Search Results (164)

Nasal irrigation (NI) is an effective, safe, low-cost strategy for treating and preventing upper respiratory tract diseases. High-volume, low-pressure saline irrigations are the most efficient method for removing infectious agents, allergens, and inflammatory mediators. This article reviews clinical evidence supporting NI use in various conditions: nasal congestion in infants, recurrent respiratory infections, acute and chronic rhinosinusitis, allergic and gestational rhinitis, empty nose syndrome, and post-endoscopic sinus surgery care. NI improves symptoms, reduces recurrence, enhances the efficacy of topical drugs, and decreases the need for antibiotics and decongestants. During the COVID-19 pandemic, NI has also been explored as a complementary measure to reduce viral load. Due to the safe profile and mechanical cleansing action on inflammatory mucus, nasal irrigations represent a valuable adjunctive treatment across a wide range of sinonasal conditions. Full article

Background: High Mobility Group Box 1 is a mediator in inflammation, acting as a damage-associated molecular pattern molecule in various diseases. This review examines its role in nasal inflammatory disorders, such as chronic rhinosinusitis and allergic rhinitis. Methods: A comprehensive review of recent literature was conducted using a refined PubMed search strategy, focusing on studies published from 2015 onward and targeting HMGB1’s role in nasal inflammatory diseases. Results: HMGB1 emerges as a central factor in amplifying and modulating inflammatory responses through interactions with multiple receptors. It regulates cytokine production, epithelial–mesenchymal transition, and tissue remodeling, particularly in eosinophilic CRS. While discrepancies in the literature highlight its context-dependent activity, therapeutic strategies like glycyrrhetinic acid and PPAR-γ agonists demonstrate potential in modulating its effects. Conclusions: HMGB1 represents a promising diagnostic biomarker and therapeutic target in nasal inflammatory diseases. However, due to its intrinsic nature and multiple localizations, much remains to be understood. It is precisely by reflecting on its role as an “inflammatory crossroads” that we aim to underscore the need for targeted translational research to elucidate the molecular mechanisms and therapeutic applications of HMGB1. Full article

Asthma is defined as a chronic respiratory disease, the processes of which are mainly related to the hyperreactivity of the immune system. Airway hyperresponsiveness and remodeling are other hallmarks of asthma that are strongly involved in the progression of the disease. Moreover, asthma is associated with the occurrence of atopic dermatitis, chronic sinusitis, allergic rhinitis, and a high profile of T2-type cytokines, such as IL-4, IL-5 and IL-13. The hyperresponsiveness of the immune system is a consequence of aberrant levels of alarmins, endogenous molecules that induce pro-inflammatory responses. They are released as a result of a defect or cell death, leading to the initiation of an inflammatory reaction. High-mobility group box 1 (HMGB1), S100 proteins, interleukin-33 (IL-33), thymic stromal lymphopoietin (TSLP), and IL-25 bind to various receptors, influencing the behavior of immune cells, resulting in stimulated migration and activation of these cells. In this review, we will discuss the potential role of alarmins in the pathogenesis of asthma. Full article

