Evaluation of the tear film instability in children with allergic diseases

Context: The presence of dry eye syndrome (DES) in ocular allergic diseases was evaluated in several studies. Despite this, little exists about the tear film instability in atopic children including patients with allergic rhinitis (AR), allergic conjunctivitis (AC) and asthma. This is a study which presents intriguing findings regarding the relationship of tear film instability with clinical aspects in atopic children.

Objective: To determine the tear film instability in children with AR, AC and asthma.

Materials and methods: One hundred and thirty-five consecutive children with AR, AC and asthma as study group and 45 children without any systemic and ocular abnormality as control group were included in the study. Skin prick tests, measurement of tear film breakup time (TFBUT), serum immunoglobulin E and eosinophil counts were performed in all patients. Also four subgroups of patients were designated as AR group (Group I), AC group (Group II), asthma group (Group III) and control group (Group IV).

Results: Socio-demographic characteristics were similar except for family atopy between the groups (p?>?0.05). The mean TFBUT was significantly lower in the study group (15.5?±?4.4?s) than the control group (18.4?±?2.9?s; p?=?0.000). Also, there was no significant differences in the percentage of the patients who has TFBUT<10?s (p?=?0.066). In logistic regression analysis, atopy was found to be the determinant of lower TFBUT (OR?=?16.33, 95%; CI?=?1.17 to 228.05, p?=?0.03).

Conclusion: The presence of tear film instability was higher in children with AC, AR and asthma. This finding should be taken in consideration in atopic children.     

奥洛他定滴眼液联合普拉洛芬滴眼液治疗过敏性结膜炎的临床疗效

目的研究奥洛他定滴眼液联合普拉洛芬滴眼液治疗过敏性结膜炎的临床疗效。方法将136例过敏性结膜炎患者随机分为奥洛他定联合普拉洛芬组82例及单纯奥洛他定组54例,进行治疗,观察治疗前后患者症状与体征的变化情况,评价临床疗效。结果治疗结束后,两组患者的症状和体征均得到显著的改善,奥洛他定联合普拉洛芬组与单纯奥洛他定组的总有效率分别为97.6%及88.9%,两组比较,差异有显著性(P<0.05)。两组患者治疗期间未观察到明显的不良反应。结论奥洛他定滴眼液联合普拉洛芬滴眼液治疗过敏性结膜炎具有较好的临床疗效和安全性,值得临床推广应用。     

色苷酸钠与奥洛他定治疗儿童过敏性结膜炎的临床对比研究

目的探讨色甘酸钠与奥洛他定治疗过敏性结膜炎的临床效果。方法将2010年10月至2012年10月我院诊治的84例过敏性结膜炎患者随机分成2组,对照组42例,采用色甘酸钠滴眼液治疗;实验组42例,采用奥洛他定滴眼液治疗。观察比较两组的近期疗效、眼部综合症状评分、症状体征改善时间。结果实验组的总有效率为92.86%,显著高于对照组的总有效率76.19%,两组比较差异具有统计学意义(P<0.05);实验组治疗3、7、14 d的眼部综合症状评分显著性低于对照组(P<0.05);实验组的眼痒、眼异物感、结膜水肿、结膜充血、眼睑乳头、睑滤泡等症状体征改善时间均显著性短于对照组(P<0.05)。结论奥洛他定治疗过敏性结膜炎的临床药理作用更强,改善眼部症状更快速有效。     

Extracts of different pollen species and their effect on human tear fluid and an epithelial cell line

Purpose: Hazelnut and birch pollen are known to destroy tear film components and attack ocular surface cells. We investigated further pollen species from different plant families, whether they show similar effects on human tear fluid and an epithelial cell line in vitro, to provide a broad basis for further research on pollen reactions affecting the tear film and ocular surface.

Materials and methods: Regional pollen species from different plant families (Adoxaceae, Betulaceae, Fagaceae, Juglandaceae, Malvaceae, Oleaceae, Pinaceae, Plantaginaceae, Poaceae, Salicaceae, Sapindaceae) were collected. Their proteolytic activity was evaluated by Zymography. Human tear fluid and cells of an epithelial cell line were incubated with pollen extracts. Tear fluid was analyzed by Polyacrylamide gel electrophoresis (PAGE). Cytomorphology was assessed microscopically and cell viability by proliferation (MTS), water-soluble tetrazolium (WST-1) assay and the impedance-based xCELLigence real-time analysis (RTCA).

