Dietary fibre in relation to asthma,allergic rhinitis and sensitization from childhood up to adulthood

BackgroundDietary fibre may reduce the risk of allergy. Our aim was to investigate the association between fibre intake in childhood, asthma, allergic rhinitis and IgE sensitization up to adulthood.MethodsThe individual fibre intake of 2285 participants from the Swedish population‐based birth cohort BAMSE was estimated between 98‐ and 107‐item food frequency questionnaires at ages 8 and 16 years, respectively. At 8, 16 and 24 years, asthma and allergic rhinitis symptoms were assessed by questionnaires, and sensitization to common allergens by serum IgE. Longitudinal associations were analysed by generalized estimating equations, adjusting for potential confounders.ResultsAn inverse overall association was indicated between fibre intake at 8 years and allergic rhinitis symptoms up to 24 years (OR per 5 g/d 0.86; 95% CI 0.77–0.96), particularly in combination with airborne (0.74; 0.62–0.89) and food (0.69; 0.54–0.88) allergen sensitization. Higher fibre intake was also associated with specific allergen sensitization, for example, birch (0.77; 0.67–0.88) and soy (0.68; 0.53–0.87). No association was observed with asthma. Regarding sources, fruit (0.79; 0.67–0.94) and other (potatoes, chips/popcorn, legumes, and nuts, 0.71; 0.50–0.99), but not cereal or vegetable fibre were associated with allergic rhinitis. In additional analyses, including long‐term fibre intake at 8 and 16 years, excluding participants with food‐related allergic symptoms to examine reverse causation, as well as adjusting for antioxidant intake, associations were attenuated and became non‐significant.ConclusionHigher fibre intake in mid‐childhood may be inversely associated with allergic rhinitis and sensitization to specific allergens up to adulthood. However, avoidance of food triggers of allergic symptoms in allergic rhinitis patients may contribute to the protective associations.     

过敏性哮喘和鼻炎患儿的临床免疫治疗研究

目的：探讨过敏性哮喘和鼻炎患儿的特异性免疫治疗的临床应用。方法采用体外特异性过敏原检测系统对儿童医院门诊患儿进行血清过敏原特异性 lgE（SlgE）抗体和总 lgE 进行检测,对尘螨过敏患儿进行分组治疗,免疫治疗组采用粉尘螨滴剂舌下脱敏治疗,对照组按普通药物抗过敏治疗,治疗6个月、12个月给予临床控制指标评分,同时观察患儿血清中 SIgE 的改变。结果218例过敏患儿吸入性过敏114例（52．4％）,食入性过敏101例（46．3％）。98例尘螨过敏患儿占总过敏者和吸入性过敏者的44．95％和85．96％。免疫治疗组与对照组比较差异有统计学意义（P ＜0．05）;脱敏治疗患儿 SIgE 阳性率有所下降,但差异无统计学意义（P ＞0．05）。结论218例过敏患儿的特异性过敏原检测中尘螨过敏者最多;舌下特异性免疫治疗过敏性哮喘和鼻炎效果显著。     

Total IgE in tears accurately reflects the severity and predicts the prognosis of seasonal allergic conjunctivitis

BackgroundAlthough immunoglobulin E (IgE) increases significantly in tears and serum during seasonal allergic conjunctivitis (SAC), it is unclear whether tear total IgE can reflect the severity and prognosis of SAC more accurately than serum total IgE. We aimed to investigate the usefulness of measuring the total IgE in tears to evaluate the severity and determine the treatment of SAC.MethodsThis prospective, nonrandomized study involved 55 patients with SAC and 10 age‐ and sex‐matched healthy controls. Serum and tears were collected before and after treatment to analyze the total IgE. SAC patients received the same topical anti‐allergy treatment and were followed‐up every 2 weeks for 1 month. The relationship of tear and serum total IgE concentrations with pollen concentrations and symptom severity before and after treatment was assessed.ResultsThe total IgE concentration in tears was higher in SAC patients than in healthy participants with significant correlations between tear and serum total IgE concentrations. The total IgE concentration in tears, but not in serum, correlated with the pollen concentration and severity of ocular symptoms and reactions in SAC. Treatment‐associated improvements in symptoms and reactions in SAC correlated with decreased concentrations of the tear total IgE. Patients with disease recurrence following treatment demonstrated significantly higher tear total IgE concentrations than patients with no recurrence.ConclusionThe total tear IgE level can indicate the severity and predict the prognosis of SAC more accurately than the serum total IgE.     

