Publications by authors named "Boleslaw Samoliński"

114 Publications

Heterogeneity of the pharmacologic treatment of allergic rhinitis in Europe based on MIDAS and OTCims platforms.

Clin Exp Allergy 2021 Apr 20. Epub 2021 Apr 20.

Charité, Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Comprehensive Allergy Center, Department of Dermatology and Allergy, Berlin, Germany.

Background: The practice of allergology varies widely between countries, and the costs and sales for the treatment of rhinitis differ depending on practices and health systems. To understand these differences and their implications, the rhinitis market was studied in some of the EU countries.

Methods: We conducted a pharmaco-epidemiological database analysis to assess the medications that were prescribed for allergic rhinitis in the years 2016, 2017 and 2018. We used the IQVIA platforms for prescribed medicines (MIDAS Meaningful Integration of Data, Analytics and Services) and for OTC medicines (OTC International Market Tracking - OTCims). We selected the five most important markets in the EU (France, Germany, Italy, Poland and Spain).

Results: Intra-nasal decongestants were excluded from the analyses because they are not prescribed for allergic rhinitis. For both Standard Units (SU) and costs, France is leading the other countries. In terms of SU, the four other countries are similar. For costs, Poland is lower than the three others. However, medication use differs largely. For 2018, in SU, intra-nasal corticosteroid is the first treatment in Poland (70.0%), France (51.3%), Spain (51.1%) and Germany (50.3%) whereas the Italian market is dominated by systemic anti-histamines (41.4%) followed by intra-nasal corticosteroids (30.1%). Results of other years were similar.

Discussion: There are major differences between countries in terms of rhino-conjunctivitis medication usage.
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http://dx.doi.org/10.1111/cea.13884DOI Listing
April 2021

Management of anaphylaxis due to COVID-19 vaccines in the elderly.

Allergy 2021 Apr 2. Epub 2021 Apr 2.

Regional Ministry of Health of Andalusia, Seville, Spain.

Older adults, especially men and/or those with diabetes, hypertension and/or obesity, are prone to severe COVID-19. In some countries, older adults, particularly those residing in nursing homes, have been prioritised to receive COVID-19 vaccines due to high risk of death. In very rare instances,the COVID-19 vaccines can induce anaphylaxis, and the management of anaphylaxis in older people should be considered carefully. An ARIA-EAACI-EuGMS (Allergic Rhinitis and its Impact on Asthma, European Academy of Allergy and Clinical Immunology, and European Geriatric Medicine Society)Working Group has proposed some recommendations for older adults receiving the COVID-19 vaccines. Anaphylaxis to COVID-19 vaccines is extremely rare (from 1 per 100,000 to 5 per million injections). Symptoms are similar in younger and older adults but they tend to be more severe in the older patients. Adrenaline is the mainstay treatment and should be readily available. A flowchart is proposed to manage anaphylaxis in the older patients.
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http://dx.doi.org/10.1111/all.14838DOI Listing
April 2021

Differentiation of COVID-19 signs and symptoms from allergic rhinitis and common cold- An ARIA-EAACI-GA LENconsensus.

Allergy 2021 Mar 17. Epub 2021 Mar 17.

Division of Allergy, Department of Pediatric Medicine, The Bambino Gesù Children's Research Hospital Holy see, IRCCS, Rome, Italy.

Background: Although there are many asymptomatic patients, one of the problems of COVID-19 is early recognition of the disease. COVID-19 symptoms are polymorphic and may include upper respiratory symptoms. However, COVID-19 symptoms may be mistaken withthe common cold or allergic rhinitis. An ARIA-EAACI study group attempted to differentiate upper respiratory symptoms betweenthe three diseases.

Methods: A modified Delphi process was used and ARIA members who were seeing COVID-19 patients were asked to fill in a questionnaire on the upper airway symptoms of COVID-19, common cold andallergic rhinitis.

Results: Among the 192 ARIA members who were invited to respond to the questionnaire, 89 responded. 87 questionnaires were analysed. The consensus was then reported.A two-way ANOVA analysis revealed significant differences inthe symptom intensity between the three diseases (p<0.001).