Results: Zymography revealed significant protease activity and PAGE showed the degradation of tear proteins by different pollen species. Cells incubated with pollen extracts presented dose- and time-dependent cytomorphological changes. MTS, WST-1, and RTCA revealed cytostatic as well as cytotoxic effects of pollen extracts.

Conclusions: Pollen species from different plant families exert proteolytic activity and degrade human tear fluid as well as epithelial cells, which may play a crucial role in the pathogenesis of allergic and non-allergic reactions affecting the ocular surface.     

Olopatadine hydrochloride ophthalmic solution for the treatment of allergic conjunctivitis

Introduction: Olopatadine hydrochloride is an antihistamine and mast cell stabilizer available as oral, intranasal and ocular preparations. Most of the practical applications of olopatadine therapy focus on the treatment of allergic rhinoconjunctivitis via intranasal and ocular routes.

Areas covered: This article was created from a comprehensive literature search with information taken from meta-analyses, systematic reviews, and clinical trials of children and adults. The articles that have been selected, evaluate the use of intranasal and ocular antihistamines and their role in allergic rhinoconjunctivitis.

Expert opinion: Olopatadine is significantly more effective than placebos in relieving the symptoms of allergic rhinoconjunctivitis. It can function both as a viable alternative or addition to first line therapies such as intranasal steroids and oral antihistamines.     

酶联免疫吸附试验检测囊虫病患者血清中特异性IgE

应用酶联免疫吸附试验(ELISA)间接法检测了35例囊虫病患者血清中的特异性 IgE,同时以30例献血员做为对照。实验结果显示:患者血清中特异性 IgE 的阳性率达85.7%,单纯脑型患者的特异性 IgE 的阳性率低于混合型病人。上述结果说明,囊虫的可溶性抗原能够诱导 B 淋巴细胞产生特异性 IgE;寄生于皮下和肌肉中的囊虫易将可溶性抗原物质释入血循环,诱导抗体生成细胞产生 IgE;而单纯脑型病人因血脑屏障的作用使囊虫抗原不易与免疫细胞发生反应。IgE 及其介导的免疫反应可能参与人体囊虫病的发病过程。     

Evaluation of the effects of olopatadine ophthalmic solution, 0.2% on the ocular surface of patients with allergic conjunctivitis and dry eye*

ABSTRACT

Purpose: Olopatadine hydrochloride 0.2% (Pataday^?, Alcon, Fort Worth, USA) is a topical ocular anti-allergic agent that has shown high rates of efficacy in treating ocular itching, the primary symptom of allergic conjunctivitis, and allows for once-daily dosing. Since some patients suffer from signs or symptoms of dry eye in addition to ocular allergy, this study was designed to evaluate the safety of olopatadine 0.2% in a population of patients with both allergic conjunctivitis and dry eye.

Methods: This was a single-center, 3-visit, double-masked, randomized study. Fifty-two patients diagnosed with ocular allergy and mild-to-moderate dry eye were evaluated. After a run-in period, patients were randomized to receive either olopatadine hydrochloride 0.2% or a tear saline, and self-dosed once-daily for 1 week. Outcome measures included tear film break-up time, corneal and conjunctival staining, tear volume and flow as measured by fluorophotometry, Schirmer's test, injection, and symptom evaluations.

Results: No significant differences between the treatment groups were observed (?p > 0.05). No serious adverse events occurred during the trial. Variability in the presentation of dry eye can hinder the observation of treatment effects. Although the study design facilitated the comparison of olopatadine 0.2% against an agent that was certain to not exacerbate dry eye, future comparison of olopatadine 0.2% against other agents in its drug class would provide useful information about relative drug tolerabilities.

Conclusion: As there were no significant changes in the signs and symptoms of dry eye, olopatadine hydrochloride 0.2% is safe to use in ocular allergy patients with mild-to-moderate dry eye.     

Effects of a new formulation of olopatadine ophthalmic solution on nasal symptoms relative to placebo in two studies involving subjects with allergic conjunctivitis or rhinoconjunctivitis

ABSTRACT

Background: A new formulation of olopatadine hydrochloride ophthalmic solution (olopatadine 0.2%) was evaluated in two separate, randomized, placebo-controlled, double-masked, hybrid environmental studies intended to determine efficacy and safety in subjects with histories of seasonal allergic conjunctivitis or rhinoconjunctivitis.

