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27 active trials for Allergic Rhinitis

Integrative Omics Approach to Allergic Rhinitis

Nasal mucus and nasal epithelium are the first defense barriers against allergens. Various proteins are found in nasal mucus that play a role in allergic rhinitis and reflect immune response to allergen exposure. The difference in the proteomic profile of allergic rhinitis patients and healthy controls can give insight about how the response works and which proteins could lead to either enhanced immune reaction or to defense response like augmentation of epithelial integrity. It is also known that the airway epithelium plays a crucial role in the regulation of airway immune responses and inflammation. Gene expression profiling is widely used to analyses complex disease. For the airway epithelium gene expression profile in diseased and healthy state as well as in baseline and provoked state can clarify the mechanism of defense reactions and the course of inflammatory processes. Nasal mucus proteins as consequence of different gene expression can be seen as part of the end products of this complex mechanisms and interactions between allergens and the epithelium. Nasal mucus proteins have different origins and production sites and gene expression does not necessarily result in functional metabolites. The aim of this proposed project is to try and analyze in a holistic proteomic approach the response to allergen on a genetic/genomic level from the nasal epithelium to protein/proteomic level in nasal mucus. This analysis gives us insight of how the different gene expression profiles result in a protein expression and further clarifies which proteins are directly originate from the epithelium and which are result of plasma exudation or underlie different regulatory processes. From allergic rhinitis patients and healthy controls nasal mucus, nasal mucosa, and serum will be obtained. Nasal mucus will be collected with a special suction device equipped with a mucus trap from the middle meatus under endoscopic control without touching the mucosa. Nasal mucosa will be obtained through nasal brushes under local anesthesia and put into primary culture. Serum prepared from blood samples. Patients with grass or tree pollen allergy will be included and allergic state will be determined by skin prick tests and RAST (Radio-Allergo-Sorbent-test). The aimed for sample size will be 15 patients per group. Samples will be obtained in and out of pollen season. Allergic patients will fill out a symptom score and samples will be taken when symptoms are strong (in pollen season) and disappeared (out of pollen season). For healthy controls the time point of sample taking will be correlated to the allergic rhinitis patients to have a similar pollen exposure. Nasal mucus will be sent for Liquid Chromatography Tandem mass spectrometry for proteomic analysis and from nasal epithelial cells RNA will be isolated and send for Microarray analysis. By an integrative omics approach gene and protein expression will be correlated and cross talk between nasal mucus and epithelium will be analysed. The identification of key genes or gene clusters leads to further identification of key proteins or protein groups as biomarkers that could serve for novel therapeutic or diagnostic strategies in allergic rhinitis. The integrative omic approach downsizes the potential candidates since the focus lies on epithelial gene expression and their protein products and excludes proteins that are highly abundant without direct correlation to allergen exposure e.g. through plasma exudation. Moreover, the genomic and proteomic analysis could explain in more detail how the barrier of mucus and epithelium are affected by allergen exposure. The comparison to healthy controls and the longitudinal changes throughout the season further sheds light on how these individuals react upon allergen exposure and how this could lead to prevention of sensitization.

Start: April 2018
Comparison of Montelukast and Azelastine in Treatment of Moderate to Severe Allergic Rhinitis

Comparison of Montelukast and Azelastine In treatment of Allergic Rhinitis Allergic intent is one of the most common diseases of the respiratory system that has a devastating effect on the quality of life. The importance of studying this disease can be seen from the high prevalence of this diseas. In addition to the high prevalence, due to the reducing effect of this disease on the economy and academic performance of patients, a great burden is imposed by this disease on the country's health care system.Also finding the best treatment of allergic can help to control of Asthma if exists concurrently. Inflammation of the nasal mucosa following the release of IgE can be shown as symptoms of runny nose, sneezing, nasal congestion.Many studies have been done in the field of allergic rhinitis to increase the cost-effectiveness of treatment of this complication. Among the treatments for this disease is the use of antihistamine nasal sprays such as Azelastine. Combination therapies such as combining Mometason furoate or fluticasone with Azelastine or Montelukast can also be mentioned. However, there is still a long way to go to find the best drug combination to reduce the economic and human costs to the global health system. Due to the high prevalence of allergic diseases such as allergic rhinitis, finding the best treatment or management of such diseases plays an important role in improving the quality of life and reducing the economic burden on society.

Start: January 2020