Conclusions: This modified Delphi approach enabled thedifferentiationof upper respiratory symptoms betweenCOVID-19, common cold and allergic rhinitis. An electronic algorithm will be devised using the questionnaire.
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http://dx.doi.org/10.1111/all.14815DOI Listing
March 2021

The role of the nasal allergen provocation test in local allergic rhinitis cases: a preliminary report.

Postepy Dermatol Alergol 2020 Dec 15;37(6):890-897. Epub 2019 May 15.

Unit of Environmental Hazard Prevention and Allergology, Medical University of Warsaw, Warsaw, Poland.

Introduction: The current state of knowledge is that allergic rhinitis can occur in two forms. One is allergic rhinitis as a manifestation of a systemic allergy with systemic atopy and positive results of skin prick tests or sIgE tests. The other is local allergic rhinitis (LAR) as a local allergic reaction affecting only the nasal mucosa without systemic atopy.

Aim: To attempt to assess the usefulness of the nasal allergen provocation test for the purposes of differential diagnosis and the qualification of LAR patients for therapy.

Material And Methods: The subjects in the study were a group of 6 adults diagnosed with LAR on the basis of their medical history and the results of nasal allergen provocation tests, with the allergens being house dust mites ( The methods adopted in the study were a point-based rating scale as a measure of nasal/extranasal complaints and active anterior rhinomanometry.

Results: Significant differences ( < 0.05) were observed, using the subjective rating scale, in relation to registered nasal and extranasal complaints in the early phase of the allergic reaction. Similarly, the rhinomanometry method revealed significant differences in nasal resistance values before and after the administration of an allergen.

Conclusions: The nasal allergen provocation test is the only testing tool that objectively measures the degree of the patient's allergic reactions and is useful in qualifying LAR patients for further therapy.
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http://dx.doi.org/10.5114/ada.2019.84719DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7874866PMC
December 2020

Potential Interplay between Nrf2, TRPA1, and TRPV1 in Nutrients for the Control of COVID-19.

Int Arch Allergy Immunol 2021 10;182(4):324-338. Epub 2021 Feb 10.

Division of Infection, Immunity & Respiratory Medicine, Royal Manchester Children's Hospital, University of Manchester, Manchester, United Kingdom.

In this article, we propose that differences in COVID-19 morbidity may be associated with transient receptor potential ankyrin 1 (TRPA1) and/or transient receptor potential vanilloid 1 (TRPV1) activation as well as desensitization. TRPA1 and TRPV1 induce inflammation and play a key role in the physiology of almost all organs. They may augment sensory or vagal nerve discharges to evoke pain and several symptoms of COVID-19, including cough, nasal obstruction, vomiting, diarrhea, and, at least partly, sudden and severe loss of smell and taste. TRPA1 can be activated by reactive oxygen species and may therefore be up-regulated in COVID-19. TRPA1 and TRPV1 channels can be activated by pungent compounds including many nuclear factor (erythroid-derived 2) (Nrf2)-interacting foods leading to channel desensitization. Interactions between Nrf2-associated nutrients and TRPA1/TRPV1 may be partly responsible for the severity of some of the COVID-19 symptoms. The regulation by Nrf2 of TRPA1/TRPV1 is still unclear, but suggested from very limited clinical evidence. In COVID-19, it is proposed that rapid desensitization of TRAP1/TRPV1 by some ingredients in foods could reduce symptom severity and provide new therapeutic strategies.
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http://dx.doi.org/10.1159/000514204DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8018185PMC
April 2021

Efficacy of broccoli and glucoraphanin in COVID-19: From hypothesis to proof-of-concept with three experimental clinical cases.

World Allergy Organ J 2021 Jan 9;14(1):100498. Epub 2020 Dec 9.

IMIM (Hospital del Mar Research Institute), Barcelona, Spain.

