Shared and unique individual risk factors and clinical biomarkers in children with allergic rhinitis and obstructive sleep apnea syndrome

Ha, Eun Kyo; Park, Jun Hyeong; Lee, Seung Jin; Yon, Dong Keon; Kim, Ju Hee; Jee, Hye Mi; Lee, Kyung Suk; Sung, Myongsoon; Kim, Mi Ae; Shin, Youn Ho; Han, Man Yong

doi:10.1111/crj.13124

Cited by 8 publications

(7 citation statements)

References 28 publications

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“…26 Ha and colleagues demonstrated significantly lower values of NLR in patients with AR when compared with healthy controls. 11 Similar to the results of the study conducted by Ha and colleagues, 11 we also observed significantly lower levels of NLR in AR patients versus the control group. An NLR cut-off value of ≤1.7 had 42.8% sensitivity, 73.5% specificity, and 86.5% PPV for predicting AR with an AUC of 0.602.…”

Section: Resultssupporting

confidence: 90%

“…Growing evidence shows that absolute neutrophil, lymphocyte, and neutrophil counts and their respective ratios could be used to assess severity of AR. 11,12 In this study, 160 patients (78.0%) had persistent AR. Istanbul and Trabzon, where the research was conducted, have zero altitude and have a climate with an average relative humidity of 80-85% 13 .…”

Section: Discussionmentioning

confidence: 65%

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Association of severity of allergic rhinitis with neutrophil-to-lymphocyte, eosinophil-to-neutrophil, and eosinophil-to-lymphocyte ratios in adults

Kant

Terzioğlu

2021

aei

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Background: Allergic rhinitis (AR) is characterized by chronic inflammation of the nasal mucosa. T-helper 2 lymphocytes, neutrophils, and eosinophils play an active role during the late-phase immune response after exposure to allergen.Objective: We aimed to investigate the usefulness of inflammatory parameters of neutro-phil-to-lymphocyte ratio (NLR), eosinophil-to-neutrophil ratio (ENR), and eosinophil-to-lymphocyte ratio (ELR) as markers for distinction between intermittent and persistent allergic rhinitis.Material and Methods: This was a double-center, retrospective study. Patients were enrolled after diagnosed with AR according to the Allergic Rhinitis and Its Impact on Asthma guide-lines. Individuals with an active infection were excluded. A cohort of healthy subjects acted as a control group. NLR, ENR, and ELR were calculated using the results obtained from the patients’ complete blood count. Descriptive statistical analysis was performed for all studied variables.Results: In all, 205 AR patients and 49 healthy individuals were included. AR patients had sig-nificantly higher levels of absolute eosinophils, ENR, and ELR, and significantly lower levels of NLR than the healthy controls (P < 0.05). A total of 160 (78%) patients with persistent AR had significantly higher levels of absolute eosinophils, ENR, and ELR, and significantly lower levels of NLR than patients with intermittent AR (P < 0.05). Conclusion: Currently, classification of severity of AR is based on the patient’s anamnesis. It has been shown in this study that serum eosinophil levels in persistent AR patients could be used as traceable parameters in evaluating severity of the disease by looking at the propor-tions of ENR and ELR. We anticipate that in the future this issue would be supported by a larger number of studies.

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Section: Resultssupporting

confidence: 90%

Section: Discussionmentioning

confidence: 65%

Association of severity of allergic rhinitis with neutrophil-to-lymphocyte, eosinophil-to-neutrophil, and eosinophil-to-lymphocyte ratios in adults

Kant

Terzioğlu

2021

aei

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“…Pre-term birth has previously been linked to a higher risk of OSAS ( 43 ). Breastfeeding has been shown to be positively correlated with OSAS incidence, and breastfeeding rates are higher for parents with a lower education level as compared to patients with a higher education level ( 11 ).…”

Section: Discussionmentioning

confidence: 99%

Analysis of the Risk Factors Associated With Obstructive Sleep Apnea Syndrome in Chinese Children

Ling

Jia

et al. 2022

Front. Pediatr.