Allergic multimorbidity is associated with self‐reported anaphylaxis in adults—A cross‐sectional questionnaire study

BackgroundAnaphylaxis has increased over the last two decades in Europe, reaching an estimated prevalence of 0.3% and an incidence of 1.5–7.9 per 100,000 person‐years. Allergic multimorbidity is associated with asthma severity, yet its role in anaphylaxis is not fully understood. Our aim was to study association between allergic multimorbidity and anaphylaxis in adults.MethodsWe used population‐based data from the Finnish Allergy Barometer Study (n = 2070, age range: 5–75). Food allergy (FA), atopic dermatitis (AD), allergic rhinitis (AR) and allergic conjunctivitis (AC), were defined from a self‐completed questionnaire. A logistic regression adjusted on potential confounders (sex, age, smoking status) was applied to estimate the anaphylaxis risk associated with allergic multimorbidity.Results1319 adults with at least one allergic disease (FA, AD, AR, AC) with/without asthma (AS) were included. Of these, 164 had self‐reported anaphylaxis [mean (SD, min‐max) 54 (14, 22–75) years, 17% men]. AS, FA, AR, AC, or AD were reported by 86.0%, 62.2%, 82.3%, 43.3%, and 53.7% of subjects with anaphylaxis and respectively by 67.8%, 29.5%, 86.2%, 29.4%, and 34.4% of subjects without anaphylaxis. Compared with subjects exhibiting only one allergic disease, the risk of anaphylaxis increased with the number of allergic diseases; adjusted odds ratios (OR) [CI95%] for two, three, four and five coinciding allergic diseases were 1.80 [0.79–4.12], 3.35 [1.47–7.66], 7.50 [3.25–17.32], and 13.5 [5.12–33.09], respectively. The highest risk of anaphylaxis (6.47 [4.33–9.92]) was associated with FA + AS or their various variations with AR/AC/AD embodied, when compared with AR, AC, and AS separately or their combinations.ConclusionsAnaphylaxis was positively associated with the number of allergic diseases a subject exhibited and with subgroups including FA and/or AS. The results can be applied when estimating the risk of anaphylaxis for individual patients.     

儿童过敏性结膜炎与变应性鼻炎的相关性及鼻眼联合治疗的研究分析

目的探讨儿童过敏性结膜炎与变应性鼻炎的相关性及鼻眼联合防治的临床效果。方法回顾性分析2010年10月至2014年6月收治的300例儿童过敏性结膜炎与310例儿童变应性鼻炎患者的临床资料,首先对儿童过敏性结膜炎与变应性鼻炎的相关关系进行分析。然后将过敏性结膜炎合并变应性鼻炎患儿按照抽签方法随机地均分为对照组与观察组。对照组采用常规点眼的方法进行治疗,观察组则采用生理性海水鼻腔喷雾剂喷鼻联合人工泪液点眼进行治疗。对比观察两组患者临床疗效、治疗前后症状评分、泪膜破裂时间(BUT)及角膜荧光素染色评分、不良反应发生情况。结果 1300例过敏性结膜炎患儿中,50例(16.67%)并发变应性鼻炎;310例变应性鼻炎患儿中,59例(19.03%)并发过敏性结膜炎,二者差异无统计学意义(P0.05);2109例同时并发两种疾病患儿,均进行眼结膜与鼻黏膜的刮片检查嗜酸性粒细胞,其中60例(55.05%)结膜刮片与67例(61.47%)鼻黏膜刮片检测到嗜酸性粒细胞,二者差异无统计学意义(P0.05);3经治疗,观察组总有效率显著高于对照组(92.00%比72.00%)(P0.05);4两组治疗后症状评分、BUT及角膜荧光素染色评分均较治疗前有显著改善,差异有统计学意义(P0.05,P0.01),且观察组治疗后上述指标均优于对照组,差异均具有统计学意义(P0.05);5两组治疗过程中均未见不良反应发生。结论儿童过敏性结膜炎与变应性鼻炎具有一定的相关性,提示预防过敏性结膜炎在未来预防变应性鼻炎中应作为一项重要的纳入指标;生理性海水鼻腔喷雾剂喷鼻联合人工泪液点眼治疗儿童过敏性结膜炎合并变应性鼻炎的临床疗效显著,值得临床推广应用。     