COVID-19 is described in a clinical case involving a patient who proposed the hypothesis that Nuclear factor (erythroid-derived 2)-like 2 (Nrf2)-interacting nutrients may help to prevent severe COVID-19 symptoms. Capsules of broccoli seeds containing glucoraphanin were being taken before the onset of SARS-CoV-2 infection and were continued daily for over a month after the first COVID-19 symptoms. They were found to reduce many of the symptoms rapidly and for a duration of 6-12 h by repeated dosing. When the patient was stable but still suffering from cough and nasal obstruction when not taking the broccoli capsules, a double-blind induced cough challenge confirmed the speed of onset of the capsules (less than 10 min). A second clinical case with lower broccoli doses carried out during the cytokine storm confirmed the clinical benefits already observed. A third clinical case showed similar effects at the onset of symptoms. In the first clinical trial, we used a dose of under 600 μmol per day of glucoraphanin. However, such a high dose may induce pharmacologic effects that require careful examination before the performance of any study. It is likely that the fast onset of action is mediated through the TRPA1 channel. These experimental clinical cases represent a proof-of-concept confirming the hypothesis that Nrf2-interacting nutrients are effective in COVID-19. However, this cannot be used in practice before the availability of further safety data, and confirmation is necessary through proper trials on efficacy and safety.
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http://dx.doi.org/10.1016/j.waojou.2020.100498DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7770975PMC
January 2021

Spices to Control COVID-19 Symptoms: Yes, but Not Only….

Int Arch Allergy Immunol 2020 Dec 22:1-7. Epub 2020 Dec 22.

Maladies Infectieuses et Tropicales, CHU, Montpellier, France.

There are large country variations in COVID-19 death rates that may be partly explained by diet. Many countries with low COVID-19 death rates have a common feature of eating large quantities of fermented vegetables such as cabbage and, in some continents, various spices. Fermented vegetables and spices are agonists of the antioxidant transcription factor nuclear factor (erythroid-derived 2)-like 2 (Nrf2), and spices are transient receptor potential ankyrin 1 and vanillin 1 (TRPA1/V1) agonists. These mechanisms may explain many COVID-19 symptoms and severity. It appears that there is a synergy between Nrf2 and TRPA1/V1 foods that may explain the role of diet in COVID-19. One of the mechanisms of COVID-19 appears to be an oxygen species (ROS)-mediated process in synergy with TRP channels, modulated by Nrf2 pathways. Spicy foods are likely to desensitize TRP channels and act in synergy with exogenous antioxidants that activate the Nrf2 pathway.
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http://dx.doi.org/10.1159/000513538DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7900475PMC
December 2020

Sensitisation to airborne allergens as a risk factor for allergic rhinitis and asthma in the Polish population.

Postepy Dermatol Alergol 2020 Oct 9;37(5):751-759. Epub 2019 Apr 9.

Department of the Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland.

Introduction: The patterns of sensitisation to airborne allergens and their association with allergic diseases have been analysed in different geographical regions.

Aim: To analyse the impact of sensitisation to airborne allergens on allergic rhinitis (AR) and asthma in different age groups of the Polish population.

Material And Methods: Completed questionnaires of 18,617 subjects (53.8% females), collected within the ECAP, a cross-sectional multicentre study, were analysed. Three groups of respondents were included: 6-7-year-olds (24.2%), 13-14-year-olds (25.4%), 20-44-year-olds (50.4%). The clinical part (an anamnesis, physical examination, spirometry, skin prick tests and an assay of major airborne allergen-specific IgE) was attended by 25.7% of the respondents.

Results: The AR was most strongly related to sensitisation to , with the highest odds ratios of 10 in two younger groups and of 16 for persistent AR in children. It was also the most important risk factor for allergic asthma, with odd ratios from 8.34 in children to 6.40 in adolescents. Sensitisation to grass pollen allergens was a major risk factor for both AR, with odds ratios from 9.16 in adults to 7.87 in adolescents, and asthma, with odds ratios from 6.16 in adolescents to 5.67 in adults.

