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Objectives: Our intention was to review all material published to date regarding superantigens (SAgs) and allergy from an otorhinolaryngological viewpoint to understand this association more clearly., Methods: We identified all materials published mentioning both SAg and allergic rhinitis (AR), chronic sinusitis, asthma, and atopic dermatitis (AD) that are indexed on PubMed, Google, or the ProQuest Central databases., Results: Staphylococcus aureus is a significant bacterial pathogen in humans and has the ability to produce enterotoxins with superantigenic features. The inflammatory response in allergy seen in both B cell and T cell may be attributed to SAgs. Sufferers of both allergic asthma with rhinitis and AR alone produce serological evidence of immunoglobulin E formation to SAgs produced by S. aureus. Perennial AR sufferers carry S. aureus more frequently and the presence of the organism within the nasal cavity may exacerbate perennial AR. SAg produced by S. aureus potentially worsens the asthmatic inflammatory response within the airway and may lead to the airways becoming hyperresponsive, as well as possibly activating T cells if asthmatic control is poor. Staphylococcal SAgs potentially increase the risk of developing chronic rhinosinusitis with nasal polyposis, additionally being a marker for more severe disease. If SAgs bring about chronic inflammatory responses in the nose and sinuses, then T cells excreting interferon-gamma may be a crucial mediator. In allergic dermatitis, S. aureus could be a key player in exacerbation of the condition. Even in younger pediatric patients with allergic dermatitis, allergic hypersensitivity to SAgs is frequent and may be a factor explaining how severe the condition becomes., Conclusion: Just as SAgs are known to feature in many allergic conditions, they play their part in AR, chronic rhinosinusitis, asthma, and AD. Further research is required before the relationship between SAgs and allergy can be adequately explained.

Aspirin-exacerbated respiratory disease (AERD) refers to the combination of asthma, chronic rhinosinusitis with nasal polyposis, and acute upper and lower respiratory tract reactions to the ingestion of aspirin (acetylsalicylic acid, ASA) and other cyclooxygenase-1 inhibiting non-steroidal anti-inflammatory drugs. AERD affects 0.3-0.9 % of the general population. AERD generally occurs due to abnormalities in mediators and expression of arachidonic acid biosynthesis. Local IgE responses to staphylococcal enterotoxins may also be responsible for eosinophilic activation in the nasal polyp tissues of AERD patients. Clinical features of AERD include the onset of nasal congestion with anosmia, progressing to chronic pansinusitis and nasal polyps that regrow rapidly after surgery. Aspirin desensitization, Leukotriene-modifying agents, biologic agents, management of asthma, chronic rhinosinusitis, and nasal polyposis are recommended as treatment modalities. Immunotherapy is prescribed only to those AERD patients who experience clear seasonal or perennial allergy symptoms in addition to the symptoms attributable to chronic nasal polyposis. There are also investigational and dietary therapies. In this review, the important aspects of AERD will be presented, along with a literature survey.

Leukotrienes (LTs) are a family of inflammatory mediators including LTA4, LTB4, LTC4, LTD4, and LTE4. By competitive binding to the cysteinyl LT1 (CysLT1) receptor, LT receptor antagonist drugs, such as montelukast, zafirlukast, and pranlukast, block the effects of CysLTs, improving the symptoms of some chronic respiratory diseases, particularly bronchial asthma and allergic rhinitis. We reviewed the efficacy of antileukotrienes in upper airway inflammatory diseases. An update on the use of antileukotrienes in upper airway diseases in children and adults is presented with a detailed literature survey. Data on LTs, antileukotrienes, and antileukotrienes in chronic rhinosinusitis and nasal polyps, asthma, and allergic rhinitis are presented. Antileukotriene drugs are classified into two groups: CysLT receptor antagonists (zafirlukast, pranlukast, and montelukast) and LT synthesis inhibitors (5-lipoxygenase inhibitors such as zileuton, ZD2138, Bay X 1005, and MK-0591). CysLTs have important proinflammatory and profibrotic effects that contribute to the extensive hyperplastic rhinosinusitis and nasal polyposis (NP) that characterise these disorders. Patients who receive zafirlukast or zileuton tend to show objective improvements in, or at least stabilisation of, NP. Montelukast treatment may lead to clinical subjective improvement in NP. Montelukast treatment after sinus surgery can lead to a significant reduction in eosinophilic cationic protein levels in serum, with a beneficial effect on nasal and pulmonary symptoms and less impact in NP. Combined inhaled corticosteroids and long-acting β-agonists treatments are most effective for preventing exacerbations among paediatric asthma patients. Treatments with medium- or high-dose inhaled corticosteroids, combined inhaled corticosteroids and LT receptor antagonists, and low-dose inhaled corticosteroids have been reported to be equally effective. Antileukotrienes have also been reported to be effective for allergic rhinitis.

Background: In this prospective, multicenter, randomized, controlled, double-blind study, we investigated the impact of a mobile patient engagement application on health outcomes and quality of life in allergic rhinitis (AR) and asthma patients., Methods: In total, 327 patients with diagnoses of persistent AR or mild-to-severe persistent asthma were randomized into 2 intervention groups and 2 control groups upon their admission at outpatient clinics. The intervention groups (POPET-AR and POPET-Asthma) received a mobile phone application ("physician on call patient engagement trial" [POPET]), enabling them to communicate with their physician, and record their health status and medication compliance. The AR groups completed the Rhinitis Quality of Life Questionnaire (RQLQ) at initiation and at the first month of the study. The asthma groups completed the Asthma Control Test (ACT) at initiation and at the third month of the study., Results: The POPET-AR group showed better clinical improvement than the control group in terms of the overall RQLQ score as well in measures of general problems, activity, symptoms other than nose/eye, and emotion domains (p < 0.05). In the POPET-Asthma group, more patients (49%) achieved a well-controlled asthma score (ACT > 19) compared with the control group (27%); this was statistically significant (p < 0.05)., Conclusion: Use of a mobile engagement platform, such as POPET, can have a significant impact on health outcomes and quality of life in both AR and asthma, potentially decreasing the number of hospital admissions, repeat doctor visits, and losses in productivity. Improvements were seen in domains related to activity, productivity, perception of disease, and emotion., (© 2015 ARS-AAOA, LLC.)

