Current therapeutical strategies for allergic rhinitis

Introduction: Allergic rhinitis is a common condition with increasing prevalence and is associated with several comorbid disorders such as bronchial asthma and atopic dermatitis. If allergen avoidance is not possible, allergen-specific immunotherapy is the only causal treatment option.

Areas covered: This review focuses on current treatments and the future outlook for allergic rhinitis. Pharmacotherapy includes mast cell stabilizers, antihistamines, glucocorticosteroids (GCSs), leukotriene receptor antagonists, and nasal decongestants. Nasal GCSs are currently regarded as the most effective treatment and are considered first-line therapy together with non-sedating antihistamines. The new formulation MP29-02 combines the nasal GCS fluticasone propionate with azelastine in one single spray and has achieved greater improvements than those under monotherapy with modern GCSs or antihistamines. Furthermore, this review discusses allergen immunotherapy alone and in combination with modern monoclonal antibodies.

Expert opinion: Despite the variety of medications for allergic rhinitis, ranging from general symptomatic agents like GCSs or decongestants, to more specific ones like histamine receptor or leukotriene blockers, to causal therapy like immunotherapy, many patients still experience treatment failures or unsatisfactory results. The ultimate goal may be to endotype every downstream pathway separately in order to offer patients individualized, targeted therapy with specific antibodies against the respective pathway.     

Allergic fungal sinusitis— A clinico-pathological study

The co-existence of fungal elements in allergic nasal Polyposis, has given rise to a distinct clinical entity known as ‘Allergic fungal sinusitis ’ (AF’S). Many a time, these fungal elements may not be diagnosed pre-operatively by routine diagnostic nasal endoscopy or CT scan of paranasal sinuses, due to the florid presentation of nasal polyps, which usually obscure the underlying fungal pathology. The diagnosis is often made intra-operatively. The post-operative confirmation of AFS is by histopathology, fungal smear, fungal culture, allergic murin study and fungal specific IgE titres. We report a series often such cases done in our institution, which highlight that AFS should be considered as a differential diagnosis in Sinonasal Polyposis cases, for their effective management.     

TGF-β and IL-17 serum levels and specific immunotherapy

Two new T cell subsets may be involved in allergic rhinitis (AR) pathogenesis: Th17 and T regulatory cells, mainly producing IL-17 and TGF-β respectively. Successful Sublingual Immunotherapy (SLIT) induces relevant immunological changes, thus the aim of this study was to evaluate serum IL-17 and TGF-β levels in AR patients treated with SLIT for 2 years. Patients' blood samples were collected before initiating SLIT (baseline), three months after the end of the first pre-seasonal SLIT course, and at the end of the second pre-seasonal course. IL-17 was detectable only in the most severe allergic patients. SLIT significantly induced an increase in serum TGF-β levels. There was moreover a significant relationship between TGF-β and symptom severity and drug use at the end of the study. Therefore, this study provides clinically relevant evidence that two pre-seasonal SLIT courses may significantly affect serum TGF-β levels.     

环丙沙星滴眼液治疗急性细菌性结膜炎的临床疗效

本文对１０９例（１３０眼）临床诊断急性细菌性结膜炎，应用０．３％环丙沙星（ＣＰＬＸ）滴眼液（７０眼）和０．３％诺氟沙星（ＮＦＬＸ）滴眼液（６０眼），作了双盲随机治疗研究各１个星期。治愈率ＣＰＬＸ组６２．８６％、ＮＦＬＸ组４５％，显效ＣＰＬＸ组３２．８５％，ＮＦＬＸ组４６．６６％。治疗后细菌清除率ＣＰＬＸ组９４．７８％、ＮＦＬＸ组９２．９５％。两种抗菌素对革兰氏阳性和阴性菌的作用相似，治疗中无一例有任何副反应或局部不能耐受。ＣＰＬＸ对治疗外眼部细菌感染如急性细菌性结膜炎为一安全有效的药物，其临床疗效与对微生物作用在本组试验中与ＮＦＬＸ相似。     

Phaeohyphomycosis caused by Bipolaris spicifera: An informative case

A case of phaeohyphomycosis caused by Bipolaris spicifera involving the brain and sinuses is presented. The patient survived following surgery and ketoconazole therapy, which successfully treated both the sinus and the brain infections.     

金珠滴眼液治疗慢性结膜炎的临床研究

目的　探讨金珠滴眼液治疗慢性结膜炎的疗效。方法　将慢性结膜炎患者 36例 6 8眼随机分为2组 ,每组 34眼 ,实验组用 7.8%金珠滴眼液点眼治疗 ,对照组用 0 .2 5 %氯霉素点眼治疗。结果　金珠滴眼液1、2、4周疗效的综合分值判定均与对照组有显著差异 (P <0 .0 5 ) ,且无局部刺激性。结论　金珠滴眼液对慢性结膜炎有明显的治疗作用 ,可望为临床常见多发的慢性结膜炎患者消除或缓解症状     

鼻内镜下激光凝固中鼻甲前端治疗变应性鼻炎

（1）目的 探讨鼻内窥镜下Nd:YAG激光治疗变应性鼻炎的方法。（2）方法 应用鼻内镜下Nd:YAG激光凝固中务甲前1／3端治疗变应性鼻炎126例。（3） 结果 随访1年，显效109例（86．5％），有效13例（10．3％），无效4例（3．2％），总有效率96．8％。（4）结论 鼻内镜下Nd:YAG激光凝固中鼻甲前1．3端治疗变应性鼻炎，具有视野清楚，操作简便，疗效好等优点，值得临床应用。