Epidemiological investigation of allergic rhinitis in central cities and countrysides of Inner Mongolia region / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the prevalence of allergic rhinitis (AR) in 3 central cities (Chifeng, Hohhot, Ordos) and the surrounding rural areas of Inner Mongolia region, and to look for possible risk factors related to the disease. Methods: From March to October of 2019, a multi-stage stratified random sampling epidemiological survey was conducted in Chifeng, Hohhot, Ordos and rural areas. The AR-related factors of the population were obtained in the form of face-to-face questionnaire survey, and the skin prick test (SPT) was taken for the participants. AR disease was diagnosed according to the "Guidelines for the Diagnosis and Treatment of Allergic Rhinitis (2015, Tianjin)". The daily airborne pollen situation in the three regions was monitored during the same period. SPSS 23.0 was used to analyze all survey results. Results: A total of 6 818 questionnaires were recovered, with 6 393 valid questionnaires. The self-reported prevalence of AR was 27.72% (1 772/6 393) and the confirmed prevalence of AR was 17.10% (1 093/6 393). The prevalence of perennial AR was 1.83% (117/6 393) while the prevalence of seasonal AR was 15.27% (976/6 393). The prevalence of AR diagnosed in females was higher than that in males (19.19% vs 15.34%, χ²=16.594, P<0.001) and the prevalence of females in the two age groups of 36-45 years and 46-55 years was significantly higher than that of males (18.17% vs 9.73%, 14.13% vs 7.25%, χ2 value was 23.848, 18.772, respectively, all P<0.001). The prevalence of confirmed diagnoses in ethnic minorities was higher than that of Han nationality, and the prevalence of confirmed diagnoses in urban areas was higher than that in rural areas (23.13% vs 16.20%, 27.27% vs 9.71%, χ2 value was 24.516, 336.024, respectively, all P<0.001). The main nasal symptoms of AR patients were sneezing (91.31%), nasal congestion (85.91%) and nasal itching (85.00%). The most common concomitant disease of AR was allergic conjunctivitis (73.99%). Asthma (OR=6.629), food allergy (OR=3.236), drug allergy (OR=1.786), application of antibiotics (OR=1.553), recent home decoration (OR=2.307), and smoking (OR=1.322) were the AR related risk factors. The highest proportion of SPT positive reactions was Artemisia annua (80.15%). The peak period of clinical symptoms of AR patients in Inner Mongolia region was July to September, which was consistent with the second peak period of airborne pollen monitoring. Conclusions: The prevalence of AR in central cities and the surrounding rural areas of Inner Mongolia region is 17.10%, and Artemisia species is the most important pollen allergen in this area. History of asthma, food allergy, drug allergy, antibiotic use, home decoration and smoking history are the related risk factors for AR.

Grading forecast research for pathogenesis of allergic rhinitis directed by meteorological elements / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To analyze the correlation between meteorological factors and onset of allergic rhinitis (AR), and to establish the prediction of AR epideminlogical trend.</p><p><b>METHODS</b>According to skin prick test (SPT) data of AR from Beijing Tongren Hospital and meteorological data of Beijing Observatory (2007 -2010) , analyzed the relationship between meteorological factors and onset in patients with AR. To analyze the probability distribution of onset in AR patients, and establish the grade of AR epideminlogical trend index. SPSS 16. O software was used to analyze the data.</p><p><b>RESULTS</b>The peak of onset in patients with AR appeared in 15 - 30 th August. There was significant correlation between the onset of AR patients and air temperature and vapor pressure(r = 0. 7473, F = 206. 13; r =0. 8465, F = 321. 04; all P < 0. 001) , and the peak of air temperature and vapor pressure were one month earlier than the peak of onset AR patients in 4 years. According to the above correlation, nonlinear prediction models of AR were established; used probability grading method, onset index of AR was divided into 4 grades.</p><p><b>CONCLUSION</b>Index grade forecast of AR onset has important guiding significance for AR diagnosis and prophylaxis, offers objective reference information for health departments.</p>

Correlation between symptoms of pollen allergic rhinitis and pollen grain spreading in summer and autumn / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To analyze the correlation between airborne pollen concentrations and symptoms in patients with pollen allergic rhinitis.</p><p><b>METHODS</b>Durhum sampler was used to collect the pollen concentration and species from June to September in 2011. The clinical skin prick test (SPT) data were analyzed. The patients with pollen allergic rhinitis were divided into pure pollen allergic rhinitis group (pollen group) and pollen combined perennial allergens allergic rhinitis group (combined group). Symptom scores of patients were assessed, and correlation between pollen concentration and onset of symptoms of patients were analyzed. SPSS 16.0 software was used to analyse the data.</p><p><b>RESULTS</b>While the peak of Summer-Autumn pollen concentration appeared from August 20 to September 15, the major pollen included Artemisia L, Chenopodium album and Humulus scandens. The peak of pollen concentration in one day reached 638/1000 mm(2). The patients taken SPT from June to September accounted for 51.9% of the patients in whole year, among which SPT pollen positive patients were 1509, 60.7% of all SPT positive patients. The amount and rate of SPT positive patients showed significant correlation with pollen concentration(r value were 0.90 and 0.99, both P < 0.05). Onset of symptoms in two groups was correlated with pollen concentration in Summer-Autumn. Symptoms of cough in combined group showed more severe compared with patients with pollen group (t = 2.36, P < 0.05).</p><p><b>CONCLUSIONS</b>Pollen concentration has a major effect on onset of symptoms of allergic rhinitis. Airborne pollen monitoring has important preventive and therapeutic significance on patients with allergic rhinitis.</p>

