Methods: A total of 392 patients with seasonal allergic rhinitis were selected from the population of the epidemiological investigation project of allergic diseases in Hohhot, Inner Mongolia. The project was led by Department of Allergy, Beijing Shijitan Hospital, Capital Medical University, and assisted by Hohhot First Hospital from April to May 2023. The patients were randomly divided into a spleen aminopeptide group (296 cases) and control group (96 cases) at a ratio of 3∶1, and the enrollment period was from June 1 to 14, 2023. The treatment group was treated with spleen aminopeptide oral solution for 12 weeks starting from 4-6 weeks (±7 days) before the pollen dispersal period, while the control group was treated with a simulated agent of spleen aminopeptide oral solution. Both the treatment group and the control group were treated with oral antihistamines and/or nasal glucocorticoids as needed during the pollen dispersal period. Evaluate the therapeutic effect by comparing the symptom scores, drug scores and quality of life scores of the two groups, and detect the expression levels of cytokines in serum. Symptom scores, quality of life scores, drug scores and laboratory results were compared by independent sample t test/Kruskal-Wallis test and χ2 test/Fisher\'s exact test. Results: Compared with the control group, spleen aminopeptide treatment for 12 weeks significantly improved symptoms of nasal congestion [M(Q1,Q3):2(1, 2) vs. 2(1, 3), H=6.308, P<0.05], nasal itching [M(Q1,Q3):2(1, 2) vs. 2(1, 3), H=4.966, P<0.05], sneezing [M(Q1,Q3):2(1, 2) vs. 2(1, 3), H=5.245, P<0.05], runny nose [M(Q1,Q3):2(1, 2) vs. 2(1, 3), H=5.41, P<0.05] and tearing [M(Q1,Q3):1(0, 2) vs. 1(0, 3), H=4.664, P<0.05]. At 12 weeks of treatment, the scores of nasal symptoms and ocular symptoms in control group and experimental group were significantly increased compared with baseline (P<0.05). In experimental group, nasal congestion [M(Q1,Q3):1(0, 1) vs. 1(0, 2), H=4.042, P<0.05], eye itching/foreign body sensation/redness symptom scores [M(Q1,Q3):1(0, 2) vs. 1(0, 2), H=5.302, P<0.05] and total scores [M(Q1,Q3):4(-1, 9) vs. 5(0, 12.5), H=3.958, P<0.05] were significantly increased. The antihistamine drug score of the splenic peptide treatment group at 6 weeks were lower than that of the control group (H=4.232, P<0.05). After 12 weeks of treatment, the antihistamine drug score [M(Q1,Q3):10(0, 24) vs. 19(2, 36.5), H=6.67, P<0.05] and the total drug score [M(Q1,Q3):28.5(5, 77.5) vs. 46(6, 155.5), H=3.995, P<0.05] were significantly lower than those of the control group. The serum IL-17A levels of the treatment group were significantly lower than those of the control group after 6 weeks (0.7±1.77 vs. 0.85±1.67,H=10.08, P<0.05) and 12 weeks (0.81±1.63 vs. 0.94±1.73,H=5.196, P<0.05) of splenic aminopeptide treatment. Conclusions: Early treatment with spleen aminopeptide oral solution can significantly improve nasal and ocular symptoms of patients with seasonal allergic rhinitis, reduce the use of drugs during the onset period, and improve the quality of life. It may exert an immunomodulatory effect by reducing the expression level of IL-17A in the serum of patients. Objects: To conduct a study on the prevention and treatment of seasonal allergic rhinitis in Hohhot, Inner Mongolia, evaluate the preventive and therapeutic effects of spleen aminopeptide oral solution on seasonal allergic rhinitis, and explore its related mechanisms.
