Severity of allergic rhinitis assessed by using urine metabolomic profiling: Proof of concept

Adamko, Darryl J.; Khamis, Mona M.; Steacy, Lisa M.; Regush, Shana; Bryce, Rhonda

doi:10.1016/j.jaci.2018.02.051

“…A previous study demonstrated that IL-1β was a strong risk factor for the development of moderate to severe PAR and other active allergic diseases, and therefore, it can serve as a biomarker for the exacerbation and activation of allergic diseases including AR [19]. The primary role of inflammasomes is to direct inflammation by controlling unregulated IL-1β release; therefore, IL-1β is an important marker of activation of allergic diseases and severity.…”

Section: Discussionmentioning

confidence: 99%

Obesity Can Contribute to Severe Persistent Allergic Rhinitis in Children through Leptin and Interleukin-1β

Han

¹

,

Kim

²

,

Oh

³

et al. 2021

Int Arch Allergy Immunol

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Background: Obesity/overweight is associated with a higher risk of allergic rhinitis (AR) in children. Objective: This study aimed at exploring the mechanisms by which obesity affects the severity of AR through leptin and interleukin (IL)-1β were investigated. Methods: In all, 210 subjects with AR and 82 subjects without AR were included in this study. The levels of leptin and inflammatory biomarkers were measured in the serum to investigate the correlation with the severity of AR. Additionally, we analyzed whether changes in BMI regulate the severity of AR through serial follow-up of obese children. Results: IL-1β, which is a biomarker of active inflammation in AR, was significantly higher in individuals with AR than in those without and higher in subjects in the obesity group than in those in the normal weight group. A regression analysis showed that the leptin level was associated with increased IL-1β expression in children with AR. In the multivariate analysis, only parental AR (9.2-fold increase in risk), elevated leptin (11.3-fold increase in risk), and high expression of IL-1β (5.8-fold increase in risk) emerged as significant risk factors of moderate to severe persistent allergic rhinitis. We also found that children with an increase or decrease in BMI showed changes in IL-1β and AR symptoms, which these changes were dependent on leptin and BMI. Conclusions: These results suggest that obesity is an important risk factor for the exacerbation of symptoms and leptin can exacerbate inflammation as well as severe and persistent symptoms through IL-1β in AR.

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“…Participants scored their symptoms by utilizing the widely accepted TNSS which was a validated and easy-to-use patient-reported measure to subjectively delineate the clinical severity of AR [ 21 , 22 ]. Accordingly, TNSS is the sum of 4 individual symptom scores for rhinorrhea, nasal congestion, nasal itching, and sneezing, each parameter ranged from 0 to 4.…”

Section: Methodsmentioning

confidence: 99%

Serum Soluble ST2 Correlated with Symptom Severity and Clinical Response of Sublingual Immunotherapy for House Dust Mite-Induced Allergic Rhinitis Patients

Zhu

¹

,

Cui

²

,

Chen

³

et al. 2021

Mediators of Inflammation

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Background. Suppressor of tumorigenicity 2 (ST2) is a key biomarker in inflammation and cardiovascular diseases, but limited data is available on its role in allergic rhinitis (AR). Objective. The aim of this study is to explore the role of serum soluble ST2 (sST2) in evaluating disease severity and predicting the efficacy of sublingual immunotherapy (SLIT) in house dust mite- (HDM-) induced AR patients. Methods. Eighty healthy controls (HC group) and 160 HDM-induced AR patients, including 40 mild patients (MAR group) and 120 moderate-severe patients (MSAR group), were recruited in this study. Serum was collected from all participants and levels of sST2 were determined by ELISA and the relationship between sST2 levels and disease severity was assessed. In the MSAR group, 109 patients received 3 years of SLIT, and the relationship between serum levels of sST2 and efficacy of SLIT was exampled. Results. Serum sST2 levels were increased in HDM-induced AR patients compared to the HC group ( P < 0.001 ), and the concentrations were higher in the MSAR group than in the MAR group and HC group (all P < 0.05 ). Moreover, sST2 levels positively correlated with the total nasal symptom score (TNSS), visual analogue scale (VAS), and specific IgE levels ( P < 0.05 ). Seventy-eight MSAR patients accomplished SLIT, and they were divided into an effective group ( n = 40 ) and an ineffective group ( n = 38 ). The serum sST2 levels in the effective group were lower than those in the ineffective group ( P < 0.001 ). In addition, patients in the effective group levels exhibited significantly lower sST2 levels post-SLIT than pre-SLIT ( P < 0.001 ), but no statistic difference was observed in the ineffective group ( P > 0.05 ). Receiver operating characteristic (ROC) curve showed promising accuracy for predicting clinical efficacy of SLIT in AR patients ( area under the curve = 0.839 , P < 0.001 ). Conclusion. Serum sST2 is a potential biomarker for assessing disease severity and may serve as a sensitive biomarker for predicting the therapeutic response of SLIT in HDM-induced AR patients.

