Efficacy of sublingual immunotherapy with dermatophagoides farinae drops in patients with allergic rhinitis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy of sublingual immunotherapy (SLIT) with dermatophagoides farinae drops in patients with allergic rhinitis (AR).</p><p><b>METHODS</b>Two hundred and six patients with AR aged from 4 to 60 years were included in this study. Among them, 123 patients completed more than one year treatment, the number of patients completed one year, one year and a half, two years were 61, 41, 21 cases. Rhinitis symptom scores and medication scores of the three groups before and after treatment were compared. And rhinitis symptom scores and medication scores of patients with one year drug withdrawal after one and two years treatment were aslo compared.</p><p><b>RESULTS</b>After SLIT one year, one year and a half, two years treatment, the symptoms in these patients were significantly improved compared with before. The symptom scores (x±s) were reduced from 6.00±2.27, 7.39±1.99 and 6.29±2.14 to 2.95±1.82, 3.28±2.58, 2.48±1.99. The differences were statistically significant (t value was 8.19, 10.29, and 5.97, all P<0.01). The proportion of patients without drug treatment of the three group were 68.9%, 73.2% and 80.9%, there was statistical significance before and after treatment in every group (value was 50.391, 43.619, 27.776, all P<0.01). Symptom improvement of sneezing, runny nose, nasal congestion, nasal itching were similar after one year, one year and a half, two years SLIT treatment, the differences were not statistically significant (F values were 1.200, 1.276 and 2.333, all P>0.05). The proportion of patients without drug treatment in the group which stopped medication one year after two year SLIT (76.2%) was higher than group stopped medication one year after one year SLIT (61.3%). There was no statistical significance (χ2=1.263, P>0.05).</p><p><b>CONCLUSION</b>The dust mite drops can relieve symptoms after one year treatment, but the proposed two years treatment is important for the consolidation of improved symptoms, especially for the effect of reducing the use of symptomatic medication.</p>

Relationship between allergic symptoms and RORC2 and IL-17 in patients with allergic rhinitis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the relationship between allergic symptoms and retinoic acid-related orphan receptor variant 2 (RORC2) and interleukin (IL) 17 in patients with allergic rhinitis (AR).</p><p><b>METHODS</b>Blood sample, nasal secretion and nasal mucosa were taken from 23 patients with AR and 16 health individuals. The expression of RORC2 and IL-17 were detected by immunohistochemistry and quantitative real-time fluorescence reverse polymerase chain reaction. The allergic symptoms in patients were graded.</p><p><b>RESULTS</b>The rate of positive cells of RORC2 and IL-17 in AR group were 0.17 ± 0.05 and 0.72 ± 0.13, higher than the 0.05 ± 0.02 and 0.27 ± 0.11 of health controls, the difference was statistically significant (t were 9.51 and 11.92 respectively, all P < 0.05). The expression level of RORC2 mRNA in nasal mucosa and peripheral blood of AR group were 0.063 ± 0.011 and 0.452 ± 0.031, higher than the 0.029 ± 0.009 and 0.239 ± 0.027 of health controls, the difference was statistically significant (t were 6.51 and 3.35 respectively, all P < 0.05). The concentrations of IL-17 in the nasal mucosa, nasal secretions and serum levels of AR group were (70.28 ± 10.69), (45.32 ± 8.55) and (6.76 ± 1.18) pg/ml, compared with (18.43 ± 8.34), (6.83 ± 1.31) and (0.74 ± 0.05) pg/ml of controls, the difference was statistically significant (t were 7.92, 17.66 and 15.43 respectively, all P < 0.05). The allergy symptom scores of AR group were 9.43 ± 1.27. There were correlations between the allergic symptom and the expression of RORC2 mRNA and IL-17 in nasal mucosa and peripheral blood (r value were 0.820, 0.746, 0.629, 0.841 respectively, all P < 0.05).</p><p><b>CONCLUSION</b>RORC2 and IL-17 involved in the inflammatory response of AR and can be used as an indicator to judge the severity.</p>