Environmental and sensitization variations among asthma and/or rhinitis patients between 2008 and 2018 in China

BackgroundLittle is known about the changes in allergen sensitization in China secondary to the environmental variations over the past decade. We aimed at investigating the variations in sensitization among asthma and/or rhinitis patients in China between 2008 and 2018.MethodsThis study analyzed cross‐sectional data from national surveys conducted in China in 2008 and 2018. After finishing the questionnaire, participants underwent serum specific IgE measurements. A total of 2322 and 2798 patients were enrolled in 2008 and 2018, respectively. The significance of differences in sensitization rates among four regions of China were assessed. Correlation analysis was used to identify the associations of sensitization with climate change and planting of Artemisia desertorum between the two surveys.ResultsCompared with 2008, the general sensitization rate to mites significantly increased in 2018, which ranked highest among all tested allergens. Sensitization to pollens, especially Artemisia vulgaris, showed the greatest increase in the north. The annual mean temperature, rainfall and relative humidity in all four regions, and the Artemisia desertorum coverage in the northeastern area, increased significantly in 2018 as compared with 2008. From 2008 to 2018, an increase in Dermatophagoides pteronyssinus sensitization was significantly associated with an increase in relative humidity (r = 0.54, p = 0.037). The increase in A. vulgaris sensitization was significantly associated with the increase in the A. desertorum planting area (r = 0.67, p = 0.006) and with a decrease in rainfall (r = −0.59, p = 0.021).ConclusionsHouse dust mites remain the most important allergen in Chinese individuals with asthma and/or rhinitis. Pollen sensitization dramatically increased in northern China. Increases in sensitization to dust mites and Artemisia were related to the increases in humidity and planting area of A. desertorum.     

Anti-IgE in allergic asthma and rhinitis: an update

Allergic asthma and rhinitis imposes a huge burden in terms of treatment costs, productivity loss and hospital admissions. IgE plays a significant role in the manifestation of these conditions and the identification of a monoclonal antibody that binds to IgE provides clinicians another therapeutic strategy in the management of these conditions. Blocking the effects of IgE by omalizumab, a recombinant humanised monoclonal antibody that selectively binds to IgE has been shown to be a useful adjunct in the treatment of allergic asthma and rhinitis. Omalizumab is effective as a steroid reducing agent in patients with severe asthma and is successful in decreasing asthma exacerbations. Omalizumab was well tolerated in clinical trials, however, the potential long-term side effects need careful monitoring. The high cost of the molecule could make this a therapeutic option in a small proportion of patients in whom there is a large unmet need.     

黄芪防芷汤对变应性鼻炎患者血清IgE,IL-4,IL-12含量的影响

目的探讨黄芪防芷汤在变应性鼻炎治疗中的作用。方法 68例变应性鼻炎患者随机分为对照组和治疗组,各34例。对照组应用布地奈德,孟鲁司特,酮替芬治疗。治疗组在对照组治疗基础上,服用自拟中药方。观察2组患者治疗前后血清IgE、IL-4、IL-12水平、变应性鼻炎症状评分、气道反应性。结果 2组患者治疗后血清IgE、IL-4水平较均较治疗前明显降低（P〈0.05）,IL-12水平较治疗前明显升高（P〈0.05）;治疗组治疗后IL-4水平明显低于对照组治疗后（P〈0.05）,IL-12水平明显高于对照组治疗后（P〈0.05）。治疗组治疗后变应性鼻炎症状评分明显低于对照组治疗后（P〈0.05）。2组治疗后Fres、R5及R20均较治疗前明显降低（P〈0.05）,治疗组较对照组降低的更加明显（P〈0.05）。结论黄芪防芷汤治疗变应性鼻炎疗效可靠,其治疗作用可能与纠正患者体内Th1/Th2平衡状态有关。     

