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ABSTRACT Allergic conjunctivitis is an increasingly frequent condition with a higher prevalence in children. It can be debilitating and is responsible for a great economic burden. These guidelines were developed on the basis of the medical literature (PubMed/Medline database) and the experience of an Expert Committee composed of members of the Brazilian Society of Pediatric Ophthalmology, the Brazilian Council of Ophthalmology, the Brazilian Society of Pediatrics, and the Brazilian Association of Allergy and Immunology. Allergic conjunctivitis is considered to be controlled when the ocular symptoms are not uncomfortable or are present, at most, on 2 days a week; the visual analog scale score is below 5; and the degree of conjunctival hyperemia is graded 0 or 1 on the Efron scale. Allergic conjunctivitis should be classified as mild, moderate, severe, and vision-threatening for adequate treatment and monitoring of frequency. The present document is a guideline for diagnosing, treating, and monitoring pediatric allergic conjunctivitis considering the clinical and demographic aspects of allergic conditions in Brazil.
RESUMO A conjuntivite alérgica (CA) é uma condição frequente, debilitante e responsável por grande impacto econômico, proporcionalmente maior quando acomete crianças. Essas diretrizes foram desenvolvidas com base na literatura científica (PubMed/Medline) e na experiência de um Comitê de Especialistas composto por membros da Sociedade Brasileira de Oftalmologia Pediátrica, do Conselho Brasileiro de Oftalmologia, da Sociedade Brasileira de Pediatria e da Associação Brasileira de Alergia e Imunologia. A conjuntivite alérgica é considerada controlada quando os sintomas não são desconfortáveis ou estão presentes por dois dias na semana; o escore visual pela escala analógica é inferior a 5 e o grau de hiperemia conjuntival é de 0-1 pela escala de Efron. A conjuntivite alérgica deve ser classificada em leve, moderada, grave e com risco de perda visual para tratamento e frequência de monitoramento adequados. Esta diretriz orienta o diagnóstico, tratamento e monitoramento da conjuntivite alérgica pediátrica, considerando aspectos clínicos e demográficos das condições alérgicas no Brasil.
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PURPOSE: The pollen calendar is the simplest forecasting method for pollen concentrations. As pollen concentrations are liable to seasonal variations due to alterations in climate and land-use, it is necessary to update the pollen calendar using recent data. To attenuate the impact of considerable temporal and spatial variability in pollen concentrations on the pollen calendar, it is essential to employ a new methodology for its creation.METHODS: A pollen calendar was produced in Korea using data from recent observations, and a new method for creating the calendar was proposed, considering both risk levels and temporal resolution of pollen concentrations. A probability distribution was used for smoothing concentrations and determining risk levels. Airborne pollen grains were collected between 2007 and 2017 at 8 stations; 13 allergenic pollens, including those of alder, Japanese cedar, birch, hazelnut, oak, elm, pine, ginkgo, chestnut, grasses, ragweed, mugwort and Japanese hop, were identified from the collected grains.RESULTS: The concentrations of each pollen depend on locations and seasons due to large variability in species distribution and their environmental condition. In the descending order of concentration, pine, oak and Japanese hop pollens were found to be the most common in Korea. The pollen concentrations were high in spring and autumn, and those of oak and Japanese hop were probably the most common cause of allergy symptoms in spring and autumn, respectively. High Japanese cedar pollen counts were observed in Jeju, while moderate concentrations were in Jeonju, Gwangju and Busan.CONCLUSIONS: A new methodology for the creation of a pollen calendar was developed to attenuate the impact of large temporal and spatial variability in pollen concentrations. This revised calendar should be available to the public and allergic patients to prevent aggravation of pollen allergy.