目的： 开展内蒙古呼和浩特地区季节性过敏性鼻炎防治的研究，探讨脾氨肽口服溶液对季节性过敏性鼻炎的预防与治疗作用，以及其相关机制。 方法： 于2023年4—5月首都医科大学附属北京世纪坛医院变态反应科牵头，呼和浩特市第一医院协助开展的内蒙古呼和浩特地区过敏性疾病流行病学调查项目的流调人群中，选取392例季节性过敏性鼻炎患者，按3∶1随机分为脾氨肽治疗组（296例）和对照组（96例），并在2023年6月1—14日完成入组。治疗组在花粉播散期前4~6周（±7 d）开始应用脾氨肽口服溶液治疗12周，对照组应用脾氨肽口服溶液模拟剂，治疗组和对照组在花粉播散期间均按需使用口服抗组胺药物和/或鼻用糖皮质激素治疗。通过对比两组人群的症状评分、药物评分和生活质量评分评估疗效，并检测血清中多种细胞因子的表达水平。采用独立样本t检验/Kruskal-Wallis检验、χ2 检验/Fisher 精确检验比较症状评分、生活质量评分、药物评分和实验室检查。 结果： 与对照组相比，脾氨肽治疗12周可显著改善鼻塞［M（Q1，Q3）：2（1，2）vs. 2（1，3），H值=6.308，P<0.05］、鼻痒［M（Q1，Q3）：2（1，2）vs. 2（1，3），H值=4.966，P<0.05］、喷嚏［M（Q1，Q3）：2（1，2）vs. 2（1，3），H值=5.245，P<0.05］、流涕［M（Q1，Q3）：2（1，2）vs. 2（1，3），H值=5.41，P<0.05］、流泪［M（Q1，Q3）：1（0，2）vs. 1（0，3），H值=4.664，P<0.05］症状。治疗12周时对照组和试验组鼻部症状及眼部症状评分与基线相比均升高（P<0.05），试验组鼻塞［M（Q1，Q3）：1（0，1）vs. 1（0，2），H值=4.042，P<0.05］、眼痒/异物感/眼红［M（Q1，Q3）：1（0，2）vs. 1（0，2），H值=5.302，P<0.05］症状评分及总评分［M（Q1，Q3）：4（-1，9）vs. 5（0，12.5），H值=3.958，P<0.05］升高的幅度低于对照组。脾氨肽治疗组治疗6周抗组胺药物评分低于对照组（H值=4.232，P<0.05）；治疗12周时，抗组胺药物评分［M（Q1，Q3）：10（0，24）vs. 19（2，36.5），H值=6.67，P<0.05］及药物总评分［M（Q1，Q3）：28.5（5，77.5）vs. 46（6，155.5），H值=3.995，P<0.05］均低于对照组。在脾氨肽治疗6周（0.7±1.77 vs. 0.85±1.67，H值=10.08，P<0.05）和12周（0.81±1.63 vs. 0.94±1.73，H值=5.196，P<0.05）时，治疗组血清IL-17A水平均低于对照组。 结论： 脾氨肽口服溶液早期干预治疗可能改善患者季节性过敏性鼻炎的鼻部症状和眼部症状，减少发作期用药，改善患者的生活质量，其可能通过降低患者血清中IL-17A的表达水平从而发挥免疫调节作用。.

BACKGROUND: Allergic rhinitis (AR) or seasonal allergy characterized by sneezing, nasal congestion, nasal itching, and nasal discharge, triggered by immune reactions to environmental allergens. Present day customers also monitor the personal improvements in the area of Evidence-Based natural medicines/supplements.
METHODS: A randomized, double-blind, placebo-controlled study was conducted on 65 participants aged 18 to 60 years having 2 or more allergic symptoms like sneezing, rhinorrhoea, nasal obstruction, and nasal itching for a cumulative period greater than 1 hour per day. The study participants received a capsule of NSO (250 mg) with 2.5 mg piperine (BioPerine) as a bioavailability enhancer or a placebo, twice a day, after food for 15 days. The primary objectives were evaluated by mean change in Total Nasal Symptom Score and the duration of AR symptoms per day from baseline to Day 15. Secondary endpoints were changes in Total Ocular Symptoms Score, AR symptom frequency and severity, serum Immunoglobulin E levels, and Patient Global Impression of Change scale. Adverse events were monitored throughout the study.
