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1.
Acta Pharmaceutica Sinica B ; (6): 2114-2135, 2021.
Article in English | WPRIM | ID: wpr-888856

ABSTRACT

Natural extracellular vesicles (EVs) play important roles in many life processes such as in the intermolecular transfer of substances and genetic information exchanges. Investigating the origins and working mechanisms of natural EVs may provide an understanding of life activities, especially regarding the occurrence and development of diseases. Additionally, due to their vesicular structure, EVs (in small molecules, nucleic acids, proteins, etc.) could act as efficient drug-delivery carriers. Herein, we describe the sources and biological functions of various EVs, summarize the roles of EVs in disease diagnosis and treatment, and review the application of EVs as drug-delivery carriers. We also assess the challenges and perspectives of EVs in biomedical applications.

3.
Article in English | WPRIM | ID: wpr-762183

ABSTRACT

PURPOSE: The effect of air pollution-related particulate matter (PM) on epithelial barrier function and tight junction (TJ) expression in human nasal mucosa has not been studied to date. This study therefore aimed to assess the direct impact of PM with an aerodynamic diameter less than 2.5 μm (PM2.5) on the barrier function and TJ molecular expression of human nasal epithelial cells. METHODS: Air-liquid interface cultures were established with epithelial cells derived from noninflammatory nasal mucosal tissue collected from patients undergoing paranasal sinus surgery. Confluent cultures were exposed to 50 or 100 µg/mL PM2.5 for up to 72 hours, and assessed for 1) epithelial barrier integrity as measured by transepithelial resistance (TER) and permeability of fluorescein isothiocyanate (FITC) 4 kDa; 2) expression of TJs using real-time quantitative polymerase chain reaction and immunofluorescence staining, and 3) proinflammatory cytokines by luminometric bead array or enzyme-linked immunosorbent assay. RESULTS: Compared to control medium, 50 and/or 100 µg/mL PM2.5-treatment 1) significantly decreased TER and increased FITC permeability, which could not be restored by budesonide pretreatment; 2) significantly decreased the expression of claudin-1 messenger RNA, claudin-1, occludin and ZO-1 protein; and 3) significantly increased production of the cytokines interleukin-8, TIMP metallopeptidase inhibitor 1 and thymic stromal lymphopoietin. CONCLUSIONS: Exposure to PM2.5 may lead to loss of barrier function in human nasal epithelium through decreased expression of TJ proteins and increased release of proinflammatory cytokines. These results suggest an important mechanism of susceptibility to rhinitis and rhinosinusitis in highly PM2.5-polluted areas.


Subject(s)
Asthma , Budesonide , Claudin-1 , Cytokines , Enzyme-Linked Immunosorbent Assay , Epithelial Cells , Fluorescein , Fluorescein-5-isothiocyanate , Fluorescent Antibody Technique , Humans , Interleukin-8 , Mucous Membrane , Nasal Mucosa , Occludin , Particulate Matter , Permeability , Polymerase Chain Reaction , Rhinitis , RNA, Messenger , Tight Junctions
4.
Asia Pacific Allergy ; (4): 8-2020.
Article in English | WPRIM | ID: wpr-785457

ABSTRACT

There are geographical, regional, and ethnic differences in the phenotypes and endotypes of patients with drug hypersensitivity reactions (DHRs) in different parts of the world. In Asia, aspects of drug hypersensitivity of regional importance include IgE-mediated allergies and T-cell-mediated reactions, including severe cutaneous adverse reactions (SCARs), to beta-lactam antibiotics, antituberculous drugs, nonsteroidal anti-inflammatory drugs (NSAIDs) and radiocontrast agents. Delabeling of low-risk penicillin allergy using direct oral provocation tests without skin tests have been found to be useful where the drug plausibility of the index reaction is low. Genetic risk associations of relevance to Asia include human leucocyte antigen (HLA)-B*1502 with carbamazepine SCAR, and HLA-B*5801 with allopurinol SCAR in some Asian ethnic groups. There remains a lack of safe and accurate diagnostic tests for antituberculous drug allergy, other than relatively high-risk desensitization regimes to first-line antituberculous therapy. NSAID hypersensitivity is common among both adults and children in Asia, with regional differences in phenotype especially among adults. Low dose aspirin desensitization is an important therapeutic modality in individuals with cross-reactive NSAID hypersensitivity and coronary artery disease following percutaneous coronary intervention. Skin testing allows patients with radiocontrast media hypersensitivity to confirm the suspected agent and test for alternatives, especially when contrasted scans are needed for future monitoring of disease relapse or progression, especially cancers.


