An Instant, Safe, Antihistamine, Anti-Inflammatory and Decongestant Polymeric Nasal Barrier to Prevent and To Treat Allergic Rhinitis in Children

2021 ◽  
Vol 7 (5) ◽  
pp. 01-09
Author(s):  
Ravi Shrivastava
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Side Effects ◽  
Symptom Score ◽  
Inflammatory Cytokines ◽  
Nasal Mucosa ◽  
Eosinophil Count ◽  
Allergen Exposure ◽  
Glycerol Solution

Introduction: Allergic rhinitis (AR) in children is a common chronic pathology with a strong impact on patient quality of life. The main physiopathology affects the nasal cavity as a multi-factorial disease involving nasal mucosa damage, nasal inflammation with high concentrations of histamine, pro-inflammatory cytokines such as histamine, TNF-α, IL-4, IL-5, IL-6, IL-10, IL-13, and IgE antibodies on the nasal mucosa. Systemic entry of these proteins through damaged nasal mucosa maintains continued inflammatory and allergen cascades. Therefore, an ideal treatment should be multitarget in order to stop allergen exposure, inflammation, and nasal mucosa barrier degradation, but such treatments are nearly impossible to conceive. We envisaged an osmotic and protective nasal barrier film, not only capable of protecting the nasal mucosa from allergen exposure but also of trapping and neutralizing selected cytokines and cleaning the nasal surface continuously without using any harmful substance for children. Materials and Methods: We associated highly osmotic glycerol solution with specific plant polymers to conceive an osmotic but stable film. As plant polymers (tannins) can bind with selective proteins, a range of glycerol binding non-cytotoxic polymers were screened using the sandwich ELISA method to select those having binding affinity for allergen induced nasal proinflammatory cytokines. After verifying cytotoxicity and irritant potential, a 15-day observational clinical study was performed with approval from the ethics committee on 30 children aged between 4-13, suffering from allergic rhinitis. The test product (TP) was supplied in 15-ml nasal sprays and applied 2-3 times per day for a period of 15 days. Saline solution served as control (CP). The scores of nasal and ocular symptoms, effect on quality of life, eosinophil count in nasal smears, and need for antihistamine treatment was evaluated at the start, at 30 minutes and on days 2, 3 and 15 of treatment. Results: A few specific polymers were able to bind with selected cytokines and histamine at adequate filmogen concentrations. The osmotic film was stable, non-irritant and was able to clean the nasal mucosa continuously for 4-6h after each application. Clinical observations of Total Nasal Symptom Score (TNSS) grouping the scores of nasal congestion, runny nose, sneezing, and itching, revealed a strong decrease right after the 1st treatment in both groups but the reduction was much stronger and faster with the TP. The mean TNSS score reduction was 44.74% in CP vs 83.53% in the TP group after 7 days of treatment (p<0.001). Total Ocular Symptom Score (TOSS) was decreased by 21.13% and 51.41% in CP v/s 35.12 and 99.59% in TP group on days 2 and 7, respectively. Nasal smear eosinophil count was equally strongly reduced in the TP v/s CP group. No treatment-related side effects were recorded in any of the groups. Conclusion: Protecting the nasal mucosa against allergens, neutralizing inflammatory cytokines, and keeping the nasal surface clean with an osmotic polymeric film, constitute a major breakthrough for the treatment of allergic rhinitis in children. This simple but scientific and logical approach should avoid exposing children to chemicals and to their long-term side effects.

Pharmacoeconomic features of the use of drugs used in the treatment of allergic rhinitis

2021 ◽  
pp. 9-16
Author(s):  
Afanasyeva T.G. ◽  
Lavrova N.N. ◽  
Tumentseva V.R.
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Nasal Mucosa ◽  
Generic Drugs ◽  
Cost Minimization ◽  
Nasal Congestion ◽  
World Health ◽  
Cost Minimization Analysis ◽  
Wide Range

