Rhinoconjunctivitis,bronchial responsiveness,and atopy as determinants for incident non-work-related asthma symptoms in apprentices exposed to high-molecular-weight allergens

OBJECTIVE: The aim of this study was to explore the role of rhinoconjunctivitis (RC), taking into account atopy and the level of bronchial responsiveness to methacholine, on the incidence of respiratory symptoms and in the development and/or worsening of asthma. METHODS: We examined data from a prospective study in 769 students starting exposure to high-molecular-weight occupational allergens and who were serially followed for up to 44 months. RESULTS: The presence of RC symptoms at baseline was significantly associated with an increased risk of developing shortness of breath and wheezing in atopic subjects regardless of PC20 level and in subjects with a PC20 相似文献   

The effect of encasings on quality of life in adult house dust mite allergic patients with rhinitis, asthma and/or atopic dermatitis

BACKGROUND: Environmental control has been put forward as an integral part of the management of house dust mite (HDM) allergy in sensitized patients. To validate this statement allergic disorders involved in HDM allergy--allergic asthma, rhinitis and atopic eczema/dermatitis syndrome (AEDS)--should be taken together and studied in terms of the efficacy of environmental control. Because a generic quality of life questionnaire exceeds the border of disease, this may be used as major outcome parameter. RESEARCH OBJECTIVE: To study the effects of bedding encasings in HDM allergic patients with asthma, rhinitis and AEDS. MATERIAL AND METHODS: A total of 224 adult HDM allergic patients with rhinitis and/or asthma and/or dermatitis were randomly allocated impermeable or nonimpermeable encasings for mattress, pillow and duvet. Short form 36 (SF-36) was filled in at baseline and after 12 months. Results: Lower physical (P = 0.01) and emotional (P < 0.001) sumscores were seen in females. Also, the presence of asthma resulted in lower physical sumscore (P = 0.01). However, no effect was seen of encasings on either sumscore. CONCLUSION: Bedding encasings do not improve quality of life in a mixed population of subjects with combinations with rhinitis, asthma and atopic dermatitis and sensitized to HDMs.     

Comparison of local risk factors for children's atopic symptoms in Hanoi, Vietnam

BACKGROUND: A 1999 study in Hanoi, Vietnam using the International Study on Asthma and Allergies in Childhood (ISAAC) questionnaire showed a high prevalence of atopic symptoms. Identifying risk factors for symptoms in these children may help in understanding the causes for these high estimates. METHODS: An ISAAC questionnaire with supplemental questions on environmental variables was distributed to 5495 school children in Hanoi and a suburban district, Dong Anh. The response rate was 65.7%. RESULTS: In Dong Anh, the following were among the significant age and gender adjusted associations: pig ownership [odds ratio (OR) (95% confidence interval), OR = 1.79 (1.18-2.70) for doctor-diagnosed asthma (DDA), OR = 1.72 (1.08-2.78) for doctor diagnosed hay fever (DDHF)] and farming [OR = 1.67 (1.27-2.19) for ever asthma, OR = 1.51 (1.09-2.09) for DDHF]. In multivariate models, tuberculosis (TB) was a significant predictor of atopic symptoms [Hanoi: OR = 3.09 (1.10-8.70) for DDA, Dong Anh: OR = 3.71 (1.40-9.84) for DDA, OR = 4.66 (1.88-11.57) for DDHF]. CONCLUSIONS: These findings are contrary to the "hygiene hypothesis". Recent immunologic and epidemiologic studies refute the inverse association between allergy and TB and may be one explanation for the positive association in this study. The positive association with pig ownership and farming may be because of exposures on farms in a developing country that may be different from exposures in farms of developed countries.     

Environmental priming influences allergen-specific nasal reactivity

Background Preceding mucosal response to one allergen leads to the priming of the nasal mucosal response to another allergen. This study aimed t o determine whether environmental allergens, especially ubiquitous animal dander, can induce nasal priming.
Methods We investigated 26 grass-pollen-allergic subjects with additional sensitization to other aeroallergens. We performed continuous allergen challenge for 2 h with 1500 Dactylis glomerata pollen/m³ in the Vienna challenge chamber. The nasal flow at 150 Pa was examined, and subjective scores were obtained every 15 min. Statistical analysis was calculated from the area under curve of nasal flow reduction by Student's f-test and the Mann-Whitney U-test. Alpha was 0.05.
Results In subjects with positive cat-dander RAST (class of ≥ 3), besides grass-pollen allergy, the specific nasal allergic reaction to Dactylis challenge was significantly pronounced (P <0.01). and an earlier onset of reaction was evident. TTie same results were obtained with additional sensitization to dog dander (P<0.05). Concomitant sensitization to mugwort also led to escalating symptoms (P<0.05).
Conclusions These results indicate that a specific nasal allergic reaction is augmented by environmental priming caused by ubiquitous animal dander and possibly is influenced by the daily use of spices.     