The association of asthma,atopic dermatitis,and allergic rhinitis with peripartum mental disorders

BackgroundAtopic diseases are characterized by dysregulated inflammatory response, which may incur the onset of peripartum mental disorders, but the impact remains unknown. This study examined whether and to what extent the history of atopic diseases is associated with newly onset peripartum mental disorders.MethodsUsing population‐based registries, we identified all primiparous women who gave birth to live singletons in Denmark during 1978–2016 (n = 937,422). The exposure was hospital contact due to the three major types of atopic diseases—asthma, atopic dermatitis, and allergic rhinitis—before conception. The primary outcome was any hospital contact for mental disorder during pregnancy and 1‐year postpartum, which was further classified into affective disorders, neurotic, stress‐related and somatoform disorders, and substance abuse. The follow‐up started from the date of conception and ended at the date of the first diagnosis of mental disorders, 1‐year postpartum, death, emigration, or December 31, 2016, whichever came first. Cox regression was used, adjusted for calendar year, age at childbirth, education, residence, and Charlson comorbidity index.ResultsA total of 24,016 (2.6%) women received diagnosis of at least one of the three atopic diseases before conception (asthma, 1.7%; atopic dermatitis, 0.6%; and allergic rhinitis, 0.8%). Exposure to asthma, atopic dermatitis, or allergic rhinitis was associated with a 37% increased overall risk of peripartum mental disorders (hazard ratio [HR], 1.37; 95% confidence interval [CI], 1.27–1.49). Higher risks were observed among women with more frequent hospital contacts for atopic disease (HR, 1.80; 95% CI, 1.37–2.35; ≥5 times), and with recent hospital contacts for atopic disease (HR, 1.74; 95% CI, 1.48–2.06; within 2 years before conception). Specific associations were observed between asthma and neurotic, stress‐related and somatoform disorders (HR, 1.40; 95% CI, 1.21–1.62), and between atopic dermatitis and substance abuse (HR, 1.62; 95% CI, 1.12–2.34).ConclusionsHistory of asthma, atopic dermatitis, and allergic rhinitis before conception was associated with increased risks of peripartum mental disorders. Women who have atopic diseases before pregnancy may benefit from systematic mental health monitoring.     

吸入物变应原过筛试验和总IgE检测在变应性鼻炎诊断中的应用

探讨吸入物变应原过筛试验和总检测对变应性鼻炎诊断的意义。应用ＣＡＰＳｙｓｔｅｍ检测鼻炎患者的吸入物变应原过筛试验和总ＩｇＥ。对５８例变压性鼻炎及２２例非变应性鼻炎均进行ＰｈＡＤＩＡＴＯＰ、ＴＩｇＥ检测。     

变应性鼻炎患者血清总IgE和特异性IgE分析

目的分析深圳特区变应性鼻炎的吸入性过敏原分布特点,为该地区变应性鼻炎的预防、诊断和治疗提供依据。方法采用德国Mediwiss过敏原体外检测系统,对569例变应性鼻炎患者血清特异性IgE和总IgE检测结果进行回顾性分析。结果 569例变应性鼻炎患者中,吸入性过敏原中以户尘螨阳性率最高(62.6%),其次是蟑螂、狗毛和屋尘,阳性率分别为14.4%、14.1%和10.0%;男女性别间过敏原阳性率没有显著差异(P0.05),但儿童组吸入性过敏原阳性率为87.8%,成人组吸入性过敏原阳性率为65.4%,两者差异显著(P0.0001);血清总IgE阳性率为81.9%,吸入性过敏原特异性IgE阳性率为74.2%,总IgE阳性率明显高于特异性IgE阳性率,差异有统计学意义(P0.0001)。结论户尘螨是诱发深圳特区变应性鼻炎的主要过敏原;儿童AR患者过敏原阳性率高于成人AR患者,可能与其免疫系统发育尚不完善有关;联合检测血清总IgE和过敏原特异性IgE可提高变应性鼻炎诊断的准确性。     

