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.     

Prevalence of childhood asthma and allergic diseases in Ankara, Turkey

Kalyoncu AF, Selçuk ZT, Karakoca Y, Emri AS, Çöplü L, Şahin AA, Bariş YI. Prevalence of childhood asthma and allergic diseases in Ankara, Turkey.
The first epidemiologic survey of the prevalence of childhood asthma and other allergic disease in Ankara, Turkey, was done in May 1992. A questionnaire on factors influencing the atopic status and allergic symptoms was distributed to parents of 1226 children aged 6-12 years. In this questionnaire, parents were asked to give information about physician-diagnosed asthma and atopic dermatitis (AD), and self-reported wheezing and rhinoconjunctivitis (perennial or seasonal). The overall response rate was 85 % and included 502 boys (48.5%) and 534 girls (51.5%). The lifetime prevalences of asthma, wheezing, rhinoconjunctivitis, and AD were 17.4%, 23.3%, 28%, and 6.1%, respectively, and the reported prevalences for the last 12 months were 8.3%, 11.9%, 15.4%, and 4%, respectively. Asthma and other allergic disease had been recognized in 23.2% of the children during the last year; in half of these, more than one disease was present. Eight percent of the families kept pet animals; 95.4% of children had been breast-fed, of whom 61% for more than 6 months; and at least one person smoked at home in the case of 73.9% of children. Some health insurance was available to 72.8% of the families. Cumulative prevalences of wheezing, rhinoconjunctivitis, and AD were significantly associated with the presence of pets, passive smoking at home, and absence of health insurance. The prevalence of asthma was not affected by any of these factors except atopic family history. In conclusion, asthma and other allergic diseases constitute a major health problem for schoolchildren in Ankara.     

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.     

中草药的变态反应

通过大量的文献调查、以鱼腥草和丹参及其制剂引起的变态反应为重点,介绍常用中草药诱发变态反应的临床表现、分型、处理和预防方法。为临床安全、有效使用中草药提供借鉴。     

Intracellular production of IL-2, IL-4 and IFN-γ by peripheral blood CD3+ cells in intermittent allergic rhinitis

Background: Allergic inflammation is mainly driven by type 2 T helper cells. The aim was to assess the changes in production of type 1 and 2 cytokines by CD3⁺ T cells dependent on natural exposure to allergens in subjects with intermittent allergic rhinitis (IAR) and in non-atopic subjects.Material: A total of 13 patients with IAR and 13 healthy non-atopics were recruited into the study. 11 patients with IAR were examined during the grass pollen season and 11 patients outside the season, 9 of them were assessed on both occasions.Methods: A flow cytometric assessment of intracellular expression of IL-2, IL-4 and IFN- by CD3⁺ cells was performed. For statistical analysis non-parametric tests were used.Results: A tendency to decreased production of IL-4 outside the season was observed (6.94% [3.42–13.33] in season vs. 2.06% [0.7–3.6] out of season). The production of IL-4 was higher in the rhinitic group in the season than in the control group (1.93% [1.07–4.97], p = 0.0034) and production of IL-2 was higher both in and outside the season (9.1% [3.94–15.09] and 10.0% [4.79–25.35] vs. 3.64% (2.64–5.03), p = 0.037 and 0.045, respectively). IL-4/IL-2 and IL-4/IFN- ratios were higher in the IAR group in the season than outside the season.Conclusion: A tendency towards a switch from a predominant type 2 response during natural allergen exposure to its suppression outside the season was found, together with a stable type 1 response.Received 22 July 2004; returned for revision 27 August 2004; accepted by M. J. Parnham 2 November 2004