OBJECTIVES. We reviewed the literature on allergic disorders during adolescence. MATERIAL AND METHODS. The Pubmed, Google, Google Scholar and Proquest Central databases were used with search terms: adolescent, teenager, allergic rhinitis, asthma, atopic dermatitis and food allergy. RESULTS. Children with a proven allergy have a risk for developing another allergic disorder that is 8-fold higher compared to normal and approaching 7-fold for asthma. The age at which allergy is diagnosed in childhood has a powerful bearing on whether allergic disorders or asthma develop in adolescence. Atopic response severity in a patient during childhood predicts the severity of allergic asthma as an adult. Patients may become asthmatic as adolescents, probably due to a late presentation of allergic disease, or as the presenting complaint for the triad of intrinsic asthma, nasal polyp formation and aspirin intolerance (so-called Samter triad). Allergic eczema (Atopic dermatitis) carries on into their adolescent years in between 10 and 20% of children. Food allergy (FA) is more frequently noted in childhood and adolescence than in adulthood. For the most part, symptoms were attributable to pollen-associated FA and of mild severity. Being hypersensitive to food for non-allergic reasons was rarer. CONCLUSION. Allergic rhinitis represents a significant risk factor for becoming asthmatic, whether in childhood, adolescence or adulthood. Atopic dermatitis and food allergy are also frequent conditions during adolescence. Pollen-associated FA constitutes an important part of the food allergy. Furthermore, food allergy may be the leading trigger for anaphylaxis. Common associations/comorbidities of atopic dermatitis reported are other atopic conditions such as food allergies, asthma and allergic rhinitis/rhinoconjunctivitis. [ABSTRACT FROM AUTHOR]

OBJECTIVES. As a person ages, the mucosal epithelium degenerates over time and the elderly often have complications due to dehydration. Nasal airflow decreases and nasal airway resistance increases. In this review, we discuss the relationship of rhinitis, sinusitis and asthma in elderly patients. MATERIAL AND METHODS. The literature survey was performed using the search engines PubMed, Google, Proquest Central, and EBSCO at the Kırıkkale University Library. RESULTS. With the aging process, allergic rhinitis decreases, whereas non-allergic rhinitis, such as drug-induced rhinitis can be observed more. Atrophic rhinitis is often seen in the elderly. Patients with geriatric rhinitis typically complain of constant sinus drainage problems, which may cause sinusitis. In addition, asthma prevalence has also been shown to be higher in elderly patients. Concurrent upper (rhinitis) and lower (asthma) respiratory tract symptoms are defined as Combined Allergic Rhinitis and Asthma Syndrome. CONCLUSION. Rhinitis and asthma as well as sinusitis and asthma may be present in elderly patients. The incidence of allergic rhinitis has been shown to decrease with age. To achieve good results from treatment, the concurrent rhinitis and asthma as well as sinusitis and asthma should be kept in mind in elderly patients. [ABSTRACT FROM AUTHOR]

OBJECTIVES. The aim of this paper is to review the united airway concept. MATERIAL AND METHODS. We searched Pubmed, Google, Google Scholar and Proquest Central database of Kırıkkale University. RESULTS. Upper and lower airways are thought as a morphological and functional unit. There is a link between rhinitis and asthma. Over 80% of asthmatics have rhinitis and 10-40% of rhinitis patients have asthma. Rhinosinusitis is related to asthma in 34-50% of the patients. The relationship between rhinosinusitis and asthma may include “nasobronchial reflex, pharyngobronchial reflex, inhalation of dry, cold air and environmental pollutants inhalation". CONCLUSION. The united airway concept suggests that upper and lower airways are thought as a morphological and functional unit. It has been commonly accepted in recent years. Allergic rhinitis (AR) is a risk factor for asthma; and Allergic Rhinitis and Asthma (ARIA) suggest bronchial involveme nt in AR patients. [ABSTRACT FROM AUTHOR]

Background: Aeroallergen immunotherapy (AIT) should be considered for patients who exhibit symptoms of allergic rhinitis (AR), rhinoconjunctivitis, and/or asthma after natural exposure to allergens and who also demonstrate specific immunoglobulin E antibodies against relevant allergens. Methods: In this paper, clinical efficacy of immunotherapy in allergic rhinitis is reviewed. Result: Subcutaneous allergen immunotherapy (SCIT) is effective for seasonal and perennial AR. Sustained effectiveness requires several years of treatment. SCIT may prevent the development of allergic asthma in children with AR. Sublingual allergen immunotherapy (SLIT) is currently considered an alternative treatment to the subcutaneous route. The use of SLIT has been included in international guidelines for the treatment of AR with or without conjunctivitis. Conclusion: Patients treated with SCIT are at risk of both local and systemic adverse reactions; however, in most cases, symptoms are readily reversible if they are recognized early and treated promptly. The safety profile of SLIT is good; therefore, SLIT can be self-administered by patients in their homes. In this article, we reviewed the efficacy and safety of allergen immunotherapy. [ABSTRACT FROM AUTHOR]