Effects of Serum Vitamin D and Efficacy of Subcutaneous Immunotherapy in Adult Patients With Allergic Rhinitis

Immunotherapy is the standard of treatment for long-life relief of symptoms of allergic rhinitis. Vitamin D may affect the outcomes of treatment. This study evaluated the clinical efficacy of subcutaneous allergen immunotherapy in adult patients with allergic rhinitis based on the serum level of vitamin D. Patients with persistent allergic rhinitis and positivity for skin prick test were evaluated by Sino-nasal Outcome Test (SNOT-22) and Mini Rhinoconjunctivitis Quality of Life Questionnaire (MiniRQLQ) before subcutaneous allergen immunotherapy and during the maintenance phase to assess the relation of the serum level of vitamin D and the clinical efficacy of immunotherapy. After immunotherapy, the greatest reduction in SNOT-22 scores were reported in patients with vitamin D sufficiency (39.0 ± 9.2), followed by vitamin D suboptimal provision (35.1 ± 12.1), insufficiency (25.0 ± 7.5), and deficiency (18.3 ± 6.0) (P < 0.001). The MiniRQLQ reduction in patients with vitamin D sufficiency, suboptimal provision, insufficiency, or deficiency was 30.7 ± 8.7, 27.1 ± 8.7, 20.0 ± 8.6, or 17.4 ± 7.1, respectively (P < 0.001). Both of SNOT-22 and MiniRQLQ scores decreased significantly following immunotherapy in patients with different levels of vitamin D. However, these effects were more pronounced when the level of vitamin D was sufficient.

Effect of a new synbiotic mixture on atopic dermatitis in children: a randomized-controlled trial

Atopic dermatitis [AD] is the most common chronic relapsing skin disease seen in infancy and childhood. The intestinal microbiota play an important role in immune development and may play a role in the development of allergic disorders. Manipulation of the intestinal microbiota by synbiotics may therefore offer an approach to the prevention or treatment of AD and allergic diseases. We studied the clinical and immunologic effects of a new symbiotic [a mixture of seven probiotic strains of bacteria and Fructooligosaccharide] in infants and children with AD. In a randomized, double-blind, placebo-controlled study, 40 infants and children aged 3 months to 6 years with AD received either a synbiotic or placebo for 8 weeks. The Severity Scoring of Atopic Dermatitis [SCORAD] index was recorded at baseline and also at 4 and 8 weeks of treatment. There was no significant difference between the probiotic and placebo group in baseline characteristics including sex, age, family history, corticosteroid usage and prick testing. Mean age was 23 months. The synbiotic group showed a significantly greater reduction in SCORAD than did the placebo group [P=0.001]. No specific effect was demonstrated of the probiotics employed on cytokine profile [P=0.4, P=0.6]. Egg white was the most common [45%] allergen followed by peanut and cow's milk. This study provides evidence that a mixture of seven strains of probiotics and Fructooligosaccharide can clinically improve the severity of AD in young children. Further studies are needed to investigate the effects on underlying immune responses and the potential long term benefits for patients with AD

Comparison of two flow cytometric methods for detection of human invariant natural killer T cells [iNKT]

Invariant natural killer cells [iNKT] are an important immunoregulatory T cell subset. Currently several flow cytometry-based approaches exist for the identification of iNKT cells, which rely on using the 6B11 monoclonal antibody or a combination of anti-V alpha 24 and anti-V beta 11 antibodies. The aim of this study was to compare the ability of two flow cytometry-based methods for detecting the frequency of circulating iNKT cells. The frequency of iNKT cells was detected in the peripheral blood of 37 healthy adult donors by flow cytometry using the 6B11 antibody or a combination of anti-V alpha 24 and anti-V beta 11 antibodies. The frequency of iNKT cells detected by 6B11 antibody or by combination of anti-V alpha 24 and anti-V beta 11 antibodies was significantly different [0.54% vs. 0.31%, respectively, p<0.001] but the values were highly correlated [Spearman r=0.742, p<0.0001]. The results of this study indicate that different combinations of mAbs detect different frequencies of peripheral blood iNKT cells and a consensus in the field needs to be established to allow better assessment of iNKT-related studies and suggest using different methods for accurate identification of iNKT cells

Assessment of the immune system activity in Iranian patients with major depression disorder [MDD]

Major Depression Disorder [MDD] is a common disorder with prevalence of 15% among men and up to 25% among women. In recent years the association of immune system alterations and MDD has been investigated. Assessments of immunologic and inflammatory responses in these patients enhance our knowledge of the etiology and pathogenesis of this disease. To investigate the changes in immunoglobulin and cytokine serum levels and lymphocyte subsets in patients with MDD. We studied 37 adult patients with MDD, diagnosed based on DSM-IV diagnostic criteria, and 15 healthy controls matched with the patients. Plasma concentration of interleukin-4 [IL-4], IL-10, TNF alpha, and IFN gamma were measured by ELISA and serum immunoglobulins by SRID. Total number of NK cells [CD16 and CD56], B cells [CD19], and T cells [CD8, CD4, and CD3] were determined by flow cytometry. We found no significant differences in plasma concentration of IL-4, IL-10, TNF-alpha, IFN-gamma, and immunoglobulins as well as total number of NK cells, B cells, and T cells between major depressed patients and healthy control subjects. We conclude that in our patients, there were no significant differences in immune system activity between MDD patients and controls

HTLV-I infection: virus structure, immune response to the virus and genetic association studies in HTLV-I-infected individuals

