic status have impacts on asthma control. Identification of social markers in asthma and better recognition of risk factors based on the population gives us clues to provide better asthma control in the future.
{"title":"Socioeconomic status has direct impact on asthma control: Turkish adult asthma registry","authors":"Bahar Arslan, Murat Türk, Serhat Hayme, Ömür Aydin, Derya Gokmen, Gozde Koycu Buhari, Zeynep Celebi Sozener, Bilun Gemicioglu, Ismet Bulut, Sengul Beyaz, Cihan Orcen, Secil Kepil Ozdemir, Metin Keren, Ebru Damadoglu, Tugce Yakut, Ayse Fusun Kalpaklioglu, Ayse Baccioglu, Sumeyra Alan Yalim, Insu Yilmaz, Ilkay Koca Kalkan, Elif Yelda Ozgun Niksarlioglu, Ali Fuat Kalyoncu, Gul Karakaya, Muge Erbay, Sibel Nayci, Fatma Merve Tepetam, Asli Akkor Gelincik, Hulya Dirol, Ozlem Goksel, Selen Karaoglanoglu, Ferda Oner Erkekol, Sacide Rana Isik, Fusun Yildiz, Yasemin Yavuz, Dilek Karadogan, Nurgul Bozkurt, Ummuhan Seker, Ipek Kivilcim Oguzulgen, Ilknur Basyigit, Serap Argun Baris, Elif Yilmazel Ucar, Tuba Erdogan, Mehmet Polatli, Dane Ediger, Fatma Esra Gunaydin, Leyla Pur, Zeynep Yegin Katran, Yonca Sekibag, Enes Furkan Aykac, Dilsad Mungan, Ozcan Gul, Ali Cengiz, Bulent Akkurt, Seyma Ozden, Semra Demir, Derya Unal, Ayse Feyza Aslan, Ali Can, Reyhan Gumusburun, Gulhan Bogatekin, Hatice Serpil Akten, Sinem Inan, Munevver Erdinc, Aliye Candan Ogus, Murat Kavas, Demet Polat Yulug, Mehmet Erdem Cakmak, Saltuk Bugra Kaya, Gulistan Alpagat, Eylem Sercan Ozgur, Oguz Uzun, Sule Tas Gulen, Gulseren Pekbak, Deniz Kizilirmak, Yavuz Havlucu, Halil Donmez, Gulden Pacaci Cetin, Sadan Soyyigit, Bilge Yilmaz Kara, Gulden Pasaoglu Karakis, Adile Berna Dursun, Resat Kendirlinan, Ayse Bilge Ozturk, Can Sevinc, Gokcen Omeroglu Simsek, Oznur Abadoglu, Pamir Cerci, Taskin Yucel, Irfan Yorulmaz, Zahide Ciler Tezcaner, Emel Cadalli Tatar, Ahmet Emre Suslu, Serdar Ozer, Engin Dursun, Arzu Yorgancioglu, Gulfem Elif Celik, Mehmet Atilla Uysal","doi":"10.1002/clt2.70018","DOIUrl":"10.1002/clt2.70018","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Asthma is one of the most common causes of chronic respiratory disease, and countries with low socioeconomic status have both a high prevalence of asthma and asthma-related death.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>In this study, we aimed to determine socioeconomic levels of asthmatic patients according to a national database and investigate the effects of social markers on disease control in our region.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is an analysis of data from 2053 adult asthma patients from a multicentre chart study in Turkey. Socioeconomic status (SES) data were collected from questionnaires and this form was sent to the patients via e-mail. Parameters related to social status and poor disease control were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Illiteracy (OR:2.687 [95% CI: 1.235–5.848]; <i>p</i> = 0.013) and lower household income (OR:1,76 [95% CI: 1.002–3.09]; <i>p</i> = 0.049) were found as independent risk factors for hospitalization in the multivariate logistic regression analysis. Therewithal, being aged between 40 and 60 (OR: 1.435 [95% CI: 1.074–1.917]; <i>p</i> = 0.015), illiteracy (OR: 2.188 [95% CI: 1.262–3.795]; <i>p</i> = 0.005) and being employed (OR: 1.466 [95% CI: 1.085–1.847]; <i>p</i> = 0.011) were considered as independent risk factors for systemic corticosteroid use at least 3 days within last 1 year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>As a result of our national database, education level, household income and working status briefly socioeconomic status have impacts on asthma control. Identification of social markers in asthma and better recognition of risk factors based on the population gives us clues to provide better asthma control in the future.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Danielle E. Medek, Constance H. Katelaris, Andelija Milic, Paul J. Beggs, Edwin R. Lampugnani, Don Vicendese, Bircan Erbas, Janet M. Davies
Background
Globally, many pollen monitoring networks provide the community with daily pollen information, but there are limited data on health consumer uses and benefits. This research investigated why individuals in the community access pollen information, how they use it, and the perceived benefits.
