No causal association between allergic rhinitis and migraine: a Mendelian randomization study.

PURPOSE: Allergic rhinitis (AR) and migraine are among the most common public health problems worldwide. Observational studies on the correlation between AR and migraine have reported inconsistent results. This study aimed to investigate the causal relationship of AR with migraine and its subtypes, including migraine with aura (MA) and migraine without aura (MO). METHODS: Bidirectional two-sample Mendelian randomization (MR) analysis was performed with publicly available summary-level statistics of large genome-wide association studies to estimate the possible causal effects. The inverse variance-weighted method was selected for primary analysis and was supplemented with the weighted median, weighted mode, and MR-Egger methods. The causal analysis using summary effect estimates (CAUSE) were further performed to verify the causality. Several sensitivity tests, including the leave-one-out, Cochran's Q, MR-Egger intercept, and MR-PRESSO tests, were performed to assess the robustness of the results. RESULTS: AR did not exhibit a significant causal correlation with the elevated risk of any migraine (odd ratio (OR), 0.816; 95% confidence interval (CI), 0.511-1.302; P = 0.394), MA (OR, 0.690; 95% CI 0.298-1.593; P = 0.384), or MO (OR, 1.022; 95% CI 0.490-2.131; P = 0.954). Consistently, reverse MR analysis did not reveal causal effects of any migraine or its subtypes on AR. Almost all sensitivity analyses supported the robustness of the results. CONCLUSIONS: This MR study did not reveal a clear causal association between AR and migraine risk. More research is warranted to reveal the complex association between AR and migraine.

[A multi-dimensional analysis of pollen broadcasting concerns in Chinese population: a large-scale multi-center cross-sectional survey].

Objective: To investigate the concern about pollen broadcasting in Chinese population from multiple dimensions and to understand the information about allergic rhinitis (AR) in China by analyzing related factors. Methods: From March 1 to September 30, 2022, a large-scale multi-center cross-sectional survey was conducted based on the Questionnaire Star platform in 21 Chinese hospitals. A total of 7 056 subjects from 7 regions in China: Northeast, North, East, Central, South, Southwest, and Northwest China were included. Basic characteristics (including social demographic characteristics and disease characteristics of AR patients), concern about pollen broadcasting, the willingness of pollen-induced AR (PiAR) patients to receive pollen broadcasting, and the treatment satisfaction rate of AR patients were collected. The chi-square test, multivariate linear regression model, and Logistic regression analysis were used to analyze the concern about pollen broadcasting in the Chinese population and related factors from multiple dimensions. Results: Among 7 056 subjects, 23.02% were concerned about pollen broadcasting. Among 3 176 self-reported AR and 1 019 PiAR patients, 25.60% and 39.16% were concerned about pollen broadcasting, respectively, which was higher than that of non-AR or non-PiAR subjects (χ2 value was 21.74 and 175.11, respectively, both P<0.001). Among AR patients, the proportion of spring and autumn allergen-positive patients concerned about pollen broadcasting was higher than that in perennial allergen-positive patients (χ2 value was 20.90 and 19.51, respectively, both P<0.001). The proportion of AR patients with asthma, sinusitis, allergic conjunctivitis, and cardiovascular and cerebrovascular diseases was higher than those without complications (χ2 value was 50.83, 21.97, 56.78, 7.62, respectively, all P<0.05). The proportion of AR patients in North China who could find pollen broadcasting locally was 31.01%, significantly higher than those in other regions (all P<0.05). Multivariate linear regression model analysis showed that among PiAR patients, those with higher per capita household income and higher AR disease cognition levels had been concerned about pollen broadcasting in the past, and those complicated with allergic conjunctivitis had stronger intention to receive pollen broadcasting (B value was 0.24, 0.13, 0.66, 0.47, respectively, all P<0.05). The higher the disease cognition level of PiAR patients, the stronger their willingness to actively participate in treatment (R2=0.72, P<0.001). Only 18.89% of AR patients felt satisfied with the treatment effect. Logistic regression analysis showed that in AR patients, the treatment satisfaction rate was significantly higher among those concerned about pollen broadcasting compared to those who were not (OR=1.83, P<0.001). Conclusions: Currently, the dissemination of pollen broadcasting in China is hindered by various factors such as disease cognition level. The treatment satisfaction among AR patients remains unsatisfactory.