Relationship between longitudinal changes in type‐2 inflammation,immunoglobulin E sensitization,and clinical outcomes in young asthmatics

BackgroundAsthma is a heterogeneous condition where biomarkers may be of considerable advantage in diagnosis and therapy monitoring. However, the changes in asthma biomarkers and immunoglobulin E (IgE) over the course of life has not been extensively investigated.ObjectiveTo study longitudinal changes in type‐2 inflammatory biomarkers, IgE, and clinical outcomes, and the association between these changes, in young asthmatics.MethodsAsthmatics (age 10–35 years, n = 253) were examined at baseline and at a follow‐up visit, 43 [23–65] (median [range]) months later. Subjects were analyzed using the multi‐allergen tests Phadiatop and fx5 (ImmunoCAP) and grouped based on the baseline allergen‐specific IgE antibody (sIgE) concentration: <0.10, 0.10–0.34, and ≥0.35 kU_A/L. The relationship between changes (Δ values) in type‐2 biomarkers (individualized fraction of exhaled nitric oxide [FeNO%], blood eosinophil [B‐Eos] count, total IgE [tIgE] and sIgE, lung function [% predicted forced expiratory volume in 1 second (FEV₁) and FEV₁/forced vital capacity (FVC)], and Asthma Control Test [ACT]) score were determined.ResultsAt follow up, FEV₁ and FEV₁/FVC had decreased (93.6% vs. 95.8%, and 93.4% vs. 94.7% of predicted, respectively [p < 0.001 both]), whereas ACT score had increased (21.6 vs. 20.6, p = 0.001). A significant decline in lung function was seen in subjects with sIgE ≥ 0.10 kUA/L, but not in those with undetectable sIgE (<0.10 kU_A/L). Furthermore, tIgE and sIgE declined over time (p < 0.001 all) whereas FeNO% and B‐Eos count were not significantly changed. In univariate analysis, significant negative correlations between ∆B‐Eos count and ∆FeNO%, on one hand, and changes in lung function, on the other hand, were seen, and multivariate analysis showed an independent relationship between ΔFeNO%, and ΔFEV₁ (p < 0.05) and ΔFEV₁/FVC% (p < 0.01). Sex‐specific analysis showed that the independent association between ΔFeNO%, and ΔFEV₁ remained only in females (p = 0.005), and there was a significant interaction with sex (p = 0.02).ConclusionIn young asthmatics, IgE levels declined over 43 months, whereas FeNO and B‐Eos remained unchanged. In spite of improved asthma control, an accelerated lung function decline was seen in patients with detectable sIgE at baseline, and the decline correlated with changes in type‐2 biomarkers. Particularly, the increase in individualized FeNO associated independently with decline in FEV₁ in females.     

变应性鼻炎血清总IgE水平测定及临床意义

目的研究血清总IgE在季节性与常年性变应性鼻炎中的变化,并探讨其临床意义。方法采用酶联免疫法检测62例变应性鼻炎患者和20例健康者血清总IgE水平,并进行相关性分析。结果季节性和常年性变应性鼻炎血清总IgE明显高于健康对照组(P<0.01),季节性变应性鼻炎血清总IgE明显高于常年性变应性鼻炎(P<0.01)。季节性变应性鼻炎症状和体征高于常年性,差异有统计学意义(P<0.05)。结论血清总IgE水平与变应性鼻炎的发作强度呈正相关,有助于临床诊断及病情评估。     

