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Keywords: allergy; achievements; China; journal EN allergy achievements China journal 422 424 3 02/20/21 20210201 NES 210201 With the rapid economic development and increased national financial support for scientific research in China, there has been considerable progress in the technological innovation capabilities of the country. As elucidated in this issue of I Allergy i , the remarkable efforts and the inspiring achievements of Chinese researchers are changing our understanding of some of the key issues in the field of allergies. Distinct effects of asthma and COPD comorbidity on disease expression and outcome in patients with COVID-19. [Extracted from the article]

In December 2019, China reported the first cases of the coronavirus disease 2019 (COVID‐19). This disease, caused by the severe acute respiratory syndrome–related coronavirus 2 (SARS‐CoV‐2), has developed into a pandemic. To date, it has resulted in ~9 million confirmed cases and caused almost 500 000 related deaths worldwide. Unequivocally, the COVID‐19 pandemic is the gravest health and socioeconomic crisis of our time. In this context, numerous questions have emerged in demand of basic scientific information and evidence‐based medical advice on SARS‐CoV‐2 and COVID‐19. Although the majority of the patients show a very mild, self‐limiting viral respiratory disease, many clinical manifestations in severe patients are unique to COVID‐19, such as severe lymphopenia and eosinopenia, extensive pneumonia, a "cytokine storm" leading to acute respiratory distress syndrome, endothelitis, thromboembolic complications, and multiorgan failure. The epidemiologic features of COVID‐19 are distinctive and have changed throughout the pandemic. Vaccine and drug development studies and clinical trials are rapidly growing at an unprecedented speed. However, basic and clinical research on COVID‐19–related topics should be based on more coordinated high‐quality studies. This paper answers pressing questions, formulated by young clinicians and scientists, on SARS‐CoV‐2, COVID‐19, and allergy, focusing on the following topics: virology, immunology, diagnosis, management of patients with allergic disease and asthma, treatment, clinical trials, drug discovery, vaccine development, and epidemiology. A total of 150 questions were answered by experts in the field providing a comprehensive and practical overview of COVID‐19 and allergic disease. [ABSTRACT FROM AUTHOR]

Background: Pruritus is identified as an adverse drug reaction to arsenic trioxide, but the association of arsenic exposure with pruritus has not been investigated. Methods: A cross‐sectional study was conducted in Shimen, China. A Mendelian randomization analysis was conducted to confirm the causal relationship between genetically predicted percentages of monomethylated arsenic (MMA%) and dimethylated arsenic (DMA%) in urine with chronic pruritus in UK Biobank. A case–control study was then conducted to determine the biomarker for pruritus. Arsenite‐treated mice were used to confirm the biomarker, and von Frey test was used to induce scratching bouts. Last, a randomized, double‐blind, placebo‐controlled trial was conducted to test the efficacy of naloxone in arsenic‐exposed patients with pruritus in Shimen. Results: Hair arsenic (μg/g) showed a dose–response relationship with the intensity of itch in 1079 participants, with odds ratios (OR) of 1.11 for moderate‐to‐severe itch (p = 0.012). The Mendelian randomization analysis confirmed the causal relationship, with ORs of 1.043 for MMA% (p = 0.029) and 0.904 for DMA% (p = 0.077) above versus under median. Serum β‐endorphin was identified as a significant biomarker for the intensity of itch (p < 0.001). Consistently, treatment with arsenite upregulated the level of β‐endorphin (p = 0.002) and induced scratching bouts (p < 0.001) in mice. The randomized controlled trial in 126 participants showed that treatment with sublingual naloxone significantly relieved the intensity of itch in arsenic‐exposed participants in 2 weeks (β = −0.98, p = 0.04). Conclusion: Arsenic exposure is associated with pruritus, and β‐endorphin serves as a biomarker of pruritus. Naloxone relieves pruritus in patients with arseniasis. [ABSTRACT FROM AUTHOR]

