Neuropsychiatric Adverse Events of Montelukast: An Analysis of Real-World Datasets and drug−gene Interaction Network

Montelukast is a selective leukotriene receptor antagonist that is widely used to treat bronchial asthma and nasal allergy. To clarify the association between montelukast and neuropsychiatric adverse events (AEs), we evaluated case reports recorded between January 2004 and December 2018 in the Food and Drug Administration Adverse Event Reporting System (FAERS). Furthermore, we elucidated the potential toxicological mechanisms of montelukast-associated neuropsychiatric AEs through functional enrichment analysis of human genes interacting with montelukast. The reporting odds ratios of suicidal ideation and depression in the system organ class of psychiatric disorders were 21.5 (95% confidence interval (CI): 20.3–22.9) and 8.2 (95% CI: 7.8–8.7), respectively. We explored 1,144 human genes that directly or indirectly interact with montelukast. The molecular complex detection (MCODE) plug-in of Cytoscape detected 14 clusters. Functional analysis indicated that several genes were significantly enriched in the biological processes of “neuroactive ligand–receptor interaction.” “Mood disorders” and “major depressive disorder” were significant disease terms related to montelukast. Our retrospective analysis based on the FAERS demonstrated a significant association between montelukast and neuropsychiatric AEs. Functional enrichment analysis of montelukast-associated genes related to neuropsychiatric symptoms warrant further research on the underlying pharmacological mechanisms.

The Functional Diversity of Nitric Oxide Synthase Isoforms in Human Nose and Paranasal Sinuses: Contrasting Pathophysiological Aspects in Nasal Allergy and Chronic Rhinosinusitis

The human paranasal sinuses are the major source of intrinsic nitric oxide (NO) production in the human airway. NO plays several roles in the maintenance of physiological homeostasis and the regulation of airway inflammation through the expression of three NO synthase (NOS) isoforms. Measuring NO levels can contribute to the diagnosis and assessment of allergic rhinitis (AR) and chronic rhinosinusitis (CRS). In symptomatic AR patients, pro-inflammatory cytokines upregulate the expression of inducible NOS (iNOS) in the inferior turbinate. Excessive amounts of NO cause oxidative damage to cellular components, leading to the deposition of cytotoxic substances. CRS phenotype and endotype classifications have provided insights into modern treatment strategies. Analyses of the production of sinus NO and its metabolites revealed pathobiological diversity that can be exploited for useful biomarkers. Measuring nasal NO based on different NOS activities is a potent tool for specific interventions targeting molecular pathways underlying CRS endotype-specific inflammation. We provide a comprehensive review of the functional diversity of NOS isoforms in the human sinonasal system in relation to these two major nasal disorders’ pathologies. The regulatory mechanisms of NOS expression associated with the substrate bioavailability indicate the involvement of both type 1 and type 2 immune responses.

Supporting people to self-manage their allergic rhinitis

Allergic rhinitis is common in the UK and can cause significant symptoms and reductions in quality of life. Viv Marsh considers how health professionals can support self-management of these patients Many of us look forward to the spring and summer months with warmer weather, longer days and more opportunity to spend time outdoors. But for hay fever sufferers these months can be truly miserable. For others, the winter months can be equally challenging as, with more time spent indoors, exposure to indoor allergens is greater. Hay fever is the term commonly used to describe seasonal nasal allergy triggered by pollen. It affects many children and adults in the UK, causing significant symptoms and reduction in quality of life. Often, people with allergic rhinitis try to manage the condition themselves using home or over-the-counter remedies to reduce and control symptoms. However, effective management may not be straightforward and guidance from knowledgeable and experienced health professionals can lead to improved outcomes. Taking an evidence-based approach, this article will explore the impact of allergic rhinitis on those who experience it, and will consider how health professionals can support self-management to enable people with the condition to manage their symptoms and minimise its impact on their lives.

