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Individualized treatment for allergic rhinitis based on key nasal clinical manifestations combined with histamine and leukotriene D4 levels / Tratamento individualizado para a rinite alérgica baseado nas principais manifestações clínicas nasais e dos níveis de histamina e leucotrieno D4
Shen, Congxiang; Chen, Fang; Wang, Huigang; Zhang, Xinyu; Li, Guanxue; Wen, Zhong.
  • Shen, Congxiang; Department of Otorhinolaryngology Head and Neck Surgery. Southern Medical University. Zhujiang Hospital. Guangzhou. CN
  • Chen, Fang; Department of Otorhinolaryngology Head and Neck Surgery. Southern Medical University. Zhujiang Hospital. Guangzhou. CN
  • Wang, Huigang; Department of Otorhinolaryngology Head and Neck Surgery. Southern Medical University. Zhujiang Hospital. Guangzhou. CN
  • Zhang, Xinyu; Department of Otorhinolaryngology Head and Neck Surgery. Southern Medical University. Zhujiang Hospital. Guangzhou. CN
  • Li, Guanxue; Department of Otorhinolaryngology Head and Neck Surgery. Southern Medical University. Zhujiang Hospital. Guangzhou. CN
  • Wen, Zhong; Department of Otorhinolaryngology Head and Neck Surgery. Southern Medical University. Zhujiang Hospital. Guangzhou. CN
Braz. j. otorhinolaryngol. (Impr.) ; 86(1): 63-73, Jan.-Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1089372
ABSTRACT
Abstract Introduction The types of allergic rhinitis are roughly classified based on the causative antigens, disease types, predilection time, and symptom severity. Objective To examine the clinical typing and individualized treatment approach for allergic rhinitis and to determine the optimal treatment method for this disease using various drug combination therapies. Methods A total of 108 participants with allergic rhinitis were divided into three groups based on symptoms. Subsequently, each group was further categorized into four subgroups based on the medications received. The efficacy of the treatments was evaluated using the visual analog scale VAS scores of the total and individual nasal symptoms, decline index of the symptom score, histamine and leukotriene levels, and mRNA and protein expression levels of histamine 1 and cysteinyl leukotriene 1 receptors. Results Loratadine + mometasone furoate and loratadine + mometasone furoate + montelukast significantly improved the sneezing symptom and reduced the histamine levels compared with the other combination therapies (p < 0.05). Meanwhile, montelukast + mometasone furoate and montelukast + mometasone furoate + loratadine considerably improved the nasal obstruction symptom and decreased the leukotriene D4 levels compared with the other combination therapies (p < 0.05). Conclusion Clinical symptom evaluation combined with experimental detection of histamine and leukotriene levels can be an objective and accurate method to clinically classify the allergic rhinitis types. Furthermore, individualized treatment based on allergic rhinitis classification can result in a good treatment efficacy.
RESUMO
Resumo Introdução A rinite alérgica é basicamente classificada de acordo com os antígenos causadores, tipos de doença, peridiocidade e gravidade dos sintomas. Objetivo Avaliar os tipos clínicos e a abordagem terapêutica individualizada para cada tipo de rinite alérgica e determinar o método de tratamento ideal utilizando várias terapias de combinação de fármacos. Método Um total de 108 participantes com rinite alérgica foram divididos em três grupos com base nos sintomas. Posteriormente, cada grupo foi subsequentemente categorizado em quatro subgrupos com base nos medicamentos recebidos. A eficácia dos tratamentos foi avaliada utilizando os escores da escala visual analógica EVA dos sintomas nasais totais e individualmente, índice de declínio do escore de sintomas, níveis de histamina e leucotrienos e níveis de expressão de mRNA e proteína dos receptores de histamina 1 e cisteinil-leucotrieno 1. Resultados As associações entre loratadina + furoato de mometasona, assim como a de loratadina + furoato de mometasona + montelucaste melhoraram significativamente o sintoma de espirros e reduziram os níveis de histamina em comparação às outras terapias combinadas (p < 0,05). Por outro lado, a associação montelucaste + furoato de mometasona, assim como a associação montelucaste + furoato de mometasone + loratadina melhoraram consideravelmente o sintoma de obstrução nasal e diminuíram os níveis de leucotrieno D4 em comparação com as outras combinações (p < 0,05). Conclusão A avaliação clínica dos sintomas combinada com a detecção experimental dos níveis de histamina e leucotrieno pode ser um método objetivo e preciso para classificar clinicamente os tipos de rinite alérgica. Além disso, o tratamento individualizado baseado na classificação da rinite alérgica pode resultar no aumento da eficácia do tratamento.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Histamine / Leukotriene D4 / Drug Therapy, Combination / Precision Medicine / Rhinitis, Allergic Type of study: Controlled clinical trial / Diagnostic study / Prognostic study Limits: Adolescent / Adult / Aged / Female / Humans / Male Language: English Journal: Braz. j. otorhinolaryngol. (Impr.) Journal subject: Otolaryngology Year: 2020 Type: Article Affiliation country: China Institution/Affiliation country: Department of Otorhinolaryngology Head and Neck Surgery/CN

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Full text: Available Index: LILACS (Americas) Main subject: Histamine / Leukotriene D4 / Drug Therapy, Combination / Precision Medicine / Rhinitis, Allergic Type of study: Controlled clinical trial / Diagnostic study / Prognostic study Limits: Adolescent / Adult / Aged / Female / Humans / Male Language: English Journal: Braz. j. otorhinolaryngol. (Impr.) Journal subject: Otolaryngology Year: 2020 Type: Article Affiliation country: China Institution/Affiliation country: Department of Otorhinolaryngology Head and Neck Surgery/CN