Design and methods: In these 10- and 12-week trials (conducted April–August 2003 and July–December 2001, respectively), subjects assessed their ocular signs and symptoms. Additionally, subjects in the 10-week trial evaluated the frequency of their nasal symptoms while subjects in the 12-week trial evaluated both the frequency and severity of their nasal symptoms. The two trials had a combined enrollment of 500 subjects (217 males, 283 females) including 44 children aged 10–17 years; the combined population was 81.4% Caucasian, 9.2% Black, 2% Hispanic, and 7.4% other. Daily throughout these studies, either ragweed (fall study) or grass (spring study) pollen counts were obtained from each investigative center. Slope analyses were conducted on the nasal symptom assessments by pollen count.

Results: The nasal results from the two clinical trials are presented herein. In the fall study, relative to placebo, olopatadine 0.2% significantly reduced the frequency of pollen effects on sneezing (p = 0.0355) and itchy nose (p = 0.0032), and reduced the severity of pollen effects on sneezing (p = 0.0451), itchy nose (p = 0.0178), and runny nose (p = 0.0327). In the spring study, olopatadine 0.2% significantly reduced the frequency of pollen effects on sneezing (p = 0.0017) and runny nose (p = 0.0031) relative to placebo. In the fall trial, 2 subjects discontinued due to treatment-related adverse events (tachycardia and dry eye), while in the spring study, no subject discontinued due to a treatment-related adverse event. No subject in either study suffered a treatment-related serious adverse event.

Conclusions: For the subjects enrolled in these studies, olopatadine 0.2% appeared to be safe, well-tolerated, and effective in significantly reducing the frequency and/or severity of some effects of pollen on nasal symptoms.     

普拉洛芬联合重组牛碱性成纤维细胞生长因子滴眼液治疗过敏性结膜炎的临床效果观察

目的 观察普拉洛芬联合重组牛碱性成纤维细胞生长因子(贝复舒)滴眼液治疗过敏性结膜炎的临床疗效及其对干眼症的预防作用。方法 选取2015年8月至2017年4月无锡市锡山人民医院收治的过敏性结膜炎病人116例,采用随机数字表法分成对照组与观察组,每组各58例。对照组予普拉洛芬滴眼液治疗,观察组予普拉洛芬联合贝复舒滴眼液治疗。连续治疗2周后比较两组症状与体征的变化并评价疗效差异,记录治疗前后泪膜破裂时间(break up time,BUT)、角膜荧光素染色(corneal fluorescent staining,FL)评分。结果 两组病人中对照组治愈19例,显效17例,有效率62.07%;观察组治愈28例,显效19例,有效率81.03%,两组有效率比较,差异有统计学意义(P<0.05)。两组病人治疗后BUT、FL评分均较治疗前改善(P<0.05)。治疗后观察组BUT(10.55±1.80)s高于对照组BUT(9.62±1.67)s,观察组FL评分 (0.83±0.68)分显著低于对照组(1.59±0.94)分,均差异有统计学意义(P<0.05)。结论 普拉洛芬联合贝复舒滴眼液治疗过敏性结膜炎具有较好的临床效果且具有预防干眼症的作用。     

生物共振与血清sIgE检测过敏原对比分析

目的探讨生物共振过敏原检测仪在变态反应性疾病中的临床应用价值。方法采用德国百康生物共振检测仪及UniCAP自动体外过敏原检测系统,对533例变态反应性疾病患者进行过敏原检测,对比两种检测方法的相关性。结果533例患者中,生物共振法过敏原阳性检出率为71％,血清sIgE检测过敏原阳性检出率为43％。对两种方法检测结果进行分类／组比较：除豚草和鱼类外,余5类／组过敏原组间比较差异无统计学意义（P〉0．05）。生物共振检测与血清sIgE检测的符合率在47％～83％之间,其中尘螨、花生的符合率较低分别为52％和47％,其他过敏原的符合率均在69％以上。结论生物共振与血清sIgE检测过敏原具有一定的符合性,蒿草、豚草、尘螨是本地区常见的过敏原。     

广州市某中医院过敏性疾病过敏原检测分析

目的:探讨过敏性患者的过敏原情况。方法:共纳入2019年11月至2020年10月期间来广东省第二中医院儿科、呼吸科、耳鼻喉科等科室就诊的507例患者为研究对象,采用免疫印迹法进行过敏原特异性免疫球蛋白E（immunoglobulin E,IgE）抗体检测,用 χ2检验分析过敏原分布情况及统计学差异。 ...     