Effects of airborne pollen on allergic rhinitis and asthma across different age groups in Beijing, China.

In the context of global warming and rapid urbanization, pollen has become a significant public health concern for Chinese citizens. However, there is a paucity of epidemiological research on the impact of pollen on allergen-linked diseases, such as allergic rhinitis and asthma, in China. Using data from the Beijing Chaoyang Hospital between 2013 and 2019, which included allergic rhinitis and asthma incidence, meteorological records, and air pollution data, we employed a Generalized Additive Model (GAM) to examine the relationship between overall and type-specific pollen concentrations in relation to varying population exposures. We found that increased overall pollen concentrations significantly increased the risks of allergic rhinitis and asthma in diverse populations. Notably, the risk of allergic rhinitis was higher than that of asthma at equivalent pollen concentrations. Seasonal trends indicated that spring pollen peaks, primarily from trees, were associated with a lower risk of both allergic rhinitis and asthma than autumn peaks, predominantly from weeds. This study underscores the importance of identifying pollen species that pose heightened risks to different demographic groups across seasons, thereby providing targeted interventions for public health agencies.

Examining the Correlation between Allergic Conjunctivitis and Allergic Rhinitis.

Objective: This study aims to assess the correlation between allergic conjunctivitis (AC) and allergic rhinitis (AR). Methods: A total of 462 patients diagnosed with either allergic conjunctivitis or allergic rhinitis and treated at our hospital from January 2018 to December 2020 were included. Patients were categorized into two groups, the AC group and the AR group, based on their initial department of consultation. The AC group comprised 232 patients diagnosed with allergic conjunctivitis in the ophthalmology department, while the AR group consisted of 230 patients diagnosed with allergic rhinitis in the ENT department. Allergen analysis was conducted on patients presenting with both AC and AR and conjunctival and nasal mucosal scrapings were performed to examine eosinophil presence. The study analyzed the association between allergic AC and AR. Results: In the AC group, 174 patients (75.00%) had concurrent AR, while in the AR group, 169 patients (73.48%) had concurrent AC. Inhalant allergen testing among patients with concurrent AC and AR revealed that the primary inhalant allergens were dust mites, house dust, and fungi, with specific immunoglobulin E (IgE) positivity of 91.23%. Testing for food allergens identified fish, shrimp, and crab as ingestive allergens, with a specific IgE positivity of 58.58%. Eosinophil presence was assessed through conjunctival and nasal mucosal scrapings in patients with concurrent AC and AR. Eosinophils were detected in 188 cases (54.81%) through conjunctival scraping and 197 cases (57.43%) through nasal mucosal scraping, with no significant differences observed (P > .05). Conclusions: AC and AR share a common pathophysiological process and allergen profile, with the conjunctiva and nasal mucosa serving as sites of allergic reactions. This study suggests the integration of AC prevention and treatment into AR prevention strategies.

Knowledge, attitudes, and practice towards allergic rhinitis in patients with allergic rhinitis: a cross-sectional study.

BACKGROUND: The knowledge, attitude, and practice (KAP) of Chinese patients with allergic rhinitis (AR) on AR is poorly known. This study investigated the KAP towards AR in patients with this disease and explored the factors associated with KAP. METHODS: This cross-sectional study enrolled patients with AR in Zhangjiagang Hospital of Traditional Chinese Medicine between October 2022 and March 2023. RESULTS: This study included 656 valid questionnaires. Most participants were 26-35 years old (36.13%) and were female (55.18%). The knowledge, attitude, and practice scores were 5.70 ± 2.88 (possible range: 0-12), 29.51 ± 3.52 (possible range: 9-45), and 34.13 ± 7.55 (possible range: 9-45), indicating poor knowledge, unfavorable attitudes, and proactive practice. AR history of 3-5 years (adjusted odds ratio (adjOR) = 1.62, 95% confidence interval (CI): 1.03-2.54, P = 0.037), AR history of > 6 years (adjOR = 1.64, 95%CI: 1.06-2.54, P = 0.027), and know their own allergens (adjOR = 2.34, 95%CI: 1.28-4.25, P = 0.005) were independently associated with the sufficient knowledge. AR history of ≥ 6 years (adjOR = 0.60, 95%CI: 0.37-0.96, P = 0.035), and liking sports (adjOR = 1.58, 95%CI = 1.07-2.33, P = 0.020) were independently associated with the positive attitude. The knowledge scores (adjOR = 1.14, 95%CI: 1.05-1.22, P = 0.001), attitude scores (adjOR = 1.24, 95%CI: 1.17-1.32, P < 0.001), age 36-45 (adjOR = 2.13, 95%CI: 1.19-3.82, P = 0.011), employed (adjOR = 0.59, 95%CI: 0.37-0.94, P = 0.026), and liking sports (adjOR = 2.11, 95%CI: 1.43-3.14, P < 0.001) were independently associated with the proactive practice. CONCLUSIONS: Patients with AR have poor knowledge and unfavorable attitudes but good practice toward AR. Continuous quality teaching interventions and education on patients for AR were recommended.