Rhinitis is an inflammation of the nasal mucosa; today, according to the World Health Organization, the prevalence of the disease is 40% of the world's population. Allergic rhinitis is the most common type of chronic rhinitis, affecting 10–20% of the world's population, and the severity of the disease is associated with a significant deterioration in the quality of life, sleep and performance. Allergic rhinitis is an inflammatory disease of the nasal mucosa caused by exposure to an allergen, causing IgE-mediated inflammation. Clinically, the disease is characterized by the following main symptoms: rhinorrhea, sneezing, itching and nasal congestion. Despite the general symptoms of allergic rhinitis, its impact on the quality of life of patients and the significant cost of treatment, including pharmacotherapy, many patients do not adhere to drug treatment regimens due to their insufficient effectiveness in eliminating the emerging symptoms. Pharmacoeconomic research identifies, measures and compares the costs and effects of drug use. This framework includes research methods related to cost minimization, cost-effectiveness, decision analysis, cost of illness, and patient quality of life. This article will consider one of the four main methods for assessing pharmacoeconomics - cost minimization analysis. A cost-minimization analysis is a pharmacoeconomic assessment by comparing the costs of two or more drug alternatives regardless of outcome. Since the pharmaceutical market is represented by a wide range of original, reference and generic drugs for the treatment of allergic rhinitis, an important aspect of our research is the selection of effective and economically acceptable therapy for outpatients.

scholarly journals Perubahan kualitas hidup, eosinofil mukosa hidung, dan interleukin-5 serum pasien rinitis alergi pasca terapi

2015 ◽  
Vol 45 (2) ◽  
pp. 121
Author(s):  
Arinda Putri Pitarini ◽  
Nina Irawati ◽  
Niken Lestari Poerbonegoro ◽  
Dewi Wulandari ◽  
Saptawati Badarsono
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Eosinophil Count ◽  
Immunoglobulin E ◽  
Nasal Congestion ◽  
Inflammatory Cells ◽  
Clinical Practices ◽  
Interleukin 5 ◽  
Comprehensive Management

 Latar belakang: Rinitis alergi adalah suatu penyakit inflamasi pada hidung yang dimediasi oleh imunoglobulin-E, yang terjadi setelah mukosa hidung terpajan alergen. Sel dan mediator inflamasi yang berperan penting adalah eosinofil, histamin, dan sitokin produk Th2. Penyakit ini ditandai dengan gejala rinorea, bersin berulang, hidung tersumbat dan/atau hidung gatal. Selain dari gejala yang mengganggu, rinitis alergi berdampak buruk terhadap kualitas hidup penderita. Tatalaksana komprehensif, meliputi penghindaran alergen, farmakoterapi, imunoterapi dan edukasi, ditujukan untuk menghilangkan gejala dan memperbaiki kualitas hidup pasien. Tujuan: Mengetahui perubahan kualitas hidup, jumlah eosinofil mukosa hidung, dan kadar IL-5 serum pada pasien rinitis alergi setelah mendapat terapi farmaka sesuai panduan. Metode: Penelitian ini merupakan studi pre-eksperimental analitik dengan pengambilan data sebelum dan sesudah pemberian farmakoterapi. Hasil: Sebanyak 31 dari 33 subjek mengalami perubahan kualitas hidup yang bermakna (MID>0,7). Seluruh pasien, 33 subjek memperlihatkan perubahan yang responsif dari jumlah eosinofil mukosa hidung. Sebanyak 30 subjek dinyatakan responsif dan terdapat penurunan kadar IL-5. Tidak ada hubungan yang bermakna antara perubahan kualitas hidup dan kadar IL-5. Kesimpulan: Perubahan kualitas hidup, jumlah eosinofil mukosa hidung, dan kadar IL-5 serum dapat digunakan sebagai penanda objektif keberhasilan terapi rinitis alergi yang dapat dipakai dalam praktik klinis sehari-hari maupun kepentingan riset. Kata kunci: rinitis alergi, kualitas hidup, eosinofil, interleukin-5ABSTRACT Background: Allergic rhinitis defined as an inflammatory disease of the nose mediated by immunoglobulin-E, induced after nasal mucosa exposure to allergen. Important inflammatory cells and mediators are eosinophils, histamine, and Th2-related cytokines. Symptoms include rhinorrhea, repeated sneezing, nasal congestion and/or nasal itching. Aside from its bothersome symptoms, allergic rhinitis decreases patient’s quality of life (QOL). Comprehensive management consist of allergen avoidance, medication, immunotherapy, and education, aimed to diminish symptoms and improve the patient’s quality of life. Purpose: To evaluate changes in quality of life, nasal mucosal eosinophil count, and level of interleukin-5 in allergic rhinitis after medicamentous treatment. Methods: This was an analytic pre-experimental study with data taken before and after medicamentous treatment. Results: Thirty-one of 33 subjects showed significant changes of QOL (MID>0,7). All samples, 33 subjects, experienced responsive changes in nasal mucosal eosinophil count. Thirty subjects were responsive, which showed decrease of IL-5 level. There was no significant relation between changes of QOL and changes of IL-5 level. Conclusion: Changes in quality of life, nasal mucosal eosinophil count, and IL-5 level are objective markers of treatment efficacy in Allergic Rhinitis, which can be used in clinical practices and researches. Keywords: allergic rhinitis, quality of life, eosinophil, interleukin-5, intranasal steroid, antihistamine