Methods
In- and post-pollen season surveys (2017–2018 and 2018–2019) enquired about symptoms, diagnoses, symptom management, access, benefits and usefulness of pollen information provided by the AusPollen Partnership. Open text responses were examined by thematic analysis. Theme frequency and quantitative data were compared across pollen seasons, within and after the season, and between respondents with and without access to AusPollen information.
Results
Surveys were completed 4044 times by 3604 individuals who predominantly self-reported severe and frequent allergic rhinitis symptoms. Local AusPollen information was accessible to 84.6% of participants, and was reportedly used for preparation and planning (34.6%), guiding activities (32.9%), and medication decisions (28.2%). When asked how pollen information helped, similar themes were evident; but 16.1% also mentioned safety for themselves and others. However, secondary analysis of survey responses indicated that self-reported medication use did not differ between those with or without access to pollen information or between time points surveyed. Suggestions for improvement included extended duration (16.4%), wider geographic range (13.5%), and information on other taxa (17.2%).
Conclusion
There was a perceived need for localised, detailed and timely pollen information by people with pollen allergy. Whilst responses suggested this helped inform behaviours linked to allergen avoidance, further education strategies on allergic rhinitis control are needed to support patients who self-manage their condition.
{"title":"Aerobiology matters: Why people in the community access pollen information and how they use it","authors":"Danielle E. Medek, Constance H. Katelaris, Andelija Milic, Paul J. Beggs, Edwin R. Lampugnani, Don Vicendese, Bircan Erbas, Janet M. Davies","doi":"10.1002/clt2.70031","DOIUrl":"10.1002/clt2.70031","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Globally, many pollen monitoring networks provide the community with daily pollen information, but there are limited data on health consumer uses and benefits. This research investigated why individuals in the community access pollen information, how they use it, and the perceived benefits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In- and post-pollen season surveys (2017–2018 and 2018–2019) enquired about symptoms, diagnoses, symptom management, access, benefits and usefulness of pollen information provided by the AusPollen Partnership. Open text responses were examined by thematic analysis. Theme frequency and quantitative data were compared across pollen seasons, within and after the season, and between respondents with and without access to AusPollen information.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Surveys were completed 4044 times by 3604 individuals who predominantly self-reported severe and frequent allergic rhinitis symptoms. Local AusPollen information was accessible to 84.6% of participants, and was reportedly used for preparation and planning (34.6%), guiding activities (32.9%), and medication decisions (28.2%). When asked how pollen information helped, similar themes were evident; but 16.1% also mentioned safety for themselves and others. However, secondary analysis of survey responses indicated that self-reported medication use did not differ between those with or without access to pollen information or between time points surveyed. Suggestions for improvement included extended duration (16.4%), wider geographic range (13.5%), and information on other taxa (17.2%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There was a perceived need for localised, detailed and timely pollen information by people with pollen allergy. Whilst responses suggested this helped inform behaviours linked to allergen avoidance, further education strategies on allergic rhinitis control are needed to support patients who self-manage their condition.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ya-Ting Li, Qi-Qing Ye, Ya-Xin Lu, Ke-Xin Yang, Ping-Ping Zhang, Chang Chen, Min Zhou, Pei-Ying Feng, Zhuang-Gui Chen
Background
Allergic rhinitis (AR) multimorbidity may need to be considered a specific disease because of distinct clinical and immunological differences from AR alone. Allergic multimorbidity often involves polysensitization, where allergen-specific immunoglobulin E (IgE) plays a significant role.
Objective
This study aims to explore differences in allergen IgE sensitization patterns between AR alone and AR multimorbidity.