Prenatal exposure to selenium, mercury, and manganese during pregnancy and allergic diseases in early childhood: The Japan Environment and Children's study.

BACKGROUND: Prenatal exposure to metallic elements may adversely affect early childhood health. However, more evidence is needed as population-based cohort studies are currently limited. OBJECTIVES: We aimed to examine the associations between prenatal metallic (mercury, selenium, and manganese) exposure and the risk of allergic diseases in early childhood until three years of age. METHODS: The data from 94,794 mother-infant pairs, who participated in the Japan Environment and Children's study, were used in this study. Prenatal metallic element exposure was measured in maternal blood collected during mid-pregnancy. The incidence of atopic dermatitis, food allergies, asthma, and allergic rhinitis during the first three years of life was prospectively investigated using self-reports of physician-diagnosed allergies. A multivariable modified Poisson regression model was used to estimate the cumulative incidence ratio and their 95% confidence intervals of allergic diseases associated with prenatal exposure to mercury, selenium, and manganese. We further evaluated the interaction between mercury and selenium exposures in this association. RESULTS: We confirmed 26,238 cases of childhood allergic diseases: atopic dermatitis, food allergies, asthma, and allergic rhinitis in 9,715 (10.3%), 10,897 (11.5%), and 9,857 (10.4%), 4,630 (4.9%), respectively. No association was found between prenatal mercury or manganese exposure and the risk of allergic diseases. Prenatal selenium exposure was inversely associated with atopic dermatitis, food allergies, allergic rhinitis, and any allergic diseases, but not with asthma. These inverse associations were more pronounced for lower mercury exposures than for higher exposures. CONCLUSIONS: Our findings suggest that prenatal exposure to selenium may be beneficial for reducing the risk of atopic dermatitis, food allergies, allergic rhinitis, and any allergic diseases in early childhood, especially with lower prenatal mercury exposure.

Sensitization characteristics in allergic rhinitis and transport pathway for Artemisia pollen in northern Beijing, China.

The genus Artemisia, an important allergen related to Allergic Rhinitis (AR), is widespread in temperate regions. However, the sensitization rate of Artemisia pollen varies significantly, and the source of Artemisia pollen is not clear. Based on continuous daily airborne pollen monitoring in the summer and autumn of 2019 and 2020 in northern Beijing, the daily number of AR patient visits during the same period, and the detection of allergen serum-specific immunoglobulin E (sIgE) in some AR patients, this study discusses the sensitization rate of Artemisia pollen and its transmission pathway and possible source area. The results show that (1) Artemisia pollen is the most important airborne pollen in summer and autumn in northern Beijing, and the pollen concentration is significantly related to the daily number of AR patient visits; (2) the rate of AR patients testing positive for Artemisia pollen allergens is 32.35 %, which is the first risk allergen and is consistent with the high sensitization rate of Artemisia pollen in northern China; and (3) in addition to local sources, central and southern Inner Mongolia, southern Mongolia and northwestern China are potential source areas of Artemisia pollen within the study area. This study provides first-hand data for accurately understanding the allergenic characteristics and sources of Artemisia pollen in northern Beijing and provides a scientific basis for the prevention of AR induced by Artemisia pollen in patients in China.

Effects of pollen concentration on allergic rhinitis in children: A retrospective study from Beijing, a Chinese megacity.