Conclusions: AR and asthma shared common risk factors, independently of age. Sensitisation to airborne allergens was significantly associated with asthma and, even more strongly, with AR, across all age groups. The AR was the strongest risk factor for allergic asthma in the youngest group. Persistent AR increased asthma risk more than intermittent AR in all age groups.
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http://dx.doi.org/10.5114/ada.2019.84231DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7675083PMC
October 2020

Objectification of the nasal patency assessment techniques used in nasal allergen provocation testing.

Postepy Dermatol Alergol 2020 Oct 21;37(5):635-640. Epub 2019 Jan 21.

Unit of Environmental Hazard Prevention and Allergology, Faculty of Public Health and Environmental Health, Medical University of Warsaw, Warsaw, Poland.

Topical allergen application in nasal provocation testing (NPT) is associated with remarkably rapid changes in nasal patency. Thus, selecting the techniques of assessing the extent of nasal obstruction (as one of the responses to topical allergen application) is an important component of NPT. The study attempted to systematize and evaluate the techniques selected for assessing nasal patency during NPT based on a review of relevant literature. We reviewed the literature on the attempts to standardize the objective techniques for assessing nasal patency and their use in NPT. The best known, well-established technique for assessing nasal patency as part of NPT was rhinomanometry, followed by peak nasal inspiratory flow (PNIF) testing and acoustic rhinometry.
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http://dx.doi.org/10.5114/ada.2019.81404DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7675096PMC
October 2020

Prevalence of allergic rhinitis and asthma in Poland in relation to pollen counts.

Postepy Dermatol Alergol 2020 Aug 27;37(4):540-547. Epub 2019 Mar 27.

Department of the Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland.

Introduction: Despite the known role of pollen allergens in causing allergy symptoms in sensitized individuals, there are few publications investigating the relationship between pollen exposure in different regions and the prevalence of inhalant allergy.

Aim: To assess the association between the prevalence of allergic rhinitis and asthma and the degree of exposure to pollen in various regions of Poland.

Material And Methods: Completed questionnaires of 9,443 subjects living in four urban centres (Wroclaw, Katowice, Warsaw, Bialystok), collected within part of the ECAP project, were analyzed. Children aged 6-7 ( = 2,278), adolescents aged 13-14 ( = 2,418), and adults aged 20-44 ( = 4,747) constituted 24.2%, 25.6% and 50.3% of the respondents, respectively. The clinical part (including skin prick tests, an assay of Timothy grass-specific IgE), was attended by 24% of the respondents. Data from 6-year pollen monitoring served to characterize birch and grass pollen seasons.

Results: We found insignificant negative associations between the duration of birch pollen season and the prevalence of declared allergic rhinitis and asthma during the season across all age groups. There were insignificant inverse associations between the number of days with above-threshold and high grass pollen concentrations, total grass pollen count and the prevalence of declared allergic rhinitis and asthma during the season across all age groups. Associations noted in the clinical part were also non-significant; however, these trends were not uniform across the age groups.

Conclusions: Our findings do not confirm the hypothesis of a positive association between pollen exposure and the prevalence of allergic rhinitis and asthma.
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http://dx.doi.org/10.5114/ada.2019.83624DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7507156PMC
August 2020

COVID-19 pandemic: Practical considerations on the organization of an allergy clinic-An EAACI/ARIA Position Paper.

Allergy 2021 03;76(3):648-676

Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.

Background: The coronavirus disease 2019 (COVID-19) has evolved into a pandemic infectious disease transmitted by the severe acute respiratory syndrome coronavirus (SARS-CoV-2). Allergists and other healthcare providers (HCPs) in the field of allergies and associated airway diseases are on the front line, taking care of patients potentially infected with SARS-CoV-2. Hence, strategies and practices to minimize risks of infection for both HCPs and treated patients have to be developed and followed by allergy clinics.

Method: The scientific information on COVID-19 was analysed by a literature search in MEDLINE, PubMed, the National and International Guidelines from the European Academy of Allergy and Clinical Immunology (EAACI), the Cochrane Library, and the internet.

