Effectiveness of ribosomal fractions ofKlebsiella pneumoniae, Streptococcus pneumoniae, Streptococcus pyogenes, Haemophilus influenzae and the membrane fraction ofKp (Ribomunyl) in the prevention of clinical recurrences of infectious rhinitis

A multicenter, double-blind, placebo-controlled study was conducted to investigate the efficacy of an immunostimulant, Ribomunyl, in the prevention of recurrences of infectious rhinitis in adults. This trial involved 327 patients (168 Ribomunyl treated and 159 placebo cases) with an average of 4.3 ± 1.8 rhinitis episodes per patient recorded during the year preceding the study. The main criterion of efficacy was the cumulative number of recurrences of infectious rhinitis during a 6-month follow-up period, as analyzed by standard tests. An additional analysis of relative risk of recurrences used multivariate failure for time data. Ribomunyl was effective throughout the study period, starting from the first month of treatment: a mean of 1.0 ± 1.1 recurrences was recorded in the Ribomunyl group as compared to 1.5 ± 1.4 recurrences in the placebo group; this indicated one-third fewer infections (P = 0.001). The protective effect of Ribomunyl on the relative risk for recurrences was estimated to be 0.58 by multivariate analysis (95% CI: 0.43–0.78,P = 0.0001). Analysis of secondary criteria also favored Ribomunyl: 38.5% less antibiotic courses per patient (0.8 ± 1.3 vs 1.3 ± 1.6;P = 0.002) and the number of days with antibiotics (5.6 ± 9.3 vs 9.1 ± 12.1;P = 0.002).     

The effect of immunotherapy on the serum levels of eosinophil cationic protein in seasonal allergic rhinitis

The role of serum eosinophil cationic protein levels in allergic rhinitis is controversial. It is also unclear whether with immunotherapy it is possible to reduce these serum levels in allergic diseases. We studied serum eosinophil cationic protein levels in patients with cedar-induced allergic rhinitis and compared them with non-atopic controls. The second aim of this study was to elucidate whether immunotherapy is capable of decreasing the seasonal elevation in serum eosinophil cationic protein levels in seasonal allergic rhinitis. The serum eosinophil cationic protein levels of the untreated patient group were significantly higher than those of the non-atopic controls. The levels in patients who received immunotherapy for 2 yr were also significantly higher than those of the non-atopic controls. However, the levels were not different between the patients undergoing immunotherapy for over 3 yr and the non-atopic controls. The serum levels of the 31 patients treated with immunotherapy correlated with the duration of immunotherapy. In conclusion, the serum eosinophil cationic protein levels are higher in untreated patients with seasonal allergic rhinitis and this seasonal activation in circulating eosinophils decreases gradually during immunotherapy, but this inhibitory effect becomes apparent only after a number of years of immunotherapy. This prevention of seasonal eosinophil activation is one of the mechanisms responsible for the clinical effect of immunotherapy.     

鼻泰治疗变应性鼻炎的实验研究

鼻泰为治疗变应性鼻炎的中药滴鼻剂。实验表明，该药可抑制大鼠肥大细胞脱颗粒，抑制小鼠皮肤被动过敏反应，抑制实验性变应性鼻炎家兔的鼻粘膜炎症反应并减少其Ｐ物质水平。     

P物质神经阻滞疗法治疗变应性鼻炎疗效观察

目的观察P物质神经阻滞疗法(CAP)治疗变应性鼻炎疗效和安全性.方法100例变应性鼻炎患者,用CAP在双侧鼻腔黏膜表面涂布,每日1次,连续15日为一疗程.结果100例在治疗后平均记分均明显降低,统计学分析差异均有显著性意义(P＜0.01),治疗后显效73例(73%),有效19例(19%),无效8例(8%),总有效率92%.无1例毒副反应.结论CAP疗法治疗方便、效果好、无副作用,是治疗变应性鼻炎的理想方法.     