With global climate change and rapid urbanization, the prevalence of allergic diseases caused by pollen is rising dramatically worldwide with unprecedented complexity and severity, especially for children in mega-cities. However, because of the lack of long time-series pollen concentrations data, the accurate evaluation of the impact of pollen on allergic rhinitis (AR) was scarce in the Chinese metropolis. A generalized additive model was used to assess the effect of pollen concentration on pediatric AR outpatient visits in Beijing from 2014 to 2019. A stratified analysis of 10 pollen species and age-gender-specific groups was also conducted during the spring and summer-autumn peak pollen periods separately. Positive associations between pollen concentration and pediatric AR varied with the season and pollen species were detected. Although the average daily pollen concentration is higher during the spring tree pollen peak, the influence was stronger at the summer-autumn weed pollen peak with the maximum relative risk 1.010 (95% CI 1.009, 1.011), which was higher than the greatest relative risk, 1.003 (95% CI 1.002, 1.004) in the spring peak. The significant adverse effects can be sustained to lag10 during the study period, and longer in the summer-autumn peak (lag13) than in the spring peak (lag8). There are thresholds for the health effects and they varied between seasons. The significant effect appeared when the pollen concentration was higher than 3.74 × 105 grain·m-2·d-1 during the spring tree pollen peaks and 4.70 × 104 grain·m-2·d-1 during the summer-autumn weed pollen peaks. The stratified results suggested that the species-specific effects were heterogeneous. It further highlights that enough attention should be paid to the problem of pollen allergy in children, especially school-aged children aged 7-18 years and weed pollen in the summer-autumn peak pollen period. These findings provide a more accurate reference for the rational coordination of medical resources and improvement of public health.

Effect of birth season on allergic rhinitis and cedar pollinosis considering allergen and vitamin D exposure: The Japan Environment and Children's study (JECS).

BACKGROUND: The relationship between the season of birth, allergen sensitization, and allergic rhinitis have been inconsistent, and there are no studies that simultaneously consider vitamin D and allergen exposure. This study aimed to determine the associations between the season of birth, house dust mite (HDM) and Japanese cedar pollen (JCP) sensitization, and allergic rhinitis and pollinosis, while taking vitamin D levels and allergen exposure into account. METHODS: This study included 4323 participants in the Sub-Cohort Study of the Japan Environment and Children's Study. A logistic regression model was used to analyze the association between the season of birth and sensitization to JCP or HDM (judged by specific immunoglobulin E) at age 2 and allergic rhinitis or pollinosis at age 3, adjusted for HDM or JCP exposure and vitamin D levels with potential confounders. RESULTS: Participants born in spring or summer were more likely to have pollinosis than were those born in winter (adjusted odds ratio [aOR]: 2.08, 95% confidence interval [CI]: 1.13-3.82 for spring; aOR: 1.89, 95% CI: 1.03-3.47 for summer). Participants born in summer were more likely to have HDM sensitization than were those born in winter (Der p 1, aOR: 1.53, 95% CI: 1.10-2.15; Der f 1, aOR: 1.44, 95% CI: 1.03-2.01). Exposure to JCP and HDM were associated with pollinosis and HDM sensitization, respectively. CONCLUSIONS: Spring and summer births were associated with the development of pollinosis, and summer birth was associated with HDM sensitization, even when vitamin D and allergen exposure were considered. Further studies on mechanisms other than vitamin D and allergen exposure are required.

Association between household income levels and nutritional intake of allergic children under 6 years of age in Korea: 2019 Korea National Health and Nutrition Examination Survey and application of machine learning.