scholarly journals Allergen-specific immunotherapy for local allergic rhinitis: a systematic review and meta-analysis

2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
M.P. Hoang ◽  
J. Samuthpongtorn ◽  
W. Chitsuthipakorn ◽  
K. Seresirikachorn ◽  
K. Snidvongs
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Symptom Score ◽  
Observational Studies ◽  
Specific Immunotherapy ◽  
Allergen Specific Immunotherapy ◽  
Local Allergic Rhinitis ◽  
Medication Score ◽  
Disease Specific

Background: Local allergic rhinitis (LAR) is a phenotype of chronic rhinitis exhibiting a local Th2-driven inflammation without positive clinical markers of atopy. Immunomodulatory effects of allergen-specific immunotherapy (AIT) induce allergen-specific tolerance. However, AIT is not well-recognized as a treatment for LAR. Methodology: Systematic search on six electronic databases and registries was performed. Experimental and observational studies of AIT for LAR patients were retrieved. The primary outcomes were symptom score, medication score, combined symptom medication score, and disease-specific quality of life. Secondary outcomes were serum specific(s) IgG4, sIgE, and adverse events. Results: Four double-blind randomized controlled trials (156 patients) from two research units assessed the effects of subcutaneous immunotherapy (SCIT). Compared with placebo, SCIT showed significant reductions in symptom score, medication score, combined symptom medication score, disease-specific quality of life, and an increase in serum sIgG4. There was no significant change in serum sIgE. Likewise, two observational studies (one using SCIT and one using sublingual immunotherapy) improved post-therapeutic symptom score. No studies assessed the effects after discontinuation of treatment. AIT was safe without serious adverse events. Conclusion: AIT has beneficial effects and safe for LAR. Its effects are restricted to studies with short-term follow-up. AIT may be considered in LAR patients.

scholarly journals Assessment of quality of life measured by rhinoconjuctivits quality of life questionnaire in patients of allergic rhinitis treated with commonly used oral antihistaminics

2019 ◽  
Vol 8 (8) ◽  
pp. 1830
Author(s):  
Ganesh S. Pentewar ◽  
Ranjit J. Wagh
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Symptom Score ◽  
Life Questionnaire ◽  
Open Label ◽  
Treatment Groups ◽  
Quality Of Life Questionnaire ◽  
Nasal Symptoms ◽  
The Impact

