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Allergic rhinitis (AR) is a prevalent disease affecting the quality of life of patients throughout the world. This study aimed to assess the prevalence of AR and its association with chronic rhinosinusitis (CRS) in the adult population living in Bushehr, southwestern part of Iran. In this population-based study, a total of 5420  individuals aged 15-65 years were selected through a multi-stage, cluster, random sampling method from which 5201 of them completed the Global Allergy and Asthma Network of Excellence (GA2LEN) questionnaire (Response rate=96.1%). The prevalence of AR, based on Allergic Rhinitis and Its Impact on Asthma (ARIA) classification (mild or moderate; intermittent or persistent) was calculated and the association of AR and CRS was evaluated using a multiple logistic regression model. The overall prevalence of AR was 28.8%, and for the intermittent and persistent AR were 25.9% (out of which 81.34% were moderate to severe) and 74.1% respectively. Moreover, the prevalence of AR was significantly higher in health workers and smokers (p=0.002 and p<0.001, respectively). Furthermore, an association was found between AR and CRS (p<0.001, aOR: 4.68, 95%CI: 4.07-5.39), and also, between the persistent AR and CRS as compared with the intermittent (p<0.001, aOR: 4.21, 95%CI: 3.40-5.22). The present study showed that the prevalence of AR in Bushehr (Southwestern part of Iran) was significantly high. In addition, the results indicated a strong association between AR and CRS, especially in individuals with moderate to severe persistent AR.

Aeroallergens continue to have a key role in the pathogenesis of asthma and allergic diseases and have recently received increased attention in medical research throughout the world. The prevalence of aeroallergens vary in different regions, depending on the type of climate. The aim of the present study was to determine prevalence of the sensitivity to aeroallergens among patients with asthma and allergic rhinitis (AR), based on skin prick test (SPT) reactivity in the province of Bushehr, Iran. In this cross-sectional study, 743 patients were enrolled. The participants had asthma and AR and reacted to at least one allergen with SPT. Skin prick test with standard extracts including house dust mites (HDMs), animal dander, molds and pollens were performed on patients according to the herbal geography of the area. The male to female ratio and mean age of the patients were 1.03 and 27.6± 15.4 year, respectively. Out of 567 patients with AR, the common aeroallergens were HDMs (88.5%), molds (82.9%), animal dander (79.5%), weeds (77.6%), trees (75.5%) and grass pollen (71.5%). Moreover, among 176 patients with asthma, the prevalence of aeroallergens were HDMs (90.5 %), molds (80.7%), animal dander (77.5%), weeds (73.3%), trees (73.3%) and grass pollen (67.9%). The sensitivity to animal dander, Chenopodium album and Russian thistle pollens were significantly associated with the severity of AR. Moreover, sensitivity to animal dander such as cat and feather of birds, cockroach, Bermuda grass and Chenopodium album pollens were significantly associated with the severity of asthma. The results of this study revealed that HDM was the most common sensitizing aeroallergen in patients with asthma and AR. Molds and animal dander as indoor allergens were also common aeroallergens. We suggest that the hot weather and ambient humidity in the region may be the main cause of the change in the pattern of SPT reactivity.

Concerns have been raised about the adverse impact of dusty air pollution (DAP) on human health. The aim of this study was to find the association between dusty air pollution based on air quality index (AQI) and the risk of allergic diseases in southwestern provinces of Iran, with assessing cytokine profiles and lymphocyte immunophenotypes.In this case control study 148 individuals participated. The sampling was done in hazardous condition (AQI>300) as the case and clean air (AQI<50) as the control. We measured cytokine production by using ELISA method and phenotypes of T-lymphocytes (CD4+ and CD8+), CD19+ B-lymphocytes, CD25+, CD4+ CD25+ cells by FACSort flow cytometer.The mean serum level of IL-4 (33.4 ± 2.9 vs 0.85 ± 0.65 pg/dl) and IL-13 (15.1 ± 4.4 vs. 0.12 ± 0.7 pg/dl) in the subjects exposed to ambient DAP was increased significantly compared to the individuals in the clean air condition. Also, CD19+ B-lymphocytes (12.6 ± 4.9 vs 8.9 ± 3.2%) and CD4+ CD25+ cell count (13.6 ± 4.6 vs 7.7 ± 3.8%) in peripheral blood were increased significantly in subjects exposed to ambient DAP compared with the controls.The result of our study suggested that ambient DAP affected immune system in a way that might lead to allergic diseases in the population.