儿童过敏性鼻炎和支气管哮喘中周围Th17和调节性T细胞的失衡

目的探讨周围Th17细胞(Th17)和调节性T细胞(Treg)在儿童过敏性鼻炎(AR)与支气管哮喘(BA)中的失衡及临床意义。方法选取单纯过敏性鼻炎(AR组)、单纯支气管哮喘(BA组)及过敏性鼻炎合并支气管哮喘儿童(AR+BA组)为研究对象,每组25例。以同期入院体检的25例健康儿童为对照组。比较4组外周血Th17细胞、Treg细胞水平,对比4组免疫球蛋白E(IgE)、转化生长因子β_1(TGF-β_1)、第1秒用力呼气容积占预计值百分比(FEV_1%)及血清白介素IL-6、IL-17、IL-23、IL-10水平,并分析AR合并BA患儿IgE、FEV1%与Th17、Treg、TGF-β_1、IL-17的相关性。结果 AR组、BA组、AR+BA组外周血Th17细胞、Treg细胞、IgE、TGF-β_1、FEV1%与对照组比较均有显著差异(P0.05);AR组、BA组、AR+BA组IL-6、IL-17、IL-23均显著高于对照组(P0.05),且AR+BA组IL-17显著高于AR组、BA组(P0.05);相关分析显示IgE与Th17、IL-17水平呈正相关,与Treg、TGF-β_1水平呈负相关(P0.05)。结论儿童过敏性鼻炎和支气管哮喘中Th17与Treg细胞存在失衡,且其表达与IgE、FEV_1%均存在一定相关性。     

Fractional exhaled nitric oxide levels in relation to work‐related respiratory burden and sensitization to wheat flour and multigrain in bakers

BackgroundWork‐related lower airway symptoms (WR‐LAS), rhinitis (WRR), and asthma (WRA) are very common among bakers, due to airborne exposure to wheat flour and multigrain. Limited data is available regarding fractional exhaled nitric oxide (FeNO) in bakers in relation to respiratory burden and occupational sensitization in a real‐life situation.ObjectiveTo analyze FeNO levels in relation to WRR, WR‐LAS, and WRA with regard to allergic sensitization to occupational allergen in bakers.MethodsCross‐sectional, observational study of 174 bakers employed in traditional small bakeries in the Verona District. Subjects did FeNO measurements, spirometry, methacholine challenge, and skin prick test to common inhalant aeroallergens and bakeries occupational allergens.ResultsFeNO levels were higher in subjects sensitized to occupational allergens compared with bakers not sensitized to occupational allergens (22.8 ppb (18.9, 27.6) vs. 12.0 ppb (9.9, 14.5), p < 0.05). FeNO levels were higher in bakers with WRR and occupational sensitization (25.4 (20.6, 31.3)) than in bakers with WRR without occupational sensitization compared and bakers without respiratory burden (13.4 (9.6, 18.6) and 11.9 (9.8, 14.5), both p < 0.001). Similar findings were found for WR‐LAS with regard to the same categories (31.2 (24.1, 40.4) vs 13.3 (11.4, 15.6) and 15.3 (8.5, 27.5), p < 0.001 and p = 0.005). Bakers with WRA, with or without occupational allergic sensitization, had higher levels of FeNO than bakers without respiratory burden (both p ≤ 0.001). These findings were consistent after adjustments for gender, age, height, weight, smoking, and sensitization to common inhalant aeroallergens and lung function.ConclusionsWRR and lower airway symptoms in bakers sensitized to occupational allergens relate to increased FeNO. Our study suggests that FeNO is associated with work‐related allergic inflammation in occupational sensitized bakers, but future studies are needed to assess how FeNO should be integrated in the diagnostic work‐up of occupational disease in bakers.     