Subject(s)
Adult , Allopurinol , Anaphylaxis , Anti-Bacterial Agents , Asia , Asian Continental Ancestry Group , Aspirin , Asthma , Carbamazepine , Child , Cicatrix , Contrast Media , Coronary Artery Disease , Diagnostic Tests, Routine , Drug Hypersensitivity , Ethnic Groups , Humans , Hypersensitivity , Penicillins , Percutaneous Coronary Intervention , Phenotype , Recurrence , Skin Tests
5.
Asia Pacific Allergy ; (4): 11-2020.
Article in English | WPRIM | ID: wpr-785454

ABSTRACT

Air pollution, climate change, and reduced biodiversity are major threats to human health with detrimental effects on a variety of chronic noncommunicable diseases in particular respiratory and cardiovascular diseases. The extent of air pollution both outdoor and indoor air pollution and climate change including global warming is increasing-to alarming proportions particularly in the developing world especially rapidly industrializing countries worldwide. In recent years, Asia has experienced rapid economic growth and a deteriorating environment and increase in allergic diseases to epidemic proportions. Air pollutant levels in many Asian countries especially in China and India are substantially higher than are those in developed countries. Moreover, industrial, traffic-related, and household biomass combustion, indoor pollutants from chemicals and tobacco are major sources of air pollutants, with increasing burden on respiratory allergies. Here we highlight the major components of outdoor and indoor air pollutants and their impacts on respiratory allergies associated with asthma and allergic rhinitis in the Asia-Pacific region. With Asia-Pacific comprising more than half of the world's population there is an urgent need to increase public awareness, highlight targets for interventions, public advocacy and a call to action to policy makers to implement policy changes towards reducing air pollution with interventions at a population-based level.


Subject(s)
Administrative Personnel , Air Pollutants , Air Pollution , Air Pollution, Indoor , Allergy and Immunology , Asia , Asian Continental Ancestry Group , Asthma , Biodiversity , Biomass , Cardiovascular Diseases , China , Climate Change , Climate , Consumer Advocacy , Developed Countries , Economic Development , Family Characteristics , Global Warming , Humans , Hypersensitivity , India , Rhinitis, Allergic , Tobacco
6.
Article in English | WPRIM | ID: wpr-785344

ABSTRACT

The current document is based on a consensus reached by a panel of experts from the Chinese Society of Allergy and the Chinese Society of Otorhinolaryngology-Head and Neck Surgery, Rhinology Group. Chronic rhinosinusitis (CRS) affects approximately 8% of Chinese adults. The inflammatory and remodeling mechanisms of CRS in the Chinese population differ from those observed in the populations of European descent. Recently, precision medicine has been used to treat inflammation by targeting key biomarkers that are involved in the process. However, there are no CRS guidelines or a consensus available from China that can be shared with the international academia. The guidelines presented in this paper cover the epidemiology, economic burden, genetics and epigenetics, mechanisms, phenotypes and endotypes, diagnosis and differential diagnosis, management, and the current status of CRS in China. These guidelines—with a focus on China—will improve the abilities of clinical and medical staff during the treatment of CRS. Additionally, they will help international agencies in improving the verification of CRS endotypes, mapping of eosinophilic shifts, the identification of suitable biomarkers for endotyping, and predicting responses to therapies. In conclusion, these guidelines will help select therapies, such as pharmacotherapy, surgical approaches and innovative biotherapeutics, which are tailored to each of the individual CRS endotypes.