RESULTS: Sixty-five patients were enrolled and all of them completed the study, N = 33 in NSO and N = 32 in placebo. A significant reduction in Total Nasal Symptom Score and Total Ocular Symptoms Score was observed in the NSO group compared to the placebo, highlighting the potential of NSO in alleviating AR symptoms. The episodes of AR symptoms per day and the frequency of symptoms in 24 hours reduced significantly in 15 days in both groups, but the extent of improvement was significantly higher in NSO compared to placebo. Improvement in Patient Global Impression of Change was also significantly better in NSO compared to the placebo. Serum Immunoglobulin E levels decreased in NSO but were not significantly different from placebo. No clinically significant changes were observed in vital signs, liver and renal function, lipid profile, hematology, fasting blood sugar, or urine analysis at the end of the study.
CONCLUSIONS: The result of the study demonstrates that NSO 250 mg with 2.5 mg piperine is an effective and well-tolerated supplement for the management of AR symptoms.

UNASSIGNED: Polymerized allergoids conjugated with mannan represent a novel approach of allergen immunotherapy targeting dendritic cells. In this study, we aimed to determine the optimal dose of mannan-allergoid conjugates derived from grass pollen (Phleum pratense and Dactylis glomerata) administered via either the subcutaneous or sublingual route.
UNASSIGNED: A randomized, double-blind, placebo-controlled trial with a double-dummy design was conducted, involving 162 participants across 12 centers in Spain. Subjects were randomly allocated to one of nine different treatment groups, each receiving either placebo or active treatment at doses of 500, 1,000, 3,000, or 5,000 mTU/mL over four months. Each participant received five subcutaneous (SC) doses of 0.5 mL each, every 30 days, and a daily sublingual (SL) dose of 0.2 mL. Participants who received active treatment through SC, received placebo through SL. Participants who received active treatment through SL, received placebo SC. One Group, as control, received bot SC and SL placebo. The primary efficacy outcome was the improvement in titrated nasal provocation tests (NPT) at the end of the study compared to baseline. Secondary outcomes included specific antibody (IgG4, IgE) and cellular (IL-10 producing and regulatory T cell) responses. All adverse events and side reactions were recorded and assessed.
UNASSIGNED: Post-treatment, the active groups showed improvements in NPT ranging from 33% to 53%, with the highest doses showing the greatest improvements regardless of the administration route. In comparison, the placebo group showed a 12% improvement. Significant differences over placebo were observed at doses of 3,000 mTU/mL (p=0.049 for SL, p=0.015 for SC) and 5,000 mTU/mL (p=0.011 for SL, p=0.015 for SC). A dose-dependent increase in IgG4 was observed following SC administration, and an increase in IL-10 producing cells for both routes of administration. No serious systemic or local adverse reactions were recorded, and no adrenaline was required.
UNASSIGNED: Grass pollen immunotherapy with mannan-allergoid conjugates was found to be safe and efficacious in achieving the primary outcome, whether administered via the subcutaneous or sublingual routes, at doses of 3,000 and 5,000 mTU/mL.
UNASSIGNED: https://www.clinicaltrialsregister.eu/ctr-search (EudraCT), identifier 2014-005471-88; https://www.clinicaltrials.gov, identifier NCT02654223.

BACKGROUND: Molecular diagnosis in allergology helps to identify multiple allergenic molecules simultaneously. The use of purified and/or recombinant allergens increases the accuracy of individual sensitization profiles in allergic patients.
OBJECTIVE: To assess the impact of molecular diagnosis through the ImmunoCAPTM ISAC 112 microarray on etiological diagnosis and specific immunotherapy (SIT) prescription. This was compared to the use of conventional diagnoses in pediatric, adolescent, and young adult patients with rhinitis or rhinoconjunctivitis and/or allergic asthma, sensitized to three or more pollen allergens of different botanical species.
METHODS: A multicenter, prospective, observational study was conducted in patients aged 3-25 years who received care at the Allergology service of 14 hospitals in Catalonia from 2017 to 2020. Allergology diagnosis was established based on the patient\'s clinical assessment and the results of the skin prick test and specific immunoglobulin E assays. Subsequently, molecular diagnosis was conducted using ImmunoCAPTM ISAC® 112 to recombinant and/or purified allergen components.
RESULTS: A total of 109 patients were included; 35 (32.1%) were pediatric patients and 74 (67.9%) were adolescents or young adults (mean age: 18 years), with 58.0% being females. A change of 51.0% was observed in SIT prescription following molecular etiological diagnosis by means of a multi-parameter microarray.