84例变应性鼻炎患儿过敏原皮内试验结果分析

目的 了解新疆地区变应性鼻炎患儿气传过敏原的分布状况,探讨气传变应原分布的地区差异及产生原因,为本地区儿童变应性鼻炎的防治方案提供客观依据.方法 采用阿罗格(NHD)点刺液进行皮肤点刺试验84例变应性鼻炎患儿进行气传变应原测试.结果 84例变应性鼻炎患儿吸入变应原测试总阳性率96.4%(81例),以藜属花粉最高70.2%(59例),蒿属植物次之42.9%(36例),其后依次为杨树27.4%(23例),榆树25.0%(21例),槭树17.8%(15例),柳树11.9%(10例),豚草(巨大豚草、普通豚草)11.9%(10例),粉螨10.7%(9例),尘螨9.5%(8例),交链孢霉8.3%(7例),特异青霉7.1%(6例),白色念珠菌4.8%(4例)等.81例对不同变应原过敏,其中42例(51.9%)患儿对2种或2种以上变应原过敏.点刺试验皮肤反应强度蒿属最明显,强阳性占蒿属过敏病人的50.0%,藜属次之,强阳性占藜属过敏病人的40.7%.结论 藜属和蒿属为新疆地区变应性鼻炎患儿最主要的变应原,在治疗过程中对这类变应性鼻炎患儿可采取有效的避、忌、替、移等措施,明确变应原后对特异性免疫治疗具有重要的指导意义.     

Relationships between allergic inflammation and nasal airflow in children with persistent allergic rhinitis due to mite sensitization

BACKGROUND: Allergic rhinitis is associated with Th2-dependent inflammation. Nasal obstruction is the most typical symptom in children with mite allergy. OBJECTIVES: The aim of this study was to evaluate the possible relationships among nasal symptoms, allergic inflammation, including inflammatory cells and cytokine pattern, and nasal airflow in children with persistent allergic rhinitis because of mite sensitization. METHODS: Twenty children (13 males and seven females, mean age 13.4 +/- 1.6 years) with persistent rhinitis because of mite allergy were evaluated. All of them had moderate-severe grade of nasal obstruction. Total symptom score (TSS), rhinomanometry, nasal lavage, and nasal scraping were obtained in all subjects. Inflammatory cells were counted by conventional staining; interleukin (IL)-5, and IL-8 were measured by immunoassay on fluids recovered from nasal lavage. RESULTS: Eosinophils were significantly associated with TSS (R = 74.4%, P = 0.0002), with IL-5 (R = 90.6%, P < 0.0001) and with nasal flow (R = -69%, P = 0.0007), but not with IL-8 (R = 0.1%, P = 0.995). Eosinophil levels were shown to independently predict nasal flow (P < 0.001), with flow decreasing linearly for increasing eosinophils, together with a significant effect of neutrophils (P = 0.016, linear increase in flow) and a borderline effect of IL-8 (P = 0.063, linear increase in flow). CONCLUSIONS: This study demonstrates the close association between IL-5 concentration and eosinophil infiltration. In addition, there is clear evidence concerning the relationship between eosinophil infiltration and nasal airflow. Thus, nasal eosinophils can be regarded as the most important predictor of upper airway function. These findings constitute first evidence of the relationship between nasal airflow impairment and Th2-related eosinophilic inflammation in children with persistent allergic rhinitis because of mite sensitization.     

Nasal nitric oxide is increased in allergic rhinitis

Background Nitric oxide (NO) plays a major role in the regulation of vascular tone and in non-specific host defence. The epithelium in the paranasal sinuses was recently identified as the major site of NO production in the upper airways. Objective To investigate NO status in allergic rhinitis, we compared the NO concentration in the nasal cavities of control subjects (n= 19) and in patients with allergic rhinitis (n= 36) with symptoms (WS, n= 17) or without symptoms (WOS, n= 19) on the day of the test. Methods NO concentration was measured using a chemiluminescent analyser aspiring from each nasal cavity at a sampling flow rate of 0.7L/min, before and 10min after administration of a nasal vasoconstrictor. Results The mean NO concentration (± se) in the control was 235 ± 11 ppb and 225 ± 9 ppb in the right and left nostrils respectively, and was decreased by 14% and 12% by the nasal vasoconstrictor (P < 0.001). The NO concentration in patients with allergic rhinitis was significantly higher in the right and left nostrils (382 × 20 ppb and 396 ± 28 respectively, P < 0.0001 versus control). All WOS patients demonstrated normal or increased NO concentrations in both nostrils, whereas two WS patients showed decreased NO concentrations in the left nostril. Inhalation of a nasal vasoconstrictor increased NO concentration by 6% and 27% in the right and left nostrils respectively in WS patients. Conclusion Nasal NO concentration is increased in patients with allergic rhinitis. Interestingly, patients without symptoms on the day of the test also showed a clear-cut increase in nasal NO production, which could reflect a permanent inflammation of the sinus mucosa.     