Background: Cardiovascular disorders, especially atherosclerosis, have been associated with allergic inflammation. In addition to traditional inflammatory responses, there is evidence that the development and instability of coronary artery plaque may be influenced by effector cells of allergic inflammation. This review examines the phases of allergic pathology, the immunological mechanisms of atherosclerosis, and the clinical link between allergic diseases (asthma, atopic dermatitis, allergic rhinitis, and food allergy) and cardiovascular disease (CVD), along with future therapeutic perspectives. Material and Method: A literature search was conducted in PubMed, Google scholar; ScienceDirect, Scopus, and studies published between 2014–2024 were taken into consideration. Keywords included allergic inflammation, eosinophils, mast cells, reactive oxygen species, atherosclerosis, Th2 cells, and cytokines. Epidemiological studies and review articles were included. Results: Emerging evidence suggests that allergic inflammation contributes to atherosclerosis through interconnected mechanisms such as eosinophil activation, reactive oxygen species production, mast cell degranulation, and endothelial dysfunction. Th2-driven immune responses, which are mediated by cytokines such as IL-4, IL-5, and IL-13, as well as eosinophil activity and mast cell degranulation, play a crucial role in vascular inflammation and plaque progression. Additionally, changes in lipid metabolism contribute to this process. Epidemiological studies support this connection, indicating that patients with chronic allergic conditions such as asthma, allergic rhinitis, food allergy, and atopic dermatitis experience increased cardiovascular morbidity. However, most current data are observational, and our understanding of the underlying mechanisms in humans remains limited, often relying on insights gained from preclinical models. Conclusions: A potential mechanism for cardiovascular risk is suggested by the interaction between atherosclerosis and allergic inflammation. Promising alternatives for treating allergic inflammation and cardiovascular issues include novel treatments like cytokine inhibitors, mast cell stabilizers, and biologics that target certain pathways. Further research is necessary to see whether concentrating on allergy pathways could lead to innovative treatments for cardiovascular disorders or vice versa. Full article

The interplay between allergic diseases and neurological disorders has gained increasing attention over the past decades, highlighting potential shared pathophysiological pathways. Allergic diseases, including asthma, eczema, and allergic rhinitis, are characterized by chronic inflammation and immune dysregulation, which may impact the pathogenesis of certain neurological conditions. Emerging evidence suggests that conditions such as multiple sclerosis (MS), migraine, epilepsy, neurodegenerative diseases, and neurodevelopmental disorders may be influenced by systemic inflammation and altered immune responses associated with allergies. The purpose of this paper is to provide an overview of current epidemiological evidence suggesting a relationship between allergic and neurological diseases. Understanding the complex interactions between allergic and neurological diseases could provide new insights into their aetiology and reveal novel therapeutic targets, paving the way for integrated approaches in managing comorbid allergic and neurological conditions, ultimately improving patient outcomes and quality of life. Full article

Allergic rhinitis and asthma are common chronic airway diseases that present significant public health challenges. Previous research has shown how the nasal and oral mycobiomes influence the onset, progression and severity of these two conditions, but no study so far has directly compared those mycobiomes within the same cohort during health and disease. To address this gap, I analyzed next-generation fungal ITS sequence data from 349 participants, including individuals with allergic rhinitis, asthma, and healthy controls. The nasal and oral mycobiomes showed a great overlap in composition but differed significantly (p < 0.04) in the relative abundance of several dominant genera. Moreover, only 18.6% of the fungal amplicon variants were shared among cavities. Microbial alpha-diversity was significantly higher (p < 0.05) in the nasal cavity, while beta-diversity varied significantly (p < 0.045) across all indices and clinical groups. Fungal networks were largely fragmented and showed relatively low ecological niche specialization, which contrasts with a previous study of bacteriomes from the same cohort. These networks also differed in structure, complexity and keystone nodes across clinical phenotypes. Overall, these findings highlight that the nasal and oral mycobiomes play distinct yet interconnected roles in allergic rhinitis and asthma. Full article

Background: Although upper and lower respiratory tract diseases coexist, studies discussing the relationship between chronic rhinitis (CR) and chronic obstructive pulmonary disease (COPD) are limited. Fluticasone nasal sprays are common treatment options for patients with rhinitis. Therefore, we aimed to investigate the effects of fluticasone nasal spray on patients with both CR and COPD. Methods: A retrospective review was performed using data from former smokers with CR and COPD at China Medical University Hospital (CMUH). Based on their medication history, patients were allocated into Group A, who had received treatment with fluticasone nasal spray, and Group B, who had never received this treatment. Pulmonary function test results, including forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC), were collected for both groups before treatment and one year after treatment. Statistical analysis was performed to evaluate the impact of fluticasone nasal spray treatment on pulmonary function. Results: A total of 123 former smokers were included, with 62 patients in Group A and 61 patients in Group B. At baseline, there was no significant difference in age, sex, and pulmonary function between the two groups. After one year of treatment, Group A showed an upward trend in pulmonary function, with the FEV1 increasing from 1.613 ± 0.554 to 1.708 ± 0.675 (p < 0.05) and the FVC increasing from 2.540 ± 0.694 to 2.670 ± 0.839 (p < 0.05). On the other hand, Group B exhibited a downward trend in pulmonary function after one year, with the FEV1 decreasing from 1.609 ± 0.554 to 1.544 ± 0.517 (p < 0.05) and the FVC decreasing from 2.586 ± 0.665 to 2.495 ± 0.679 (p < 0.05). Conclusions: This retrospective study suggests that the combined use of fluticasone nasal spray may be associated with improved pulmonary function in former smokers with both CR and COPD. This finding supports the concept of “united airway disease”. Full article