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Humans , Alnus , Ambrosia , Artemisia , Asian People , Betula , Climate , Corylus , Cryptomeria , Forecasting , Ginkgo biloba , Hypersensitivity , Korea , Methods , Poaceae , Pollen , Rhinitis, Allergic, Seasonal , SeasonsABSTRACT
Objective To compare the effects of mizolastine intensive dose and mizolastine conventional dose+momestasone furoate on symptom score and laboratory index of patients with allergic rhinitis caused by pollen allergy.Methods From June 2016 to January 2018,one hundred and fifty allergic rhinitis patients caused by pollen allergy were chosen in the First People＇s Hospital of Taizhou and randomly divided into two groups according to the digital table,with 75 patients in each group.A group was treated with mizolastine intensive dose scheme,and B group was treated with mizolastine conventional dose +momestasone furoate. The short -term efficacy,rhinitis symptoms score,the levels of histamine,leukotrienes C4,IL-6,IL-8 and TNF-α before and after treatment,the incidence of adverse reactions and daily treatment cost of the two groups were compared.Results The short-term efficacy of B group was significantly better than that of A group(93.33% vs.81.33% ,χ2 =9.15,P<0.05).The rhinitis symptoms scores of B group[(0.49 ± 0.19)points,(1.02 ± 0.20) points,(0.95 ± 0.28) points,(0.84 ± 0.20)points] after treatment were significantly lower than those of A group [(0.87 ± 0.21) points,(1.40 ± 0.24) points,(1.63 ± 0.36)points,(1.19 ± 0.27) points] and before treatment[(3.13 ± 1.06) points,(2.88 ± 0.57) points,(2.81 ± 0.79)points,(2.85 ± 0.61)points](t=2.45,2.71,2.66,2.89,3.78,3.75,3.44,4.53,all P<0.05).The levels of histamine,leukotrienes C4,IL-6,IL-8 and TNF-α of B group[(15.76 ± 3.54) mg/L,(12.17 ± 3.58) mg/L, (1.23 ± 0.19)mg/L,(3.27 ± 0.62)mg/L,(3.96 ± 1.05)mg/L] after treatment were significantly lower than those of A group [(19.58 ± 5.25) mg/L,(15.44 ± 4.14) mg/L,(1.96 ± 0.33)mg/L,(5.40 ± 0.88) mg/L,(5.01 ± 1.40)mg/L] and before treatment[(24.57 ± 7.67) mg/L,(18.90 ± 6.33) mg/L,(2.58 ± 0.54) mg/L,(7.66 ± 1.17)mg/L,(6.81 ± 1.67)mg/L](t=2.31,2.50,2.53,2.39,3.05,3.60,3.10,3.57,3.90,all P<0.05).There was no statistically significant difference in the incidence rate of adverse reactions between the two groups ( P >0.05).The daily treatment cost of B group after treatment was significantly less than that of A group and before treatment[(7.56 ± 1.02)CNY vs.(6.88 ± 0.80)CNY,t=3.12,P<0.05].Conclusion Compared with mizolas-tine intensive dose scheme,mizolastine conventional dose + momestasone furoate in the treatment of patients with allergic rhinitis caused by pollen allergy can efficiently relieve the nasal symptoms, down - regulate the levels of histamine,leukotriene C4 and inflammatory cytokines,reduce the treatment cost and has the approved safety.
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Objective To compare the efficacy and adverse reactions of desloratadine citrate disodium tablets and loratadine dispersible tablets in treatment of patients with allergic rhinitis,and their influence on leukotriene B4(LTB4),interleukin-4 (IL-4),interleukin-10 (IL-10) and interferon gamma (INF-γ).Methods From June 2015 to June 2016,a total of 110 patients with allergic rhinitis in the Second People's Hospital of Cangnan County were selected and randomly divided into control group and observation group according to the digital table,with 55 cases in each group.The control group was given loratadine dispersible tablets,while the observation group was given desloratadine citrate disodium tablets.Both two groups were treated for 14 days.The clinical efficacy,adverse reactions and changes of LTB4,IL-4,IL-10,INF-γ levels before and after treatment were compared between the two groups.Results The total effective rate of the observation group was 94.5 ％,which was significantly higher than 80.0％ of the control group(x2 =6.310,P ＜ 0.05).The incidence rate of adverse reactions in the observation group was 16.4％,which was similar to 20.0％ in the control group.Before treatment,there were no statistically significant differences in LTB4,IL-4,IL-10,INF-γ levels between the two groups (all P ＞ 0.05).After 2 weeks of treatment,the levels of LTB4,IL-4,IL-10 and INF-γ in the observation group were (67.74 ±10.15) ng/L,(52.37 ± 5.12) μg/L,(81.26 ± 11.78) μg/L,(94.47 ± 7.87) μg/L,respectively,which in the control group were (80.32 ± 9.97) ng/L,(62.95 ± 5.45) μg/L,(96.32 ± 11.57) μg/L,(86.74 ± 7.63) μg/L,respectively,there were statistically significant differences between the two groups (t =7.124,5.262,4.654,3.718,all P ＜ 0.05).Conclusion Both desloratadine citrate disodium tablets and loratadine dispersible tablets can effectively treat patients with allergic rhinitis,improve the symptoms and physical signs,reduce the levels of LTB4,IL-4 and IL-10,increase the level of INF-γ,and the adverse reactions are less and slight,but the efficacy of desloratadine citrate disodium tablets is better than loratadine dispersible tablets.