CONCLUSIONS: Molecular diagnosis by means of multi-parameter tests increases the accuracy of etiological diagnosis and helps to define an accurate composition of SIT.

BACKGROUND: Recent studies have related high pollen concentrations to increased cardiovascular morbidity and mortality, yet very little research concerns pre-clinical cardiovascular health, including effects on blood pressure (BP). The EPOCHAL panel study investigated the exposure-response relationship between ambient pollen exposure and systolic and diastolic BP in adults.
METHODS: BP was measured in 302 adults with and in 94 without pollen allergy during the pollen season, on approximately 16 days per person (6253 observations). Average individually-relevant pollen exposure in the 96 h prior to each BP measurement was calculated by summing up the averages of all ambient pollen concentrations to which the individual was found to be sensitized in a skin prick test, and which originated from seven highly allergenic pollen types (hazel, alder, birch, ash, grasses, mugwort and ragweed). Generalized additive mixed models were used to study the association between mean individually-relevant pollen exposure in the last 96 h and BP, adjusting for individual and environmental time-varying covariates. Effect modification by pollen allergy status, sex and BMI was evaluated.
RESULTS: Positive non-linear associations between individually-relevant pollen exposure and both systolic and diastolic BP were found in the allergic but not in the non-allergic group. BP increased sharply for exposures from zero to 60/80 pollen/m3 (diastolic/systolic BP), followed by a tempered further increase at higher concentrations. Increases of 2.00 mmHg [95% confidence interval (CI): 0.80-3.19] in systolic and 1.51 mmHg [95% CI: 0.58-2.45] in diastolic BP were associated with 96-h average pollen exposure of 400 pollen/m3, compared to no exposure. Obesity and female sex were associated with larger BP increases.
CONCLUSIONS: The finding that short-term pollen concentration is associated with increased systolic and diastolic BP in persons with pollen allergy strengthens the evidence that pollen may cause systemic health effects and trigger cardiovascular events.

暂无摘要。

BACKGROUND: Nasal congestion could affect the absorption of an epinephrine nasal spray (ENS).
OBJECTIVE: To compare the pharmacokinetics of 13.2 mg ENS with nasal congestion vs without congestion and vs intramuscular (IM) treatments.
METHODS: This phase I, open-label, 4-period randomized crossover study enrolled 51 healthy adults with seasonal allergies into cohorts that received a single dose of 13.2 mg ENS (NDS1C; Bryn Pharma, Lebanon, New Jersey) administered as 2 consecutive sprays in either opposite nostrils (cohort 1) or the same nostril (cohort 2). Both cohorts received 13.2 mg ENS with and without nasal allergen challenge (NAC), 0.3 mg IM epinephrine by autoinjector, and 0.5 mg IM epinephrine by manual syringe (MS).
RESULTS: The ENS after NAC resulted in higher extent and peak exposures and more rapid time to maximum plasma concentration vs ENS without NAC and IM treatments. In cohort 1, the maximum observed baseline-adjusted epinephrine plasma concentration (pg/mL) of ENS with NAC, IM autoinjector, IM MS, or ENS without NAC was 458.0, 279.0, 364.2, and 270.1, respectively, and in cohort 2 was 436.3, 228.2, 322.3, and 250.8, respectively. The maximum observed baseline-adjusted epinephrine plasma concentration geometric mean ratio (90% CI) for ENS with NAC vs without NAC in cohort 1 was 170% (123%-234%), and in cohort 2 was 174% (115%-263%). In cohort 1, the time to maximum plasma concentration was 15, 21, 45, and 25 minutes, respectively, and in cohort 2 was 18, 20, 45, and 20 minutes, respectively (P < .01 for ENS with NAC vs IM MS). The postdose mean heart rate and blood pressure remained stable and relatively similar to predose values regardless of plasma epinephrine concentration. Mild nausea and headache were the most common adverse events with ENS.
CONCLUSIONS: The 13.2 mg ENS with congestion exhibited enhanced absorption vs IM treatments and ENS without congestion and seemed to be well tolerated. There was no clinically impactful relationship between pharmacodynamic effects and plasma epinephrine concentration.