通窍活血汤治疗过敏性鼻炎患儿的临床效果

〔摘 要〕 目的：分析通窍活血汤加减治疗过敏性鼻炎患儿的效果及对嗅觉功能的影响。 方法：选择 2018 年 7 月至 2021 年 12 月在登封市人民医院诊治的 95 例过敏性鼻炎患儿,随机分为观察组（48 例）与对照组（47 例）。对照组患儿 行常规西药治疗,观察组患儿在对照组治疗的基础上给予通窍活血汤加减治疗,比较两组患儿的疗效及对嗅觉功能的影响。 结果：观察组患儿的总有效率为 97.9 %,高于对照组的 80.9 %,差异具有统计学意义（P ＜ 0.05）;治疗后两组患儿的呼 气流量峰值、第 1 秒用力呼气量占用力肺活量比值均高于治疗前,且治疗后观察组患儿呼气流量峰值、第 1 秒用力呼气量 占用力肺活量比值均高于对照组,差异具有统计学意义（P ＜ 0.05）;观察组患儿不良反应发生率为 6.3 %,低于对照组的 31.9 %,差异具有统计学意义（P ＜ 0.05）;治疗后两组患儿的嗅觉功能评分低于治疗前,且治疗后观察组患儿嗅觉功能评 分低于对照组,差异具有统计学意义（P ＜ 0.05）。 结论：通窍活血汤加减治疗过敏性鼻炎患儿能提高治疗效果,改善患 儿的肺功能,减少不良反应的发生,改善患儿的嗅觉功能。     

大连地区儿童变应性鼻炎患者血清特异性IgE分析

目的 了解大连地区儿童变应性鼻炎患者血清特异性IgE情况,为临床诊疗及流行病学防治提供参考。方法 分析2014年8月—2020年7月年龄小于14周岁的变应性鼻炎患者血清312例的特异性IgE结果,按性别、变应原阳性例数、变应原阳性的种类数量、检测时间等进行分组,比较不同组间变应原的分布情况。结果 变应原阳性例数前三位依次为屋尘螨/粉尘螨(34.1%)、艾蒿(18.6%)、猫(8.9%),后三位为羊肉(0.3%)、花生(0.6%)、螃蟹(0.9%);单一变应原患者126例,双重及以上变应原患者186例,差异具有统计学意义(χ²=15.75,P=0.031);变应原种类最多的依次为双重(47.8%)、三重(26.3%)和四重(14.0%)。Pearson相关分析显示,变应原个数与相应人数之间呈负相关(r=-0.800,P=0.017),最多有11种变应原阳性,仅1例。占比最高的双重变应原患者中,屋尘螨/粉尘螨+艾蒿组合数量最多,其次为屋尘螨/粉尘螨+猫组合。两性中变应原种类阳性例数最多的前三种均为屋尘螨/粉尘螨、艾蒿和猫,男童中艾蒿、屋尘螨/粉尘螨、屋尘、狗、啤酒花、牛肉、虾变应原阳性患者数量多于女童(χ²=13.64、11.67、9.45、8.63、10.31、8.36、5.37,P＜0.05),蛋清变应原阳性在女童中更多(χ²=18.67,P=0.027)。患者数量最高月份依次为9月(31.41%)、8月(20.51%)、7月(8.01%),此间为本地的夏末秋初,占全年患者量的59.93%;而患者数量最少的月份依次为1月(1.60%)、3月(1.60%)、2月(1.88%),此间为本地的冬末春初,仅占全年患者量的5.08%。结论 螨、艾蒿和猫是大连地区儿童变应性鼻炎常见变应原,夏末秋初高发,应作为本地区防治的重点。     

豚草花粉变应原致过敏性鼻炎豚鼠模型的建立

为了建立豚草花粉变应原致过敏性鼻炎的实验动物模型,将健康豚鼠42只,随机分为致敏组(n=32)和对照组(n=10).致敏组经腹腔、四肢皮下注射豚草花粉变应原免疫4周后,鼻腔滴入豚草花粉变应原;对照组以生理盐水代替变应原.结果致敏组28只出现鼻痒、喷嚏、流清涕等过敏性鼻炎的临床体征(评分》5分),鼻腔分泌物涂片见大量嗜酸性粒细胞,以及鼻粘膜水肿、粘膜嗜酸性粒细胞和肥大细胞浸润等组织学变化,而对照组无上述变化(P《0.001).本实验建立的豚草花粉变应原致过敏性鼻炎的实验动物模型,为过敏性鼻炎,特别是豚草花粉变应原所致的过敏性鼻炎的诊断、治疗及研究工作提供了有力的方法及形态学依据.