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OBJECTIVE To investigate the effects of behavior, pathology, the serum IL-17, IL-23 level, and the expressing of RORγt, IL-17 and IL-23 mRNA in nasal tissues of experimental allergic rhinitis rats after the scoparone treatment. METHODS The animal model were divided into 4 groups: normal control group(group NC), allergic rhinitis group(group AR), artemolactone group(group Sco) and dexamethasone group(group Dxm). The symptom score, HE staining of the nasal mucosa, IL-17 and IL-23 level in serum measured by ELISA, the RORγt, IL-17 and IL-23 mRNA level detected by RTPCR. RESULTS Symptoms and inflammatory pathology were relieved in the experimental group after scoparone treatment. The serum levels of the IL-17, IL-23 in group Sco and group Dxm were little higher than that in group NC. The levels of RORγt, IL-17 and IL-23 mRNA in group AR were significantly higher than that in the other three groups. The levels of RORγt, IL-17 and IL-23 mRNA in group Sco and group Dxm were little higher than that in the group NC. CONCLUSION Sco could significantly inhibited or eliminated the allergy symptoms of AR in rats, and could reduce the severity and inflammatory response of diseases.
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OBJECTIVE To invest igate the therapeutic effect and mechanism of PPAR gamma agonist on allergic rhinitis(AR) in mice. METHODS AR murine model was established by OVA sensitization and challenge. The behavior observation was used to understand the improvement effect of PIO on AR symptoms. The morphological characteristics of nasal tissues were observed by HE staining. The total RNA was extracted to investigate the level of mRNA expression of Foxp3, T-bet and GATA-3. The changes of CD4+Foxp3+T cells in spleen of mice were analyzed by flow cytometry. RESULTS BALB/c mice received OVA sensitization followed by OVA intranasal challenge, the frequencies of sneezing and nose-scratching increased signif icantly in AR group compared with control group. The frequencies decreased significantly in PIO group, compared with AR group. The continuity of nasal mucosa ciliated columnar epithelium in AR group was destroyed and appeared to be repaired in PIO group. Inflammatory cells infiltration was also markedly decreased by PIO treatment. PIO significantly increased the expression of Foxp3 mRNA(P ＜0.001) compared with AR and control group. There was no significant difference in T-bet between PIO group and AR group, but the expression of GATA-3 mRA in PIO group was significantly lower than AR group. The proportion of CD4+Foxp3+T cells in AR group (4.43％±0.25％) decreased compared with control group (5.19％±0.39％) (P ＜0.001). PIO treatment induced production of Tregs (6.35％±0.37％) compaered with control group(P ＜0.001). CONCLUSION PPAR-gamma agonist can effectively alleviate allergic symptoms of mice and regulate the balance of Th1/Th2. The role of PPAR gamma agonist in the treatment of AR may be the amplification of Tregs by promoting Foxp3 expression.
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OBJECTIVE To invest igate the correlation between fractional exhaled nitric oxide(FeNO) and lung function in artemisia argyi allergy patients. Whether the course of disease and rhinitis score are correlated with FeNO and lung function. METHODS A total of 88 patients with mugwort pollen allergy, who visited the hospital between August and September 2017 and August and September 2018, the results of their FeNO and Pulmonary ventilation function, were included in this study. RESULTS Compared with patients with a duration of 9 years or more, FeNO and FEV1％ of patients with a duration of 5 years were significantly different(P =0.004, P =0.032), and FeNO increased with the extension of the duration, while FEV1％ decreased gradually. FeNO was negatively correlated with FEF25％-75％pred and FEV1％, while there was no correlation with FEV1％pred. Rhinitis score was positively correlated with FeNO. There was no correlation with FEV1％pred, FEV1％, FEF25％-75％pred. CONCLUSION With the development of mugwort pollen allergy, the probability of airflow limitation is also increased. To some extent, FeNO can predict the changes of airway function early, and can be used as a monitoring indicator for asthma prediction.FeNO value can reflect the degree of inflammation of the body, and can be used in the auxiliary diagnosis of the severity of allergic rhinitis patients.