奥洛他定滴眼液治疗变态反应性结膜炎的临床观察

目的观察奥洛他定滴眼液在变态反应性结膜炎中的临床疗效。方法入选变态反应性结膜炎患者56例（88眼）,给予患者0．196盐酸奥洛他定滴眼液,每眼1滴,早晚各1次,共7d。观察治疗前后变态反应性结膜炎各项症状与体征的变化情况。结果奥洛他定滴眼液治疗变态反应性结膜炎的总有效率为94．696．变态反应性结膜炎的各项症状和体征均得到显著的改善。治疗期间未观察到明显的不良反应。结论奥洛他定滴眼液治疗变态反应性结膜炎具有较好的疗效和安全性。     

血清霉菌特异性IgE阳性支气管哮喘患者的临床及过敏状态分析

目的探讨分析血清霉菌特异性IgE阳性支气管哮喘患者的临床及过敏状态。方法选取2010年1月至2013年1月在我院接受诊断和治疗的支气管哮喘患者70例为研究对象,抽取所有受试者的静脉血液,将血液样本进行常规离心(2000 r/min,10 min)处理后分离血清样本。使用固相酶斑点技术测定血清中霉菌过敏原特异性IgE。结果 70例患者中9例检测出霉菌,特异性IgE阳性率为12.86%;70例患者中在4¹0月中检出霉菌的为7例占17.07%,在1110月中检出霉菌的为7例占17.07%,在11³月份检出霉菌的为2例占6.90%,43月份检出霉菌的为2例占6.90%,4¹0月的检出率明显高于1110月的检出率明显高于11³月,P<0.05,差异统计学显著。结论霉菌是过敏性支气管哮喘的致敏原之一,并呈现季节性变化。血清霉菌特异性IgE的检测对临床诊断、治疗和预防支气管哮喘有重要意义,也为哮喘的流行病学提供了宝贵的实验室数据。     

新生儿脐血IgE水平对幼儿不同过敏性疾病的预测作用

目的 研究新生儿的脐血IgE水平在幼儿不同过敏性疾病预测中的作用.方法 收集新生儿的脐血标本,测定脐血IgE结果,随访至3～4岁,完善过敏相关症状的问卷调查.将过敏相关症状分成4组:无症状组、皮肤症状组、呼吸症状组和多症状组,观察脐血IgE水平在不同过敏症状组中的分布有无差别.结果 过敏相关问卷调查结果如下:无症状组46例、皮肤症状组30例、呼吸症状组50例和多症状组79例.脐血IgE水平在不同过敏症状组中的分布经秩和检验,差异无统计学意义.结论 新生儿脐血IgE水平可作为致敏指标,预测过敏性疾病的发生,但不能预测过敏相关的具体皮肤、呼吸等症状的发生.     

Oxidative stress parameters and serum magnesium levels in patients with seasonal allergic conjunctivitis

Objective: To evaluate oxidative stress parameters and serum magnesium (Mg) levels in patients with seasonal allergic conjunctivitis (SAC) during the pollen season.

Methods: This observational cross-sectional study involved 35 patients with SAC without any other ocular and systemic diseases, and 38 consecutive, age- and sex-matched healthy subjects. Serum malondialdehyde (MDA), adjusted ischemia modified albumin (IMA), and Mg levels were quantified, and the results were compared between the groups.

Results: No significant differences were found between the groups with respect to age (p?=?0.416) and sex (p?=?0.362). Serum MDA and adjusted IMA levels of the subjects with SAC (69.54?±?7.71 μM and 0.74?±?0.39 ABSU) were significantly higher than the control group (64.61?±?5.89 μM and 0.57?±?0.19 ABSU) (p?=?0.002 and p?=?0.025, respectively). There was no significant difference for serum Mg levels between the groups (p?=?0.177).

Conclusion: We demonstrated higher levels of oxidative stress parameters in patients with SAC compared to the control group, which imply a possible role of oxidative stress in the pathogenesis of SAC.     

盐酸左卡巴斯汀滴眼液治疗过敏性结膜炎68例

目的评价盐酸左卡巴斯汀滴眼液治疗过敏性结膜炎的疗效和安全性.方法140例结膜炎患者随机分成2组.试验组68例用盐酸左卡巴斯汀滴眼液,对照组72例,用色甘酸钠滴眼液,用药均为每次1滴,qid,疗程均为10d.结果试验组用药10d后的缓解眼痒效果达75%,缓解充血效果达76%;总有效率达76%,对照组为71%,64%和71%,2组差异无显著性(P＞0.05).试验组不良反应发生率为4.4%,与对照组(1.4%)相比,差异无显著性(P＞0.05).结论盐酸左卡巴斯汀滴眼液治疗过敏性结膜炎疗效明显,无明显不良反应.     