血清sIgE和sIgG4检测在儿童过敏性疾病中的临床应用

目的：探讨血清特异性IgE（sIgE）和特异性IgG4（sIgG4）检测在儿童过敏性哮喘及过敏性鼻炎中的临床应用价值。方法采用ELISA法对85例过敏性哮喘组患儿、72例过敏性鼻炎组患儿及60例对照组健康儿童血清中sIgE和sIgG4进行检测。采用ROC曲线分析sIgE和sIgG4对过敏性哮喘和过敏性鼻炎的诊断效能。结果过敏性哮喘组和过敏性鼻炎组治疗前血清sIgE和sIgG4水平均明显高于对照组,差异有统计学意义（P＜0．01）。治疗6个月后,过敏性哮喘组及过敏性鼻炎组血清sIgE水平均较治疗前有明显下降,而血清sIgG4水平却较治疗前明显上升,差异均有统计学意义（P＜0．01）。sIgE和sIgG4联合检测,对过敏性哮喘和过敏性鼻炎的诊断灵敏度分别为90．6％（77/85）和84．7％（61/72）,诊断特异度分别为81．2％（69/85）和76．4％（55/72）。结论sIgE和sIgG4是反映过敏性疾病的良好指标。     

特应性舌下免疫治疗儿童哮喘并变应性鼻炎的临床研究

目的 探讨舌下含服尘螨变应原疫苗治疗儿童哮喘的临床疗效和免疫指标变化.方法 选取年龄4～13岁哮喘缓解期伴变应性鼻炎患儿300例为免疫治疗对象,完成包括粉尘螨在内的10种常见过敏原皮肤点刺实验,点刺试验结果呈阳性反应.全部患者肺功能检查在个人预计值正常值范围.应用粉尘螨滴剂进行临床免疫治疗,记录治疗前后症状和体征评分和不良反应.采用夹心酶联免疫吸附测定方法检测治疗前后血清尘螨免疫球蛋白E(slgE)和特异性IgG4.结果 进入治疗的300例儿童哮喘并变应性鼻炎患儿坚持完成1年治疗的有221例,治疗总有效率为71.0%,有效病例中平均起效时间为6.8月(中位时间6个月).与用药相关的皮疹,鼻咽痒和哮喘发作的不良反应发生率21.7%(48/221),未出现过敏性休克的严重不良反应.儿童哮喘并变应性鼻炎患者血清slgE治疗前(125.21±96.70)kU/L,治疗后(121.19±87.01)kU/L,治疗前后比较无明显变化(t=0.913,P>0.05);血清特异性IgG4治疗后(894.2±687.1)ku/L比治疗前(696.7±452.8)ku/L明显升高(t=3.519,P<0.01).结论 特应性舌下免疫治疗方法安全有效,是治疗儿童变应性疾病的重要措施之一.     

Association between SP‐A rs1965708 gene polymorphism and allergic rhinitis risk in Chinese population

BackgroundPulmonary surfactant protein A (SP‐A) in the respiratory tract plays an important role in host. In the present, we assessed the association between SP‐A gene polymorphism and allergic rhinitis.MethodsUsing a case–control design, we compared the genotype frequencies of SP‐A rs1965708 between allergic rhinitis patients and healthy control group. Genotyping was performed using real‐time quantitative PCR‐based molecular identification methods. Univariate and multivariate logistic regression were performed to quantitatively assess the association between rs1965708 polymorphism and allergic rhinitis, and the odds ratio (OR) and 95% confidence interval (CI) were also calculated.Results500 patients with allergic rhinitis and 500 healthy controls were included in the study. Compared with the CC genotype, we found that AA genotype of rs1965708 could increase the allergic rhinitis risk in the univariate analysis (OR = 2.63, 95% CI: 1.56–4.54, p = 0.000). For dominant model, we found no significant difference in the dominant model (OR = 1.14, 95% CI: 0.86–1.52, p = 0.367). In the recessive model, the CC genotype could elevate the risk of allergic rhinitis compared with CC + AA genotype (OR = 2.70, 95% CI: 1.61–4.54, p = 0.000). Similar results were also found in the allele model (OR = 1.28, 95% CI: 1.07–1.54, p = 0.008). Interactions between rs1965708 AA or AC and smoking increased the allergic rhinitis risk.ConclusionsThe rs1965708 variants of SP‐A gene polymorphism are associated with allergic rhinitis, and the A allele could increase the allergic rhinitis risk. The AA SNP variants that interact with smoking may alter the susceptibility to allergic rhinitis.