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OBJECTIVE We used Al lergic Rhinitis Control Test (ARCT) questionnaire to evaluate the control level of allergic rhinitis, in order to get the data of prevalence rate, epidemiological characters and risk factors of uncontrolled allergic rhinitis. METHODS Patients with AR were recruited from our department and the treatment based on the Allergic Rhinitis and Its Impact on Asthma(ARIA) guidelines. Telephone interview will be taken after 2 weeks in these patients, compared to symptoms, impact on quality of life, ARCT value before and after treatment. RESULTS Among 134 patients enrolled, moderate/severe AR account for 95％. After 2 weeks of treatment, both symptom and quality of life were marked improvement(P <0.001). Patients with uncontrolled AR(26.1％) at day 15 more frequently presented higher height and weight(P <0.001), history of ear, nose, and throat(ENT) infection or antibiotics intake for respiratory infection in the last 12 months (40.4％ versus 62.9％, P =0.022), smoking (4.0％ versus 17.1％, P =0.02), and smell disturbance (10.1％ versus 25.7％, P =0.044). CONCLUSION Most of AR patients have remarkable improvements in symptom and quality of life after treatment, but 26.1％ of patients still remain uncontrolled. Smoking and nose infection are risk factors of uncontrolled AR.
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Objective@#To evaluate the effects of extended nursing mode on the asthmatic children with allergic rhinitis (AR).@*Methods@#Totally116 children aged 6-14 years old with asthma and AR were enrolled to this study from November 2015 to October 2016 in our hospital. They were divided into the regular nursing group and the extended nursing group according to the voluntary principle. The patients in regular nursing group were received routine nursing care in or out of hospital, while the patients in extended nursing group received extended care besides routine nursing. The children were required to record diary about asthma and AR And participate in asthma action projects. Before and after intervention we observed the quantitative score of symptoms and signs, the times of acute attack, the times of oblivion medication, the average days of stay in hospital, the days of fail to School or kindergarten, the lung function and the fractional exhaled nitric oxide (FeNO) in children with asthma and AR within 1 year. These above marks were assessed five times respectively at starting (baseline) , 3 months, 6 months, 9 months and 12 months (1 year) The differences between two groups were compared with appropriate statistical methods.@*Results@#1 year later, out of 58 cases in extended nursing group, 40 patients (68.97%)were in good control and 18 cases (31.03%) in partial control. Out of 58 cases in regular nursing group, 22 cases (37.93%) were in good control and 36 patients (62.07%) in partial control. There were significant differences between two groups in the effect of disease (χ2=11.23, all P<0.01), the experimental group was significantly better than the control group. The symptoms and signs of allergic rhinitis average scores in regular nursing group were 1.88 ± 0.72, extended nursing group were 0.79 ± 0.71, the difference was statistically significant (t=8.080, P<0.01) with the extended nursing group much better that the regular nursing group. The symptoms and signs of asthma average scores in regular nursing group were1.83 ± 0.75, extended nursing group were 0.88 ± 0.67, the difference was also statistically significant (t=7.133, P<0.01) with the extended nursing group much better that the regular nursing group. In extended nursing groups within 1 year the numbers of acute attack (0.60±0.59), the times of oblivion medication (11.05±7.40), the average days of stay in hospital (8.83±2.79) days,the average days of failing to school or kindergarten (8.69±5.46) days, while in regular nursing group within 1 year the numbers of acute attack(2.94±1.52), the times of oblivion medication (35.28±8.84), the average days of stay in hospital(20.95±5.46 days), the average days of fail to school or kindergarten(24.72±5.92) days, the differences were also statistically significant (t=10.50-15.87, P<0.01). The lung function in extended nursing group (PEF: 82.02±6.04, FEVI: 88.19±5.10, FEV25: 80.67±4.88, FEV50: 80.07±3.73, FEV75: 81.52±3.85) and in regular nursing group (PEF: 79.02±6.12,, FEV1: 80.52±4.72, FEV25: 75.05±7.79, FEV50: 77.59±4.60, FEV75: 78.41±4.19) . The differences were also statistically significant (t=2.90-6.15, P<0.01).The FeNO(13.66±2.87) ppb in extended nursing group and (14.95±3.12) ppb in regular nursing group. There were statistical significant differences between the two groups (t=2.30, P<0.05) with extended nursing group much better than regular nursing group.@*Conclusion@#The effect of extended care group is better than that of regular nursing group, and extended care is much more benefit to control asthma and allergic rhinitis in children.