A 2-year-old neutered female domestic shorthair cat presented with chronic, progressively worsening upper respiratory symptoms that were unresponsive to long-term medical treatment. Initial management involved antibiotics, antivirals, and anti-inflammatory drugs, all of which failed to provide substantial clinical improvement. Diagnostic imaging with computed tomography revealed bilateral nasal and frontal sinus obstructions with viscous inflammatory exudate and localized osteolytic changes in the patient. Despite adjustments to the antimicrobial therapy regimen based on the PCR results, clinical signs persisted. Surgical intervention through frontal sinus trephination, physical removal of the exudate, placement of a temporary drainage tube, and repeated irrigation successfully resolved most of the clinical symptoms. Follow-up over two years showed sustained clinical improvement, with only mild intermittent serous nasal discharge reported. This case highlights the efficacy of surgical management, specifically frontal sinus trephination and repeated irrigation, in the treatment of cats with refractory chronic rhinosinusitis. Full article

Allergic rhinitis (AR) is a common and increasingly prevalent chronic inflammatory disorder of the nasal mucosa that severely impacts patients’ quality of life, causing symptoms like nasal congestion, sneezing, and itching. AR is primarily mediated by immunoglobulin E (IgE) when allergens are present, making it challenging to manage despite available therapies like pharmacotherapy, immunotherapy, and surgery. Recently, research has focused on biologics as an emerging therapeutic option for AR. Biologics target specific immune pathways in type 2 inflammation, which underlies many allergic diseases including AR. Biologics offer a targeted and potentially more effective alternative to traditional therapies, addressing the underlying immune mechanisms rather than simply alleviating symptoms. Based on key clinical trial evidence, this paper tentatively proposes a multidimensional strategy for selecting biologics in AR, integrating serum IgE levels, disease phenotypes (seasonal/persistent), and comorbid characteristics to guide individualized treatment. However, the long-term cost-effectiveness, optimal dosing regimens, and patient adherence to biologics require further validation through real-world data. Despite these challenges, recent advancements in biologics represent a promising step forward in AR management. With ongoing research and clinical trials, biologics may soon provide more effective and lasting relief for patients suffering from allergic rhinitis. Full article

Background and Objectives: Asthma is a prevalent chronic respiratory disease in children, with increasing rates in Saudi Arabia. Allergen sensitization plays a crucial role in asthma development and severity. This study aimed to investigate the prevalence and clinical impact of aeroallergen and food sensitization in children with asthma in Southwestern Saudi Arabia. Materials and Methods: A retrospective chart review was conducted at Abha Maternity and Children’s Hospital, including 194 children aged 3–12 years with atopic asthma. Sensitization to 26 common aeroallergens and food allergens was assessed using the EUROLINE Allergy test. Associations between sensitization patterns, atopic comorbidities (allergic rhinitis and eczema), and asthma-related outcomes (hospitalizations, medication use, and school absenteeism) were analyzed. Results: A high prevalence of sensitization was observed (74.2% for aeroallergens; 56.7% for food allergens). Aeroallergen sensitization was associated with older age (p < 0.001), male sex (p = 0.026), allergic rhinitis (p < 0.001), eczema (p = 0.295), and increased asthma morbidity, including hospitalizations (p = 0.002) and corticosteroid use (p = 0.012). Food sensitization was associated with eczema (p < 0.001) but did not significantly impact other asthma outcomes. Poly-sensitization was associated with a higher prevalence of eczema (p = 0.003). Dust mite sensitization was a strong independent predictor of severe asthma (adjusted odds ratio = 4.4, 95% CI = 1.7–11.8, p = 0.003). Conclusions: This study demonstrates a high prevalence of aeroallergen and food sensitization among children with atopic asthma in Southwestern Saudi Arabia, with distinct sensitization patterns and associated comorbidities. Aeroallergen sensitization, particularly to dust mites, was associated with increased asthma morbidity, highlighting the importance of comprehensive sensitization assessment in this population. While limited by its retrospective design, this study provides valuable insights into the interplay between sensitization and childhood asthma, informing future research and clinical practice. Full article