Introduction: This study investigated the prevalence of allergic diseases in Korean children aged 6 and below, focusing on the interplay between nutritional status, household income levels, and allergic disease occurrence. Methods: This study used data from the 2019 Korea National Health and Nutrition Examination Survey, a nationwide comprehensive survey, and included a representative sample of 30,382 children under the age of 6 to investigate in detail the relationship between allergic diseases, nutritional intake, and socioeconomic factors. Logistic regression analysis was performed to identify factors associated with allergic diseases, including gender, BMI, eating habits, dietary supplement intake, and nutrient consumption. To predict childhood asthma, 14 machine learning models were compared using the 'pycaret' package in Python. Results: We discerned that 24.7% were diagnosed with allergic conditions like atopic dermatitis, asthma, and allergic rhinitis. Notably, household income exhibited a significant influence, with the lowest income quartile exhibiting higher prevalence rates of asthma, allergic rhinitis, and multiple allergic diseases. In contrast, the highest income quartile displayed lower rates of allergic rhinitis. Children diagnosed with allergic diseases demonstrated compromised intake of essential nutrients such as energy, dietary fiber, vitamin B1, sodium, potassium, and iron. Particularly noteworthy were the deficits in dietary fiber, vitamin A, niacin, and potassium intake among children aged 3-5 with allergies. Logistic regression analysis further elucidated that within low-income families, female children with higher BMIs, frequent dining out, dietary supplement usage, and altered consumption of vitamin B1 and iron faced an elevated risk of allergic disease diagnosis. Additionally, machine learning analysis pinpointed influential predictors for childhood asthma, encompassing BMI, household income, subjective health perception, height, and dietary habits. Discussion: Our findings underscore the pronounced impact of income levels on the intricate nexus between allergic diseases and nutritional status. Furthermore, our machine learning insights illuminate the multifaceted determinants of childhood asthma, where physiological traits, socioeconomic circumstances, environmental factors, and dietary choices intertwine to shape disease prevalence. This study emphasizes the urgency of tailored nutritional interventions, particularly in socioeconomically disadvantaged populations, while also underscoring the necessity for comprehensive longitudinal investigations to unravel the intricate relationship between allergic diseases, nutritional factors, and socioeconomic strata.

Correlation of Pollen Concentration and Meteorological Factors with Medical Condition of Allergic Rhinitis in Shenyang Area.

Background: The pathogenesis of allergic rhinitis (AR) was affected by meteorological and environmental factors. This study investigated the association between clinical symptoms of AR patients with pollen dispersal and meteorological conditions. Methods: The clinical features of 10,838 AR patients who were treated in the Department of Otorhinolaryngology, The First Hospital of China Medical University, Shenyang, from March 2021 to October 2021 were retrospectively analyzed. We collected pollen by a pollen collector, read and counted it under a microscope, identified the species of the pollen particles, and recorded meteorological data (average daily temperature, maximum and minimum temperature, average daily wind, average daily precipitation, average daily humidity, average pressure, air quality index, PM2.5, PM10, SO2, NO2, CO, and O3), to analyze the correlation among meteorological conditions, pollen dispersal, and number of AR visits. Finally, pollen allergen-positive and symptoms were scored. Results: Among the AR visits, patients >41 years old accounted for the highest proportion (64.15%). 43.67% of the patients were complicated with bronchial asthma, and the disease incidence peaked in September. During the period of the study, a total of 27,512 pollen grains were collected, and 17 species were identified. The pollens of Compositae and Moraceae were the main allergenic sources leading to the increase in AR visits from August to September. The peak of pollen dispersal was in spring, summer, and autumn. The total amount of pollen was not only related to the average daily minimum temperature, average daily precipitation, and average daily humidity but also had a significant correlation with air quality index and air pollutants (PM2.5 and PM10, SO2, NO2, and CO). In addition, there was a significant correlation between the number of daily pollen allergen-positive patients and the pollen concentration of Compositae and Moraceae as well as air pollution components. The clinical symptoms of pollen allergen-positive patients were mainly nasal congestion, red/itchy eyes, and epiphora. Conclusion: The peak seasons of pollen dispersal in Shenyang were in spring, summer, and autumn, and the allergenic pollens were mainly Compositae and Moraceae. In addition, AR was substantially correlated with pollen concentration and meteorological factors. This study may help provide early warning information and prevention for AR patients.

Characteristics of annual mold variations and association with childhood allergic symptoms/diseases via combining surveys and home visit measurements.