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Objectives To determine the short term relationship between the number of old allergic rhinitis(AR) patients and the air quality index(AQI) data in autumn and winter in Beijing.Methods Between October 2015 and December 2015,the AQI index data and the number of old outpatients with AR in Beijing Hospital were collected and the relation between them was evaluated by Pearson correlation analysis.Results The AR patients aged over 60 were 1 892 cases (36.72％ of the total number of outpatients).The males were 953 (50.4％),The females were 939 (49.6％).The number of old outpatients with AT changed from 4/d to 39/d.When the AQI rised,the total number of old outpatients was increased;however,when the AQI rised to a certain extent,especially to the serious pollution value (＞300),the number of old outpatients was declined.Pearson correlation analysis showed that there was a negative correlation between the amount of old AR patients and the AQI in the high incidence of air pollution seasons in Beijing (r=0.311,P＜0.01).Conclusions Air pollution is one of the most important reasons for the increased rate of AR patients in the elderly.
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OBJECTIVE To explore the possible role and mechanism of vitamin D on the pathogenesis of allergic rhinitis by adjuvant therapy with vitamin D3. METHODS A total of 60 allergic rhinitis patients and 30 healthy subjects were selected as the combination therapy group, standard treatment group and control group. Vitamin D3 nasal drops to nasal cavity and oral Desloratadine Citrate Disodium at the same time 8.8 mg once a day were given in combined treatment group patients. Standard treatment group patients received oral Desloratadine Citrate Disodium 8.8 mg once a day. The total course of treatment was 4 weeks and then to assess the changes of serum 25(OH)D concentration, eosinophils, IL-4 levels and the therapeutic effect before and after treatment. RESULTS The serum 25(OH)D levels before and after treatment in combination therapy group were(23.67±4.47)ng/ml and (47.57±2.83)ng/ml, the IL-4 levels were (14.576 ± 4.472)pg/ml and (10.381 ± 3.41l)pg/ml, and the eosinophils of peripheral blood counts were (0.71±0.14)× 109/L and (0.34 ± 0.09)×109/L. The total effective rate was 97％. The serum 25(OH)D levels before and after treatment in standard treatment group were (23.42±3.83)ng/ml and(31.51 ±2.95)ng/ml, the IL-4 levels were (15.187±5.144)pg/ml and (12.794 ±5.396)pg/ml, and the eosinophils of peripheral blood counts were (0.67±0.12)×109/L and (0.41 ±0.10)×109/L. The total effective rate was 84％. CONCLUSION Nasal vitamin D3 drops combined with antihistamines for allergic rhinitis can effectively improve the clinical symptoms and reduce the related inflammatory markers.