Background: Artemisia annua is an important autumnal pollen allergen for seasonal allergic rhinitis (SAR) in northern China. To date, no study has investigated allergen immunotherapy with A annua. We aimed to investigate the efficacy and mechanisms underlying A annua-sublingual immunotherapy (SLIT)., Methods: This was a randomized, double-blind, placebo-controlled phase III clinical trial involving 71 SAR patients, randomized to SLIT with A annua extract (n = 47) or placebo (n = 24) for 32 weeks. Total nasal symptom score (TNSS; primary clinical end point) was evaluated at baseline (peak pollen phase (PPP) in the previous year), initiation of A annua-SLIT, 1st PPP during SLIT, end of SLIT and 2nd PPP during follow-up. Blood samples and nasal secretions were collected at beginning and after SLIT for assessment of T cells and inflammatory mediators. Safety was assessed according to adverse events (AEs) reported., Results: Artemisia annua-SLIT significantly reduced TNSS to a greater level from baseline (from 9.45 ± 1.68 to 6.16 ± 2.27) than placebo (from 9.29 ± 2.09 to 9.05 ± 2.40) at the 1st PPP (P < .001) and sustained the improvement in symptoms throughout to the 2nd PPP. Preseasonal A annua-SLIT for 16 weeks significantly decreased Th2 cells, increased nTreg and Tr1 cells in blood; and increased cystatin 1 (CST1) in nasal secretion after 16 and 32 weeks compared with pretreatment. Overall, 17/47 patients experienced mild local AEs and 2 patients mild systemic AEs, after A annua-SLIT., Conclusion: Artemisia annua-SLIT is an efficacious and safe treatment in patients with A annua SAR., (© 2020 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.)

Background: Artemisia pollen allergy is a major cause of asthma in Northern China. Possible associations between IgE responses to Artemisia allergen components and clinical phenotypes have not yet been evaluated. This study was to establish sensitization patterns of four Artemisia allergens and possible associations with demographic characteristics and clinical phenotypes in three areas of China. Methods: Two hundred and forty patients allergic to Artemisia pollen were examined, 178 from Shanxi and 30 from Shandong Provinces in Northern China, and 32 from Yunnan Province in Southwestern China. Allergic asthma, rhinitis, conjunctivitis, and eczema symptoms were diagnosed. All patients' sera were tested by ImmunoCAP with mugwort pollen extract and the natural components nArt v 1, nArt ar 2, nArt v 3, and nArt an 7. Results: The frequency of sensitization and the IgE levels of the four components in Artemisia allergic patients from Southwestern China were significantly lower than in those from the North. Art v 1 and Art an 7 were the most frequently recognized allergens (84% and 87%, respectively), followed by Art v 3 (66%) and Art ar 2 (48%). Patients from Northern China were more likely to have allergic asthma (50%) than patients from Southwestern China (3%), and being sensitized to more than two allergens increased the risk of allergic asthma, in which co‐sensitization to three major allergens Art v 1, Art v 3, and Art an 7 is prominent. Conclusions: Component‐resolved diagnosis of Chinese Artemisia pollen‐allergic patients helps assess the potential risk of mugwort‐associated allergic asthma. Component‐resolved diagnosis of Chinese Artemisia pollen allergic patients helps assess the potential risk of mugwort‐associated allergic asthma. Sensitization to more than two Artemisia pollen allergens resulted in higher risk of allergic asthma, in which co‐sensitization to Art v 1, Art v 3 and Art an 7 allergens is prominent. [ABSTRACT FROM AUTHOR]

