Probiotic Mixture Reduces Allergic Rhinitis Symptoms in Children, Study Finds

A randomized controlled trial has shown that a probiotic combination of Bifidobacterium longum and Lactobacillus plantarum (NVP-1703) significantly alleviates symptoms of allergic rhinitis (AR) in children. 
The study included children aged 6 to 19 with perennial AR, who were treated with NVP-1703 or a placebo over a 4-week period.
Results indicated that the total nasal symptom score (TNSS) in the NVP-1703 group decreased significantly compared to the placebo group. Symptom relief was observed both in the morning and evening, with notable improvements in nasal symptom duration and quality of life (QoL), particularly in reducing mouth breathing and itchy nose.
 Additionally, the NVP-1703 group showed reduced levels of inflammatory markers, specifically lower ratios of interleukin (IL)-4 and IL-5 to IL-22, which are associated with allergic responses.
No adverse events were reported, confirming the safety of NVP-1703 in children. These findings suggest that probiotics could offer a safe and effective treatment for managing AR in children, potentially improving both symptom control and overall quality of life. The study adds to the growing body of evidence supporting the role of probiotics in treating allergic conditions.
 

Immune Signatures as Predictive Biomarkers for SCIT Response in Allergic Rhinitis Patients

A new study reveals immune signatures that predict the effectiveness of subcutaneous immunotherapy (SCIT) in allergic rhinitis (AR) patients with house dust mite allergies. The research aimed to identify biomarkers that could enhance clinical outcomes by distinguishing SCIT responders from nonresponders.
The study analyzed circulating T and B cell subsets, serum immunoglobulin levels, and combined symptom and medication scores (CSMS) in two cohorts: a discovery group (Tongji cohort, n=72) and a validation group (Wisco cohort, n=43). SCIT responders were defined by a ≥30% improvement in CSMS after 12 months.
Key findings indicate that SCIT responders exhibited higher baseline levels of allergen-specific IgE (sIgE)/total IgE (tIgE) ratio, Type 2 helper T (TH2) cells, Type 2 follicular helper T (TFH2) cells, and memory B cell subtypes (CD23+ nonswitched memory B cells and switched memory B cells), along with lower follicular regulatory T cells (TFR) and TFR/TFH2 cell ratio. 
Using random forest and logistic regression algorithms, three key biomarkers- sIgE/tIgE ratio, TFR/TFH2 ratio, and CD23+ B memory cell frequency, were identified as significant predictors of SCIT response. 
The predictive model demonstrated high accuracy (AUC = 0.899 in Tongji; AUC = 0.893 in Wisco), underscoring the potential of personalized immunotherapy approaches for AR patients based on immune signatures. 
These findings offer a promising step towards optimizing SCIT efficacy through biomarker-based treatment plans.
 

Allergic Rhinitis Increases Risk for Moderate-to-Severe Pediatric Obstructive Sleep Apnea

A recent study has highlighted allergic rhinitis (AR) as a significant predictor of moderate-to-severe obstructive sleep apnea (OSA) in children.

Conducted at the Children's Hospital of Chongqing Medical University, the research analyzed 263 pediatric patients diagnosed with OSA in 2020, assessing factors contributing to disease severity.

Polysomnography was performed to determine each patient’s apnea-hypopnea index (AHI) and lowest oxygen saturation (LSaO₂), essential markers of OSA severity. The study found that nearly half (48.7%) of the patients had moderate-to-severe OSA, with 60.8% experiencing moderate-to-severe hypoxemia.

After adjusting for various factors, AR (adjusted odds ratio [aOR] = 1.75, 95% confidence interval [CI]: 1.03-2.96) and male gender (aOR = 1.77, 95% CI: 1.03-3.06) were identified as independent risk factors for more severe OSA. Notably, AR also emerged as the sole predictor of hypoxemia, further emphasizing its role in worsening sleep-disordered breathing.

These findings underscore the necessity of early detection and management of AR in children to reduce the risk of severe OSA and its complications. Individualized therapeutic approaches for pediatric OSA patients, particularly those with AR, could improve outcomes and mitigate progression to more severe disease stages.