Although the structure of human T lymphoptropic virus type I [HTLV-I] has been known well, the function of some proteins encoded by HTLV-I PX region is not fully understood. Furthermore, the responses of the immune system to HTLV-I remain still unknown. Most of HTLV-I infected individuals show a strong and persistently activated cytotoxic T-cell [CTL] response to the virus. The frequency of HTLV-I specific CTL is higher in patients with HTLV-I -associated myelopathy/ tropical spastic paraparesis [HAM/TSP] compared with HTLV-I carriers. However, the efficacy of the immune response determines the outcome of HTLV-I-associated diseases. Among the risk factors which contribute to the observed differences between HAM/TSP patients and HTLV-I carriers, the interaction between different genes and/or environmental factors seem to be important. These factors may also involve in outcome of HTLV-I infection in infected- individuals

Evaluation of six years allergen immunotherapy in allergic rhinitis and allergic asthma

Allergen immunotherapy involves the administration of gradually increasing quantities of specific allergens to patients with IgE-mediated conditions until a dose is reached that is effective in reducing disease severity from natural exposure. In the present study we evaluated a period of six years immunotherapy allergic rhinitis and allergic asthma patients with positive skin prick test of common aeroallergen. The immunotherapy was performed on 156 patients. One hundred twenty of the cases were allergic rhinitis [80%], 29 cases had allergic asthma and 7 cases were mixed [4.5%]. 70% in allergic rhinitis group, 75% in allergic asthma group and 42.8% in mixed group completely improved. Immunotherapy, an older therapeutic method, has now been updated, and with appropriate indications, precautions and methods, has been clearly shown to be effective in the treatment of allergic rhinitis and in some cases of asthma and insect hypersensitivity

Effect of aerobic exercise training on pulmonary function and tolerance of activity in asthmatic patients

The aim of the present study was to examine the effects of a course of aerobic exercise on pulmonary function and tolerance of activity in asthmatic patients. Among the asthmatic patients, 36 patients [M= 16, F= 20] were chosen after clinical examinations, pulmonary function test, skin prick test [SPT] for aeroallergen and a six minute walk test [6MWT] on their own free will. A patient was said to have Exercise Induced Asthma [EIA] when he/she fulfilled the following criteria; [1] FEV[1] < 80%, [2] 12% increase or more in FEV[1] or PEF after short-acting [beta][2] agonist prescription and [3] 15% decrease in FEV[1] or PEF after 6MWT with 70% or 80% of maximum heart rate. The patients were randomly put into two groups of case [M=8, F=10, Mean age=27] and control [M=8, F=10, Mean age=29]. Case group participated in eight week aerobic exercise plan, while control group had no plan of exercise. Pulmonary function tests were done before and after the course of exercise. There were significant changes in FEV1, FVC, PEF, FEF[25-75%], MVV, RF and 6MWT between asthmatic patients of the two groups [P

Serum level of selenium, IL-4, IL-10 and IFN-gamma in patients with allergic asthma, allergic rhinitis and healthy controls

Background: Allergic diseases have increased during the past decade I worldwide. Th2 type lymphocyte response is known to play an important j role in the process of allergic inflammation. IL-4, a mediator of type II I cytokine response increases IgE synthesis and Interferon gamma, a cytokirie I of type I response interferes with IL-4 and inhibits IgE production. Selenium j is an essential component of glutathione peroxides and changes in its plasma I level has been proposed to be associated with allergic diseases

Materials and Methods: This study comprised of 21 cases of allergic asthma [AA], I 33 cases of allergic rhinitis [AR] whose age and sex were matched with 28 healthy controls. IL-4, IL-10, IFN-y levels were tested by ELISA assay, I and serum selenium was measured by atomic absorption spectorphotometery I method

Results: Mean serum selenium level of AA and AR groups were I lower than controls

Conclusion: Mean serum IL-4 level of AA was higher than the AR I group. Mean serum IL-4 level of AA and AR group were higher than I controls. The results of this study indicate that low selenium | level may have a role in the pathogenesis of allergic diseases

Evaluation of fluticasone [flixonase] nasal spray versus beclomethasone [beconase] nasal spray in the treatment of allergic rhinitis

Although response to intranasal steroid therapy has been reported in patients with allergic rhinitis, efficacy of some nasal steroids is noteworthy. This study was undertaken to evaluate the efficacy of a two-week course of Fluticasone [Flixonase] nasal spray vs. Beclomethasone [Beconase] nasal spray in patients with symptoms of allergic rhinitis referred to our clinic. This study reviewed sixty randomized studies with symptoms of allergic rhinitis which supported common aeroallergens with skin prick test. Patients received a total daily dose of nasal spray of Fluticasone [Flixonase] 100 mcg bid [N=30] compared with patients with allergic rhinitis who received a total daily dose of Beclomethasone [Beconase] 50mcg 2 puffs bid [N=30] patients were visited before and after therapy, and efficacy of flixonase and beconase was evaluated by the change in nasal symptoms including: nasal discharge, nasal obstruction, nasal itching, and sneezing. After two weeks of treatment nasal symptoms of blockage, discharge, sneezing and itching were significantly better in the group treated with fluticasone nasal spray 65%, 82%, 67%, 79% respectively [p<0.001] but after treatment with beconase nasal spray lower benefits in the nasal symptoms includes: 50%, 71%, 51%, 57% respectively. After two weeks of treatment no deleterious changes consequent to therapy were observed in nasal symptoms. 100 mcg bid flixonase [Fluticasone] intranasal spray is more effective than 50 mcg 2 puffs bid beconase [Beclomethasone] intranasal spray. Like asthma, allergic rhinitis is an inflammatory disease and should be managed with anti-inflammatory medication