Long-term efficacy of Dermatophagoides pteronyssinus immunotherapy in patients with allergic rhinitis: a 3-year prospective study / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the long-term efficacy of subcutaneous immunotherapy with Dermatophagoides pteronyssinus (DerP) in patients with allergic rhinitis.</p><p><b>METHODS</b>Ninety-two patients with allergic rhinitis to DerP were randomly allocated to receive either specific immunotherapy (n = 46) or medical treatment (n = 46). Symptom and medication scores and skin response to Derp were assessed to evaluate the clinical efficacy in the baseline and after three years treatment. DerP-specific IgE and IgG4 were measured.</p><p><b>RESULTS</b>After three years treatment, the immunotherapy group showed sustained reductions in symptom scores (before treatment 9.20 [7.50;11.13], after treatment 3.32 [2.49;5.12], Z = -5.13, P < 0.05), medication scores (before treatment 0.72 [0.47;0.83], after treatment 0.31 [0.28;0.45], Z = -5.78, P < 0.05) and specific skin response to Derp (t = 6.37, P < 0.05) when compared with control group. There were no differences in the level of serum specific IgE before and after three-year treatment (before treatment 16.32 [4.34;38.65] kU/L, after treatment 15.85 [4.93;46.27] kU/L, Z = -0.84, P > 0.05), but the level of serum specific IgG4 increased significantly after one year treatment in immunotherapy group (before treatment 486 [319;1439] AU/L, after treatment 8387 [7732;16 634] AU/L, Z = -2.81, P < 0.05). After three-year treatment, 7.5% (3/40) of patients had asthma in immunotherapy group compared to 27.8% (10/36) in the control group (χ(2) = 5.50, P < 0.05), and 15.0% of the initially DerP nonsensitized patients in immunotherapy group had developed new sensitization compared to 47.2% in the control group (χ(2) = 9.32, P < 0.05).</p><p><b>CONCLUSION</b>Three years immunotherapy improves allergic rhinitis symptoms, increases the level of serum specific IgG4, reduces the development of asthma and new sensitization.</p>

Comparative study on cluster and conventional immunotherapy with Dermatophagoides pteronyssinus in patients with allergic rhinitis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To compare the efficacy and safety of a 6-week cluster schedule of specific immunotherapy with that of a 14-week conventional schedule for the treatment of subjects with persistent allergic rhinitis (AR).</p><p><b>METHODS</b>The trial was a prospective and randomized study involving 80 patients with persistent AR, who were allergic to Dermatophagoides pteronyssinus. While 40 patients were randomly assigned to the cluster schedule reaching the maintenance dose within 6 weeks, the other 40 patients were randomly assigned to the conventional schedule reaching the maintenance dose within 14 weeks. Symptom scores and medication scores were used to evaluate the clinical efficacy. Serum specific IgG4 level was examined to mark immunologic change, adverse reactions were recorded during the treatment.</p><p><b>RESULTS</b>Cluster group achieved clinical efficacy (reducing symptom scores and medication score) and increasing serum specific IgG4 sooner (after 6 weeks treatment). During the incremental dose phase, there were 6 systemic adverse reactions (1.12% of all injection) in 3 patients in cluster group and there were 5 systemic adverse reactions (0.85% of all injection) in 3 patients in conventional group. No severe systemic reactions occurred in both group. There was no difference between the 2 groups in frequency or type of systemic reaction (χ(2) = 0.333, P > 0.05).</p><p><b>CONCLUSION</b>The cluster schedule is a safe alternative to the conventional schedule with the advantage of achieving clinical efficacy sooner.</p>

Clinical efficacy and immunological changes in children with allergic rhinitis receiving specific immunotherapy with Dermatophagoides pteronyssinus / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and immunological changes of children receiving subcutaneous immunotherapy with Dermatophagoides pteronyssinus.</p><p><b>METHODS</b>Sixty-four children with allergic rhinitis to Dermatophagoides pteronyssinus (Der p) were randomly allocated to receive either specific immunotherapy (n = 32) or medical treatment (n = 32). Symptom and medication scores were assessed to evaluate the clinical efficacy in the baseline and after one year treatment. Total IgE, Der p-specific IgE, and specific IgG4 were measured.</p><p><b>RESULTS</b>Immunotherapy reduced the symptom (the scores reduced from 10[9;11] to 4[3;6]) and medication score (the scores reduced from 0.76[0.61;0.90] to 0.35[0.30;0.43]) in children with allergic rhinitis significantly(Z value were -4.80 and -4.74, respectively, each P < 0.01). There was a significant difference in symptom and medication scores between both groups after one year treatment (U value were 155.00 and 139.50, respectively, each P < 0.01). There were no differences in levels of serum total IgE, specific IgE before and after one year treatment, but the level of serum specific IgG4 increased significantly after one year treatment.</p><p><b>CONCLUSIONS</b>Immunotherapy with standardized extract is efficacious to treat children sensitive to Der p, allergen-specific IgG4 is significant as immunological marker to predict efficacy of immunotherapy.</p>