The role of histamine H(1) receptors in late-phase reaction of allergic conjunctivitis

The role of histamine H(1) receptors in the late-phase reaction of allergic conjunctivitis was studied using histamine H(1) receptor-deficient mice. To clarify the eosinophil infiltration, which is a reliable indicator of late-phase reaction, eosinophil peroxidase activity in the conjunctiva was measured. Mice were actively immunized with ovalbumin, and conjunctivitis was induced by topical instillation of ovalbumin. A significantly high eosinophil peroxidase level in the conjunctiva was observed in sensitized wild-type mice, whereas sensitized histamine H(1) receptor-deficient mice showed no significant increase in the conjunctival eosinophil peroxidase level. In addition, the elevation of eosinophil peroxidase level observed in sensitized wild-type mice was significantly antagonized by pretreatment with anti-P-selectin antibody. From these findings, it was concluded that eosinophil infiltration into the conjunctival tissue in late-phase reaction of allergic conjunctivitis is mediated by P-selectin stored in endothelial cells via histamine H(1) receptors.     

放射过敏原吸附试验检测青霉素过敏病人血清中特异性IgE抗体

采用放射过敏原吸附试验 (RAST)检测 13 0例青霉素过敏病人血清中 9种主要和次要抗原决定簇 (BPO ,AXO ,APO ,PVO ,FLUO ,BPA ,AXA ,APA ,PVA)特异性IgE抗体 ,以探讨青霉素过敏反应机制并改进过敏反应诊断方法。结果 13 0例过敏病人中有 44例 (3 3 .8% )特异性IgE抗体呈阳性 ,其中 86例皮试阳性和 44例有过敏史病人血清特异性IgE抗体阳性率分别为 2 4.4%和 5 2 .3 % ,后者较前者明显升高 (P <0 .0 5 )。 13 0例过敏病人主要抗原决定簇 (BPO ,AXO ,APO ,PVO ,FLUO)和次要抗原决定簇 (BPA ,AXA ,APA ,PVA)IgE抗体阳性率分别为 19.2 %和 2 7.6% ,后者明显高于前者 (P <0 .0 5 )。根据皮试或发生过敏反应与抗体测定时间间隔分为 4个时间段 :即刻、3 0d内、3 0d～ 2年和 2年以上 ,皮试阳性病人各时间段特异性IgE抗体阳性率分别为42 9%、2 8 6%、18 8%和 10 5 % ;有过敏史病人分别为 87.5 %、71.4%、5 3 .3 %和 2 1.4%。研究结果提示 ,次要抗原决定簇在过敏反应中发挥着重要作用 ,且过敏病人特异性IgE抗体随时间延长呈下降趋势。     

Omalizumab decreases IgE production in patients with allergic (IgE-mediated) asthma; PKPD analysis of a biomarker, total IgE

AIMTo determine whether excessive IgE production by patients with atopic allergic asthma decreases with omalizumab therapy.METHODSOmalizumab, free and total IgE data were obtained from an epidemiological study and six randomized, double-blind, placebo-controlled trials in patients with allergic asthma. The binding between omalizumab and IgE together with the production and elimination of IgE were modelled as previously, except that, in order to explain why total IgE was decreasing over a period of 5 years, the expression of IgE was allowed to change.RESULTSThe prior constant IgE production model failed to converge on the data once long-term observations were included, whereas models allowing IgE production to decrease fitted. A feedback model indicated that, on average, IgE production decreased by 54% per year. This model was further developed with covariate searches indicating clinically small but statistically significant effects of age, gender, body mass index and race on some parameters. Model predictions were checked internally and externally against 3–5 year data from paediatric and adult atopic asthmatic patients and externally against extensive total IgE data from a long-duration (>1 year) phase 1 study which was not used in the model building.CONCLUSIONSA pharmacokinetic–pharmacodynamic model incorporating omalizumab–IgE binding and feedback for control of IgE production indicates that omalizumab reduces production of IgE. This raises the possibility that indefinite treatment may not be required, only for perhaps a few years. After the initial accumulation, total IgE should provide a means to monitor IgE production and guide individual treatment decisions.