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“…Patients were asked to record their disease symptoms with the visual analogue scale (VAS) and total nasal symptom score (TNSS) as previously described ( Adamko et al, 2018 ; Zhao et al, 2019b ). VAS is a 10-point scale from 0 (no symptom) to 10 (maximum).…”

Section: Methodsmentioning

confidence: 99%

“…Epidemiological studies showed that the prevalence of AR has increased progressively, and this clinical disorder approximately affected a billion people worldwide ( Han et al, 2020 ; Meng et al, 2020 ). AR is highly heterogeneous with a wide range of severity, which has been subjectively evaluated by many symptom scoring scales, such as the total nasal symptom score (TNSS) and visual analogue scale (VAS) ( Adamko et al, 2018 ; Shi et al, 2020 ). However, AR patients often do not realize how severe their symptoms are, and self-reported symptoms may hinder clinicians to evaluate the disease progression and adjust the treatment plan accordingly ( Del Cuvillo et al, 2017 ; Han et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

Circulating MIF Associated With Disease Severity and Clinical Response of Sublingual Immunotherapy in House Dust Mite–Induced Allergic Rhinitis

Xie

¹

,

Zhang

²

,

Wang

³

et al. 2021

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Background: Macrophage migration inhibitory factor (MIF) is described as a pro-inflammatory cytokine involved in many inflammatory and allergic disorders, but the role of MIF in allergic rhinitis (AR) remains poorly clarified. The aim of this study was to investigate the association between circulating MIF levels and house dust mite (HDM)-induced AR, and evaluate MIF as a potential biomarker in reflecting disease severity and predicting the clinical response of sublingual immunotherapy (SLIT) in HDM-induced AR patients.Methods: In this study, we enrolled 160 persistent HDM-induced AR patients (AR group), including 48 mild AR patients (MAR group) and 112 moderate–severe AR patients (MSAR group), and 77 healthy controls (HC group). Circulating levels of MIF were measured by ELISA, and the relationship between MIF concentrations and disease severity was assessed. In the MSAR group, 106 patients were assigned to receive SLIT for 3 years. At the end of the study, patients were categorized into good response group and poor response group, and associations between clinical variables or biomarkers and clinical response were analyzed by the multivariate regression analysis.Results: The concentrations of serum MIF were significantly higher in AR patients than in HCs, especially in those with MSAR. Moreover, circulating MIF levels were positively correlated with TNSS, VAS, serum HDM–specific IgE, total IgE, blood eosinophil count, and blood eosinophil percentage (all p < 0.05). Eighty MSAR patients finally completed SLIT, 45 patients obtained good response, and 35 patients resulted in poor response. The serum levels of MIF were significantly lower in the good-response group than in the poor-response group (p < 0.001). The receiver operating characteristic analysis for MIF showed good accuracy for predicting clinical response of SLIT (area under the curve = 0.877, p < 0.001). The multivariate regression analysis demonstrated that serum MIF was an independent factor for SLIT responsiveness.Conclusion: Serum MIF appeared to be an important biological indicator in reflecting disease severity and an independent predictor for clinical responsiveness of SLIT in HDM-induced AR patients.

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Severity of allergic rhinitis assessed by using urine metabolomic profiling: Proof of concept

Cited by 11 publications

References 33 publications

Obesity Can Contribute to Severe Persistent Allergic Rhinitis in Children through Leptin and Interleukin-1β

Obesity Can Contribute to Severe Persistent Allergic Rhinitis in Children through Leptin and Interleukin-1β

Serum Soluble ST2 Correlated with Symptom Severity and Clinical Response of Sublingual Immunotherapy for House Dust Mite-Induced Allergic Rhinitis Patients

Circulating MIF Associated With Disease Severity and Clinical Response of Sublingual Immunotherapy in House Dust Mite–Induced Allergic Rhinitis

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