Rhinitis in the geriatric population

The current geriatric population in the United States accounts for approximately 12% of the total population and is projected to reach nearly 20% (71.5 million people) by 2030[1]. With this expansion of the number of older adults, physicians will face the common complaint of rhinitis with increasing frequency. Nasal symptoms pose a significant burden on the health of older people and require attention to improve quality of life. Several mechanisms likely underlie the pathogenesis of rhinitis in these patients, including inflammatory conditions and the influence of aging on nasal physiology, with the potential for interaction between the two. Various treatments have been proposed to manage this condition; however, more work is needed to enhance our understanding of the pathophysiology of the various forms of geriatric rhinitis and to develop more effective therapies for this important patient population

Natural History of Perceived Food Hypersensitivity and IgE Sensitisation to Food Allergens in a Cohort of Adults

BACKGROUND: No longitudinal studies exist on the natural history of food hypersensitivity and IgE sensitisation to food allergens in adults. OBJECTIVE: To examine the natural history of food hypersensitivity, the natural history of IgE sensitisation to food allergens and to investigate the risk factors for new onset food hypersensitivity. METHODS: Food hypersensitivity was questionnaire-assessed in 2307 individuals (aged 20-45 years) from Iceland and Sweden during the European Community Respiratory Health Survey both at baseline and follow-up 9 years later. IgE food and aeroallergen sensitisation were assessed in a subgroup of these individuals (n = 807). Values of 0.35 kU/L and above were regarded as positive sensitisation. RESULTS: Food hypersensitivity was reported by 21% of the subjects and this proportion remained unchanged at follow-up (p = 0.58). Fruits, nuts and vegetables were the three most common causes of food hypersensitivity, with a similar prevalence at baseline and follow-up. The prevalence IgE sensitisation to food allergens decreased in general by 56% (p<0.001) and IgE sensitisation to peanut decreased in particular by 67% (p = 0.003). The prevalence of timothy grass IgE sensitisation decreased by 15% (p = 0.003) while cat, mite and birch IgE sensitisation did not decrease significantly. Female sex, rhinitis, eczema and presence of IgE sensitisation to aeroallergens were independently associated with new onset food hypersensitivity. CONCLUSION: The prevalence of food hypersensitivity remained unchanged while the prevalence of IgE sensitisation to food allergens decreased in adults over a 9-year follow-up period. The decrease in prevalence of IgE sensitisation to food allergens was considerably larger than the change in prevalence of IgE sensitisation to aeroallergens

A systematic review of CD14 and toll-like receptors in relation to asthma in Caucasian children

The aetiology of childhood asthma is complex. An early dysfunction in immunological development of the innate immune system in combination environmental factors possibly triggers asthma. CD14 and toll-like important components of the innate immune system. The aim of this review was to obtain a better insight into the relation between CD14 and toll-like receptors and childhood asthma in Caucasians. We searched EMBASE for relevant articles. In total, 44 articles were included. The the selected studies was independently assessed by the first two authors the Newcastle-Ottawa quality assessment scale. Toll-like receptor 2, receptor 6, toll-like receptor 9, and toll-like receptor 10 appear to association with childhood asthma in Caucasians. The evidence for a CD14 with childhood asthma is limited. In conclusion, there is no evidence yet for a role of CD14 and toll-like receptors in relation to asthma. Future studies should include haplotype analysis and take factors into account to further clarify the role of CD14 and toll-like on childhood asthma