Results: Based on the diagnostic and treatment standards developed by EAACI, on international information regarding COVID-19, on guidelines of the World Health Organization (WHO) and other international organizations, and on previous experience, a panel of experts including clinicians, psychologists, IT experts, and basic scientists along with EAACI and the "Allergic Rhinitis and its Impact on Asthma (ARIA)" initiative have developed recommendations for the optimal management of allergy clinics during the current COVID-19 pandemic. These recommendations are grouped into nine sections on different relevant aspects for the care of patients with allergies.

Conclusions: This international Position Paper provides recommendations on operational plans and procedures to maintain high standards in the daily clinical care of allergic patients while ensuring the necessary safety measures in the current COVID-19 pandemic.
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http://dx.doi.org/10.1111/all.14453DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7323448PMC
March 2021

ARIA digital anamorphosis: Digital transformation of health and care in airway diseases from research to practice.

Allergy 2021 01 23;76(1):168-190. Epub 2020 Oct 23.

Dept of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan.

Digital anamorphosis is used to define a distorted image of health and care that may be viewed correctly using digital tools and strategies. MASK digital anamorphosis represents the process used by MASK to develop the digital transformation of health and care in rhinitis. It strengthens the ARIA change management strategy in the prevention and management of airway disease. The MASK strategy is based on validated digital tools. Using the MASK digital tool and the CARAT online enhanced clinical framework, solutions for practical steps of digital enhancement of care are proposed.
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http://dx.doi.org/10.1111/all.14422DOI Listing
January 2021

Is diet partly responsible for differences in COVID-19 death rates between and within countries?

Clin Transl Allergy 2020 27;10:16. Epub 2020 May 27.

Charité Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.

Reported COVID-19 deaths in Germany are relatively low as compared to many European countries. Among the several explanations proposed, an early and large testing of the population was put forward. Most current debates on COVID-19 focus on the differences among countries, but little attention has been given to regional differences and diet. The low-death rate European countries (e.g. Austria, Baltic States, Czech Republic, Finland, Norway, Poland, Slovakia) have used different quarantine and/or confinement times and methods and none have performed as many early tests as Germany. Among other factors that may be significant are the dietary habits. It seems that some foods largely used in these countries may reduce angiotensin-converting enzyme activity or are anti-oxidants. Among the many possible areas of research, it might be important to understand diet and angiotensin-converting enzyme-2 (ACE2) levels in populations with different COVID-19 death rates since dietary interventions may be of great benefit.
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http://dx.doi.org/10.1186/s13601-020-00323-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7250534PMC
May 2020

Building age, type of indoor heating and the occurrence of allergic rhinitis and asthma.

Postepy Dermatol Alergol 2020 Feb 9;37(1):81-85. Epub 2020 Mar 9.

Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland.

Introduction: Structural materials and interior appliances are frequently mentioned as elements of modern buildings which may have an impact on the natural history of allergic diseases.

Aim: We hypothesized that the building age, the type of the heating system and the use of various indoor appliances can influence the occurrence of allergic rhinitis (AR) and asthma.

Material And Methods: The study group comprised 18,617 individuals. The tool used in the study was the European Community Respiratory Health Survey (ECRHS) and the International Study of Asthma and Allergies in Childhood (ISAAC) study questionnaire, adapted to European conditions (Middle and Eastern Europe) and used as part of the study called "Implementation of a System for the Prevention and Early Detection of Allergic Diseases in Poland".

Results: Questionnaire results indicated that people living in homes built in the years 1971-1990 had higher rates of allergic rhinitis (OR = 1.15025), which was correlated with clinical findings of increased occurrence of seasonal allergic rhinitis (OR = 1.60543). The leading factor contributing to the intensification of AR symptoms was the central heating (OR = 1.45358). As opposed to AR, people living in buildings with central heating less often declared asthma (OR = 0.8407). A clinical examination confirmed that central heating reduced the symptoms of moderate asthma (OR = 0.3524).

Conclusions: Increasing building age and certain indoor heating methods are important risk factors for the occurrence of allergic rhinitis and asthma.
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http://dx.doi.org/10.5114/ada.2019.85288DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7247069PMC
February 2020

Managing Allergic Rhinitis in the Pharmacy: An ARIA Guide for Implementation in Practice.

