Will every child have allergic rhinitis soon?
- PMID: 30580075
- DOI: 10.1016/j.ijporl.2018.12.019
Will every child have allergic rhinitis soon?
Abstract
Objectives: Given the increasing prevalence of AR amongst children, we aimed to review the literature regarding the future of AR in this population.
Methods: We searched the PubMed, Google and Proquest Central databases at Kırıkkale University Library. Search terms used were: "allergic rhinitis", "children", "paediatric", "allergy", "future", "risk factors", "treatment", "pharmacotherapy" and/or "allergen - specific immunotherapy". With regard to risk factors for allergic rhinitis, the terms "Environmental factors", "Improved hygiene", "Increased indoor allergen exposure", "Farms, villages, worms, and other parasites", "Environmental toxicants", "Diet", "Lifestyle changes", "Air pollution" and "Climate factors" were searched for. "Prevention of allergic diseases" and "Allergen-specific immunotherapy in the future" were also included in the search.
Results: AR has a high prevalence and causes considerable morbidity, has associated comorbidity and features specific complications. The principal treatments rely on avoiding the allergens responsible, and administering drug treatment or immunotherapy, which targets specific antigens. Genetic drift does not explain the rising prevalence of allergic disorders, but multifactorial environmental factors are likely culprits. Amongst such environmental factors to consider are the rise in caesarean births, decreases in breast feeding, dietary changes resulting in less fresh produce being consumed, the eradication of intestinal worm infestations, alterations in the way homes are aired and heated, children taking less exercise and being outdoors for shorter periods, whilst also having more contact with pollution.
Conclusion: Barring substantial lifestyle alterations, more and more children are likely to develop AR. It may prove feasible to stop allergy developing in the first place through manipulation of the microbiome, but the exact format such a modification should involve remains to be discovered. Molecular allergological techniques do offer the prospect of more precisely targeted immunotherapy, the sole disease modifier at present. However, at present the complexity and cost of such interventions prevents their widespread use and research in this area is still needed. The majority of children with AR are going to be managed using nasal saline sprays, since they are the most straightforward and least risky alternative for first line treatment.
Keywords: Allergen-specific immunotherapy; Allergic rhinitis; Children; Disease-modifying treatment; Future; Microbiome; Pharmacotherapy; Primary prevention.
Copyright © 2018 Elsevier B.V. All rights reserved.
Similar articles
-
Prevention of allergic disease in childhood: clinical and epidemiological aspects of primary and secondary allergy prevention.Pediatr Allergy Immunol. 2004 Jun;15 Suppl 16:4-5, 9-32. doi: 10.1111/j.1399-3038.2004.0148b.x. Pediatr Allergy Immunol. 2004. PMID: 15125698 Review.
-
Allergen specific sublingual immunotherapy in children with asthma and allergic rhinitis.World J Pediatr. 2016 Aug;12(3):283-290. doi: 10.1007/s12519-016-0022-1. Epub 2016 Jun 29. World J Pediatr. 2016. PMID: 27351563 Review.
-
Early indoor aeroallergen exposure is not associated with development of sensitization or allergic rhinitis in high-risk children.Allergy. 2016 May;71(5):684-91. doi: 10.1111/all.12853. Epub 2016 Mar 2. Allergy. 2016. PMID: 26836471
-
Immunotherapy in allergic rhinitis and lower airway outcomes.Allergy. 2017 Jan;72(1):35-42. doi: 10.1111/all.12989. Epub 2016 Aug 15. Allergy. 2017. PMID: 27439141 Review.
-
Clinical efficacy of immunotherapy in allergic rhinitis.Am J Rhinol Allergy. 2016 Sep 1;30(5):4-7. doi: 10.2500/ajra.2016.30.4368. Am J Rhinol Allergy. 2016. PMID: 29025463 Review.
Cited by
-
Mass Spectrometry Applications to Study Human Microbiome.Adv Exp Med Biol. 2024;1443:87-101. doi: 10.1007/978-3-031-50624-6_5. Adv Exp Med Biol. 2024. PMID: 38409417
-
The global/local (limited to some regions) effect of cesarean delivery on the risk of pediatric allergic rhinitis: a systematic review and meta-analysis.Front Pediatr. 2023 Aug 3;11:1228737. doi: 10.3389/fped.2023.1228737. eCollection 2023. Front Pediatr. 2023. PMID: 37601128 Free PMC article. Review.
-
Pediatric tuina for allergic rhinitis in children: A systematic review and meta-analysis of randomized controlled trials.Front Pediatr. 2022 Nov 14;10:1043322. doi: 10.3389/fped.2022.1043322. eCollection 2022. Front Pediatr. 2022. PMID: 36452352 Free PMC article. Review.
-
The Crosstalk between the Gut Microbiota Composition and the Clinical Course of Allergic Rhinitis: The Use of Probiotics, Prebiotics and Bacterial Lysates in the Treatment of Allergic Rhinitis.Nutrients. 2022 Oct 16;14(20):4328. doi: 10.3390/nu14204328. Nutrients. 2022. PMID: 36297012 Free PMC article. Review.
-
Unlocking the Potential of the Human Microbiome for Identifying Disease Diagnostic Biomarkers.Diagnostics (Basel). 2022 Jul 19;12(7):1742. doi: 10.3390/diagnostics12071742. Diagnostics (Basel). 2022. PMID: 35885645 Free PMC article. Review.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical
Research Materials