OBJECTIVE: To report the Tipuana tipu pollen as a new allergen capable of triggering allergic symptoms.
METHODS: The pollen counts were made according to standardized technique with a Burkard seven days following the European Aerobiology Society´s Network Group recommendations.1 The trap was installed on the roof of Clinica SANNA, El Golf, San Isidro, which is 20 m high, 12°5\'54\"S 77°3\'6\"W in the west-south of the Lima urban area. The sampling period was performed from September 2020 to October 2021. Collection of Tipuana tipu pollens and Preparation of Tipuana tipu pollen extracts 1:20 w/v was done using a previously described method.2 We carried out systematic skin prick testing with Tipuana tipu pollen extract and other aeroallergens (Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicalis), molds (Cladosporium herbarum, Alternaria alternata, Aspergillus fumigatus, Penicillium notatum), cat and dog danders, Periplaneta americana, grass six mix, weed mix (Inmunotek, Spain) on 80 patients (18 to 50 years old) seen in our allergy center, they suffering from november to january rhinitis and/or conjunctivitis symptoms. The majority living near avenues and large green areas, where Tipuana trees grew.
RESULTS: We found a total of 952 grains/m3 of Tipuana tipu pollen between November 2020 to january 2021, with the maximum concentration of 37 grains/m3 on December 10th. We also found other airborne pollen Types: Poaceae, Myrtaceae, Compositae and Betulaceae. 14/80 patients (17,5%) showed positive skin prick test only to Tipuana tipu extract. Most of the patients with positive tests to Tipuana extract presented symptoms of rhinoconjunctivitis during the Tipuana pollination period. Four patients showed positive skin prick test to Tipuana tipu and grass 6 mix extracts, most of the rest of our patients were sensitized to dust mites\' extracts (Dermatophagoides pteronyssinus).
CONCLUSIONS: The west-south population of Lima urban city is exposed to Tipuana tipu pollen. We do not foud previous publications about Tipuana tipu allergy. Almost 18% of the patients tested in our sample were mono-sensitized to this pollen. The results of this study should be compared with data from the forthcoming years, to identify seasonal and annual fluctuations, extend the traps to other locations in Lima, and of course try to standardize and improve the Tipuana tipu pollen extract.
OBJECTIVE: Reportar al polen de Tipuana tipu como un nuevo alérgeno capaz de desencadenar síntomas alérgicos.
UNASSIGNED: Los conteos de polen se realizaron según la técnica estandarizada con un equipo colector tipo Hirst, Burkard spore trap for seven days, siguiendo las recomendaciones del grupo de la Red Europea de Sociedades de Aerobiología1. El equipo se instaló en la azotea de la Clínica SANNA El Golf, San Isidro, a 20 m de altura desde el nivel del suelo, 12°5\'54”S 77°3\'6”O en la zona suroeste del área urbana de Lima. El periodo de captación se llevó a cabo entre septiembre de 2020 y octubre de 2021. La recolección de granos de polen de Tipuana tipu, y la preparación del extracto alergénico (peso/volumen) 1:20 p/v, se realizó usando metodología previamente descrita2. Se realizaron estudios de pruebas cutáneas (skin prick test), en 80 pacientes (entre 18 y 50 años), con sintomatología de rinoconjuntivitis; referían, además, mayor intensidad de sus síntomas entre noviembre y enero. La mayoría de pacientes dijeron vivir cerca a avenidas y parques donde había árboles de Tipuana tipu. Fueron evaluados en el servicio de Alergología de la Clínica SANNA, El Golf, San Isidro. Se aplicaron extractos de polen de Tipuana tipu, y otros aeroalérgenos como ácaros del polvo (Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicalis), hongos ambientales (Cladosporium herbarum, Alternaria alternata, Aspergillus fumigatus, Penicillium notatum), epitelios de gato y perro, Periplaneta americana, mezclas de seis gramíneas, mezclas de malezas (Inmunotek, España).
