Efficacy of allergen immunotherapy in reducing the likelihood of developing new allergen sensitizations: a systematic review.

BACKGROUND: Guidelines and position papers indicate that allergen immunotherapy (AIT) is the only disease-modifying treatment, including prevention of the onset of new allergen sensitizations. However, this preventive effect was shown by only a few observational studies. Our aim was to systematically review the efficacy of AIT in preventing the onset of new allergen sensitizations. METHODS: Computerized bibliographic searches of Medline, EMBASE, and the Cochrane Library (through June 2015) were supplemented with manual searches of reference lists. Observational studies or randomized controlled trials with a long-term observation period were included. Paired reviewers extracted data about study characteristics and assessed biases. The end point was the risk difference in the onset of new allergen sensitizations between patients treated with AIT and pharmacotherapy. The strength of the evidence was graded based on the risk of bias, consistency, and magnitude of effect, according to the GRADE Working Group's guide. RESULTS: Eighteen studies (1049 children, 10 057 adults) met the inclusion criteria. The risk of bias was high in all but one study. Low evidence supports the position that AIT prevents the onset of new allergen sensitizations, with 10 of 18 studies reporting a reduction in the onset of new sensitizations in patients treated with AIT vs placebo. Small studies and studies with a shorter follow-up showed the highest benefit of AIT. CONCLUSIONS: The overall evidence provides a low-grade level of the evidence supporting the efficacy of AIT in preventing the onset of new allergen sensitizations, but high-quality studies could change this estimate.

Differences in the behavior of advanced glycation end products and advanced oxidation protein products in patients with allergic rhinitis.

BACKGROUND: The presence of oxidative stress in patients with asthma is well documented; however, the role of oxidative stress in allergic rhinitis has received less attention, although it is likely to be similar to that observed in patients with asthma. Advanced glycation end products (AGEs) and advanced oxidation protein products (AOPPs) are compounds formed by the transformation of macromolecules, including proteins, which can serve as densitometric markers of oxidative stress and inflammation in several diseases. OBJECTIVE: The aim of this study was to investigate the role of AGEs and AOPPs as new markers of oxidative stress and inflammation in patients affected by allergic rhinitis. METHODS: AGE and AOPP levels were determined in the sera of 25 patients with allergic rhinitis and 64 healthy controls. AGEs and AOPPs were detected using spectrofluorimetry and spectrophotometry, respectively. RESULTS: AGE levels in patients were significantly higher than those in controls (P < .0001). These levels were not affected by the presence of asthma. No statistically significant differences were found between AOPP levels in patients or controls (P = .38). CONCLUSIONS: Formation of AGEs and AOPPs may be accelerated in immunological and respiratory disorders such as asthma. Depending on the marker evaluated, the presence or absence of oxidative stress in allergic rhinitis is controversial. To our knowledge, this is the first study showing the possible involvement of AGEs in allergic rhinitis. The different behavior observed for these 2 biomarkers is very likely due to the activation of specific related biochemical pathways (eg, the myeloperoxidase pathway) associated with the condition under study.

Differences in the Behavior of Advanced Glycation End Products and Advanced Oxidation Protein Products in Patients With Allergic Rhinitis

Antecedentes: La presencia de estrés oxidativo en pacientes con asma bronquial ha sido bien documentada, sin embargo el papel del estrés oxidativo en las rinitis alérgicas no ha sido estudiado. Los productos finales de la glicación avanzada (AGEs), y los productos de la oxidación avanzada de proteínas (AOPPs) son compuestos formados por la transformación de macromoléculas, incluyendo proteínas, que pueden servir como marcadores densitométricos del estrés oxidativo y de la inflación en diferentes enfermedades. Objetivos: El motivo de este estudio fue investigar el papel de AGEs y AOPPs como nuevos marcadores del estrés oxidativo en la rinitis alérgica. Métodos: Estos marcadores fueron analizados en 25 pacientes con rinitis alérgica y en 64 sujetos sanos, mediante métodos de espectrofluorometría y espectrofotometría respectivamente. Resultados: Los resultados confirman la existencia de niveles elevados de AGEs en pacientes respecto a los controles sanos (p<0.0001). Estos niveles no se vieron influenciados por la presencia de asma. No encontramos diferencias significativas entre los niveles de AOPPs en pacientes y controles (p=0.38). Conclusiones: La formación de AGEs y AOPPs podría dispararse en alteraciones inmunológicas y patologías respiratorias tales como el asma bronquial. La presencia o no de estrés oxidativo en la rinitis alérgica es tema de controversia y depende del marcador evaluado. Este es el primer estudio que demuestra la posible implicación de AGEs en la rinitis alérgica. El diferente comportamiento observado para estos dos biomarcadores podría ser debido a las vías bioquímicas específicas (por ejemplo la vía de la mieloperoxidasa) relacionadas con la condición patológica bajo estudio (AU)

Background: The presence of oxidative stress in patients with asthma is well documented; however, the role of oxidative stress in allergic rhinitis has received less attention, although it is likely to be similar to that observed in patients with asthma. Advanced glycation end products (AGEs) and advanced oxidation protein products (AOPPs) are compounds formed by the transformation of macromolecules, including proteins, which can serve as densitometric markers of oxidative stress and inflammation in several diseases. Objective: The aim of this study was to investigate the role of AGEs and AOPPs as new markers of oxidative stress and inflammation in patients affected by allergic rhinitis. Methods: AGE and AOPP levels were determined in the sera of 25 patients with allergic rhinitis and 64 healthy controls. AGEs and AOPPs were detected using spectrofluorimetry and spectrophotometry, respectively. Results: AGE levels in patients were significantly higher than those in controls (P<.0001). These levels were not affected by the presence of asthma. No statistically significant differences were found between AOPP levels in patients or controls (P=.38). Conclusions: Formation of AGEs and AOPPs may be accelerated in immunological and respiratory disorders such as asthma. Depending on the marker evaluated, the presence or absence of oxidative stress in allergic rhinitis is controversial. To our knowledge, this is the first study showing the possible involvement of AGEs in allergic rhinitis. The different behavior observed for these 2 biomarkers is very likely due to the activation of specific related biochemical pathways (eg, the myeloperoxidase pathway) associated with the condition under study (AU)