Subject(s)
Adult , Asian Continental Ancestry Group , Biomarkers , China , Consensus , Diagnosis , Diagnosis, Differential , Drug Therapy , Eosinophils , Epidemiology , Epigenomics , Genetics , Humans , Hypersensitivity , Inflammation , International Agencies , Medical Staff , Neck , Phenotype , Precision Medicine
7.
Article in English | WPRIM | ID: wpr-719511

ABSTRACT

PURPOSE: Data comparing the long-term efficacy and safety of subcutaneous immunotherapy (SCIT) using house dust mite (HDM) in children and adults with allergic rhinitis (AR) are limited. This study aimed to compare the long-term effects of HDM-SCIT in a cohort of Chinese pediatric and adult patients with AR. METHODS: A total of 124 pediatric and adult AR patients received HDM-SCIT for 3 years, with 118 patients being followed-up for 2 years. Prior to treatment (baseline), at the end of the 3-year treatment periods (third year) and 2 years after the discontinuation of treatment (fifth year), all patients were evaluated for total nasal symptom scores (TNSS), daily medication score (DMS), total combined score (TCS; symptoms [nasal + ocular] + DMS) and quality of life (QoL). Safety was assessed according to adverse events reported. RESULTS: After 3-year treatment, HDM-SCIT significantly improved symptoms and QoL scores at the end of the third and fifth years in both groups. Better improvements were observed in the third and fifth years based on baseline, in children compared to adults (TNSSΔ3: 6.66 vs. 5.41, P = 0.011; TCSΔ3: 4.30 vs. 3.83, P = 0.027 and TNSSΔ5: 6.16 vs. 4.86, P = 0.037; TCSΔ5: 4.11 vs. 3.62, P = 0.044).Shorter duration of AR history before SCIT (<10 vs. ≥10 years) resulted in better improvements at the end of the third and fifth years (TCSΔ3: 4.12 vs. 3.13, P = 0.036; TCSΔ5: 3.90 vs. 3.09, P = 0.033). HDM-SCIT was safe and comparable in both children and adults with AR. CONCLUSIONS: Children with AR may achieve better long-term efficacy of HDM-SCIT than adults with AR.


Subject(s)
Adult , Asian Continental Ancestry Group , Child , Cohort Studies , Humans , Immunotherapy , Pyroglyphidae , Quality of Life , Rhinitis, Allergic , Treatment Outcome
8.
Article in English | WPRIM | ID: wpr-830106

ABSTRACT

The nasal mucociliary clearance system, which comprises epithelial cilia and mucus from goblet cells, is an important intrinsic defense mechanism of the upper respiratory tract. Intranasal drugs and additives can have a detrimental effect on ciliary activity and mucociliary clearance, and thus impact the integrity of nasal defense mechanisms. This article discusses the current literature on the effects of different classes of intranasal drugs including intranasal corticosteroids, antihistamines, decongestants, antimicrobials and antivirals, as well as various drug excipients and nasal irrigation solutions on human nasal mucociliary clearance and ciliary beat frequency. Available data indicate that some intranasal formulations tend to hamper nasal ciliary function and mucociliary clearance. Therefore, it is of great importance to assess the effects of intranasal drugs and additives on mucociliary function before they are recommended as therapy for different nasal conditions.

9.
Article in English | WPRIM | ID: wpr-830102

ABSTRACT

Allergic rhinitis (AR) is a critical public health, medical and economic problem in China. AR is also an important risk factor which will cause many diseases or disorders, especially in children. The trend of AR incidence is still on the rise in recent years and has had a significant effect on the general public. This significant increase is alarming, which highlights an urgent need for better understanding of the prevalence status and characteristics, sensitization patterns, and the associated risk factors of AR in order to improve treatment and develop effective prevention strategies.

10.
Article in Chinese | WPRIM | ID: wpr-810524

ABSTRACT

Chronic rhinosinusitis is a common disease in otorhinolaryngology, which has chronic inflammation in mucosa of nasal cavity and sinus. The mechanisms of chronic rhinosinusitis is still unknown. Recently, some studies show that tissue remodeling has important roles in chronic rhinosinusitis, and as a part of tissue remodeling, epithelial-mesenchymal transition also received high attention. Therefore, this review will summarize the present studies involve epithelial-mesenchymal transition and chronic rhinosinusitis, so as to provide reference for further exploring the pathogenesis of chronic sinusitis.