Abstract: Background: Little is known about the prevalence of food allergy (FA) in China. The aim of this study was to investigate the disparity of FA between urban and rural areas in southern China. Methods: EuroPrevall questionnaire responses were obtained from 5542 school‐age children in urban Guangzhou and 5319 in rural Shaoguan. A case‐control study enrolled 190 children with adverse reactions (ARs) after food intake as cases and 212 controls in Guangzhou, whereas 116 cases and 233 controls in Shaoguan. These subjects underwent skin prick test (SPT) and serum IgE measurements to food and inhalant allergens. Allergen extracts from shrimp, house dust mite (HDM), and cockroach were prepared for IgE cross‐reactivity testing in 23 Guangzhou and 20 Shaoguan shrimp‐sensitized subjects. Results: The prevalence of ARs to shrimp was higher in Guangzhou than in Shaoguan children (3.5% vs 1.4%, P < .001). However, sensitization rate to shrimp (SPT: 3.7% vs 11.2%, P = .015; IgE: 12.6% vs 36.2%, P < .001) and cockroach (SPT: 5.3% vs 33.5%; IgE: 2.6% vs 27.6%, P < .001) was lower in Guangzhou. A significant correlation between shrimp and HDM/cockroach IgE was found in Shaoguan children. The proportions of positive IgE to tropomyosin (Pen a 1, Der p 10) were lower than 7.4% in both areas. Cockroach allergen has a significantly higher inhibition rate of binding to IgE to house dust mite allergens in Shaoguan sera. Conclusion: Shrimp is a common allergic food in southern China. Higher proportion of shrimp sensitization in rural subjects could be explained by cross‐reactivity to cockroach. Tropomyosin was not a major allergen responding to the cross‐reactivity. [ABSTRACT FROM AUTHOR]

The article presents a study that examines 30 papers on the anaphylactic shocks and lethal anaphylaxis caused by Houttuynia Cordata injection (HCI) published in China from 1980 to 2007. It notes that HCI is derived from herbal extract of sterile volatile oil of the distilled H. Cordata and is used to treat diseases. An overview of the allergic effects of HCI is presented. It concludes that children, pregnant women or patients with common colds should not be given with HCI.

Background The prevalence of allergic rhinitis ( AR) has increased worldwide in recent decades. This study was conducted to investigate the prevalence of self-reported AR and profiles of AR-related comorbidities in the adult population of China over time. Methods This study surveyed residents of 18 major cities in mainland China. Telephone interviews were conducted with study participants after sampling target telephone numbers by random digit dialing. The questions asked during telephone interviews were based on those included in validated questionnaires and focused on topics regarding AR, nonallergic rhinitis (NAR), acute/chronic rhinosinusitis (ARS/CRS), asthma, and atopic dermatitis (AD). Results During 2011, a total of 47 216 telephone interviews were conducted, and the overall response rate was 77.5%. When compared with the AR prevalence in 11 cities surveyed in 2005, there was a significant increase in self-reported adult AR in eight of those cities ( P < 0.01). In 2011, the standardized prevalence of self-reported adult AR in the 18 cities was 17.6%. The concentration of SO2 was positively correlated with the prevalence of AR ( r = 0.504, P = 0.033). A multiple regression model showed that the absolute change in household yearly income was significantly associated with the change in the prevalence of AR ( R2 = 0.68), after adjusting for PM10, SO2, NO2, temperature, and humidity. The overall prevalences of NAR, ARS, CRS, asthma, and AD in the general population were 16.4%, 5.4%, 2.1%, 5.8%, and 14%, respectively. Conclusion During a 6-year period, there was a significant increase in the prevalence of self-reported AR in the general Chinese adult population. The incidence of AR being accompanied by rhinosinusitis, asthma, or AD was significantly higher among individuals having self-reported AR compared with the general population. [ABSTRACT FROM AUTHOR]

Background House dust mites are the most prevalent allergen causing sensitizations in patients with rhinitis and asthma in China. We aimed to investigate the changes in both upper and lower airway inflammation and responsiveness following Dermatophagoides pteronyssinus ( Der-p) nasal provocation test ( NPT) in rhinitis patients. Methods Study subjects included 15 nonasthmatic Der-p-sensitized rhinitis ( AR) patients with airway hyper-responsiveness ( AHR) ( AR+ AHR+), 15 AR patients without AHR ( AR+ AHR-), 15 healthy controls ( HCs) with Der-p sensitization ( HC+ DP+), and 15 HC without Der-p sensitization ( HC+ DP-). All subjects underwent Der-p NPT. Visual analogue scale ( VAS) scores of nasal symptoms, nasal lavage and nasal airway resistance ( NAR) measurement, sputum induction, and forced expiratory volume in 1 second ( FEV1) were performed. Airway responsiveness to histamine bronchoprovocation ( PD20- FEV1) and exhaled nitric oxide (Fe NO) was determined. Results NAR increased significantly in all subjects with the greatest effect seen in AR+ AHR+ individuals. VAS increased in all subjects at 30 min and returned to baseline at 6 h, with significantly higher levels in AR+ AHR+ and AR+ AHR- subjects ( P < 0.05). Eosinophils in nasal lavage fluid and sputum increased significantly after NPT in AR+ AHR+ and AR+ AHR- subjects ( P < 0.001). FEV1% and PD20- FEV1 decreased and Fe NO increased significantly after NPT only in AR+ AHR+ subjects ( P < 0.05). Nasal lavage eosinophil count was positively correlated with sputum eosinophil count and the level of Fe NO and negatively correlated with FEV1 and PD20. Conclusions House dust mite nasal provocation test induces and aggravates both upper and lower airway inflammation and hyper-responsiveness in patients with persistent allergic rhinitis without asthmatic symptoms. [ABSTRACT FROM AUTHOR]

