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Epidemiological studies have shown a rise in the prevalence of allergic diseases in India during the last two decades. However, recent evidence from the Global Asthma Network study has observed a decrease in allergic rhinitis, asthma and atopic dermatitis in children. Still, with a population over 1.3 billion, there is a huge burden of allergic rhinitis, asthma and atopic dermatitis, and this is compounded by an unmet demand for trained allergy specialists and poor health service framework. There is wide variation in the prevalence of allergic diseases between different geographical locations in India, and the reasons are unclear at present. This may at least in part be attributable to considerable heterogeneity in aero‐biology, weather, air pollution levels, cultural and religious factors, diet, socioeconomic strata and literacy. At present, factors enhancing risks and those protecting from development of atopy and allergic diseases have not been well delineated, although there is some evidence for the influence of genetic factors alongside cultural and environmental variables such as diet, exposure to tobacco smoke and air pollution and residence in urban areas. This narrative review provides an overview of data from India regarding epidemiology, risk factors and genetics and highlights gaps in evidence as well as areas for future research. [ABSTRACT FROM AUTHOR]

A wide range of topics have been covered by leading experts from India including indoor and outdoor allergens, allergic airways disease, allergic bronchopulmonary aspergillosis (ABPA) and food allergy. India has recently overtaken China as the most populous country in the globe with an estimated total population of ~1.43 billion people, comprising approximately 20% of the globe. REFERENCES 1 Laha A, Moitra S, Podder S. A review on aero-allergen induced allergy in India. [Extracted from the article]

The Standards of Care Committee of the British Society for Allergy and Clinical Immunology (BSACI) and a committee of experts and key stakeholders have developed this guideline for the evaluation and testing of patients with an unsubstantiated label of penicillin allergy. The guideline is intended for UK clinicians who are not trained in allergy or immunology, but who wish to develop a penicillin allergy de‐labelling service for their patients. It is intended to supplement the BSACI 2015 guideline "Management of allergy to penicillin and other beta‐lactams" and therefore does not detail the epidemiology or aetiology of penicillin allergy, as this is covered extensively in the 2015 guideline (1). The guideline is intended for use only in patients with a label of penicillin allergy and does not apply to other beta‐lactam allergies. The recommendations include a checklist to identify patients at low risk of allergy and a framework for the conduct of drug provocation testing by non‐allergists. There are separate sections for adults and paediatrics within the guideline, in recognition of the common differences in reported allergy history and likelihood of true allergy. [ABSTRACT FROM AUTHOR]

The registry is governed by a steering committee consisting of BSACI members alongside IQAS and two patient organizations (Allergy UK and Anaphylaxis Campaign). Immunomodulatory therapies alter the natural course of allergic and autoimmune disease and have cemented their place in clinical management. Allergy UK receives grants and sponsorship from a range of companies which support the patient organization projects and activities. GLO:ETE/01aug21:cea13887-fig-0001.jpg PHOTO (COLOR): 1 The BRIT Registry Logic Model shows the potential of a professional and patient interface to address gaps in safety and effectiveness of immunotherapy in allergies and urticaria. [Extracted from the article]

Briefly, the questionnaire had 21 items, including core questions to assess the prevalence of rhinitis, asthma and eczema. Asthma insights and management in India: lessons learnt from the Asia pacific-asthma insights and management (AP-AIM) Study. In conclusion, the prevalence of asthma and rhinitis in this Bengaluru cohort is higher than the previously reported overall prevalence in India. [Extracted from the article]

Nearly 60%-70% of patients have co-existing allergic rhinitis and asthma, and it remains unclear at present how well the allergic rhinitis is controlled amongst asthmatics. This editorial focusses on gaps in evidence and highlights "high-priority" areas and strategies for research in asthma and allergy in India. [Extracted from the article]

Keywords: asthma; atopic dermatitis; autoimmunity; epidemiology; ethnicity; rheumatoid; rhinitis; SLE; vitiligo EN asthma atopic dermatitis autoimmunity epidemiology ethnicity rheumatoid rhinitis SLE vitiligo 144 147 4 01/05/21 20210101 NES 210101 To the Editor, The burden of allergic diseases (ADs) such as asthma and rhinitis and autoimmune disorders (AIDs) such as rheumatoid arthritis (RA) is relatively low/moderate in low- and low-middle-income countries,1,2 and there is some evidence regarding higher incidence rates of these conditions amongst immigrant population settled in high-income countries.3,4 The burden of ADs is particularly high in high-income countries such as the UK, Republic of Ireland and New Zealand.1 Studies in immigrants have been limited by several factors including relatively small sample size, shorter duration and methodological issues such as selection bias, survey- or questionnaire-based data, focus on a single or limited number of ADs or AIDs, and some not accounting for important disease confounders such as smoking history. Specifically, the risk of AE, ARC, SLE, ATD and vitiligo is uniformly higher amongst British ethnic minority groups in comparison with the White population. Asthma, atopic dermatitis, autoimmunity, epidemiology, ethnicity, rheumatoid, rhinitis, SLE, vitiligo. [Extracted from the article]

Introduction: India is low‐middle‐income country (LMIC) with a population of 1.3bn, comprising about 20% of the global population. While the high‐income Western countries faced an "allergy epidemic" during the last three decades, there has been a gradual rise in prevalence of allergic diseases in India. Methods: Narrative review. Results and Discussion: Allergic diseases occur as a consequence of a complex interplay between genetic and environmental factors. There are multiple contrasting determinants that are important to consider in India including high levels of air pollution, in particular PM2.5 due to burning of fossil fuels and biomass fuels, diverse aero‐biology, tropical climate, cultural and social diversity, religious beliefs/myths, linguistic diversity, literacy level, breastfeeding and weaning, diet (large proportion vegetarian), and high incidence rates of TB, HIV, malaria, filariasis, parasitic infestations, and others, that not only shape the immune system early in life, but also impact on biomarkers relevant to allergic diseases. India has a relatively weak and heterogeneous healthcare framework, and allergology has not yet been recognized as an independent specialty. There are very few post‐graduate training programs, and allergic diseases are managed by primary care physicians, organ‐based specialists, and general pediatricians. Adrenaline auto‐injectors are not available, there is patient unaffordability for inhalers, nasal sprays, and biologics, and this is compounded by poor compliance leading to 40%‐50% of asthmatic children having uncontrolled disease and high rates of oral corticosteroid use. Standardized allergen extracts are not available for skin tests and desensitization. This article provides a critical analysis of pediatric allergic diseases in India. [ABSTRACT FROM AUTHOR]

Many patients report allergies to penicillin, although in over 90% of these the label of penicillin allergy is shown to be incorrect following comprehensive testing. Inappropriate and inaccurate penicillin allergy labelling is a barrier to antimicrobial stewardship and can lead to patient harm. This review assesses an emergent evidence base and trend favouring delabelling using direct oral penicillin challenges following a stratified risk assessment of the likelihood and existence of true penicillin allergy, to identify and make recommendations for key components for implementation in standard practice. Research to date has focussed on the feasibility and clinical and financial outcomes of these direct delabelling strategies. There is a paucity of studies exploring the views and engagement of patients and healthcare professionals, and a gap in the evidence for prerequisites to safely deliver, sustain and spread the implementation of such services across health systems. [ABSTRACT FROM AUTHOR]