11.
Article in Chinese | WPRIM | ID: wpr-810523

ABSTRACT

IgG4 related disease (IgG4-RD) is an independent clinical pathological entity which is different from common chronic inflammation and other autoimmune diseases in recent years. It often appears in the form of tumor like tissue-destructive lesions and may be accompanied by the increase of concentration of serum IgG4. Histopathology is characterized by a large number of lymphocytes and plasma cells infiltration, storiform fibrosis and occlusive phlebitis. The characteristics of IgG4-RD in nose and sinuses have not been widely investigated. The aim of the present study is to review the advances in IgG4 related sinonasal diseases from four aspects including pathogenesis, clinical features, treatment and future research directions.

12.
Article in Chinese | WPRIM | ID: wpr-810516

ABSTRACT

Objective@#To evaluate the expression of immunological and inflammatory biomarkers as well as to analyze their predictive value for recurrence of chronic rhinosinusitis with nasal polyps (CRSwNP).@*Methods@#Seventy-seven CRSwNP patients were enrolled in this survey from January 2011 to December 2012 in Beijing Tongren Hospital. There were 13 males and 64 females, with the range of age from 14 to 74 years old. The average follow-up period was more than 2 years. The demographic and clinical features of patients were compared between recurrence and non-recurrence groups, and 43 kinds of cytokines, chemokines and inflammatory mediators, tissue and serum total IgE, and morphological and cytology indexes were compared between the two groups. The receiver operating characteristic (ROC) curves were used to evaluate the predictive value of significant indicators for the postoperative recurrence of CRSwNP and to calculate the best diagnostic cut-off values.@*Results@#The recurrence rate of CRSwNP was 44.2% (34/77). Compared with non-recurrence CRSwNP, there were higher risk of aspirin intolerance and asthma in the recurrence group, as well as higher CT and endoscopic polyp scores and lower olfactory sense (7/34 vs 0/43, 10/34 vs 4/43, 18.5[3.0, 24.0] vs 13.8[2.0, 24.0], 2.1[0.5, 3.0] vs 1.5[0.5, 3.0], 5.0[4.5, 5.0] vs 3.0[1.0, 5.0], χ2 value was 9.738, 5.161, Z value was -3.267, -2.705, -3.213, respectively, all P<0.05). At the same time, the level of interleukin-5 (IL-5), eosinophilic cationic protein / myeloperoxidase (ECP/MPO), tissue inhibitor of metalloproteinase 1 (TIMP1), chemokine (C-C motif) ligand 2 (CCL2), CCL3, CCL4 and tissue and serum total IgE were higher in the recurrence group than those of the non-recurrence. Moreover, the oedema of the lamina propria were more severe. The total IgE, IL-5, ECP/MPO and CCL4 in the tissue had a acceptable discrimination value for the prediction of CRSwNP recurrence. The best diagnostic cut-off values and corresponding sensitivity and specificity were 124.85 pg/ml (82.4%, 60.5%), 6.22 pg/ml (76.5%, 58.1%), 0.61 (55.9%, 83.7%) and 2 456.96 pg/ml (61.8%, 79.1%), respectively.@*Conclusions@#The profile of the immunological and inflammatory biomarkers was different between the non-recurrence CRSwNP and recurrence CRSwNP groups. And a variety of biomarkers can be considered as indicators of recurrence of CRSwNP with acceptable predictive value.

13.
Article in English | WPRIM | ID: wpr-762167

ABSTRACT

PURPOSE: Chronic cough in allergic rhinitis (AR) patients is common with multiple etiologies including cough variant asthma (CVA), non-asthmatic eosinophilic bronchitis (NAEB), gastroesophageal reflux-related cough (GERC), and upper airway cough syndrome (UACS). Practical indicators that distinguish these categories are lacking. We aimed to explore the diagnostic value of the fraction of exhaled nitric oxide (FeNO) and forced expiratory flow at 25% and 75% of pulmonary volume (FEF(25–75)) in specifically identifying CVA and NAEB in these patients. METHODS: Consecutive AR patients with chronic cough were screened and underwent induced sputum, FeNO, nasal nitric oxide, spirometry, and methacholine bronchial provocation testing. All patients also completed gastroesophageal reflux disease questionnaires. RESULTS: Among 1,680 AR patients, 324 (19.3%) were identified with chronic cough, of whom 316 (97.5%) underwent etiology analyses. Overall, 87 (27.5%) patients had chronic cough caused by NAEB, 78 (24.7%) by CVA, 16 (5.1%) by GERC, and 81 (25.6%) by UACS. Patients with either NAEB or CVA (n = 165, in total) were further assigned to a common group designated as CVA/NAEB, because they both responded to corticosteroid therapy. Receiver operating characteristic curves of FeNO revealed obvious differences among CVA, NAEB, and CVA/NAEB (area under the curve = 0.855, 0.699, and 0.923, respectively). The cutoff values of FeNO at 43.5 and 32.5 ppb were shown to best differentiate CVA and CVA/NAEB, respectively. FEF(25–75) was significantly lower in patients with CVA than in those with other causes. A FEF(25–75) value of 74.6% showed good sensitivity and specificity for identifying patients with CVA. CONCLUSIONS: NAEB, CVA, and UACS are common causes of chronic cough in patients with AR. FeNO can first be used to discriminate patients with CVA/NAEB, then FEF(25–75) (or combined with FeNO) can further discriminate patients with CVA from those with CVA/NAEB.