Asthma and allergic diseases present a major health burden. Information on the prevalence of these diseases indicates that these diseases are increasing in various parts of the world. It was hoped that this study would be helpful to health system policy-makers in planning allergy prevention programs in the region.The prevalence of asthma and allergic diseases and relation between the various risk factors involved were assessed among schoolchildren in the city of Bushehr, Iran. The ISAAC Phase I and III questionnaires were completed by parents of 1280 children aged 6-7 years and self-completed by 1115 students aged 13-14 years.The prevalence of atopic eczema, allergic rhinitis and asthma among 6-7 year-old students were 12.1%, 11.8% and 6.7%, respectively. While, the prevalence of these diseases among 13-14 year-old students were found to be 19%, 30% and 7.6%, respectively. There was an association between asthma and allergic rhinitis as well as eczema (p<0.05). Consumption of fast food as a risk factor was significantly associated with asthma (p=0.03).The prevalence of asthma and allergic diseases was high among schoolchildren in the city of Bushehr, Iran. Also an association was observed between the fast food consumption and asthma.

Allergic Rhinitis (AR) is one of the most common chronic diseases in the developed countries. This study was performed to investigate the effect of CpG-ODN in alteration of T-helper (Th)1/Th2 balance of patients with AR treated with intranasal corticosteroids (INCs) and antihistamines. Peripheral blood mononuclear cells (PBMCs) of 20 patients with AR were isolated before and after 45 days therapy. Cytokine production (IL-4, IL-10, IL-13, IFN-γ) and specific Ch.a IgE in response to CpG co-administration of natural chenopodium album (CpG/Ch.a) or recombinant Ch.a (CpG/rCh.a) allergen were investigated in supernatants.of cultured PBMCs using ELISA Intracellular IL-10 was also assessed in CD4+ cells using flow cytometry. Significant increase in production of IFN-γ and IL-10 and decrease in production of IL-4 were found in supernatants of cultured PBMCs activated with CPG/ch.a and CPG/rch.a. of both CpG/Ch.a and CpG/rCh.a compared to allergens alone, before and after therapy. After therapy, IFN-γ production with CpG/Ch.a was significantly increased in comparison with before (237 vs. 44 pg/ml, p=0.001). IFN-γ and IL-10 production with CpG/rCh.a was significantly increased after therapy compared to before (407.6 vs. 109 pg/ml, p=0.01 for IFN-γ; 171.7 vs. 52.6 pg/ml, p=0.008 for IL-10), whilst IL-4 was significantly decreased (2.1 vs. 5.8 pg/ml, p=0.02). Intracellular IL-10 expression was also significantly increased in response to either CpG/Ch.a or CpG/rCh.a that showed intracellular assay could be more sensitive than ELISA. Also, treatment with intranasal corticosteroids and antihistamines could enhance this CpG effect, in vitro.

Patients with allergic rhinitis (AR) show increased production of the Th2-related cytokines. Almost always, intranasal corticosteroid (INC) and antihistamine are used as routine therapy of AR. This study was performed to determine the in vitro secretion of cytokines profiles of PBMCs in patients with AR sensitive to Chenopodium album (Ch.a) pollens before and after treatment with INC (Fluticasone propionate) and oral antihistamine (Loratadine). PBMCs of 20 patients with AR, were tested in vitro for cytokine production. These cells were stimulated with natural or recombinant Ch.a. The levels of IL-4, IL-13 and IFN-, were measured in supernatants of cultured cell 96h after stimulation using ELISA. The PBMCs of 20 normal individuals were also similarly treared for comparison of results. The production of IL-4 by the patients' cells stimulated with either Ch.a or rCh.a was significantly higher than normal levels before therapy (p=0.04 and p=0.02, respectively). After therapy, a significant decrease in production of IL-4 and a significant increase in production of IL-10 were found in PBMCs stimulated with natural Ch.a, in comparison to the results before stimulation (p=0.03 for IL-4; p=0.04 for IL-10). Similarly, these results were seen in the production of IL-4 and IL-10 stimulated with rCh.a allergen after therapy in comparison to the results before stimulation (p=0.01 for IL-4; p=0.03 for IL-10). This study suggests INC (Fluticasone propionate) and oral antihistamine (Loratadine) have the capacity to inhibit the production of IL-4 and shift Th2/Th1 responses, probably due to increase the level of immunoregulatory IL-10. Therefore, it could be concluded that therapy with INC and antihistamine has pharmacologic and immunologic therapeutic effects on AR patients.