Pharmacy (Basel) 2020 May 16;8(2). Epub 2020 May 16.

MACVIA-France, 34295 Montpellier, France.

The paradigm of how we manage allergic rhinitis is shifting with a growing understanding that it is a complex process, requiring a coordinated effort from healthcare providers and patients. Pharmacists are key members of these integrated care pathways resolving medication-related problems, optimizing regimens, improving adherence and recommending therapies while establishing liaisons between patients and physicians. Community pharmacists are the most accessible healthcare professionals to the public and allergic rhinitis is one of the most common diseases managed by pharmacists. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines developed over the past 20 years have improved the care of allergic rhinitis patients through an evidence-based, integrated care approach. In this paper, we propose an integrated approach to allergic rhinitis management in community pharmacy following the 2019 ARIA in the pharmacy guidelines.
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http://dx.doi.org/10.3390/pharmacy8020085DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7355936PMC
May 2020

[Executive Summary of ARIA 2019: Integrated care pathways for allergic rhinitis in Argentina, Spain and Mexico].

Rev Alerg Mex 2019 Oct-Dec;66(4):409-425

Universidad del Salvador, Facultad de Medicina, Buenos Aires, Argentina.

The health and economic impact of allergic diseases are increasing rapidly, and changes in management strategies are required. Its influence reduces the capacity of work and school performance by at least a third. The ICPs of the airways (integrated care pathways for respiratory diseases) are structured multidisciplinary healthcare plans, promoting the recommendations of the guidelines in local protocols and their application to clinical practice. This document presents an executive summary for Argentina, Mexico, and Spain. Next-generation ARIA guidelines are being developed for the pharmacological treatment of allergic rhinitis (AR), using the GRADE-based guidelines for AR, tested with real-life evidence provided by mobile technology with visual analogue scales. It is concluded that in the AR treatment, H1-antihistamines are less effective than intranasal corticosteroids (INCS), in severe AR the INCS represent the first line of treatment, and intranasal combination INCS + anti-H1 is more effective than monotherapy. However, according to the MASK real-life observational study, patients have poor adherence to treatment and often self-medicate, according to their needs.
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http://dx.doi.org/10.29262/ram.v66i4.643DOI Listing
September 2020

Local allergic rhinitis: nasal allergen provocation testing as a good tool in the differential diagnosis.

Int J Occup Med Environ Health 2020 Mar 24;33(2):241-246. Epub 2020 Feb 24.

Medical University of Warsaw, Warsaw, Poland (Faculty of Health Sciences, Department of the Environmental Hazards Prevention and Allergology).

Local allergic rhinitis (LAR) is a specific phenotype of allergic rhinitis. One characteristic feature of LAR is a medical history indicative of an allergic disease, negative skin-prick test results, undetectable levels of specific IgE, and a positive allergen-specific nasal provocation test. This paper presents a case of a patient with LAR and underlying house dust mite allergy, who was ultimately diagnosed >10 years after the onset of his first symptoms. Currently, there are only pharmacological treatments available for LAR. However, some studies show encouraging results with the use of allergen-specific immunotherapy in LAR, which offer hope for a future use of this causative treatment in LAR patients. Int J Occup Med Environ Health. 2020;33(2):241-6.
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http://dx.doi.org/10.13075/ijomeh.1896.01503DOI Listing
March 2020

Dietary supplements: a great menace of our time or golden remedy? A cross-sectional study amongschool-aged children.

Postepy Dermatol Alergol 2019 Dec 30;36(6):681-686. Epub 2019 Dec 30.

Department of Paediatric Pneumonology and Allergy, Medical University of Warsaw, Warsaw, Poland.

Introduction: Dietary supplements (DS) are commonly used as a remedy for various health issues as they are widely advertised and available.

Aim: This study aimed to evaluate the prevalence of DS use among school-aged children in Warsaw, the capital city of Poland. Additionally, we evaluated the parents' motivations for DS administration, the frequency of the use of specific compounds and the influence of child's history of allergy on DS use.