Background/Objectives: Patients with chronic lung diseases, such as cystic fibrosis, were considered a risk group for a severe course of coronavirus disease 2019 at the beginning of the pandemic. However, mounting evidence suggests that this group may not face an elevated risk for a severe SARS-CoV-2 infection. Methods: Here, we present data on the incidence and clinical course of SARS-CoV-2 infections in a single pediatric CF centre in Austria. Clinical variables were analyzed for their potential impact on disease acquisition and severity. A total of 135 young people with CF were assessed from February 2020 until December 2022. Results: Eighty-four patients were infected with SARS-CoV-2, out of which nine patients reported re-infection, resulting in 93 SARS-CoV-2 infections. Most infections, 76/93 (82%), occurred during the period of omicron variant predominance. Higher body mass index and respiratory colonization with Haemophilus influenzae before the beginning of the pandemic were significantly associated with the risk of acquiring SARS-CoV-2 infection. All patients had an uncomplicated COVID-19 course, regardless of the SARS-CoV-2 variant and COVID-19 vaccine status at infection. The most frequent symptoms were rhinitis (53%), fatigue (49%), cephalea (43%), and fever (38%). Neither oxygen therapy nor hospitalization were needed for any of the patients. Lung function parameters (FEV1, FVC, FEF50, LCI), both in the early post-viral as well as late post-viral stages, were not significantly impacted by SARS-CoV-2 infections. No long-term post-COVID-19 effects were reported. Conclusions: Our single-centre experience suggests that the course of SARS-CoV-2 infections in children and adolescents with CF is primarily mild and uncomplicated. Full article

The synthetic cortisol analog budesonide (BUD) is an essential drug employed to manage chronic inflammatory diseases in humans, mainly those involving gastroenteric and airway mucosa, such as rhinitis, laryngitis, bronchitis, esophagitis, gastritis, and colitis, with high levels of success. As a glucocorticoid, BUD prevents the expression of pro-inflammatory cytokines/chemokines and the recruitment of immune cells into the inflamed mucosa. However, emerging evidence indicates that BUD, unlike classical glucocorticoids, is also a potent modulator of stem and cancer cell behavior/plasticity. Certainly, BUD stabilizes cell–cell adhesions, preventing embryonic stem cell differentiation and inhibiting the development of 3D gastruloids. In addition, BUD inhibits the motile/invasive propensity of different cancer cells, including breast, lung, and pancreatic cancer. Finally, it prevents the infection of positive single-stranded human-infecting RNA viruses such as SARS-CoV-2. At a molecular level, BUD induces epigenetic changes and modifies the transcriptome of epithelial, stem, and cancer cells, providing molecular support to the immune cell-independent activity of BUD. Here, we performed an in-depth review of these unexpected activities of BUD, identified by unbiased drug screening programs, and we emphasize the molecular mechanisms modulated by this efficacious drug that deserve further research. Full article