The presence of dampness and visible molds leads to concerns of poor indoor air quality which has been consistently linked with increased exacerbation and development of allergy and respiratory diseases. Due to the limitations of epidemiological surveys, the actual fungal exposure characteristics in residences has not been sufficiently understood. This study aimed to characterize household fungal diversity and its annual temporal and spatial variations. We developed combined cross-sectional survey, repeated air sampling around a year, and DNA sequencing methods. The questionnaire survey was conducted in 2019, and 4943 valid cases were received from parents; a follow-up case-control study (11 cases and 12 controls) was designed, and onsite measurements of indoor environments were repeated in typical summer, transient season, and winter; dust from floor and beddings in children's room were collected and ITS based DNA sequencing of totally 68 samples was conducted. Results from 3361 children without changes to their residences since birth verified the significant associations of indoor dampness/mold indicators and prevalence of children-reported diseases, with increased adjusted odd ratios (aORs) >1 for studied asthma, wheeze, allergic rhinitis, and eczema. The airborne fungal concentrations from air sampling were higher than 1000 CFU/m3 in summer, regardless of indoors and outdoors, indicating an intermediate pollution level. The DNA sequencing for dust showed the Aspergillus was the predominant at genus level and the Aspergillus_penicillioides was the most common at species level; while the fungal community and composition varied significantly in different homes and seasons, according to α and ß diversity analyses. The comprehensive research methods contribute to a holistic understanding of indoor fungal exposure, including the concentrations, seasonal variations, community, and diversity, and verifies the relations with children's adverse health outcomes. The study further elucidates the role of microbiome in human health, which helps setting health-protective thresholds and managing mold treatments in buildings, to promote indoor air quality and human well-beings.

Outdoor Air Pollution and Indoor Window Condensation Associated with Childhood Symptoms of Allergic Rhinitis to Pollen.

Pollen is the main factor causing asthma and allergic rhinitis (AR). However, the key indoor and outdoor factors associated with childhood symptoms of allergic rhinitis (SAR) to pollen are unclear. We investigate the association of exposure to outdoor air pollution and indoor environmental factors with childhood SAR to pollen and consider SAR to pollen in different seasons. A cross-sectional study of 2598 preschool children aged 3-6 was conducted in Changsha, China (2011-2012). The prevalence of SAR to pollen in children and information on indoor environmental factors were obtained by questionnaire. Children's exposure to outdoor air pollutants (PM10, SO2, and NO2) was estimated from the monitored concentrations. The association of exposure to indoor environmental factors and outdoor air pollution with childhood SAR to pollen was estimated by multiple logistic regression models using odds ratio (OR) and a 95% confidence interval (CI), and the relationship between outdoor air pollutants and childhood SAR to pollen was investigated using restricted cubic splines. We found that early-life and current exposure to outdoor air pollution were significantly associated with childhood SAR to pollen in autumn, including exposure to SO2 one year before conception (OR = 1.60, 95% CI = 1.08-2.37) and during entire pregnancy (OR = 1.49, 95% CI = 1.01-2.20) periods, exposure to PM10 during the current period (OR = 1.78, 95% CI = 1.07-2.96), and exposure to NO2 during the early-life (one year before conception and entire pregnancy) and current periods with ORs (95% CI) of 1.72 (1.10-2.71), 1.82 (1.17-2.83), and 1.94 (1.11-3.40), respectively. Further, we found significant associations of both prenatal and postnatal exposure to window condensation with childhood SAR to pollen, with ORs (95% CI) = 1.37 (1.05-1.77) and 1.38 (1.02-1.88), respectively. We encourage SAR to pollen sufferers to stay indoors due to outdoor air pollution and higher pollen concentration outdoors, but indoor ventilation should be maintained.

[Role of sugarcane pollen in allergic rhinitis: a case-control study]. / Implication du pollen de canne à sucre dans les manifestations de la rhinite allergique: étude cas témoins.

The identification of allergens is essential in the management of allergic rhinitis. Sugarcane produces anemophilic pollen. The purpose of our study is to assess the role of sugarcane pollen in the occurrence of allergic rhinitis. We conducted a case-control analytical study of patients living in a Malagasy rural commune in which sugarcane cultivation and processing are important sources of employment, from July 2017 to June 2018. We enrolled 182 patients (91 cases and 91 controls). Factors associated with the occurrence of symptoms of allergic rhinitis were: a distance of less than 500 meters between homes and sugarcane fields (OR = 1.50), being a sugarcane worker (OR=1.16) and having a family history of allergic rhinitis (OR=13.67). In addition, exposure to wind gusts (OR=0.84) and outdoor occupation (OR=0.92) were protective factors. Exposure of patients to sugarcane pollen is associated with clinical manifestations of allergic rhinitis and confirms the role of this allergen in the occurrence of the disease. Avoidance and hygiene measures are the basis of treatment.

Care with allergen immunotherapy for allergic respiratory diseases in Germany-Predictors and deficits.