Subject(s)
Asthma , Bronchial Provocation Tests , Bronchitis , Cough , Eosinophils , Gastroesophageal Reflux , Humans , Methacholine Chloride , Nitric Oxide , Rhinitis, Allergic , ROC Curve , Sensitivity and Specificity , Spirometry , Sputum
14.
Article in English | WPRIM | ID: wpr-762158

ABSTRACT

PURPOSE: This study aimed to investigate the impact of short-term haze exposure on nasal inflammation in healthy volunteers. METHODS: Thirty-three healthy university students were assessed for nasal symptoms, nasal patency, upper and lower respiratory tract nitric oxide (NO) as well as inflammatory mediators and neuropeptides in nasal secretions before and after a 5-day haze episode. Peripheral blood mononuclear cells (PBMCs) were stimulated with particulate matter with an aerodynamic diameter of less than 2.5 μm (PM(2.5)), and cytokines in the supernatants were examined. RESULTS: Mild nasal symptoms were reported by some participants during the haze episode. Objective measures of nasal patency demonstrated that nasal airway resistance was significantly increased from baseline levels, while nasal cavity volume and minimum cross-sectional area were significantly decreased. Similarly, the levels of nasal and exhaled NO, eotaxin, interleukin (IL)-5, chemokine (C-C motif) ligand 17, IL-8, substance P, nerve growth factor and vasoactive intestinal peptides in nasal secretions were significantly increased from baseline values following the haze episode. In contrast, the levels of interferon-γ, IL-10, transforming growth factor-β and neuropeptide Y were significantly decreased. Incubation with 0.1-10 μg/mL PM(2.5) significantly increased release of IL-1β, IL-4, IL-5, IL-8 and IL-10 from PBMCs. CONCLUSIONS: Short-term haze exposure may lead to nasal inflammation and hypersensitivity in healthy subjects predominantly by Th2 cytokine-mediated immune responses.


Subject(s)
Air Pollution , Airway Resistance , Cytokines , Healthy Volunteers , Humans , Hypersensitivity , Inflammation , Interleukin-10 , Interleukin-4 , Interleukin-5 , Interleukin-8 , Interleukins , Nasal Cavity , Nerve Growth Factor , Neuropeptide Y , Neuropeptides , Nitric Oxide , Particulate Matter , Peptides , Respiratory System , Substance P
15.
Article in English | WPRIM | ID: wpr-762145

