Only a fraction of patients with allergic rhinitis receive allergen-specific immunotherapy (AIT). AIT is most commonly delivered subcutaneously in a series of injections over 3-5 years. Common obstacles to completing this therapy include cost and inconvenience. Intralymphatic immunotherapy (ILIT) has been proposed as a faster alternative, which requires as few as three injections spaced 4 weeks apart. This systematic review and meta-analysis evaluated the current evidence that supports the use of ILIT for allergic rhinitis. Clinical trials were identified in the published literature by using an electronic search strategy and were evaluated by using a risk of bias tool. Treatment outcome (symptom scores, medication scores, and combined symptom and medication scores) and provocation testing results (nasal provocation and skin-prick testing) were included in a meta-analysis of standardized mean difference with subgrouping by using a random-effects model. Overall adverse event rates were tabulated, and overall risk ratios were calculated by using a random-effects model. We identified 17 clinical trials that met eligibility criteria. The standardized mean difference of ILIT on the symptom and medication score was -0.72 (95% confidence interval [CI], -0.98 to -0.46; p < 0.0001) ( = 10). The standardized mean difference of ILIT on nasal provocation and skin-prick testing was -1.00 (95% CI, -1.38 to -0.61; p < 0.0001) ( = 7) and -0.73 (95% CI, -0.99 to -0.47; p < 0.0001) ( = 7), respectively. No statistically significant heterogeneity was detected. The overall adverse event rate was 39.5% for ILIT and 23.5% for placebo. Also, 98.4% of adverse events were mild. Our meta-analysis demonstrated that ILIT was safe, conferred desensitization to seasonal and nonseasonal allergens, alleviated allergic rhinitis symptoms, and reduced medication use. A larger randomized, double-blind, placebo controlled trial will be necessary for wider adaptation of this form of AIT.
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http://dx.doi.org/10.2500/aap.2021.42.210028 | DOI Listing |
J Allergy Clin Immunol
January 2025
Departments of Pediatrics and Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI.
Background: Rhinoconjunctivitis phenotypes are conventionally described based on symptom severity, duration and seasonality and aeroallergen sensitization. It is not known whether these phenotypes fully reflect the patterns of symptoms seen at a population level.
Objective: To identify phenotypes of rhinoconjunctivitis based on symptom intensity and seasonality using an unbiased approach and to compare their characteristics.
Indian Pediatr
January 2025
Community and Family Medicine, All India Institute of Medical Sciences, Deoghar, Jharkhand, India.
Objective: To estimate the proportion of eosinophilic and non-eosinophilic (NEA) endotypes in pediatric asthma, and to compare the clinical, and laboratory characterisitics, and different comorbidities between the two endotypes in the children.
Methods: Children aged 5 to 14 years of age with clinical and/or laboratory-confirmed asthma attending the pediatric outpatient department of a tertiary care hospital in Eastern India between October 1, 2023 and March 31, 2024, were included in this cross-sectional study. Complete hemogram, absolute eosinophil count (AEC), IgE, and pulmonary function tests were performed in all patients.
South Med J
January 2025
Department of Allergy and Immunology, Nemours Children's Health, Orlando, Florida.
Objectives: Despite advances in therapies and educational initiatives, pediatric allergy disorders, including asthma, allergic rhinitis, and eczema, continue to pose substantial health challenges. Understanding the social determinants of health (SDoH) linked with these conditions is a critical area of research due to their multifactorial nature. This study aimed to assess the SDoH influencing pediatric allergy disorders in central Florida, specifically examining four groups of children: with asthma only, with eczema only, with both asthma and eczema, and a control group without these conditions.
View Article and Find Full Text PDFClin Rev Allergy Immunol
December 2024
Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Olfactory dysfunction (OD) can have serious consequences as it hinders individuals from detecting important warning signals like smoke, spoiled food, and gas leaks. This can significantly impact their nutritional status, eating satisfaction, and overall quality of life. Allergic rhinitis (AR) is a common disease that greatly affects the quality of life and can lead to a decrease, distortion, or complete loss of olfactory ability.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Background: An increasing body of evidence has suggested that the pathogenesis of Alzheimer's disease (AD) is not confined to the neurons but instead that neuroinflammation plays a significant role in the disease, with an interplay between the brain and the immune system. So far, their shared genetic components have not been systematically studied.
Method: We investigated the shared genetic architecture between AD and a plethora of immune-mediated diseases using the genome-wide association studies (GWAS) summary statistics data: allergic rhinitis, asthma, atopic dermatitis, celiac disease, Crohn's disease, hypothyroidism, primary sclerosing cholangitis, RA, systemic lupus erythematosus, ulcerative colitis, and vitiligo.
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