Methods
A real-world case-control study was conducted with patients diagnosed with AR. Multivariate logistic regression analyzed the associations between AR multimorbidity and allergen sensitivity, allergen-specific IgE levels, and the count of positive allergens.
Results
A cohort of 2275 patients with AR was included, of which 1100 (48.4%) presented with AR alone, while 1175 (51.6%) exhibited AR multimorbidity. Patients with AR multimorbidity had a more diverse allergen profile than those with AR alone. An increased number of positive ingested allergens had a higher odds ratio (OR) for AR multimorbidity compared with inhaled allergens (1.46 vs. 1.96) across all phenotypes. Sensitization to allergens and their allergen-specific IgE levels, including dust mites, cat dander, and milk (p < 0.05), were associated with AR multimorbidity. In children, cat and dog dander were significant allergens associated with AR multimorbidity (p < 0.05).
Conclusions
Allergen sensitization patterns in AR multimorbidity differ from those in AR alone. Polysensitization, particularly to ingested allergens, increases the risk of allergic multimorbidity. The risk of allergic multimorbidity also increases with specific allergen positivity and higher allergen-specific IgE levels.
{"title":"Allergen sensitization patterns: Allergic rhinitis with multimorbidity versus alone—A real-world study","authors":"Ya-Ting Li, Qi-Qing Ye, Ya-Xin Lu, Ke-Xin Yang, Ping-Ping Zhang, Chang Chen, Min Zhou, Pei-Ying Feng, Zhuang-Gui Chen","doi":"10.1002/clt2.70030","DOIUrl":"10.1002/clt2.70030","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Allergic rhinitis (AR) multimorbidity may need to be considered a specific disease because of distinct clinical and immunological differences from AR alone. Allergic multimorbidity often involves polysensitization, where allergen-specific immunoglobulin E (IgE) plays a significant role.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to explore differences in allergen IgE sensitization patterns between AR alone and AR multimorbidity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A real-world case-control study was conducted with patients diagnosed with AR. Multivariate logistic regression analyzed the associations between AR multimorbidity and allergen sensitivity, allergen-specific IgE levels, and the count of positive allergens.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A cohort of 2275 patients with AR was included, of which 1100 (48.4%) presented with AR alone, while 1175 (51.6%) exhibited AR multimorbidity. Patients with AR multimorbidity had a more diverse allergen profile than those with AR alone. An increased number of positive ingested allergens had a higher odds ratio (OR) for AR multimorbidity compared with inhaled allergens (1.46 vs. 1.96) across all phenotypes. Sensitization to allergens and their allergen-specific IgE levels, including dust mites, cat dander, and milk (<i>p</i> < 0.05), were associated with AR multimorbidity. In children, cat and dog dander were significant allergens associated with AR multimorbidity (<i>p</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Allergen sensitization patterns in AR multimorbidity differ from those in AR alone. Polysensitization, particularly to ingested allergens, increases the risk of allergic multimorbidity. The risk of allergic multimorbidity also increases with specific allergen positivity and higher allergen-specific IgE levels.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143021648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Indrashis Podder, David Pesqué, Nerea Carrón, Pedro Iñaki González Torres, Ramon M. Pujol, Ana M. Giménez-Arnau
Background
Gut microbial involvement has been speculated in chronic spontaneous urticaria (CSU). The aim of the study was to compare the gut microbiome composition and diversity in CSU patients uncontrolled with second-generation antihistamines (sgAHs) and healthy individuals, as well as to explore any association between gut microbiome and disease characteristics.
Methods
A cross-sectional case-control study including 20 CSU patients unresponsive to standard doses of sgAHs, and 15 age-and-sex matched healthy controls was conducted. Clinico-demographic profile, laboratory investigations and stool analysis were conducted in all study participants. 16S RNA gene sequencing and DNA isolation was performed for all stool samples, followed by bioinformatic analysis.
Results
The CSU patients (mean age 39.5 ± 9.3, M:F 1:4) and healthy controls (mean age 35 ± 13, M:F 1:2) were statistically comparable. The median (IQR) duration of CSU was 42 months (7–81). Concomitant angioedema and concomitant symptomatic dermographism were present in 30% and 20% CSU patients, respectively. At inclusion, 60% patients were receiving add-on omalizumab, while the remaining 40% were on up-dosed sgAHs. Stool microbial analysis revealed increased diversity and higher microbial richness in CSU patients compared with healthy individuals. CSU patients showed reduced load of short-chain fatty acid (SCFA) producing microbiota and increased load of opportunistic pathogens. The Firmicutes/Bacteroides (F/B) ratio was higher in CSU patients. Among CSU patients, higher Bacteroides and reduced Firmicutes count were associated with higher disease activity and poor control; however, there was no link with the type of therapy.