Background: Nasal and non-nasal symptoms in allergic rhinitis (AR) can be assessed by measuring health related quality of life (HRQOL). Present study was to assess the impact of use of antihistaminic in AR which will affect the work productivity, sleep, frequent visits to health care professional and expenditure on medicines. For this evaluation, Rhinoconjuctivits Quality Of Life Questionnaire (RQLQ) has been used.Methods: In this study 52 patients with AR were randomized in an open-label, 4-arm, parallel group, single center study. Questionnaire information was obtained about allergy-related RQLQ. Subjects received either Tablet Cetirizine 5 mg, Levocetirizine 5 mg, Loratidine 5 mg or Fexofenadine 120 mg. Changes from baseline until the end of study visit (1 week following) were evaluated by RQLQ.Results: When compared between treatment groups using one-way ANOVA it was observed that there is no variation in RQLQ overall Score in all the four treatment groups and there is no difference from treatment to treatment. Overall RQLQ score was reduced maximum in Levocetirizine group. Individual symptoms of RQLQ that is sleep score, non-hay fever, practical problem, nasal symptom score, Eye symptom Score, activities Score, and emotion score were also improved in the Levocetirizine group.Conclusions: Patients of all four study groups showed an improved perception of their HRQL according to the RQLQ. Significant improvements are reported in nasal symptoms, daily activities, sleep and psychological impact. Our results provide support for an AR and its impact on quality of life. Our recommendation stipulating that levocetirizine is superior to rest drug group for the treatment of AR with safety and tolerability.

Sleepiness, Quality of Life and Objective Sleep Patterns in Seasonal Allergic Rhinitis

2006 ◽  
Vol 18 (03) ◽  
pp. 120-126
Author(s):  
Boris Stuck ◽  
Karl Hörmann ◽  
Joachim Maurer ◽  
Anna-Eva Hagner ◽  
Julia Johnson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Seasonal Allergic Rhinitis ◽  
Sleep Patterns

Evaluating the efficacy of intra-articular injections of platelet rich plasma (PRP) in rheumatoid arthritis patients and its impact on inflammatory cytokines, disease activity and quality of life.

2020 ◽  
Vol 16 ◽  
Author(s):  
Dalia S. Saif ◽  
Nagwa N. Hegazy ◽  
Enas S. Zahran
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Inflammatory Cytokines ◽  
Platelet Rich Plasma ◽  
Joint Inflammation ◽  
Monthly Interval ◽  
Post Injection ◽  
Tnf Α

Background: Among rheumatoid arthritis patients (RA), general disease activity is well regulated by diseasemodifying anti-rheumatic medications (DMARDS), but sometimes local inflammation still persists among a few joints. Adjuvant modern molecular interventions as Platelet Rich Plasma (PRP) with a suggested down regulating effect on inflammatory mediators has a proven effect in management of RA. We aim to evaluate the therapeutic effect of intra-articular PRP versus steroid in RA patients and their impact on inflammatory cytokines IL1B , TNF α, local joint inflammation, disease activity and quality of life (QL). Methods: Open labeled parallel randomized control clinical trial was carried out on 60 RA patients randomly divided into 2 groups, Group 1: included 30 patients received 3 intra-articular injections of PRP at monthly interval, Group 2: included 30 patients received single intra-articular injection of steroid. They were subjected to clinical, laboratory, serum IL1B and TNF α assessment at baseline and at 3, 6 months post injection. Results: Patients of both groups showed improvements in their scores of evaluating tools at 3months post injection and this improvement was persistent in the PRP group up to 6 months post injection while it was continued only for 3 months in the steroid group. Conclusions: PRP is a safe, effective and useful therapy in treating RA patients who had insufficient response and persistent pain and inflammation in just one or two joints through its down regulating effect on inflammatory cytokines IL1B, TNF α with subsequent improvement of local joint inflammation, disease activity and QL.

Proton Pump Inhibitors in 2021: Pros, Cons, and Everything in Between

2021 ◽  
pp. 263451612110217
Author(s):  
Joshua A. Sloan ◽  
Philip O. Katz
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Adverse Events ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Drug Class ◽  
Life Threatening

The medical and lay literature has exploded with reports of adverse events associated with proton pump inhibitors over the last 10 to 15 years. The dissemination of these reports to patients and clinicians have created substantial concerns regarding what has been an exceptionally valuable drug class, dramatically improving patient quality of life, and in many cases preventing life threatening side effects of other medication. Patients are more frequently seeking to avoid these medications, and practitioners are reducing or discontinuing them to the patient’s detriment due to a misunderstanding of the data. This review will discuss the data regarding the most commonly publicized adverse events and attempt to put them in perspective.

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