Effects of garlicin on the expression of transcription factor T-bet and GATA-3 in blood lymph cells in rats with allergic rhinitis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the effects of garlicin on the expression of transcription factors T-bet and GATA-3 in blood lymph cells of experimental rats with allergic rhinitis.</p><p><b>METHODS</b>Thirty healthy SD rats were randomly divided into 3 groups, with 10 rats for each. Ten rats (pharmacological group) were sensitized and intranasally challenged by ovalbumin (OVA), aluminium hydroxide hydrate gel and Bordetella pertussis (B. pertussis) inactive microorganism suspension adjuvants, as the allergic rhinitis models, and then injection of garlicin (0.4 ml) intraperitoneally per day for 10 days. Ten rats in the control group were immunized as the pharmacological group, and then injection of physiological saline as equal volume as garlicin. Ten rats in the negative control group were investigated using physiological saline only. Plasma and lymph cells were separated from 2 ml blood which was extracted from rat heart. Enzyme linked immunosorbent assay (ELISA) was utilized to detect the levels of plasma IL-4 and IFN-γ, and RT-PCR was utilized to detect the expression of T-bet and GATA-3.</p><p><b>RESULTS</b>The levels of IL-4 (x(-) ± s) were (6.292 ± 1.734), (14.252 ± 1.971), (4.916 ± 0.600) pg/ml, respectively, and the levels of IFN-γ were (24.338 ± 2.375), (12.364 ± 1.749), (16.136 ± 2.012) pg/ml, respectively, among the pharmacological, control and negative control groups. The plasma level of IL-4 in the pharmacological group rats was lower than that of control group rats (t = 4.23, P < 0.05), while there was no significant difference between the pharmacological and negative control group rats (t = 1.01, P > 0.05). The plasma level of IFN-γ was increased significantly in the pharmacological group rats when compared with the value of control group rats (t = 4.61, P < 0.05) and with the negative control group (t = 5.79, P < 0.05), respectively. There was no significant difference (t = 1.17, P > 0.05) in plasma level of IFN-γ in the control group rats when compared with the negative control group. Relative quantization of expression of GATA-3 (median) was 0.826, 1.029 and 0.474, and those of T-bet (median) were 1.245, 0.280 and 0.544, respectively, among the pharmacological, control and negative control groups. There were significant difference among 3 groups (chi² = 6.599, P = 0.019; chi² = 9.884, P = 0.007, respectively). Relative quantization of expression of GATA-3 in the control group rats was significantly higher than that in the negative control group and pharmacological group rats (chi² value were 10.113 and 2.384, respectively, all P < 0.05), and that of GATA-3 in the pharmacological group rats was increased as compared to the negative control group rats (chi² = 3.784, P < 0.05). The level of expression of T-bet in pharmacological group rats was elevated markedly with a significant difference as compared to both control (chi² = 16.021, P < 0.05) and negative control groups (chi² = 14.103, P < 0.05).</p><p><b>CONCLUSIONS</b>Garlicin may upregulate the expression of T-bet dramatically and downregulate the expression of transcription factor GATA-3 in the experimental models of allergic rhinitis.</p>

Effect of garlicin on the serum levels of interleukin 4 and interferon gamma in allergic rhinitis model in rats / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of garlicin on the levels of interferon gamma (INF-gamma) and interleukin 4 (IL-4) in blood of allergic rhinitis rat model.</p><p><b>METHODS</b>Thirty healthy female SD rats were randomly divided into 3 groups: control group, negative control group and experimental group, 10 rats for each group. Ten rats (experimental group) were sensitized and intranasally challenged by ovalbumin, aluminium hydroxide hydrate gel and Bordetella pertussis inactive microorganism suspension adjuvants, as allergic rhinitis models, and then injection of garlicin(0.4 ml) intraperitoneally per day for 10 days. Control group rats were immunized as experimental group, and then injection of physiological saline as equal volume as garlicin. Negative control group rats were investigated using physiological saline. Blood of intrajugular vein of rat was extracted for separated plasma Enzyme liked immunosorbent assay (ELISA) was utilized to detect the serum levels of IL-4 and IFN-gamma.</p><p><b>RESULTS</b>The serum levels (x +/- s) of IL4 were (22.81 +/- 8.79) pg/L, (41.43 +/- 4.93) pg/L, (9.93 +/- 2.07) pg/L, and those of IFN-gamma were (22.32 +/- 11.20) pg/L, (11.35 +/- 2.45) pg/L and (21.69 +/- 5.93) pg/L, respectively, among experimental group, control group and negative control group. The serum level of IL-4 in experimental group rats was lower than value of control group rats (t = 3.22, P < 0.05), while higher than negative control group (t = 4.17, P < 0.05). The serum level of IFN-gamma was increased significantly in experimental group rats with significant difference when compared with value of control group rats (t = 3.84, P < 0.05), while no difference was shown between experimental group and negative control group (t = 1.47, P > 0.05).</p><p><b>CONCLUSIONS</b>Garlicin could increase serum level of INF-gamma and decrease serum level of IL4 significantly in allergic rhinitis rat model. It played an important role on regulating serum levels of cytokines of Thl and Th2.</p>