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Objective@#To investigate the aeroallergen spectrum in allergic rhinitis in Xinjiang area and analyze its relating factors.@*Methods@#Skin prick test was carried out in 480 cases with allergic rhinitis using 20 inhaled allergens. The major change in recent years with allergic rhinitis and allergen distribution was compared.SPSS 17.0 software was used to analyze the data.@*Results@#Among 480 cases, 406 showed positive reaction. The most common allergens found in patients were chenopodium (61.6%) and mugwort (44.1%), followed by willow(37.7%), maple(37.7%), poplar(30.3%), house dust mite(30.3%), plantain(29.8%), acacia(25.9%), dust mite maple(25.4%), and so on. The rate of positive reaction to only one allergen was 9.6%, of which 21 were mite allergens. The positiverate to allergensin male and female were 84.2% and 85.1%, the distribution of allergens in both sexes did not differ(χ2=0.001, P=0.978). The positiverate to allergens in patients aged 21 to 35 years old was 88.6%, in patients aged 36 to 54 years old was 78.4%, the difference was statistically significant(χ2=0.258, P<0.01). The positive rate to allergens in Kazakhs was slightly higher than that in other ethnic groups (91.7%). The positive rates to allergens in the Han, Uygur and other ethnic groups were 84.8%, 86.4% and 63.3% respectively, the difference was statistically significant(χ2=9.779, P=0.044). Seventy-five point four percent of all allergen-positive patients(306 cases) combined with asthma.@*Conclusions@#The major allergen with allergic rhinitis is chenopodium. Among them, Kazakh allergic positive rate is higher than other ethnic groups.
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Objective@#To evaluate the daily airborne pollen concentrations and visiting rate of patients with allergic rhinitis (AR) and their correlation during 2012-2014 in Beijing.@*Methods@#Daily airborne pollen concentrations (55 998 numbers in total and 549 numbers in average) and its constitution from April to September each year (2012 to 2014) were compared. The number of patients with AR (44 203 in total) who visited the outpatient department of Otorhinolaryngology Head and Neck Surgery, Peking University Third Hospital between January 2012 and December 2014 was analyzed by month. Using SPSS 22.0 software, Kruskal-Wallis test was done for the comparison of visiting rate of patients with AR and airborne pollen concentrations. Correlation analysis between them was made as well.@*Results@#χ2 value of airborne pollen concentrations between different months in 2012 to 2014 was 110.7, 108.4 and 121.4, respectively; all P<0.01. The airborne pollen concentrations had two peaks per year, respectively: April to May, August to September. χ2 value of visiting rate of patients with AR between different months in 2012 to 2014 was 175.0, 185.1 and 134.5, respectively; all P<0.01. Visiting rate of patients with AR showed two scattering peaks each year, respectively: April to May, August to September. The highest pollen concentration of spring (April to May) was in early and middle April. Tree pollen was the major portion in spring, which were poplar pollen, pine tree pollen, ash tree pollen, cypress tree pollen and birch trees pollen. The highest pollen concentration of autumn (August to September) was in late August and early September. Weed pollen was the major portion in summer and autumn, which were artemisia pollen, chenopodiaceae pollen and humulus japonicas pollen. The visiting rate of patients with AR showed significant correlation with airborne pollen concentrations (r value was 0.537, 0.484 and 0.566, respectively; all P<0.01).@*Conclusion@#The visiting rate of patients with AR showed positive correlation with airborne pollen concentrations in recent three years.
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OBJECTIVE To investigate the effect of the treatment of allergic rhinitis on the quality of life of patients with bronchial asthma.METHODS Fifty-three patients with moderate-severe allergic rhinitis and mildmoderate asthma were included in this study and all of them had not yet received treatment for allergic rhinitis.There were 20 males and 33 females with an age ranged from 18 to 76 years.They had been treated with Salmeterol/Fluticasone propionate(seretide) 50/100 μg twice a day and combined with Ventolin if needed.On this basis,they were treated with loratadinel0 mg and Fluticasone proplonate nasal spray 200 micrograms once daily for 12 weeks.The visual analog scale,the asthma control test and Juniper's asthma quality of life questionnaire were recorded before and after treatment.RESULTS After treatment of allergic rhinitis,the rate of full asthma control was 28％,the rate of partial asthma control was 63％,and the rate of uncontrolled asthma was 9％.There was a significant improvement in asthma control after treatment of allergic rhinitis(P＜0.05).The scores after treatment were higher than that before treatment in all dimensions of asthma quality of life questionnaire(P＜0.01).CONCLUSION Allergic rhinitis and bronchial asthma are two closely related diseases,treatment of allergic rhinitis is benefit to bronchial asthma control and can improve the quality of life of the patients.