RESULTS: Encontramos un total de 952 granos/m3 de polen de Tipuana tipu entre noviembre de 2020 y enero de 2021; con la máxima concentración de 37 granos/m3 el 10 de diciembre. También identificamos otras familias polínicas: Poaceae, Myrtaceae, Compositae y Betulaceae. 14/80 pacientes (el 17,5%), resultaron positivos solo al extracto de Tipuana tipu, en el skin prick test. La mayoría de los pacientes con resultado positivo al extracto de Tipuana tipu referían síntomas de rinoconjuntivitis durante el periodo de polinización de los árboles de Tipuana. Cuatro pacientes tuvieron positividad al extracto de Tipuana tipu, y al extracto en mezcla de seis gramíneas; la mayoría del resto de pacientes mostraron sensibilidad a ácaros del polvo doméstico (Dermatophagoides pteronyssinus).
CONCLUSIONS: Los habitantes de la zona suroeste de la ciudad urbana de Lima están expuestos al polen de Tipuana tipu. No hemos encontrado publicaciones previas sobre alergia a este tipo de polen. Casi un 18% de pacientes estudiados en nuestra muestra, estuvieron monosensibilizados al extracto del polen de Tipuana tipu. Los resultados de este estudio deberían ampliarse y ser comparados con data en los años siguientes, identificar fluctuaciones estacionales y anuales, extender los captadores a otras locaciones en Lima, y por supuesto, intentar estandarizar y mejorar el extracto del polen de Tipuana Tipu.

Ambient pollen exposure causes nasal, ocular, and pulmonary symptoms in allergic individuals, but the shape of the exposure-response association is not well characterized. We evaluated this association and determined (1) whether symptom severity differs between subpopulations; (2) how the association changes over the course of the pollen season; and (3) which pollen exposure time lags affect symptoms.
Adult study participants (n = 396) repeatedly scored severity of nasal, ocular, and pulmonary allergic symptoms, resulting in three composite symptom scores. We calculated hourly individually relevant pollen exposure to seven allergenic plants (alder, ash, birch, hazel, grasses, mugwort, and ragweed) considering personal sensitization and exposure time lags of up to 96 h. We fitted generalized additive mixed models, with a random personal intercept, adjusting for weather and air pollution as potential time-varying confounders.
We identified a clear nonlinear positive association between pollen exposure and ocular and nasal symptom severity in the pollen allergy group: Symptom severity increased steeply with increasing exposure initially, but attenuated beyond approximately 80 pollen/m3. We found no evidence of an exposure threshold, below which no symptoms occur. While recent pollen exposure in the last approximately 5 h affected symptoms most, associations lingered for up to 60 h. Grass pollen exposure (compared to tree pollen) and younger age (18-30 years, as opposed to 30-65 years) were both associated with higher nasal and ocular symptom severity.
The lack of a threshold and attenuated dose-response curve may have implications for pollen warning systems, which may be revised to include multiday pollen concentrations in the future.

Saline nasal sprays are frequently used in the management of seasonal allergic rhinitis (SAR) for the cleansing and clearing of aeroallergens from the nasal cavity. Also using a drug-free approach, AM-301 nasal spray is forming a thin film barrier on the nasal mucosa to prevent contact with allergens, trap them, and facilitate their discharge. A clinical trial compared the efficacy, safety, and tolerability of AM-301 and saline spray in SAR.
A total of 100 patients were randomized 1:1 to self-administer AM-301 or saline 3 × daily for 2 weeks. Primary efficacy endpoint: reduction in mean daily reflective Total Nasal Symptom Score (rTNSS). Secondary efficacy endpoints: reduction in mean instantaneous TNSS and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), global impression of efficacy. Safety and tolerability: adverse events, relief medication use, symptom-free days, global impression of tolerability.
AM-301-treated patients achieved a significantly lower rTNSS than the saline group (LS square means difference -1.1, 95% CI -1.959 to -0.241, p = .013) with improvement observed across all individual nasal symptoms. Likewise, all secondary endpoints showed statistical significance in favor of AM-301; for example, quality of life was significantly improved overall (p < .001) as well as for each individual RQLQ domain. Both treatments showed similarly good safety and tolerability. With AM-301, fewer patients used relief medication and more enjoyed symptom-free days compared to saline treatment.
AM-301 was more effective than saline in improving SAR nasal symptoms and related quality of life while offering similar tolerability, demonstrating the benefits of a barrier approach.