Material And Methods: Children aged 6-7 years who attended the first grade of primary schools in Warsaw were included into the study. Forty-two out of 170 primary schools in Warsaw were randomly selected of which 38 agreed to participate. The research tool was a self-administered questionnaire.

Results: Half of the studied children received DS in the previous 6 months. Fatty acids were the most commonly administered DS (49.8%). The most common reason for administering DS was prevention of diseases (69.1%). The total household income correlated positively with the DS use. History of food allergy was one of the factors which increased the risk of DS use, whereas diagnosis of asthma did not correlate with a higher frequency of DS use.

Conclusions: This study shows the need to educate patients about medical indications for DS use and expected benefits in the specific indications.
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http://dx.doi.org/10.5114/ada.2019.91418DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6986285PMC
December 2019

Correlation between work impairment, scores of rhinitis severity and asthma using the MASK-air App.

Allergy 2020 07 22;75(7):1672-1688. Epub 2020 Mar 22.

Upper Airways Research Laboratory, ENT Dept, Ghent University Hospital, Ghent, Belgium.

Background: In allergic rhinitis, a relevant outcome providing information on the effectiveness of interventions is needed. In MASK-air (Mobile Airways Sentinel Network), a visual analogue scale (VAS) for work is used as a relevant outcome. This study aimed to assess the performance of the work VAS work by comparing VAS work with other VAS measurements and symptom-medication scores obtained concurrently.

Methods: All consecutive MASK-air users in 23 countries from 1 June 2016 to 31 October 2018 were included (14 189 users; 205 904 days). Geolocalized users self-assessed daily symptom control using the touchscreen functionality on their smart phone to click on VAS scores (ranging from 0 to 100) for overall symptoms (global), nose, eyes, asthma and work. Two symptom-medication scores were used: the modified EAACI CSMS score and the MASK control score for rhinitis. To assess data quality, the intra-individual response variability (IRV) index was calculated.

Results: A strong correlation was observed between VAS work and other VAS. The highest levels for correlation with VAS work and variance explained in VAS work were found with VAS global, followed by VAS nose, eye and asthma. In comparison with VAS global, the mCSMS and MASK control score showed a lower correlation with VAS work. Results are unlikely to be explained by a low quality of data arising from repeated VAS measures.

Conclusions: VAS work correlates with other outcomes (VAS global, nose, eye and asthma) but less well with a symptom-medication score. VAS work should be considered as a potentially useful AR outcome in intervention studies.
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http://dx.doi.org/10.1111/all.14204DOI Listing
July 2020

The use of nasal over-the-counter agents in the evaluated Polish population. The underrated role of the pharmacist in patient education on medical treatment in patients with allergic rhinitis.

Postepy Dermatol Alergol 2019 Oct 12;36(5):524-530. Epub 2019 Nov 12.

Unit of Environmental Hazard Prevention and Allergology, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland.

Introduction: The goal of treatment in allergic rhinitis is a complete elimination of symptoms or achieving significant clinical improvement. The role of the pharmacist has been receiving particular attention in terms of the initial diagnosis and treatment of allergic rhinitis patients and their sufficiently early referral to a specialist in case of persistent symptoms.

Aim: This study attempted to estimate the rates of nasal OTC use in patients diagnosed with allergic rhinitis.

Material And Methods: Study population was 18,578 subjects (4,192 patients diagnosed with AR and 14,386 healthy controls): children aged 6-7 years, adolescents aged 13-14 years, and adults aged 20-44 years. We used translated and validated versions of ECRHS and ISAAC questionnaires.

Results: The rates of nasal decongestant use in the allergic rhinitis group were 60.4% in children, 50.7% in adolescents, and 43.0% in adults, with these figures significantly higher than in the control group ( < 0.05). The most common nasal agent was and 0.1%.