ABSTRACT

PURPOSE: Corticosteroids are regarded as the mainstay of medical treatment of eosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP). To date, a head-to-head comparison of the efficacy and safety of glucocorticoid preparations administered via different routes for the treatment of chronic rhinosinusitis with nasal polyps has not been reported. To compare the efficacy and safety of steroids administered via the oral, intranasal spray and transnasal nebulization routes in the management of ECRSwNP over a short course. METHODS: Overall, 91 patients with ECRSwNP were recruited prospectively and randomized to receive either oral methylprednisolone, budesonide inhalation suspension (BIS) via transnasal nebulization, or budesonide nasal spray (BNS) for 2 weeks. Nasal symptoms and polyp sizes were assessed before and after the treatment. Similarly, nasal polyp samples were evaluated for immunological and tissue remodeling markers. Serum cortisol levels were assessed as a safety outcome. RESULTS: Oral methylprednisolone and BIS decreased symptoms and polyp sizes to a significantly greater extent from baseline (P < 0.05) than BNS. Similarly, BIS and oral methylprednisolone significantly reduced eosinophils, T helper 2 cells, eosinophil cationic protein, interleukin (IL)-5, and expression of matrix metalloproteinases 2 and 9, and significantly increased type 1 regulatory T cells, IL-10, transforming growth factor-β, and tissue inhibitor of metalloproteinases 1 and 2 in nasal polyps to a greater extent than BNS. Post-treatment serum cortisol levels were significantly decreased by oral methylprednisolone compared to BIS or BNS, which did not significantly alter the cortisol levels. CONCLUSIONS: A short course of BIS transnasal nebulization is more efficacious compared to BNS in the management of ECRSwNP and is safer than oral methylprednisolone with respect to hypothalamic-pituitary-adrenal axis function.


Subject(s)
Adrenal Cortex Hormones , Budesonide , Eosinophil Cationic Protein , Eosinophils , Glucocorticoids , Humans , Hydrocortisone , Inhalation , Interleukin-10 , Interleukins , Matrix Metalloproteinases , Methylprednisolone , Nasal Polyps , Polyps , Prospective Studies , Steroids , T-Lymphocytes, Regulatory , Tissue Inhibitor of Metalloproteinases
16.
Article in English | WPRIM | ID: wpr-739410

ABSTRACT

PURPOSE: Nitric oxide (NO) is an important endogenous mediator in both upper and lower respiratory systems. The purpose of the present study was to extract nasal NO (nNO) normal range of Chinese adults and the internal influencing factors. The differences in nNO levels between rhinitis and asymptomatic atopic subjects, and the diagnostic value of nNO in allergic rhinitis (AR) were further investigated. METHODS: One thousand adults were recruited from the general public. Participants were divided into different subgroups according to the questionnaires and skin prick tests. In all of these subjects, nNO, fractional exhaled NO (FeNO) and nasal airflow resistance were measured. The normal ranges of nNO and FeNO, the differences between subgroups, and the correlations between NO (nNO and FeNO) and other internal factors were analyzed. RESULTS: Both nNO and FeNO levels were significantly higher in AR patients than in healthy and asymptomatic atopic subjects. The nNO levels were significantly lower in asymptomatic atopic subjects than in normal adults. FeNO levels were significantly higher in non-AR patients than in the healthy and asymptomatic atopic adults. The cutoff value of nNO for the diagnosis of AR was 117.5 ppb (sensitivity, 50.9%; specificity, 63.9%). The nNO levels were correlated with FeNO levels, total nasal resistance measured at 75Pa, nasal volume within 0–7 cm from the anterior nares (V0–7cm) and nasal symptom visual analogue scale (VAS) scores, while the FeNO levels were correlated with age, height, weight, body surface area, nasal volume of V0–7cm and the nasal symptom VAS score. CONCLUSIONS: The nNO level can be significantly different between healthy and AR patients and may be significantly correlated with nasal symptoms and nasal patency of rhinitis patients. However, the clinical value of nNO is still in the exploration stage.


Subject(s)
Adult , Asian Continental Ancestry Group , Body Weight , Diagnosis , Humans , Nasal Obstruction , Nitric Oxide , Reference Values , Respiratory System , Rhinitis , Rhinitis, Allergic , Sensitivity and Specificity , Skin
17.
Article in Chinese | WPRIM | ID: wpr-692203

ABSTRACT

OBJECTIVE The objective of this study was to investigate the association between interleukin 10 (IL-10) gene polymorphism and asthma. METHODS We tried to enroll data from 205 asthma patients and 210 controls to investigate the association between IL-10 polymorphisms and asthma in the Han Chinese population. The three common single nucleotide polymorphisms (SNPs), including rs1800896, rs1800871, rs1800872 on the promoter area of IL-10 were genotyped using the sequenom mass array technology platform. RESULTS Our results showed that rs1800872 were significantly associated with asthma. In asthma groups, we found that there was significant high concentration of total serum IgE in genotype AA comparing with genotype CC. CONCLUSION In conclusion, our data showed that rs1800872 was significantly associated with asthma.