Conclusion
Gut microbial dysbiosis is seen in CSU and is linked with disease control.
{"title":"Gut microbial alteration in chronic spontaneous urticaria unresponsive to second generation antihistamines and its correlation with disease characteristics- a cross-sectional case-control study","authors":"Indrashis Podder, David Pesqué, Nerea Carrón, Pedro Iñaki González Torres, Ramon M. Pujol, Ana M. Giménez-Arnau","doi":"10.1002/clt2.70027","DOIUrl":"10.1002/clt2.70027","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Gut microbial involvement has been speculated in chronic spontaneous urticaria (CSU). The aim of the study was to compare the gut microbiome composition and diversity in CSU patients uncontrolled with second-generation antihistamines (sgAHs) and healthy individuals, as well as to explore any association between gut microbiome and disease characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional case-control study including 20 CSU patients unresponsive to standard doses of sgAHs, and 15 age-and-sex matched healthy controls was conducted. Clinico-demographic profile, laboratory investigations and stool analysis were conducted in all study participants. 16S RNA gene sequencing and DNA isolation was performed for all stool samples, followed by bioinformatic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The CSU patients (mean age 39.5 ± 9.3, M:F 1:4) and healthy controls (mean age 35 ± 13, M:F 1:2) were statistically comparable. The median (IQR) duration of CSU was 42 months (7–81). Concomitant angioedema and concomitant symptomatic dermographism were present in 30% and 20% CSU patients, respectively. At inclusion, 60% patients were receiving add-on omalizumab, while the remaining 40% were on up-dosed sgAHs. Stool microbial analysis revealed increased diversity and higher microbial richness in CSU patients compared with healthy individuals. CSU patients showed reduced load of short-chain fatty acid (SCFA) producing microbiota and increased load of opportunistic pathogens. The Firmicutes/Bacteroides (F/B) ratio was higher in CSU patients. Among CSU patients, higher Bacteroides and reduced Firmicutes count were associated with higher disease activity and poor control; however, there was no link with the type of therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Gut microbial dysbiosis is seen in CSU and is linked with disease control.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wenting Zhou, Huan Chen, Xinyu Chen, Jing Gao, Wenting Ji
Background
Asthma is currently one of the most common of respiratory diseases, severely affecting the lives of patients. With the in-depth study of the role of the nervous system and sex hormones on the development of asthma, it has been found that the nervous system and sex hormones are related to each other in the pathway of asthma.
Objective
To investigate the effects of sex hormones and the nervous system on the development of asthma.
Methods
In this review, we searched for a large number of relevant literature to elucidate the unique mechanisms of sex hormones and the nervous system on asthma development, and summarized several common targets in the pathways of sex hormones and the nervous system on asthma.
Conclusion
We summarize several common important targets in the pathways of action of sex hormones and the nervous system in asthma, provide new directions and ideas for asthma treatment, and discuss current therapeutic limitations and future possibilities. Finally, the article predicts future applications of several important targets in asthma therapy.
{"title":"Recent advances in research on common targets of neurological and sex hormonal influences on asthma","authors":"Wenting Zhou, Huan Chen, Xinyu Chen, Jing Gao, Wenting Ji","doi":"10.1002/clt2.70022","DOIUrl":"10.1002/clt2.70022","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Asthma is currently one of the most common of respiratory diseases, severely affecting the lives of patients. With the in-depth study of the role of the nervous system and sex hormones on the development of asthma, it has been found that the nervous system and sex hormones are related to each other in the pathway of asthma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the effects of sex hormones and the nervous system on the development of asthma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this review, we searched for a large number of relevant literature to elucidate the unique mechanisms of sex hormones and the nervous system on asthma development, and summarized several common targets in the pathways of sex hormones and the nervous system on asthma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We summarize several common important targets in the pathways of action of sex hormones and the nervous system in asthma, provide new directions and ideas for asthma treatment, and discuss current therapeutic limitations and future possibilities. Finally, the article predicts future applications of several important targets in asthma therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Oliver Pfaar, Anju T. Peters, Camille Taillé, Thijs Teeling, Jared Silver, Robert Chan, Peter W. Hellings
Background
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a recurrent inflammatory disease associated with several comorbidities and a significant disease burden for patients. Treatments include corticosteroids and sinonasal surgery, but these can be associated with the risk of adverse events and nasal polyp recurrence. Biologic treatments such as mepolizumab can be used as an add-on treatment and are effective at reducing surgery and corticosteroid use.