Background Chronic sinusitis (CRS) is a common otorhinolaryngologic disease that is frequently encountered in everyday practice, but there is a lack of precise data regarding the prevalence of CRS in developing countries. We performed a national investigation in China to determine the prevalence and associated factors of CRS. Methods We conducted a cross-sectional investigation in 2012. A stratified four-stage sampling method was used to select participants randomly from seven cities in mainland China. All participants were interviewed face-to-face via a standardized questionnaire. Unconditional logistic regression analyses were conducted to examine the association between smoking and sinusitis after adjusting for socio-demographic factors. Results This study included a total of 10 636 respondents from seven cities. The overall prevalence of CRS was 8.0% and ranged from 4.8% to 9.7% in seven centres. Chronic sinusitis affected approximately 107 million people in mainland China. Chronic sinusitis was particularly prevalent among people with specific medical conditions, including allergic rhinitis, asthma, chronic obstructive pulmonary disease and gout. The prevalence was slightly higher among males (8.79%) than females (7.28%) ( P = 0.004), and the prevalence varied by age group, ethnicity and marital status and education ( P < 0.05), but not by household per capita income or living space ( P > 0.05). Both second-hand tobacco smoke and active smoking were independent risk factors for CRS ( P = 0.001). Conclusions Chronic sinusitis is an important public health problem in China. Our study provides important information for the assessment of the economic burden of CRS and the development and promotion of public health policies associated with CRS particularly in developing countries. [ABSTRACT FROM AUTHOR]

Background Previous studies have shown the relationship between club cell secretory protein ( Clara) ( CC-16) and respiratory diseases. However, few studies have explored the associations between urine CC-16 levels and environmental tobacco smoke ( ETS) exposure in children. The objective of this study was to evaluate whether ETS exposure is associated with CC-16 when stratified by asthma status. Methods In our study, CC-16 was measured on 537 children aged 9-15 from northeast China in 2011-2012 using the Human Clara Cell Protein ELISA kits. Doctor-diagnosed asthma was defined as having ever been diagnosed with asthma by a physician. The relationship between ETS exposure and urine CC-16 level was assessed using linear regression. Results When stratified by asthma status, a negative association between ETS exposure and urine CC-16 was observed after adjusting for the effects of the related covariates, with an adjusted β coefficient [ P value] = −0.31 [0.006] in the first 2 years of life and with an adjusted β coefficient [ P value] = −0.68 [0.004] in the first 2 years of life and current. Conclusions Our study shows long-term exposure to ETS was associated with urinary CC-16 among children without asthma. [ABSTRACT FROM AUTHOR]