Stress and Nasal Allergy: Corticotropin-Releasing Hormone Stimulates Mast Cell Degranulation and Proliferation in Human Nasal Mucosa

Psychological stress exacerbates mast cell (MC)-dependent inflammation, including nasal allergy, but the underlying mechanisms are not thoroughly understood. Because the key stress-mediating neurohormone, corticotropin-releasing hormone (CRH), induces human skin MC degranulation, we hypothesized that CRH may be a key player in stress-aggravated nasal allergy. In the current study, we probed this hypothesis in human nasal mucosa MCs (hM-MCs) in situ using nasal polyp organ culture and tested whether CRH is required for murine M-MC activation by perceived stress in vivo. CRH stimulation significantly increased the number of hM-MCs, stimulated both their degranulation and proliferation ex vivo, and increased stem cell factor (SCF) expression in human nasal mucosa epithelium. CRH also sensitized hM-MCs to further CRH stimulation and promoted a pro-inflammatory hM-MC phenotype. The CRH-induced increase in hM-MCs was mitigated by co-administration of CRH receptor type 1 (CRH-R1)-specific antagonist antalarmin, CRH-R1 small interfering RNA (siRNA), or SCF-neutralizing antibody. In vivo, restraint stress significantly increased the number and degranulation of murine M-MCs compared with sham-stressed mice. This effect was mitigated by intranasal antalarmin. Our data suggest that CRH is a major activator of hM-MC in nasal mucosa, in part via promoting SCF production, and that CRH-R1 antagonists such as antalarmin are promising candidate therapeutics for nasal mucosa neuroinflammation induced by perceived stress.

Frontal Mucocele With Proptosis: DrafIIa Approach

Paranasal sinus mucocele commonly involved fronto-ethmoidal region rather than other due to its narrow anatomical drainage outflow, which put them at a higher tendency to get obstructed. Usually, it arises from an identifiable cause such as a history of endonasal surgery, facial trauma or background of nasal allergy or rhinosinusitis. Rarely patient presented with primary frontal mucocele, and its presentation depending on the mucocele location and extension with surrounding mass effect. Treatment is based on restoration of frontal sinus drainage and ventilation or towards a more radical and definitive approach which is sinus obliteration. Risk and benefits between these two need to be taken into consideration. We present a case of primary frontal mucocele with gradual onset of unilateral eye proptosis which first presented solely with ophthalmic symptoms.International Journal of Human and Health Sciences Vol. 05 No. 03 July’21 Page: 366-371

Prevalence and Risk Factors of Sinus and Nasal Allergies among Tannery Workers of Kanpur City

India is greatly afflicted by sinusitis, which is a condition that involves inflaming sinuses (the air cavities in the nasal passage) in your nose, according to the National Institute of Allergy and Infectious Diseases (NIAID). The study’s objective was to evaluate the prevalence and risk factors of sinus and nasal allergies among tannery workers of Kanpur city. The study has used primary datasets obtained from a cross-sectional household study of tannery workers from the Jajmau area of Kanpur in northern India, which was conducted during January–June 2015 as part of a doctoral program. The study covered 286 tannery workers from the study area. Bivariate and logistic regression analysis was used to study the association between outcome variables (self-reported prevalence of sinus and nasal allergies) and predictor variables (socioeconomic and work-related characteristics). Results portray that a higher proportion of the tannery workers belong to economically and socially backward classes. Overall, 13.4 and 12.3% of sinus and nasal allergy prevalence have been reported by tannery workers, whereas tannery workers from the oldest age group were those who mainly suffered. A study found that the severity of nasal and sinus allergies increases with the increasing age and work duration in the tannery. Workers with low exposure to airborne dust were significantly more likely to develop sinus problems (OR = 4.16; p < 0.05) than those without exposure. Those tannery workers suffering from nasal allergy were more prone to develop sinus problems than those who were not suffering from nasal allergy. The risk factors responsible for these health hazards can be eliminated by improving the overall working conditions and ensuring necessary protective regulations for the tannery workers.

Shifts in allergy practice in a COVID-19 world: Implications of pre–COVID-19 national health care provider and patient surveys of treatments for nasal allergies