CD30在变应性鼻炎患者鼻黏膜组织中的表达

目的 :探讨CD30在变应性鼻炎患者鼻黏膜组织中的表达 ,分析其在变应性鼻炎发病中的作用。方法 :应用免疫组织化学SP法和苏木精 伊红染色对 31例变应性鼻炎患者的下鼻甲黏膜 (变应性鼻炎组 )和 2 6例肥厚性鼻炎患者的下鼻甲黏膜 (对照组 )标本中CD30的表达进行检测 ,并进行统计学分析。结果 :变应性鼻炎组CD30细胞数显著高于对照组 ,其差异有统计学意义 (P <0 .0 5 )。结论 :在变应性鼻炎的鼻黏膜组织中存在着Th2细胞主导的黏膜反应 ,通过研究CD30的表达水平可了解变应性鼻炎中Th2反应的状态。     

Perennial rhinitis in the under 4s: A difficult problem to treat safely and effectively? A comparison of intranasal fluticasone propionate and ketotifen in the treatment of 2–4‐year‐old children with perennial rhinitis

To compare the safety and efficacy of fluticasone propionate aqueous nasal spray (FPANS) and oral ketotifen in children aged 2-4 years with perennial rhinitis. A randomized, multicentre, double-blind, double dummy, placebo-controlled study. Paediatric patients between the ages of 2-4 years with perennial rhinitis. Rhinitis symptoms score (parent-rated), clinical evaluation of symptoms (investigator-rated) and adverse event profiles during the treatment period. Patients treated with FPANS had a significant reduction in both the total night-time rhinitis symptom assessment for weeks 4-6 (p-value 0.036), and the total daytime rhinitis symptom score over the same period (p-value 0.049). Generally, except for nasal itching/rubbing over weeks 1-3, the patients taking FPANS had lower recorded symptom scores for all individual symptoms measured. Nasal blockage, in particular, was significantly reduced over the 4-6 week period (p-value 0.027). The overall investigator-rated clinical evaluation showed substantial improvement or improvement in nine of 12 of the children taking FPANS compared with four of 14 taking ketotifen. Finally, there were no reports of serious adverse events, the incidence of drug-related adverse events was low and there was no statistical difference between the groups. FPANS may be an appropriate treatment to control the symptoms of rhinitis in children between 2 and 4 years old.     

Socioeconomic status and prevalence of allergic rhinitis and atopic eczema symptoms in young adolescents

Environmental factors are known to influence the development of allergic rhinitis and atopic eczema in genetically susceptible individuals. Socioeconomic status (SES) may be an important indicator of risk for these conditions. The International Study of Asthma and Allergies in Childhood (ISAAC) Phase 1 written questionnaire was used to determine the prevalence and severity of allergic rhinoconjunctivitis and atopic eczema symptoms in 4947 pupils aged 13-14 years attending 30 schools in socioeconomically diverse areas of Cape Town. Home addresses were used to stratify participants into five SES bands. Relationships between symptom prevalence and severity, and SES, recent urbanization and upward socioeconomic mobility were examined. Logistic regression was used to generate odds ratios (OR) and 95% confidence intervals (CI) in order to assess overall trends by SES. The prevalences of self-reported allergic rhinitis symptoms and recurrent itchy rash in the past year were 33.2% and 11.9% respectively. Girls had a significantly higher prevalence of all symptoms than boys. The prevalence of allergic rhinitis symptoms increased from lowest to highest SES (overall OR for rhinitis symptoms in past year = 1.16, 95% CI 1.11-1.21). There was no significant trend in reported eczema symptoms by SES other than for the question, 'Have you ever had eczema' (OR = 0.88, 95% CI 0.83-0.93). Longer period of urbanization was weakly associated only with recurrent itchy skin rash (OR = 1.05, 95% CI 1.01-1.09). 'Socially mobile' pupils, i.e. those resident in the lowest SES areas but attending highest SES schools showed significantly higher prevalences of eczema and some rhinitis symptoms than pupils attending lowest SES schools. These findings may reflect differences in reporting related to language, culture and access to medical care rather than real differences in prevalence.     