To To cite this article: Ba L, Zhang N, Meng J, Zhang J, Lin P, Zhou P, Liu S, Bachert C. The association between bacterial colonization and inflammatory pattern in Chinese chronic rhinosinusitis patients with nasal polyps. Allergy 2011; 66: 1296-1303. Abstract Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) can be subdivided according to the mucosal inflammatory patterns. In mainland China, apart from interleukin (IL)-5-positive and IL-17-positive polyps, a large group of patients with IL-5/IL-17/interferon-gamma (IFNγ)-negative nasal polyps (referred to as key cytokine-negative (KCN) polyps) can be found. Objective: To further study the KCN polyps and evaluate the associations between bacterial colonization and mucosal inflammatory pattern in KCN vs IL-5-positive nasal polyps. Methods: Nasal polyp or nasal turbinate tissue was obtained from 89 Chinese CRSwNP patients and 36 nonatopic control subjects during surgery. Samples without and after SEB exposure were processed for the assessment of pro-inflammatory cytokines and mediators by immunoassay. Prior to surgery, nasal swabs were taken from each patient for microbiological evaluation. Results: Overall, 80% polyp tissue did not express IL-5, with about 70% (49/71) of these being KCN. Key cytokine-negative nasal polyps were characterized by the synthesis of mediators promoting neutrophilic inflammation (myeloperoxidase (MPO), IL-1β, IL-6 and IL-8), whereas IL-5-positive nasal polyps were characterized by the synthesis of mediators promoting eosinophilic inflammation (IL-5, ECP, total IgE and SE-IgE). Key cytokine-negative nasal polyps were associated with greater Gram-negative bacterial load compared with controls, while IL-5-positive nasal polyps were associated with greater Gram-positive bacterial colonization vs controls and KCN polyps. Conclusion: Our findings suggest that the bacteria colonizing nasal polyps of CRSwNP patients may impact on or be determined by the presence/absence of IL-5. [ABSTRACT FROM AUTHOR]

Background: High levels of sensitization to house dust mites have been observed in Chinese allergic patients. This study has measured levels and distributions of mite and cockroach allergens in household dust in Guangzhou. Influences of home characteristics and seasonal changes on allergen levels were also investigated. Methods: Dust samples were collected from bedding and living room from households in Guangzhou. Major allergens from Dermatophagoides pteronyssinus, D. farinae, D. microceras, Blomia tropicalis and cockroach allergens were measured by ELISA. Home characteristics were obtained from a questionnaire. Results: Four hundred and four dust samples were collected from 107 homes during October 2006 to November 2007. House dust mite allergen levels were detectable in 99% of the bedding samples. Der f 1 levels were significantly higher than Der p 1 levels. High levels of mite allergens (>10 lg/g) were observed in 88% of all the bedding samples. Cockroach allergens were detected in 93% of households and were higher in living room samples than in bedding samples. Blo t 5 and Der m 1 could not be detected in the dust samples. Having fabric furniture was a predictor of high allergen levels. Der f 1 levels were higher in summer time than in winter time. Cockroach allergens were higher in winter time than in summer time. Conclusion: In Guangzhou, Der f 1 is the predominant mite allergen in dust with very high levels in bedding. Cockroach allergens are also common. [ABSTRACT FROM AUTHOR]

China is going to host the Games of the XXIX Olympiad from 8–24 August 2008 in Beijing. The number of athletes and accompanying individuals expected to arrive at China for the Beijing Olympics is estimated at over 10 000 and among them at least 2 000 (20%) are suspected to suffer from respiratory allergies. It is important to monitor the pollen counts and improve air quality in Beijing because Olympic athletes would be exposed to airborne allergens and pollutants during competitions which could hinder peak performance. The main pollen and spore families in Beijing are Artemisia, Ambrosia, Chenopodiaceae and Gramineae. They can reach around 307 000 grains of pollen/1000 m3 of air in August. Economic development in China is usually linked with worsening of air quality. Due to the adoption of various control measures, the ambient air quality in a number of areas in Beijing has actually improved. The ambient air TSP and SO2 levels in Beijing have been decreasing in the last decade. However, ambient air NO x level has been increasing due to the increased number of motor vehicles. Nevertheless, dedicated medical facilities in Beijing will provide medical services to athletes and delegations from all over the world during the Beijing Olympic Games. [ABSTRACT FROM AUTHOR]

The article cites a study which investigates the specific immunoglobin E (sIgE) reactivity of Chinese house dust mites (HDM) allergic patients towards Dermatophagoide pteronyssinus (Der p) and Dermatophagoide farinae (Der f) allergens. It was concluded after the study that the sIgE reactivity patterns of Chinese HDM allergic patients are very similar to that of other patient populations recognizing allergens from Der p and Der f as major allergens.