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OBJECTIVE To explore the differences in quality of life between the patients withseasonal and perennialmoderatesevere persistent allergic rhinitis.METHODS The patients with moderatesevere persistent allergic rhinitis were divided into two groups,seasonal group and perennial group.The distribution of allergens and the quality of life scores of the patients in the two groups were compared.The relationship between the quality of life and the number of allergens in all of the patients were analyzed.The number of allergens in two groups was compared.RESULTS The quality of life scores in seasonal group is higher than that of the perennial group with statistical significance.The patients' quality of life scores was significantly associated with the number of allergens.The seasonal group had a bigger proportion of patients with a variety of allergens.CONCLUSION There was a difference in the quality of life in patients with seasonal and perennial moderatesevere persistent allergic rhinitis.This may be related to the type of allergens,the quantity of allergens,and the patient's tolerance.
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BACKGROUND: On 21st November 2016, Melbourne experienced an epidemic of ‘thunderstorm asthma.’ Although previously described in the literature, risk factors and natural history remain incompletely understood. OBJECTIVE: Our aim was to follow up those presenting to the 3 Emergency Departments (EDs) in our health service during the epidemic, and assess their history for previous asthma, rhinitis, and allergies. METHODS: ED notes of all respiratory presentations within 48 hours of the thunderstorm event were reviewed and patients with acute asthma included. A standardised questionnaire was devised encompassing asthma diagnosis, undiagnosed asthma symptoms and rhinitis severity. Patients were contacted by phone within 30 days of the event. RESULTS: Three hundred forty-four patients were identified overall; 263 patients were contactable and completed a phone or mail questionnaire. The mean age was 32.7 ± 19.2 years (range, 6 months–87 years; 25% < 18 years) with 58% male sex. A previous diagnosis of asthma was present in 42% (n = 111), and there was no previous asthma diagnosis in 58% (n = 152). Of those who had no asthma diagnosis 53% had probable undiagnosed asthma. Overall, rhinitis prevalence was 88%, of which 72% were moderate or severe (Allergic Rhinitis and its Impact on Asthma guidelines) and 51% (n = 133) reported a history of grass pollen allergy. CONCLUSION: Our data highlights the importance of atopy and rhinitis as risk factors for epidemic thunderstorm asthma. Better identification of undiagnosed asthma, and implementing treatment of asthma and rhinitis may be important.
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Humans , Male , Asthma , Diagnosis , Emergency Service, Hospital , Follow-Up Studies , Health Services , Hypersensitivity , Natural History , Poaceae , Postal Service , Prevalence , Rhinitis , Rhinitis, Allergic, Seasonal , Risk FactorsABSTRACT
OBJECTIVE To investigate the expression of SerpinB2 and SerpinB4 genes in cells from the nasal brushings in allergic rhinitis(AR) patients, and their relationships with eosinophil numbers in nasal brushings, serum total IgE level and severity of AR. METHODS Twenty nine control subjects and 59 AR patients[29 specific IgE positive AR(sIgE-P-AR) patients, 30 specific IgE negative self reported AR(sIgE-N-SR-AR) patients] were recruited. The samples of nasal brushings and peripheral blood were collected to detect SerpinB2 and SerpinB4 gene expression and eosinophil numbers in nasal brushings, and total IgE and allergen-specific IgE level in peripheral blood. RESULTS Expression of SerpinB2 and SerpinB4 genes in cells from nasal brushings were significantly higher in sIgE-P-AR [5.17(2.33-18.96), 0.6(0.355-1.08), respectively] and sIgE-N-SR-AR [3.27(1.59-13.4), 0.75(0.42-1.64), respectively] than that in control subjects[1.21(0.1-3.285), 0.29(0.165-0.505)] (sIgE-P-AR:P=0.013; sIgE-N-SR-AR:P=0.002). Expression level of SerpinB2 and SerpinB4 had no relationships with eosinophil numbers in nasal brushings and serum total IgE level. Expression of SerpinB2 in moderate/severe AR[4.74(2.68-47.5)] was significantly higher than that in mild AR[(1.333-5.603)](P=0.025); while expression of SerpinB4 in mild AR[3.95(2.6-7.59)] was significantly higher than that in moderate/ severe AR[2.83(0.715-5)](P=0.042). CONCLUSION SerpinB2 and SerpinB4 genes might be involved in the pathogenesis of AR, and their diagnostic values in AR deserve to be evaluated with larger samples.