实验性变应性鼻炎中鼻黏膜组胺的测定

目的观察变应性鼻炎(AR)动物鼻黏膜中组胺含量的变化,探讨组胺在变应性鼻炎诊断中的价值。方法对影响组胺含量测定的2个因素温度和萃取时间分别进行2个水平考察,以回收率为指标,确定Shore荧光法测定条件;另采用甲苯-2,4-二异氰酸酯(TDI)滴鼻致敏豚鼠变应性鼻炎模型,改进Shore荧光法测定豚鼠鼻黏膜组胺含量,并与对照组进行比较。结果在室温和萃取时间为45 min条件下的组胺回收率满足要求,利用该法测得自然对照组和变应性鼻炎组鼻黏膜组胺含量分别为(513.7±49.3)ng/g和(590.4±47.6)ng/g,变应性鼻炎组鼻黏膜中组胺含量显著高于自然对照组(P<0.01)。结论改进Shore荧光法测定鼻黏膜中组胺含量准确可靠,检测鼻黏膜中组胺含量的高低对诊断变应性鼻炎具有重要价值。     

Allergic rhinitis induced by intranasal sensitization and challenge with trimellitic anhydride but not with dinitrochlorobenzene or oxazolone in A/J mice.

Allergic airway diseases induced by low molecular weight (LMW) chemicals, including trimellitic anhydride (TMA), are characterized by airway mucus hypersecretion and an infiltration of eosinophils and lymphocytes. Many experimental models have linked LMW chemical-induced allergic airway disease to Th2 cytokines. Most murine models, however, use dermal exposure to sensitize mice. The present study was designed to test the hypothesis that intranasal sensitization and challenge with the known chemical respiratory allergen TMA, but not the nonrespiratory sensitizers dinitrochlorobenzene (DNCB) and oxazolone (OXA), will induce characteristic features of LMW chemical-induced allergic airway disease in the nasal and pulmonary airways. A/J mice were intranasally sensitized and challenged with TMA, DNCB, or OXA. Only mice that were intranasally sensitized and challenged with TMA had a marked allergic rhinitis with an influx of eosinophils, lymphocytes, and plasma cells, increased intraepithelial mucusubstances, and a regenerative hyperplasia. Cytokine mRNA levels in the nasal airway of TMA treated mice also revealed an increase in the mRNA levels of the Th2 cytokines IL-4, IL-5, and IL-13, but no change in the level of the Th1 cytokine IFN-gamma. No lesions were found in the nasal airways of mice exposed to DNCB or OXA. TMA increased lung-derived IL-5 mRNA while DNCB and OXA caused no change in lung-derived cytokine mRNA levels. Both TMA and DNCB caused increases in total serum IgE, unlike OXA-exposed mice. However, no adverse alterations were found microscopically in the lungs of mice treated with TMA, DNCB, or OXA. This study is the first to demonstrate that intranasal administration of a known chemical respiratory allergen is an effective method of sensitization resulting in the hallmark features of allergic rhinitis after challenge with a concomitant increase in nasal airway-derived Th2 cytokine mRNA, lung-derived IL-5 mRNA, and total serum IgE. In contrast, DNCB and OXA failed to elicit the pathologic changes in the nasal airways and cytokine changes in the lung. This model may be useful for identifying other chemical respiratory allergens.     

苏州大学附属儿童医院支气管哮喘及过敏性鼻炎患儿皮肤点刺试验结果分析

目的　应用皮肤点刺试验了解支气管哮喘及过敏性鼻炎患儿的主要过敏原, 为其预防、 诊断、 治疗提供依据。方法　选取于2015年8月至2017年7月在苏州大学附属儿童医院门诊诊断为支气管哮喘及过敏性鼻炎的2252例患儿进行皮肤点刺试验检测过敏原,并对其性别、 疾病种类数据采用SPSS 21.0软件进行分析。结果　2252例患儿进行皮肤点刺试验, 1390例阳性, 阳性率61.7%。男女比例1.75∶1, 男性阳性率（925/1433, 64.5%）高于女性阳性率（465/819, 56.8%）, 差异有统计学意义（P＜0.05）。支气管哮喘患儿阳性率为65.3%（607/929）, 过敏性鼻炎患儿阳性率为58.8%（664/1129）, 支气管哮喘合并过敏性鼻炎患儿阳性率61.3%（119/194）。支气管哮喘阳性率高于过敏性鼻炎, 差异有统计学意义（P＜0.05）。过敏原以粉尘螨（60.3%）、 屋尘螨（43.4%）最常见, 其次是草花粉、 猫毛。结论　苏州大学附属儿童医院的支气管哮喘、 过敏性鼻炎患儿最常见过敏原为螨类; 皮肤点刺试验可为过敏性疾病的诊断提供依据。