Clinical, immunomodulating and anti-recidive effects of ozone therapy in persistent allergic rhinitis in children

Research оbjective.To determine the effect of ozone therapy on clinical indicators and the state of immunity in children with moderate persistent allergic rhinitis. Material and methods. The study included children aged 5-10 years with moderate persis-tent allergic rhinitis, which were divided into two groups depending on the therapy. The first group of patients with allergic rhinitis received complex conventional therapy, the second group of patients with allergic rhinitis received complex treatment in combination with ozone therapy. Clinical parameters were studied in patients with allergic rhinitis, parameters of im-munological reactivity were investigated during periods of exacerbation of the disease and clinical remission. Results. It was found that the inclusion of ozone therapy in the complex treatment of patients of the second group ensured a faster onset of complete clinical remission (3.7 days earlier than in the first group of patients) and normalization of most immunity parameters, and also increased the expression of toll-like receptors on leukocyte cells. The duration of complete clinical remission in the group of patients with allergic rhinitis who received complex treatment in combination with ozone therapy (9.3 + 2 months) more than doubled (2.4 times) its duration in the group of patients with allergic rhinitis who received complex conventional therapy (3.9 + 0.3 months).

Relation between score for allergic rhinitis and immunoglobulin-E levels in the local population

<p class="abstract"><strong>Background:</strong> Allergic rhinitis (AR) is the most prevalent atopic disease in the world. It involves clinical hypersensitivity of the nasal mucosa to foreign substances mediated through immunoglobulin E antibodies. The quantitative Score for allergic rhinitis (SFAR) ranging between 0 and 16 has been in use from 2002.</p><p class="abstract"><strong>Methods:</strong> 240 patients diagnosed with Persistent allergic rhinitis (PAR) were taken to be part of the study after proper consent irrespective of the severity of symptoms. Each patient filled out the SFAR form before the treatment commenced. Serum IgE levels were noted and treatment was started which included oral and topical antihistamines, oral leukotriene receptor antagonists along with intranasal steroids. The IgE values were assessed along with the SFAR values side by side to look for any association. </p><p class="abstract"><strong>Results:</strong> It was noted that the individuals with identified triggers of allergy and those with a positive family history of allergy had a considerable higher IgE value as compared to those who did not. The ones with a trigger identified as a cause had a 54.88% higher IgE value. The ones with positive family history had 47.12% higher IgE than the ones without a history of allergy.</p><p class="abstract"><strong>Conclusions:</strong> Patients with well-defined trigger agents of allergy and positive family history of allergy are at a higher risk as they have a higher IgE value. They should be advised regular follow-ups and be monitored closely.</p>

Comparison of Fluticasone Furoate and Cetirizine Versus Fluticasone Furoate and Montelukast in Allergic Rhinitis

Background: The complexity of treatment in allergic rhinitis remains to be a global challenge. The medical treatment option for moderate-severe persistent allergic rhinitis is the combination of intranasal corticosteroid (INCS) and oral antihistamine or leukotriene receptor antagonist (LTRA). The combination INCS with LTRA is selected based on the presence of asthma. Purpose: To determine the effect of fluticasone furoate plus cetirizine administration comparing fluticasone furoate plus montelukast on nasal eosinophils count and clinical improvement in patients with moderate-severe persistent allergic rhinitis. Method: This study was purely experimental research with the study design randomized clinical trial, double-blind, pre and post test control. Patient were divided into two group. Group-1 received intranasal fluticasone furoate 110 μg once daily and oral cetirizine 10mg and Group-2 received intranasal fluticasone furoate 110 μg once daily and Montelukast 10mg. The treatment efficacy is assessed from nasal eosinophil count and total five symptoms score (T5SS) based on Visual Analogue Scale (VAS) before and 4 weeks after treatment. Result: Both groups show a decrease in the nasal eosinophil count and T5SS score based on VAS before and after treatment (p< 0.05). The group-2 shows a statistically significant improvement in nasal obstruction and rhinorrhea compare to the group-1 (p <0.05). The decrease in nasal eosinophil count and T5SS is higher in the group-2 than the group-1, however, it is not statistically significant. Conclusion: The combination of fluticasone furoate and montelukast is more effective in reducing nasal obstruction and rhinorrhea than the combination of fluticasone furoate and cetirizine.