Pathologic changes of palatopharyngeal muscle in patients with obstructive sleep apnea hypopnea syndrome / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the pathologic changes of the palatopharyngeal muscles in patients with obstructive sleep apnea hypopnea syndrome (OSAHS), the role of the above muscles in OSAHS pathogenesis was discussed.</p><p><b>METHODS</b>Thirty OSAHS patients receiving uvulopalatopharyngoplasty selected, and ten normal subjects without snoring as the control group. The successive longitudinal sections of palatopharyngeal muscle were stained for observing Troponin-I's content. All specimens were examined with transmission electronmicroscopy (TEM) and light microscopy.</p><p><b>RESULTS</b>Twenty nine of 30 specimens obtained from OSAHS patients evaluated with TEM showed pathologic changes of different degrees. While 2 among 10 specimens in control group showed mild myofibril edema or hypertrophy, no pathologic changes shown in other specimens. Immunohistochemistrial results of all specimens sections stained for observing Troponin-I antibody have shown that negative grey degree value is 146.30 +/- 10.72 in study group and 107.50 +/- 4.81 in control group respectively. There is significant difference between these two groups (P < 0.05). The negative grey degree value of study groupl and study group2 are 143.12 and 148.80 respectively , no statistical difference (P > 0.05).</p><p><b>CONCLUSIONS</b>Palatopharyngeal myelofibrosis may affect pharyngeal dilator muscles function, this could be one mechanism of upper airway collapsibility.</p>

Genetic epidemiologic study on nasal polyps / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the genetic mode of nasal polyp and the effect of genetic factor on occurrence of the disease.</p><p><b>METHODS</b>A genetic epidemiological case-control study including 280 pedigrees (120 nasal polyp cases and 160 controls) was conducted. The segregation ratio and the heritability of nasal polyp were respectively estimated by the Li-Mantel-Gart method and the Falconer method.</p><p><b>RESULTS</b>The segregation ratio was 0.124 (95% CI 0.081-0.167), significantly lower than 0.25, which showed that nasal polyp did not possess the characteristics of monogenetic model. The prevalence rate of first-degree and second-degree relatives in cases were 8.571% and 3.086% respectively, which were significantly different (X2 = 24.851, P < 0.01) and were higher than that noticed 1.376% and 1.141% in controls (X2 = 33.547 and 14.274, all P < 0.01). The heritability of the first-degree and second-degree relatives of nasal polyp was 64.488% and 61.947%. Among the first-degree relatives of nasal polyp probands, the heritability of the adult group and the children group were respectively 60.735% and 74.598% (the difference was significant, X2 = 4.504, P < 0.05). The heritability of the first-occurred group was 62.839% and the recurred group was 74.304% (the difference was significant, X2 = 4.105, P < 0.05).</p><p><b>CONCLUSIONS</b>This study indicated that the genetic model of nasal polyp belonged to polygenetic and the genetic factors played an important role in the occurrence of nasal polyp, especially for young or recurred patients.</p>

Expression of T-bet and its relation with IgE and eosinophil cationic protein in patients with allergic rhinitis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the expression of T-bet mRNA in peripheral blood mononuclear cells (PBMC) as well as its relations with total IgE (TIgE), eosinophil cationic protein (ECP) in serum and nasal allergic symptoms in patients with allergic rhinitis (AR).</p><p><b>METHODS</b>The allergen, TIgE and ECP in serum of patients with AR were detected by Unicap CAP system. Blood sample was taken from 8 healthy individuals and 22 patients with allergic rhinitis. PBMC was isolated by density gradient centrifugation and one part of them was cultured with 50 microg/ml mite allergen. PBMC was subjected to analysis of T-bet mRNA expression using semiquantitative reverse transcriptase-polymerase chain reaction (RT-PCR).</p><p><b>RESULTS</b>The ratio of T-bet to beta-actin mRNA levels was 0.381 +/- 0.099 in patients and 0.750 +/- 0.067 in normal individuals, the difference was significantly (P <0.01). The expression intensity of T-bet mRNA had no relation to varying severity of allergic symptoms and concentration of ECP and the correlation coefficient was 0.187 and -0.165 (all P > 0.05). However, there was an inverse correlation between expression intensity of T-bet mRNA and TIgE concentration (r = -0.525, P < 0.05). Mean mRNA level (x +/- s) of T-bet expression before and after being stimulated by allergen was 0.381 +/- 0.099 and 0.365 +/- 0.104 respectively, which indicated no significant differences (P > 0.05).</p><p><b>CONCLUSIONS</b>Among allergic patients whose allergen was mite, there was a down-regulated expression of T-bet mRNA, which had no relation to ECP concentration and allergic symptoms, but was one of important links in mechanisms of imbalance of Th1/Th2 in AR. There was no effect of specific allergen on T-bet mRNA in patients with AR T-bet was one of indirect factors that affected the level of IgE.</p>