Main text
Patients with CRSwNP may be seen by a specialist in one of several different areas and often experience delayed diagnosis due to the need to see multiple physicians, as well as misdiagnosis resulting from lack of sufficient expertise within any one speciality. Multidisciplinary team (MDT) approaches have been shown to be effective in optimising the treatment and clinical management of other respiratory diseases, such as aspirin-exacerbated respiratory disease and severe asthma. In CRSwNP, an MDT approach may reduce diagnostic delays, mitigate secondary disease burden, and reduce overprescription of corticosteroids and antibiotics.
Conclusion
This article provides an overview of the patient perspective of MDTs, existing approaches and barriers to adoption, lessons learnt from allied and rare diseases, how to address under-recognised aspects of CRSwNP, and other key considerations for developing an MDT approach.
{"title":"Chronic rhinosinusitis with nasal polyps: Key considerations in the multidisciplinary team approach","authors":"Oliver Pfaar, Anju T. Peters, Camille Taillé, Thijs Teeling, Jared Silver, Robert Chan, Peter W. Hellings","doi":"10.1002/clt2.70010","DOIUrl":"10.1002/clt2.70010","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chronic rhinosinusitis with nasal polyps (CRSwNP) is a recurrent inflammatory disease associated with several comorbidities and a significant disease burden for patients. Treatments include corticosteroids and sinonasal surgery, but these can be associated with the risk of adverse events and nasal polyp recurrence. Biologic treatments such as mepolizumab can be used as an add-on treatment and are effective at reducing surgery and corticosteroid use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main text</h3>\u0000 \u0000 <p>Patients with CRSwNP may be seen by a specialist in one of several different areas and often experience delayed diagnosis due to the need to see multiple physicians, as well as misdiagnosis resulting from lack of sufficient expertise within any one speciality. Multidisciplinary team (MDT) approaches have been shown to be effective in optimising the treatment and clinical management of other respiratory diseases, such as aspirin-exacerbated respiratory disease and severe asthma. In CRSwNP, an MDT approach may reduce diagnostic delays, mitigate secondary disease burden, and reduce overprescription of corticosteroids and antibiotics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This article provides an overview of the patient perspective of MDTs, existing approaches and barriers to adoption, lessons learnt from allied and rare diseases, how to address under-recognised aspects of CRSwNP, and other key considerations for developing an MDT approach.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142963242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carl Skröder, Laila Hellkvist, Ulla Westin, Pernilla Sahlstrand-Johnsson, Kerstin Hansson, Agneta Karlsson, Åslög Dahl, Leif Bjermer, Lars Olaf Cardell
Background
Seasonal allergic rhinitis (AR) impacts public health by affecting work productivity and quality of life. The Swedish tree pollen season starts in February with alder and hazel pollination, followed by birch and ends with oak in May. Systemic corticosteroids are often prescribed when topical treatments fail, despite limited evidence supporting their efficacy.
Objective
To compare the effectiveness of prednisolone tablets versus antihistamine tablets in reducing symptoms and medication usage in patients with moderate to severe tree pollen-induced AR.
Methods
This interventional single-center, double-blinded randomized trial included 34 patients. Treatment was initiated, and symptoms were registered during the tree pollen season. The two groups received either prednisolone tablets (20 mg) or ebastine tablets (20 mg) for 7 days. Treatment effects were evaluated by comparing daily symptom scores, use of topical medication, and a combined symptom-medical score between the groups. Quality of life was recorded at the start and after 3 weeks.