Effect of adjunctive sodium hyaluronate versus surfactant nasal irrigation on mucociliary clearance in allergic rhinitis: a single-blind, randomised, controlled study

Objective To investigate the effects of nasal irrigation with sodium hyaluronate and surfactant solutions on mucociliary clearance time in patients with mild persistent allergic rhinitis. Methods A total of 120 patients diagnosed with mild persistent allergic rhinitis were enrolled in this prospective study. The patients were allocated randomly to the surfactant, sodium hyaluronate or isotonic saline (as a control) nasal irrigation group. The mucociliary clearance times and improvements in mucociliary clearance times were compared. Results Improvements in mean mucociliary clearance time were significantly greater in the surfactant and sodium hyaluronate groups than in the control group (p < 0.01). The mean post-treatment mucociliary clearance time of the surfactant group was significantly lower than that of the control (p < 0.001) and sodium hyaluronate groups (p = 0.03). Conclusion Surfactant and sodium hyaluronate nasal irrigation solutions may both be used as adjunctive treatments for allergic rhinitis. Surfactant nasal irrigation resulted in better mucociliary clearance times.

Obesity Can Contribute to Severe Persistent Allergic Rhinitis in Children through Leptin and Interleukin-1β

Background: Obesity/overweight is associated with a higher risk of allergic rhinitis (AR) in children. Objective: This study aimed at exploring the mechanisms by which obesity affects the severity of AR through leptin and interleukin (IL)-1β were investigated. Methods: In all, 210 subjects with AR and 82 subjects without AR were included in this study. The levels of leptin and inflammatory biomarkers were measured in the serum to investigate the correlation with the severity of AR. Additionally, we analyzed whether changes in BMI regulate the severity of AR through serial follow-up of obese children. Results: IL-1β, which is a biomarker of active inflammation in AR, was significantly higher in individuals with AR than in those without and higher in subjects in the obesity group than in those in the normal weight group. A regression analysis showed that the leptin level was associated with increased IL-1β expression in children with AR. In the multivariate analysis, only parental AR (9.2-fold increase in risk), elevated leptin (11.3-fold increase in risk), and high expression of IL-1β (5.8-fold increase in risk) emerged as significant risk factors of moderate to severe persistent allergic rhinitis. We also found that children with an increase or decrease in BMI showed changes in IL-1β and AR symptoms, which these changes were dependent on leptin and BMI. Conclusions: These results suggest that obesity is an important risk factor for the exacerbation of symptoms and leptin can exacerbate inflammation as well as severe and persistent symptoms through IL-1β in AR.

Comparative analysis of use of triamcinolone and placebo in treatment of persistent allergic rhinitis

The aim of the study was to determine the effect of triamcinolone monotherapy on the quality of life of patients with persistent allergic rhinitis. The study was placebo-controlled, randomized and double-blinded. The study included 46 patients in the study group and 24 patients in the control group, all were diagnosed with persistent allergic rhinitis for at least two years. Patients were examined twice after diagnosis was made. The study group was administered intramuscularly with 40 mg of triamcinolone once, while the control group was given placebo. To estimate the quality of life in both groups, a specially designed questionnaire was used, according to which the final scores were calculated. The triamcinolone group had a lower overall score on the questionnaire compared with the placebo group (p < 0.001). The difference between the scores at the beginning of the study and at the end of the first month for all indicators was statistically significant (p < 0,001). The difference in changes from the start of the study to the end of the first month (difference in treatment) between placebo and the study groups was statistically significant, in favour of the study group. Triamcinolone is a drug that improves the quality of life of patients treated for persistent allergic rhinitis, better than placebo.