Conclusions: Over a half of the evaluated allergic rhinitis patients used nasal decongestants, which poses a potential risk of uncontrolled side effects. There is an urgent need to introduce patient education on medical treatment.
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http://dx.doi.org/10.5114/ada.2019.84289DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6906976PMC
October 2019

Survey participations rates reporting – toward standardization in epidemiological studies

Przegl Epidemiol 2019 ;73(3):383-391

Medical University of Warsaw, Department of Prevention of Environmental Hazards and Allergology

Participation rates are recognized as key indicators of the quality of the data collected during a survey. This is particularly important in epidemiological studies where the findings are extrapolated from the study sample to the general population. The response rate is very frequently selected as the key indicator of the overall quality of the data collected but the literature search shows that there are many different ways to calculate it. Only the use of the whole set of participation rates allows assessment of both the quality of the survey (the quality of the data collected) and the reliability of the fieldwork. Standardization of the methods for calculating participation rates seems to be a prerequisite for a reliable comparison of the quality of population surveys.
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http://dx.doi.org/10.32394/pe.73.31DOI Listing
April 2020

Helsinki by nature: The Nature Step to Respiratory Health.

Clin Transl Allergy 2019 30;9:57. Epub 2019 Oct 30.

29FILHA, Finnish Lung Health Association, Helsinki, Finland.

Background: was the overarching theme of the 12th General Meeting of the Global Alliance against Chronic Respiratory Diseases (GARD) in Helsinki, August 2018. New approaches are needed to improve respiratory health and reduce premature mortality of chronic diseases by 30% till 2030 (UN Sustainable Development Goals, SDGs). Planetary health is defined as the health of human civilization and the state of the natural systems on which it depends. Planetary health and human health are interconnected, and both need to be considered by individuals and governments while addressing several SDGs.

Results: The concept of the Nature Step has evolved from innovative research indicating, how changed lifestyle in urban surroundings reduces contact with biodiverse environments, impoverishes microbiota, affects immune regulation and increases risk of NCDs. The Nature Step calls for strengthening connections to nature. Physical activity in natural environments should be promoted, use of fresh vegetables, fruits and water increased, and consumption of sugary drinks, tobacco and alcohol restricted. Nature relatedness should be part of everyday life and especially emphasized in the care of children and the elderly. Taking "nature" to modern cities in a controlled way is possible but a challenge for urban planning, nature conservation, housing, traffic arrangements, energy production, and importantly for supplying and distributing food. Actions against the well-known respiratory risk factors, air pollution and smoking, should be taken simultaneously.

Conclusions: In Finland and elsewhere in Europe, successful programmes have been implemented to reduce the burden of respiratory disorders and other NCDs. Unhealthy behaviour can be changed by well-coordinated actions involving all stakeholders. The growing public health concern caused by NCDs in urban surroundings cannot be solved by health care alone; a multidisciplinary approach is mandatory.
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http://dx.doi.org/10.1186/s13601-019-0295-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6822361PMC
October 2019

Next-generation Allergic Rhinitis and Its Impact on Asthma (ARIA) guidelines for allergic rhinitis based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) and real-world evidence.

J Allergy Clin Immunol 2020 01 15;145(1):70-80.e3. Epub 2019 Oct 15.

ProAR-Nucleo de Excelencia em Asma, Federal University of Bahia, and the WHO GARD Planning Group, Bahia, Brazil.

The selection of pharmacotherapy for patients with allergic rhinitis aims to control the disease and depends on many factors. Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines have considerably improved the treatment of allergic rhinitis. However, there is an increasing trend toward use of real-world evidence to inform clinical practice, especially because randomized controlled trials are often limited with regard to the applicability of results. The Contre les Maladies Chroniques pour un Vieillissement Actif (MACVIA) algorithm has proposed an allergic rhinitis treatment by a consensus group. This simple algorithm can be used to step up or step down allergic rhinitis treatment. Next-generation guidelines for the pharmacologic treatment of allergic rhinitis were developed by using existing GRADE-based guidelines for the disease, real-world evidence provided by mobile technology, and additive studies (allergen chamber studies) to refine the MACVIA algorithm.
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http://dx.doi.org/10.1016/j.jaci.2019.06.049DOI Listing
January 2020