BACKGROUND: Allergen immunotherapy (AIT) represents the only possibility of causal therapy for allergic respiratory diseases. Although the prevailing high prevalence of allergic diseases and restrictions in the daily lives of patients, AIT is offered to a suboptimal number of patients in Germany. METHODS: Insured patients with documented allergic respiratory disease of one of the largest statutory health insurances in Germany, 'DAK-Gesundheit', were contacted by postal mail and asked to participate in the study. In case of written consent, primary and secondary data of patients were collected and analysed. Patient characteristics, predictors of being offered AIT, predictors of performing AIT and guideline-compliant care were analysed. RESULTS: 2505 subjects were included in the VerSITA study. Allergy to tree pollen and native speaking were identified as predictors, which increase the probability of being offered AIT. The probability was significantly decreased by the characteristics allergic rhinitis only, allergic asthma only, age in years, non-German citizenship, no graduation and lower secondary qualification. Significant positive predictors for an AIT to be actually performed were: Allergy to tree pollen and male sex. Predictors that decrease the likelihood that AIT is performed were: only allergic asthma, current smoker, former smoker, age and non-German citizenship. Furthermore, it was possible to identify characteristics in which guideline-compliant patients differed significantly from the rest of the study population. CONCLUSIONS: Based on statutory health insurance data and patient survey data, the VerSITA study provides a broad and in-depth overview of the care situation with regard to AIT in Germany and identifies deficits.

Prevalence of rat and mouse sensitization in Asian patients with respiratory allergy.

BACKGROUND: Skin prick test (SPT) is useful in identifying rat and mouse sensitization. OBJECTIVE: To determine the prevalence of rat and mouse sensitization by using local and commercial allergen extracts. METHODS: Patients with allergic rhinitis or asthma were recruited. SPT of local and commercial rat and mouse allergen extracts were performed. The level of rat and mouse specific IgE (sIgE) was quantified in all patients with positive SPT and randomized patients with negative SPT. RESULTS: Two hundred and thirty patients, 108 male (47%) and median age 14 years (3.2-63.5 years), were enrolled. Rat sensitization by SPT was 11.7% and mouse sensitization was 17.8%. SPT result to local rat and commercial rat allergen extracts were moderately correlated (rs = 0.51, p < 0.001), while SPT result to local mouse and commercial mouse allergen extracts showed low correlation (rs = 0.38, p < 0.001). The concordance of SPT results between local rat and commercial rat allergen extracts was 90.4%. Concordance between the local mouse and commercial mouse allergen extracts was 85.2%. When compared with rat and mouse sIgE, the concordance of local rat, commercial rat and commercial mouse allergen extract were > 80% while that of local mouse was 54.4%. No adverse effect was observed in SPT with any allergen or extract. CONCLUSIONS: The prevalence of rat and mouse sensitization was low compared to the study in USA. SPT with local rat and mouse allergen extract was safe and showed good concordance with the SPT result of commercial allergen extracts and rat and mouse sIgE levels.

Intrapartum antibiotics and childhood asthma and allergic rhinitis: a retrospective cohort study.

OBJECTIVE: This study aimed to evaluate the association between intrapartum antibiotics (IABX) and asthma and allergic rhinitis among children by ages 6, 8 and 10 years. DESIGN: Retrospective cohort. SETTING AND POPULATION: Data were collected though Kaiser Permanente Northern California's (KPNC) integrated healthcare system. Children were eligible if they were born in a KPNC hospital between 1997 and 2012 and stayed enrolled through age 6. METHODS: Modified Poisson regressions with robust error variances were used to estimate risk ratios for IABX and each outcome at each follow-up age during two separate time periods: 1997-2004 (n = 91 739) and 2005-2012 (n = 108 314). MAIN OUTCOME MEASURES: Asthma and allergic rhinitis by ages 6, 8 and 10. RESULTS: The proportion of women receiving IABX increased drastically over the study period (from 4% in 1997 to 49% in 2011), while the incidence of asthma (8%) and allergic rhinitis (6%) stayed relatively stable. In adjusted models, risk ratios for the association between IABX and asthma and allergic rhinitis were largely compatible with the null, with some slightly elevated risk ratios observed. For births from 1997 to 2004, risk ratios for asthma were 1.08 (95% CI 1.00-1.17) at age 6, 1.05 (95% CI 0.97-1.15) at age 8, and 1.08 (95% CI 0.99-1.18) at age 10. For births from 2005 to 2012, risk ratios were 1.00 (95% CI 0.95-1.04) at age 6, 1.07 (95% CI 1.01-1.12) at age 8, and 1.11 (95% CI 1.03-1.20) at age 10. CONCLUSIONS: Exposure to intrapartum antibiotics is not a strong predictor of childhood asthma or allergic rhinitis risk. TWEETABLE ABSTRACT: Exposure to intrapartum antibiotics is not a strong predictor of childhood asthma or allergic rhinitis risk.