Safety and efficacy of mannan-conjugated birch pollen allergoids in birch pollen-allergic adults

Birch pollens are tiny particles released by birch trees, especially in spring. They are one of the most common airborne allergens during the spring season. Mannan-conjugated birch pollen allergoids are modified birch pollen allergens designed for allergy immunotherapy. They are chemically altered (allergoids) and conjugated with mannan, a sugar molecule derived from yeast, which enhances the immune response while reducing allergenicity, important for desensitization therapies. Recent research demonstrated that all doses of mannan-conjugated birch pollen allergoids are safe, and the application of 10,000 mTU/mL was the most effective. The results of this study were documented in the journal Allergy.

In this study, 246 adults with birch pollen allergies received either a 0.5 mL of placebo or varying concentrations (1000 mTU/mL, 3000 mTU/mL or 10,000 mTU/mL) of the allergoids at five pre-seasonal visits. The efficacy of the treatment was evaluated by monitoring allergic symptoms and anti-allergy medication use during the peak of the 2020 birch pollen season. Additionally, tolerability, immunological, and safety outcomes were analyzed.

At the peak of birch pollen season, the highest dosage of mannan-conjugated birch pollen allergoids reduced the combined symptom and medication score by a median of 24.7% compared to the placebo. Bet v 1 specific IgG4 production significantly increased in a dose-dependent manner, with a 3.6- and 4.5-fold rise in the 3000 mTU/mL and 10,000 mTU/mL groups, respectively. The Bet v 1 specific IgE/IgG4 ratio was also greatly reduced (up to -70%). There were no fatalities or serious adverse events reported, and no adrenaline was administered. A total of four systemic reactions occurred, with two being grade I and two grade II.

Thus, it can be concluded that all doses of mannan-conjugated birch pollen allergoids are safe, and the application of 10,000 mTU/mL has been found to be the most optimal in terms of efficacy.

Examining the relationship between allergic conjunctivitis and allergic rhinitis

According to a recent study, allergic conjunctivitis (AC) and allergic rhinitis (AR) have a shared pathophysiological process and allergen profile, where the conjunctiva and nasal mucosa are involved in allergic reactions. This research proposes incorporating AC prevention and treatment into strategies for preventing AR. The findings of this study were published in the Alternative Therapies in Health and Medicine.

This study included a total of 462 patients who had been diagnosed with either allergic conjunctivitis or allergic rhinitis and had received treatment between January 2018 and December 2020. These patients were divided into two groups, the AC group and the AR group, based on the department where they had initially sought consultation. The allergic conjunctivitis group consisted of 232 patients diagnosed with allergic conjunctivitis in the ophthalmology department, while the allergic rhinitis group comprised 230 patients diagnosed with allergic rhinitis in the ENT department. Allergen analysis was carried out on patients with both AC and AR, and nasal and conjunctival mucosal scrapings were performed to examine the presence of eosinophils. This study was conducted to investigate the association between allergic conjunctivitis and allergic rhinitis.

In the AC group, 75.00% of patients were diagnosed with concurrent AR, while in the AR group, 73.48% of patients had concurrent AC. Inhalant allergen testing among patients with concurrent AR and AC revealed that the primary inhalant allergens were house dust, dust mites, and fungi, with specific immunoglobulin E (IgE) positivity of 91.23%. Testing for food allergens showed that shrimp, fish, and crab were ingestive allergens, with a specific IgE positivity of 58.58%. The presence of eosinophils was evaluated by analyzing conjunctival and nasal mucosal scrapings in individuals diagnosed with both allergic conjunctivitis and allergic rhinitis. Eosinophils were detected in 54.81% of cases through conjunctival scraping and 57.43% of cases through nasal mucosal scraping, with no significant differences observed (P > .05).

The above study demonstrated that AC and AR share a common pathophysiological process and allergen profile, with both the conjunctiva and nasal mucosa being involved in allergic reactions. This study suggests including AC prevention and treatment to prevent AR.