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OBJECTIVE To set up an intranasal ovalbumin-induced animal model of allergic rhinitis(AR) accompanied with olfactory dysfunction in mice. By observing the olfactory pathway in mice using manganese-enhanced magnetic resonance imaging (MEMRI) and the relatively morphologic structural and immunological changes in olfactory epithelium, the influence of AR on olfactory receptor neurons(ORNs) was studied.METHODS Forty SD mice were randomly divided into two groups, the research group(n=30) and the control group(n=10). The research group was intraperitoneally injected and intranasal application of ovalbumin to establish an AR mice model. The olfactory function of the mice was evaluated by buried food test(BFT). ELISA was performed to measure the level of IgE in serum. MEMRI images were acquired with a 7.0 T micro-MR scanner. HE staining and immunohistochemistry were used to observe the tissues morphology change of olfactory mucosa and OMP expression.RESULTS The olfactory function evaluation of the AR mice model indicated that the incidence of olfactory dysfunction in AR mice was 40.0%. The AR mice with olfactory dysfunction had no signal enhancement in MEMRI. The olfactory epithelium became thinner, layer numbers of ORNs were decreased with disorder arrangement and the OMP expression was decreased in AR mice with olfactory dysfunction compared with that in AR mice without olfactory dysfunction(P=0.018) and the control group(P=0.0141).CONCLUSION An animal model of AR accompanied with olfactory dysfunction in mice was successfully established. The influence of AR on ORNs and thus cause the change of the olfactory pathway is one of the major pathogenesis of olfactory dysfunction in AR.
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OBJECTIVE To evaluate the difference of efficacy of sublingual immunotherapy on different age patients with allergic rhinitis. METHODS 229 patients with dermatophagoides farina drops allergic rhinitis who have finished SLIT at least 2 years were enrolled and analyzed by retrospective analysis. All patients were divided into different age groups: pre-adolescence(n=107), adolescence(n=53), adulthood(n=69). Indexes for therapeutic effects of SLIT visual analogue scale(VAS) score, rhinitis symptom scores, medication scoreintra- and inter groups were assessed during different stage of treatment(3 months, 1 year and 2 years). Data were analyzed with SPSS 19.0 software. RESULTS Compared with prior treatment, after the SLIT for 3 months, 1 year, 2 years, VAS scores, rhinitis symptom scores, medication scoresof all the patients with allergic rhinitis are significantly decreased; Differences of rhinitis symptom scores(H=0.844, 4.153, 2.669, P>0.05), VAS score(H=1.356, 3.720, 0.313, P >0.05), medication scores(H=1.044, 5.841, 3.399, P>0.05) between groups had no statistical significance at different stage after treatment(3 months, 1 year and 2 years); The differences between 2 years and 1 year of SLIT treatment showed statistical significance in the VAS scores(Z=1.635, P =1.635). CONCLUSION SLIT with dust mites drops had good curative effect and security in patients with allergic rhinitis, which hadno obvious difference between different age groups.
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OBJECTIVE To investigate the short-term clinical efficacy of sublingual immunotherapy in children with allergic rhinitis. METHODS Forty-four patients, from 3-14 years of age, with mite-sensitive allergic rhinitis were treated sublingually with standardized dermatophagoidesfarinae extract. After treatment of 3 or 6 months using the dermatophagoidesfarinae extract, the total nasal symptoms score(including nasal congestion, nasal itching, rhinorrhea and sneezing scores), total rhinitis medicine scores, visual analog scale scores and the percentage of blood eosinophilic granulocyte(Eos%) before and after treatment were evaluated. SPSS 20.0 software was used to analyze the data. RESULTS After 3 or 6 months' treatment,thenasal symptoms score(including nasal congestion, nasal itching, rhinorrhea and sneezing scores), total rhinitis medicine scores and visual analog scale scoreshad significantly reduced,comparing with that before treatment(all P0.05), while nasal itching scores had significantly reduced(Z=-4.185, P<0.05). After 6 months' treatment, the percentage of Eos% had significantly reduced compared with that before treatment(Z=-4.544, P<0.05). CONCLUSION SLIT could be an effective treatment in patients with allergic rhinitis sensitive to house dust mite. It would have effect after3 months treatment and Eos%reduced significantly after 6 months treatment.