Results
Both interventions demonstrated efficacy in enhancing quality of life metrics. The area under the curve (AUC) for the combined symptom severity and medication usage score averaged 34.0 (SD = 19.1, 95% CI = 24.5–43.4) in the group treated with prednisolone. This was marginally lower than the control group, with an AUC of 32.6 (SD = 13.2, 95% CI = 25.6–39.7). The difference was not statistically significant (p = 0.80). Both groups exhibited only mild adverse events, which were statistically comparable in frequency and severity.
Conclusions
Prednisolone tablets did not show superior efficacy over antihistamine tablets in reducing symptoms or medication usage in tree pollen-induced AR. These results suggest that systemic corticosteroids may not provide additional benefits over antihistamines, and clinicians should prioritize individualized treatment based on patient preferences and tolerability.
背景：季节性变应性鼻炎（AR）通过影响工作效率和生活质量影响公众健康。瑞典树木的花粉季节从2月份的桤木和榛子授粉开始，接着是桦树授粉，5月份以橡树授粉结束。当局部治疗失败时，尽管支持其疗效的证据有限，但通常会开全身性皮质类固醇。目的：比较强的松龙片与抗组胺片在减轻中重度树花粉性急性呼吸道感染患者症状和用药方面的疗效。方法：采用介入性单中心、双盲随机试验，纳入34例患者。开始治疗，并在树花粉季节记录症状。两组患者分别服用强的松龙片（20mg）或依巴斯汀片（20mg），疗程7 d。通过比较两组之间的每日症状评分、局部用药的使用以及症状-医学综合评分来评估治疗效果。在治疗开始时和3周后分别记录患者的生活质量。结果：两种干预措施均显示出提高生活质量指标的有效性。强的松龙治疗组症状严重程度与用药综合评分的曲线下面积（AUC）平均为34.0 （SD = 19.1, 95% CI = 24.5-43.4）。这比对照组略低，AUC为32.6 （SD = 13.2, 95% CI = 25.6-39.7）。差异无统计学意义（p = 0.80）。两组均表现出轻微的不良事件，在频率和严重程度上具有统计学可比性。结论：泼尼松龙片在减轻树花粉引起的AR的症状或药物使用方面并没有表现出比抗组胺片更优的疗效。这些结果表明，全身皮质类固醇可能没有比抗组胺药提供额外的益处，临床医生应根据患者的偏好和耐受性优先考虑个体化治疗。
{"title":"Prednisolone versus antihistamine for allergic rhinitis: No significant difference found in randomized trial","authors":"Carl Skröder, Laila Hellkvist, Ulla Westin, Pernilla Sahlstrand-Johnsson, Kerstin Hansson, Agneta Karlsson, Åslög Dahl, Leif Bjermer, Lars Olaf Cardell","doi":"10.1002/clt2.70017","DOIUrl":"10.1002/clt2.70017","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Seasonal allergic rhinitis (AR) impacts public health by affecting work productivity and quality of life. The Swedish tree pollen season starts in February with alder and hazel pollination, followed by birch and ends with oak in May. Systemic corticosteroids are often prescribed when topical treatments fail, despite limited evidence supporting their efficacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare the effectiveness of prednisolone tablets versus antihistamine tablets in reducing symptoms and medication usage in patients with moderate to severe tree pollen-induced AR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This interventional single-center, double-blinded randomized trial included 34 patients. Treatment was initiated, and symptoms were registered during the tree pollen season. The two groups received either prednisolone tablets (20 mg) or ebastine tablets (20 mg) for 7 days. Treatment effects were evaluated by comparing daily symptom scores, use of topical medication, and a combined symptom-medical score between the groups. Quality of life was recorded at the start and after 3 weeks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Both interventions demonstrated efficacy in enhancing quality of life metrics. The area under the curve (AUC) for the combined symptom severity and medication usage score averaged 34.0 (SD = 19.1, 95% CI = 24.5–43.4) in the group treated with prednisolone. This was marginally lower than the control group, with an AUC of 32.6 (SD = 13.2, 95% CI = 25.6–39.7). The difference was not statistically significant (<i>p</i> = 0.80). Both groups exhibited only mild adverse events, which were statistically comparable in frequency and severity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Prednisolone tablets did not show superior efficacy over antihistamine tablets in reducing symptoms or medication usage in tree pollen-induced AR. These results suggest that systemic corticosteroids may not provide additional benefits over antihistamines, and clinicians should prioritize individualized treatment based on patient preferences and tolerability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11717555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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