The prevalence of complementary and alternative medicines (CAM) usage among allergic rhinitis patients in Malaysia.

PURPOSE: We conducted this study to estimate the prevalence of complementary and alternative medicines (CAM) usage among allergic rhinitis (AR) patients in Malaysia and understand the practice of CAM usage among them. We also included a literature review on the commonly used CAM for AR. METHODS: A cross-sectional study which included a questionnaire-based study and information of allergic rhinitis from patient's clinic records. Patients with AR who attended the ORL-HNS department in Hospital Universiti Sains Malaysia and Hospital Sultanah Aminah, Malaysia were enrolled after consented, on a first-come first-serve basis as convenience sampling from July 2020 until February 2021. A pre-tested self-administered, 16-item questionnaire in Malay language was distributed to the participants. The questionnaire consists of a set of 16 questions with subsets to enquire about the sociodemographic data and pattern of usage of CAM and its effectiveness. RESULTS: 372 patients were enrolled in this study consisting of 217 (58.3%) female and 155 (41.7%) male patients. 231 (62.1%) participants had used CAM for AR in the past 10 years. A higher proportion of females (p = 0.015) and those with higher income (p = 0.004) had used CAM. Among the users, 87.9% found CAM to be effective. No differences were found in terms of age (p = 0.888) and education level (p = 0.057) for CAM usage. CONCLUSION: CAM is widely used in Malaysia to alleviate AR symptoms, with a large proportion of users think it is effective. Therefore, more researches should be conducted to provide evidence and guidance to integrate CAM into AR management.

[Epidemiological survey of allergic rhinitis in steppe area of Xilingol League, Inner Mongolian of China].

Objective:To investigate the epidemiologic feature of allergic rhinitis （AR） in the grassland area of Xilin Gol League, in Inner Mongolia, including prevalence rate, clinical characteristics and main allergens, so as to provide scientific evidence for the prevention and treatment of AR. Methods:From May to August of 2015, in strict accordance with the requirements of epidemiological investigation, A multi-stage, stratified， random and cluster sampling method was adopted to investigate the population in three areas of Xilingol Grassland in Inner Mongolia （Xilinhot, Erlianhot and Duolun）, with a face to face questionnaire used to investigate the general situation, the main clinical symptoms and related symptoms of AR and the combined. Simultaneously, the skin prick test （SPT） of 10 common grassland allergens was carried out, and the gravity sedimentation method was used to monitor the daily pollen types and quantity in the area.SAS 9.4 software was used for data analysis． Results:A total of 2878 subjects in the cluster sample completed the questionnaire survey and allergen detection. The positive rate of SPT was 41.10% （1179/2787）, the self-reported prevalence rate of AR was 39.96%（1150/2878） and confirmed prevalence rate of AR was 22.72%（654/2878）. The most obvious clinical symptoms of AR were sneezing （91.13%, 1048/1150） and itchy nose （85.65%, 985/1150）. The most obvious clinical symptoms of ocular were itchy （55.13%, 634/1150） and tearing（42.96%，494/1150）. Fatigue and somnolence were prominent among other symptoms associated with AR. Among comorbidities, AR combined with conjunctivitis accounted for 60.52% （696/1150）, AR combined with asthma accounted for 13.57% （156/1150）. The major allergens of AR from high to low were Artemisia pollen, Chenopodium pollen, and Humulus pollen. The peak of AR symptoms mostly occuredin August.， and the peak period of allergic rhinitis symptoms coincided with the peak period of pollen quantity. Conclusion:The prevalence rate of AR in is extremely high due to the high seasonal pollen exposure in steppe area of Xilingol League in Inner Mongolian. Artemisia pollen is the main sensitized allergen.