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ObjectiveThe present study was developed to explore risk factors related to the incidence and severity of obstructive sleep apnea syndrome (OSAS) in children.MethodsThe present study enrolled pediatric patients who admitted to our department for snoring and/or open-mouth breathing. All children completed a questionnaire and underwent physical examination and polysomnography (PSG). The cases were separated into OSAS and primary snoring (PS) groups. Factors associated with these two groups were analyzed, with risk factors significantly associated with OSAS then being identified through logistic regression analyses. OSAS was further subdivided into mild, moderate, and severe subgroups, with correlations between risk factors and OSAS severity then being analyzed.ResultsIn total, 1,550 children were included in the present study, of which 852 and 698 were enrolled in the OSAS and PS groups. In univariate analyses, obesity, family passive smoking, a family history of snoring, allergic rhinitis, asthma, adenoid hypertrophy, and tonsil hypertrophy were all related to pediatric OSAS (P < 0.05). In a multivariate logistic regression analysis, adenoid hypertrophy (OR:1.835, 95% CI: 1.482–2.271) and tonsil hypertrophy (OR:1.283, 95% CI:1.014–1.622) were independently associated with the risk of pediatric OSAS (P < 0.05). Stratification analyses revealed that OSAS incidence increased in a stepwise manner with increases in adenoid and tonsil grading (P < 0.01). Correlation analyses revealed that adenoid hypertrophy and tonsilar hypertrophy were not significantly associated with OSAS severity (r = 0.253, 0.069, respectively, P < 0.05), and tonsil and adenoid size were no correlation with obstructive apnea-hypopnea index (OAHI) (r = 0.237,0.193, respectively, P < 0.001).ConclusionObesity, family passive smoking, a family history of snoring, allergic rhinitis, asthma, tonsil hypertrophy, and adenoid hypertrophy may be potential risk factors for pediatric OSAS. Adenoid hypertrophy and tonsil hypertrophy were independently related to the risk of pediatric OSAS, with OSAS incidence increasing with the size of the adenoid and tonsil, while the severity of OSAS is not parallel related to the adenoid or tonsil size.

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“…Nonallergic rhinitis is a diagnosis of exclusion that is characterized by signs and/or symptoms similar to allergic rhinitis (e.g., rhinorrhea, nasal obstruction, nasal itching, and sneezing after allergen exposure). After the exclusion of allergic rhinitis based on the identification of allergen sensitizations, nonallergic rhinitis is suspected and efforts are made to identify associated conditions like sinusitis or adenoid hypertrophy [ 7 , 8 ]. Studies have reported that the prevalence of nonallergic rhinitis is 0.7%–50.0 % (median, 10.1%) in pediatric population.…”

Section: Epidemiology Of Nonallergic Rhinitis In Childrenmentioning

confidence: 99%

“…After the exclusion of allergic rhinitis based on the identification of allergen sensitizations, nonallergic rhinitis is suspected and efforts are made to identify associated conditions like sinusitis or adenoid hypertrophy. 7,8) Studies have reported that the prevalence of nonallergic rhinitis is 0.7%-50.0 % (median, 10.1%) in pediatric population. Nonallergic rhinitis seems to account for 15.7%-89.0% of the chronic rhinitis cases (Table 1).…”

Section: Epidemiology Of Nonallergic Rhinitis In Childrenmentioning

confidence: 99%

Prevalence, comorbidities, diagnosis, and treatment of nonallergic rhinitis: real-world comparison with allergic rhinitis

Yum

Shin

et al. 2021

Clin Exp Pediatr

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Rhinitis is among the most common respiratory diseases in children. Nonallergic rhinitis, which involves nasal symptoms without evidence of systemic allergic inflammation or infection, is a heterogeneous entity with diverse manifestations and intensities. Nonallergic rhinitis accounts for 16%–89% of the chronic rhinitis cases, affecting 1%–50% (median 10%) of the total pediatric population. The clinical course of nonallergic rhinitis is generally rather mild and less likely to be associated with allergic comorbidities than allergic rhinitis. Here, we aimed to estimate the rate of coexisting comorbidities of nonallergic rhinitis. Nonallergic rhinitis is more prevalent during the first 2 years of life; however, its underestimation for children with atopic tendencies is likely due to low positive rates of specific allergic tests during early childhood. Local allergic rhinitis is a recently noted phenotype with rates similar to those in adults (median, 44%; range, 4%–67%), among patients previously diagnosed with nonallergic rhinitis. Idiopathic rhinitis, a subtype of nonallergic rhinitis, has been poorly studied in children, and its rates are known to be lower than those in adults. The prevalence of nonallergic rhinitis with eosinophilia syndrome is even lower. A correlation between nonallergic rhinitis and pollution has been suggested owing to the recent increase in nonallergic rhinitis rates in highly developing regions such as some Asian countries, but many aspects remain unknown. Conventional treatments include antihistamines, intranasal corticosteroids, and recent treatments include combination of intranasal corticosteroids with azelastin or decongestants. Here we review the prevalence, diagnosis, comorbidities, and treatment recommendations for nonallergic rhinitis versus allergic rhinitis in children.

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Shared and unique individual risk factors and clinical biomarkers in children with allergic rhinitis and obstructive sleep apnea syndrome

Cited by 8 publications

References 28 publications

Association of severity of allergic rhinitis with neutrophil-to-lymphocyte, eosinophil-to-neutrophil, and eosinophil-to-lymphocyte ratios in adults

Association of severity of allergic rhinitis with neutrophil-to-lymphocyte, eosinophil-to-neutrophil, and eosinophil-to-lymphocyte ratios in adults

Analysis of the Risk Factors Associated With Obstructive Sleep Apnea Syndrome in Chinese Children

Prevalence, comorbidities, diagnosis, and treatment of nonallergic rhinitis: real-world comparison with allergic rhinitis

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