Background: Atopic dermatitis (AD), allergic rhinitis (AR), and chronic rhinosinusitis with nasal polyps (CRSwNP) represent interconnected conditions within the spectrum of type 2 inflammatory diseases. While these conditions share common genetic and epigenetic pathways, the precise molecular mechanisms remain underexplored. Methods: This review integrates the latest insights on the genetic and epigenetic factors linking AD, AR, and CRSwNP, focusing on genome-wide association studies, DNA methylation patterns, histone modifications, and microRNA regulation. Results: In all three conditions, epigenetic modifications, including DNA methylation (Me) and histone acetylation (Ac) and methylation, regulate inflammatory and barrier-related genes, influencing disease severity. Notably, miRNAs such as miR-146a and miR-155 play pivotal roles in modulating inflammation across all three diseases, while disease-specific miRNAs contribute to airway remodeling (miR-125b and miR-21 in AR and CRSwNP). Emerging evidence underscores the role of microbiome-driven inflammasome activation and matrix metalloproteinases (MMP-2, MMP-9, and MMP-12) in perpetuating chronic inflammation and remodeling. Conclusions: The interplay between genetic predispositions, epigenetic modifications, and exposomal factors underscores the systemic nature of type 2 inflammation. A deeper understanding of these interconnected mechanisms could lead to transformative, personalized diagnostic and therapeutic advancements. Full article

Allergic rhinitis (AR), traditionally considered as a childhood condition, is increasingly recognized among older adults, driven by rising life expectancy and environmental factors. Although allergic sensitization declines with age, AR prevalence in the elderly is underestimated, with 3–12% of geriatric patients affected. Diagnosis is challenging due to nonspecific symptoms and overlapping conditions, leading to underdiagnosis and inadequate treatment. AR significantly impacts the quality of life (QoL), often exacerbating respiratory comorbidities like asthma and COPD. Presbynasalis, encompassing age-related sinonasal changes, includes reduced allergic responses, increased chronic rhinosinusitis, altered nasal structure, and impaired mucociliary clearance. Non-allergic rhinitis, atrophic rhinitis, and overlapping rhinitis further complicate AR diagnosis in the elderly. Effective management involves personalized pharmacotherapy, allergen-specific immunotherapy (AIT), and addressing comorbidities and polypharmacy risks. Despite safety concerns, recent studies demonstrate AIT efficacy in elderly patients, reducing symptoms and medication use. Given AR’s impact on cognitive and respiratory health, accurate diagnosis and treatment can enhance QoL and mitigate health decline. Greater awareness and further research are essential to understand AR prevalence and improve outcomes for geriatric patients. Full article

Background/Objectives: Chronic inflammation has been implicated in cancer development, but the association between allergic rhinitis (AR) and head and neck cancer (HNC) remains unclear. This study aims to investigate this potential relationship using a population-based dataset. Methods: Utilizing the Taiwan Longitudinal Health Insurance Database 2010, we conducted a case-control study encompassing 14,913 HNC patients and 59,652 propensity-score matched controls. Multivariate logistic regression analyses were performed to quantitatively evaluate the association between HNC and prior AR, adjusting for demographic factors and medical comorbidities such as hyperlipidemia, diabetes, hypertension, tobacco use disorder, HPV infection, and alcohol-related disorders. Results: This study identified that 20.19% of the entire cohort had a prior diagnosis of AR, with a significantly higher prevalence in HNC patients relative to controls (26.2% vs. 18.70%). The adjusted odds ratio (OR) for previous AR in HNC patients was 1.559 (95% CI = 1.494–1.627). Furthermore, site-specific analysis revealed increased odds ratios for AR among patients with cancers of the larynx (OR = 1.537, 95% CI = 1.307–1.807), hypopharynx (OR = 1.220, 95% CI = 1.035–1.437), nasopharynx (OR = 2.933, 95% CI = 2.722–3.160), sinonasal (OR = 3.100, 95% CI = 2.424–3.964), salivary glands (OR = 1.470, 95% CI = 1.158–1.865), and thyroid (OR = 1.566, 95% CI = 1.447–1.693). Conclusions: The findings robustly support a significant link between AR and an elevated risk of developing HNC, notably affecting the nasopharynx, sinonasal cavities, larynx, salivary glands, and thyroid. Full article