18.
Article in Chinese | WPRIM | ID: wpr-751451

ABSTRACT

OBJECTIVE To investigate the normal range of fraction exhaled nitric oxide(FeNO) in healthy schoolchildren in Beijing, Tianjin and Hebei Province. METHODS A total of 337 schoolchildren(161 males and 176 females) in Beijing, Tianjin and Hebei Province were selected randomly in our outpatient clinic and met the health standards. FeNO values were measured using NIOX. Age, height, weight and body mass index(BMI) were investigated. At the same time, skin prick tests were performed on children with suspected atopy. RESULTS Geometric mean of FeNO value in healthy schoolchildren in Beijing, Tianjin and Hebei Province was 13 ppb(part per billion, ppb), and the 95% Confidence Interval(CI, bias distribution) was 5-23 ppb, which was related to the gender of schoolchildren(P <0.001). There was no signif icant cor relation between age, height, weight, body mass index(BMI) and regional differences(P all>0.05). FeNO values were no significant difference among the three regions(P >0.05); the geometric mean of FeNO values were 13 ppb in Beijing, 13 ppb in Tianjin, and 14 ppb in Hebei; 95%CI was 5 to 21 ppb, 5 to 21 ppb, 5 to 23 ppb, respectively. CONCLUSION FeNO values of healthy schoolchildren in Beijing, Tianjin and Hebei provinces are only significantly correlated with gender. However, FeNO values are highest among schoolaged girls in Hebei, and 23 ppb is the 95% normal range of FeNO in healthy schoolchildren in Beijing, Tianjin and Hebei province. Gender and regional factors must be considered when FeNO values are evaluated.

19.
Article in Chinese | WPRIM | ID: wpr-806094

ABSTRACT

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory disease that occurs in the nasal and sinus mucosa, which is a common disease in otorhinolaryngology. At present, CRSwNP can be effectively treated by glucocorticoids (GC). GC binds to GC receptors in the nasal mucosa, affects the expression of inflammatory genes, inhibits the activation and action of eosinophils, T cell-associated inflammatory responses in nasal polyps, as well as tissue remodeling. However, there are some patients fall reponse to GC, so called GC resistance. The study suggests that the possible mechanism of CRSwNP GC resistance is mainly related to GC receptor abnormal, the role of cytokines and transcription factors, such as Th cells and IL-8. In addition, MAPK-related kinases and histone deacetylase in the GC signaling pathway also play important roles in the GC resistance process. This paper reviews the mechanism of GC treatment of CRSwNP, the mechanism of GC resistance and alternative treatment of GC.

20.
Article in English | WPRIM | ID: wpr-716009

ABSTRACT

Allergic rhinitis (AR) is a global health problem that causes major illnesses and disabilities worldwide. Epidemiologic studies have demonstrated that the prevalence of AR has increased progressively over the last few decades in more developed countries and currently affects up to 40% of the population worldwide. Likewise, a rising trend of AR has also been observed over the last 2–3 decades in developing countries including China, with the prevalence of AR varying widely in these countries. A survey of self-reported AR over a 6-year period in the general Chinese adult population reported that the standardized prevalence of adult AR increased from 11.1% in 2005 to 17.6% in 2011. An increasing number of original articles and imporclinical trials on the epidemiology, pathophysiologic mechanisms, diagnosis, management and comorbidities of AR in Chinese subjects have been published in international peer-reviewed journals over the past 2 decades, and substantially added to our understanding of this disease as a global problem. Although guidelines for the diagnosis and treatment of AR in Chinese subjects have also been published, they have not been translated into English and therefore not generally accessible for reference to non-Chinese speaking international medical communities. Moreover, methods for the diagnosis and treatment of AR in China have not been standardized entirely and some patients are still treated according to regional preferences. Thus, the present guidelines have been developed by the Chinese Society of Allergy to be accessible to both national and international medical communities involved in the management of AR patients. These guidelines have been prepared in line with existing international guidelines to provide evidence-based recommendations for the diagnosis and management of AR in China.


Subject(s)
Adult , Asian Continental Ancestry Group , China , Comorbidity , Developed Countries , Developing Countries , Diagnosis , Epidemiologic Studies , Epidemiology , Global Health , Humans , Hypersensitivity , Prevalence , Rhinitis, Allergic
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