Chinese Guideline on Allergen Immunotherapy for Allergic Rhinitis: The 2022 Update

Bao, Yongxing; Chen, Jianjun; Chen, Xiaoyang; Cheng, Long; Guo, Yinshi; Hao, Chuangli; Lai, He; Li, Hua‐Bin; Li, Jing; Liu, Changshan; Liu, Yun; Liu, Zheng; Lou, Hongfei; Lv, Wei; Nong, Guangmin; Qiu, Qianhui; Ren, Xiumin; Shao, Jie; Shen, Yihong; Li, Shi; Song, Xicheng; Song, Yuxin; Tang, Suping; Wang, Hongtian; Wang, Xiangdong; Wang, Xueyan; Wang, Zhenlin; Wei, Qingyu; Xie, Hua; Xing, Zhimin; Xu, Rui; Xu, Yu; Yang, Qintai; Yao, Hongmei; Ye, Jing; You, Yiwen; Yu, Hongmeng; Yu, Yongmei; Zhang, Huanping; Zhang, Gehua; Zhang, Yuan; Zhi, Yuxiang; Zhou, Wenjing; Zhu, Li; Zhu, Xinhua; Chai, Renjie; Chen, Dehua; Guan, Kai; Huang, Zizhen; Huang, Yanran; Ma, Tingting; Ma, Yuemei; Meng, Yifan; Ren, Lei; Wang, Nan; Xian, Ming; Xiang, Rong; Zheng, Ming; Zhang, Luo

doi:10.4168/aair.2022.14.6.604

Cited by 32 publications

(17 citation statements)

References 255 publications

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“…In recent years, the incidence of AR has been steadily increasing. AR not only causes discomfort on its own but is also recognized as an independent risk factor for other conditions such as asthma, allergic conjunctivitis, and atopic dermatitis 19 . AR significantly impacts both the health and quality of life of affected individuals, and places a substantial burden on society.…”

Section: Discussionmentioning

confidence: 99%

Long‐Term Efficacy and Safety of Subcutaneous Immunotherapy in Monosensitized and Polysensitized Children With Allergic Rhinitis

Yuan,

Xie,

Zhang

et al. 2023

Otolaryngol.--head neck surg.

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ObjectiveTo evaluate the efficacy and safety of dust mite subcutaneous immunotherapy (SCIT) in monosensitized and polysensitized children with allergic rhinitis (AR).Study DesignProspective cohort study.SettingTertiary referral center.MethodsOne hundred thirty children were enrolled and categorized into 2 groups: monosensitized to only dust mites and polysensitized to at least 1 additional allergen beyond dust mites. All patients received SCIT targeting dust mites for 3 years, followed by a 5‐year monitoring period. The Total Nasal Symptom Score (TNSS), Symptom and Medication Score (SMS), Visual Analogue Scale (VAS), and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) were assessed before SCIT (T0); at 1 (T1) and 2 (T2) years of SCIT; immediately after SCIT (T3); and 2 years post‐SCIT (T5). Safety was assessed based on adverse events (AEs).ResultsFifty‐one monosensitized and 50 polysensitized children completed the study. At T3, 47 monosensitized and 46 polysensitized children were effectively treated, with no significant between‐group difference in efficacy (P > .05). The TNSS, SMS, VAS scores, and RQLQ score were significantly lower at T1, T2, T3, and T5 than at T0 in both groups (P < .05). The differences in the TNSS, SMS, VAS score, and RQLQ score between the 2 groups were nonsignificant at T0, T1, T2, and T3 (P > .05), but significant at T5 (P < .05). No serious AEs were reported.ConclusionMonosensitized and polysensitized children exhibited similar beneficial efficacy and safety after 3 years of dust mite SCIT. Monosensitized children derived more benefits 2 years after discontinuation.

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Section: Discussionmentioning

confidence: 99%

Long‐Term Efficacy and Safety of Subcutaneous Immunotherapy in Monosensitized and Polysensitized Children With Allergic Rhinitis

Yuan,

Xie,

Zhang

et al. 2023

Otolaryngol.--head neck surg.