Background: Most U.S. patient and health care provider surveys with regard to nasal allergy treatments were conducted before sublingual immunotherapy (SLIT)-tablets and allergy immunotherapy (AIT) shared decision-making tools were available.Objective: Patient and health care provider surveys with regard to current perceptions of nasal allergy burden, symptoms, and treatments were conducted to compare with previous surveys and provide insight into the use of SLIT-tablets and AIT shared decision-making tools.Methods: From November-December 2019, adults (N = 510) diagnosed with nasal allergies and health care providers (N = 304) who treated nasal allergies in the United States completed surveys with regard to nasal allergy management.Results: Of the patient respondents, 42% reported that their symptoms were only somewhat controlled and 48% had avoided activities because of their nasal allergies. In all, 38% were using only over-the-counter (OTC) medications for treatment, and 42%, 7%, and 8% had ever received subcutaneous immunotherapy (SCIT), sublingual allergy drops, or SLIT-tablets, respectively; 56% and 85% reported that they had never discussed SCIT or SLIT, respectively, with their health care provider. Of the health care provider respondents, 45%, 58%, and 20% were very likely to discuss OTC medications, SCIT, or SLIT, respectively. Allergists were more inclined to discuss SCIT with their patients than other health care providers (82% versus 33%, respectively). Most allergists (67%) and other health care providers (62%) reported that they did not use an AIT shared decision-making tool, primarily because of unawareness.Conclusion: The patients with nasal allergies continued to report inadequate symptom control and activity impairment.SLIT-tablets and AIT shared decision-making tools were underused. In the coronavirus disease 2019 era, social distancing may limit office visits, which impacts SCIT administration and prompts increased use of telemedicine and a possible advantage for at-home–administered SLIT-tablets over SCIT.

Prediction of allergic diseases by measurement total IgE in umbilical cord blood levels: A 8 -year follow up study

Allergic diseases in children have increased significantly in recent years and now affect up to 35% of children. This study aimed to investigate the total IgE level in newborn’s umbilical cord blood and its association with the development of allergic diseases during 8 years. Methods: In cross-sectional study included 500 infants who were born in the obstetrics department at Tishreen and Al-Assad University Hospitals during the period 2007-2015. Questionnaires were administered after the birth of the infant included gender, gestational age, birth weight, mode and season of delivery, smoking during pregnancy, family history of the allergic diseases, and umbilical cord blood was obtained for measurement of total immunoglobulin E (IgE) levels. We followed the newborns for eight years through clinical examination to investigate the development of allergic diseases. Results: Of 500 newborns, 214 (42.8%) were classified as having high total immunoglobulin E in umbilical cord blood. We followed 143 of 214 newborns for 8 years. There was an allergic family history in 51.7% of newborns. During the following period, the allergic diseases developed in 76.22% of the children with high total immunoglobulin E in umbilical cord blood. Allergic symptoms in children varied between nasal allergy in 19.6% of children, skin allergy (Eczema and urticarial)in 25.2% of children, childhood asthma in 31.5% of children. The rate of development of allergic symptoms in the presence of two factors (family history and high total immunoglobulin E in umbilical cord blood) was 51.7%. Conclusion: We found a high Prevalence of allergic diseases in children with high total immunoglobulin E in umbilical cord blood. The Current study could be used as a preventative strategy to reduce the risk of allergic diseases by predictive of subsequent

Medicinal Plant Centipeda Minima: A Resource of Bioactive Compounds

Background: Centipeda minima (the family Asteraceae) is an annual herbaceous plant native to the tropical regions, especially in eastern tropical Asia. C. minima is well-known in the list of medicinal plants with capacities in treatment of whooping cough, nasal allergy, malaria, and asthma. More than sixty reports on phytochemical and pharmacological aspects of this plant are now available, but a supportive review is insufficient. Objective: The current review aims to make a compilation of almost of isolated compounds from the title plant together with their pharmacological activities. Methodology: Centipeda minima is the meaningful keyword to search for previous references, while the reliable databases such as Sci-Finder, Google Scholar, Pub Med, Science Direct, the Web of Science, Scopus, Bentham science, Taylor Francis, Springer, IOP Science have been utilized at most. Conclusion: More than one hundred secondary metabolites, classifying as terpenoids, flavonoids, mono-phenols, fatty acids, amides, and other types, were isolated from this plant. Among them, sesquiterpene lactones are dominant in either C. minima species or numerous plants of genus Centipeda. These phytochemical groups also possessed various biological results like anti-cancer, anti-bacteria, anti-allergy, antivirus, anti-inflammation, hepatoprotective activities. With many kinds of bioactive results such as anti-cancer, antiinflammation, the use of C. minima plant extracts and isolated compounds for drug development seems to be a futuristic strategy.

Role of plasma ascorbic acid in nasal allergy- a review

Ascorbic acid plays a pivotal role in common cold and allergic rhinitis by affecting the innate and adaptive immunity It antagonizes mediators of allergic rhinitis like histamine, prostaglandins etc. It also maintains the normal redox potential of the cells preventing bonding of antibody to antigen. It helps in stress conditions and has stimulatory effect on interferon synthesis. The present study was undertaken to study the role of plasma ascorbic acid in patients suffering from nasal allergy.