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“…Thereinto, AIT, an etiological treatment, is recognized as the only immune-modifying therapy to achieve long-term effects. However, considering its duration and costs, strict indications have been set for the application of AIT [3 ▪▪ ]. Pharmacotherapy, a mode of symptomatic treatment, acts by interfering with the key processes in the pathogenesis [7].…”

Section: Introductionmentioning

confidence: 99%

“…As an upper respiratory noninfectious chronic inflammatory disease, allergic rhinitis arises from immunoglobulin E (IgE)-mediated reactions in atopic individuals exposed to allergens, symptomized by nasal itching, paroxysmal repetitive sneezing, watery rhinorrhea, and nasal blockage [1,2]. Allergic rhinitis affects 40% of the global population [3 ▪▪ ], approximately 20–30% of adults [4] and 25% of children [5], depriving an annual cost of 51.28 billion EUR in China [6] and 30–50 billion EUR in European countries [7]. Allergic rhinitis is not life-threatening but impairs patients’ quality of life (QoL) [8].…”

Section: Introductionmentioning

confidence: 99%

“…Allergic rhinitis management follows the principle of ‘a combination of prevention and treatment’, which integrates environmental control, pharmacotherapy, allergen immunotherapy (AIT) and patient education [1–3 ▪▪ ,7,8,13]. Although allergic rhinitis cannot be completely cured nowadays, its clinical symptoms can be well controlled and QoL improved in a long term under this principle.…”

Section: Introductionmentioning

confidence: 99%

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Highlights of the treatment of allergic rhinitis according to Chinese guidelines

Zhang

Cheng

2023

Current Opinion in Allergy &Amp; Clinical Immunology

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Purpose of review This review aimed to introduce the pharmacotherapy of allergic rhinitis according to the 2022 updated Chinese guidelines. Recent findings Despite recent advances in basic and clinical research worldwide, pharmacotherapy remains a mainstream in allergic rhinitis treatment. Usually, the first-line drugs, involving intranasal corticosteroids, second-generation oral and intranasal H1-antihistamines, or leukotriene receptor antagonists, can achieve acceptable outcomes in the treatment of allergic rhinitis. The second-line drugs, such as oral corticosteroids, intranasal decongestants and intranasal anticholinergics, can assist in controlling severe symptoms, like nasal congestion/blockage and watery rhinorrhea. For those with moderate-to-severe allergic rhinitis, evidence-based stepwise strategies are suitable, in which the types and dosages of drugs are de-escalated or upgraded according to their therapeutic efficacy. Meanwhile, omalizumab, a novel biological agent, has burgeoned to satisfy the need of patients. Summary This review highlights the staples in Chinese guidelines about the pharmacotherapy for allergic rhinitis to better understand the guidelines and promote the clinical practice.

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“…As the only disease-modifying therapy, AIT has been reported to provide long-term clinical benefits and tolerance, even after discontinuation following a course of over three years [1][2][3]. However, a significant percentage, ranging from 20 to 50%, of patients exhibit a poor response to this treatment, reflecting our limited understanding of the mechanisms of AIT [4][5][6]. Over the past few decades, significant progress has been made in unraveling the mechanisms involved in AIT.…”

Section: Introductionmentioning

confidence: 99%

Effects of allergen immunotherapy on follicular regulatory T cells

Sun,

Yao,

Liu

2023

Current Opinion in Allergy &Amp; Clinical Immunology

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Purpose of review Emerging evidence indicating that the dysfunction of T follicular regulatory (TFR) cells contributes to excessive immunoglobulin E (IgE) production and the development of allergic diseases. Conversely, allergen immunotherapy (AIT) modulates TFR cells abundance and function to promote immune tolerance. This review focus on the role of TFR cells in allergic diseases and AIT, with the objective of providing novel insights into the mechanisms underlying immune tolerance of AIT and proposing the potential targeting of TFR cells in the context of allergic diseases. Recent findings Numerous studies have consistently demonstrated that TFR cells play a pivotal role in the inhibition of class switch recombination to IgE in both humans and specific murine models. This suppression is attributed to the actions of neuritin and IL-10 secreted by TFR cells, which exert direct and indirect effects on B cells. In patients with allergic rhinitis, reduced frequencies of circulating or tonsillar TFR cells have been reported, along with impaired functionality in suppressing IgE production. AIT, whether administered subcutaneously or sublingually, reinstates the frequency and functionality of TFR cells in allergic rhinitis patients, accompanied by changes of the chromatin accessibility of TFR cells. The increase in TFR cell frequency following AIT is associated with the amelioration of clinical symptoms. Summary TFR cells exert an inhibitory effect on IgE production and demonstrate a correlation with the clinical efficacy of AIT in patients with allergic rhinitis, suggesting TFR cells hold promise as a therapeutic target for allergic diseases and potential biomarker for AIT.

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Chinese Guideline on Allergen Immunotherapy for Allergic Rhinitis: The 2022 Update

Cited by 32 publications

References 255 publications

Long‐Term Efficacy and Safety of Subcutaneous Immunotherapy in Monosensitized and Polysensitized Children With Allergic Rhinitis

Long‐Term Efficacy and Safety of Subcutaneous Immunotherapy in Monosensitized and Polysensitized Children With Allergic Rhinitis

Highlights of the treatment of allergic rhinitis according to Chinese guidelines

Effects of allergen immunotherapy on follicular regulatory T cells

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