Prevalence of asthma and allergic rhinitis among adult population in Ulaanbaatar, Mongolia.

BACKGROUND: Mongolia is changing lifestyle, unhealthy habits, increase of air pollution, increasing life expectancy have led to an up rise of chronic respiratory diseases. Over 10 years ago, the prevalence of asthma and allergic rhinoconjunctivitis in Mongolia were in the lower range reported from previous studies. OBJECTIVE: The main aim of the survey is to know the prevalence of asthma and allergic rhinitis among adult population of Ulaanbaatar city, Mongolia and their risk factors. METHODS: Total of approximately 1,200 adults aged 20 years and over were planned to be randomly selected. The questionnaire was developed on the basis of WHO Protocol for Assessment of Prevalence of Major Respiratory Diseases and modified by local risk factors assessment and by other international survey approach including Global Initiative for Asthma and European Community Respiratory Health Survey. RESULTS: Prevalence of current wheezer in all age group was 15.7% (95% CI: 14.7-16.8). Age and sex segregated distribution of current wheezer were defined among male and female and prevalence was 14.5% (95% CI: 13.3-16.2) in male and female 16.6% (95% CI: 15.2-18.3) respectively. Prevalence of diagnosed asthma among adults was 4.7% (95% CI: 4.3-5.6) in all age group, 3% (95% CI: 2.4-3.7) in male and 6.8% (95% CI: 5.8-7.9) in female. Prevalence of rhinoconjunctivitis was 14.6% in all age group. 28.4% out of subjects with allergic rhinitis has current asthma, while 11.6% of subjects without allergic rhinitis has asthma (p < 0.01). CONCLUSION: The prevalence of asthma increased for one decade in Ulaanbaatar. Prevalence of diagnosed asthma is approximately 5% and current wheezer is approximately 15% in adults of population, which is close to other Asia and European countries. Allergic rhinitis is a risk factor for asthma.

Microsatellite polymorphisms of the MICA gene among Japanese patients with Behçet's disease.

BACKGROUND: Behçet's disease (BD) is a multisystemic inflammatory disease of unknown origin. Because some researchers have recently suggested a primary association of BD with the A6 allele of the human major histocompatibility complex class I chain-related A (MICA) gene, we investigated microsatellite polymorphisms of the MICA gene in subjects with and without BD. METHODS: This was a case-control study of 23 Japanese patients with BD and 23 Japanese volunteers without BD who were compared for MICA microsatellite polymorphisms using the polymerase chain reaction (PCR). We also analysed associations between 5 MICA alleles and the clinical features of patients. RESULTS: There was no significant difference between case patients and control subjects in phenotype frequencies. The MICA-A6 allele showed the strongest positive correlation with the human leukocyte antigen allele HLA-B51. Allele A5 showed a strong positive correlation with age at onset and a strong negative correlation with iridocyclitis and HLA-B51. A4 showed a strong negative correlation with ocular lesions and HLA-B51. Patients with the MICA-A6 allele had significantly higher HLA positivity than patients without the allele. INTERPRETATION: While the MICA-A6 allele had no significant association with BD, it showed a strong association with HLA-B51. This finding suggests that an association between MICA-A6 and BD may be a secondary phenomenon related to HLA-B51. As several associations with MICA alleles and clinical features have been found, further investigation is expected to elucidate the biological mechanism of action of the MICA protein relative to disease onset.

Research report: Frequencies of mica gene polymorphism: a comparison between Indonesians on Bacan Island and suburban Japanese.

MHC class I chain related gene A (MICA) is located near the HLA-B gene on the short arm of human chromosome 6. In the transmembrane (TM) of region of MICA, there is a trinucleotide repeat (GCT/AGC) microsatellite polymorphism in exon 5. Five alleles with 4, 5, 6 and 9 repetitions or 5 repetitions with 1 additional nucleotide insertion (GGCT) are identified and they were named A4, A5, A5.1, A6, and A9 respectively. We report the allele frequencies of 127 Indonesians on Bacan Island and 250 Japanese in the Kanto area. From the genotyping result, the frequency among Indonesians was as follows: A4 15.4%, A5 26.0%, A5.1 16.5%, A6 5.5%, and A9 36.6%. The frequency among Japanese was as follows: A4 20.6%, A5 28.1%, A5.1 10.8%, A6 27.2%, and A9 13.2%. Allele 9 is significantly increased and allele 6 significantly decreased in Indonesians compared with Japanese subjects. The results suggested that MICA microsatellite polymorphism are quite different in each race. Among Indonesians, the frequency of MICA-A9 allele, which was reported to be negatively associated with Behçet's disease, was significantly higher, whereas the MICA-A6 allele frequency, which was reported to be positively associated with Behçet's disease, was significantly lower among Japanese.

[Analysis of SMON at 30 years after its outbreak ending: special reference to those patients with blindness].

We analysed the present state of those SMON patients with severely disturbed visual acuity. In medical screening of SMON Research Group at 1999, 52 out of 1,083 patients and 549 out of 1128 had their histories of complete blindness and complete loss of locomotion ability at the onset of SMON, respectively. Eighty one out of 1,149 patients showed severe visual impairment, including 22 with complete blindness. The number of patients with complete loss of locomotion and that of gait with cane/assistance were 59 and 443, respectively. Then, a large number of SMON patients have been still suffering from sequelae of clioquinol intoxication. Those patients groups with blindness and severe visual acuity yet showed after 30 years more severe disorders in locomotive activity, muscle strength and spasticity of lower extremities, degree of dysesthesia as well as vibratory sensory deficit, and ADL score. Those patients with complete or near complete blindness were profoundly handicapped so that the ratio of patients with a life-long institutionalization was high compared to the groups with less severe visual disturbance. Thus, it seems necessary to make a more extensive and meticulous supports for those SMON patients with blindness as they are in need of more finance and care providers.

[Allergic rhinitis epidemiology in Japan].

We epidemiologically surveyed allergic rhinitis nationwide, mailing questionnaires to 9,471 otorhinolaryngologists and their families nationwide in June 1998 responses by the end of September 1998: 42.8%, providing 17,301 subjects. Few differences were seen in the age composition between the subject population and the general Japanese population. Cedar pollinosis morbidity after adjustment for population distribution was 17.3%, higher overall on the Pacific Ocean side and in central districts of Japan compared to districts on the Sea of Japan and the Inland Sea and lower in high or low latitudes. By age, morbidity increased sharply among subjects in their teens and decreased among subjects in their 60s. Morbidity was high in districts of heavy cedar pollen dissemination. By housing, morbidity was high in the suburbs, followed by residential areas and cities. Pollinosis due to causes other than cedar pollen showed results similar to those for cedar pollinosis in morbidity by age and the relationship between the housing environment and morbidity, with morbidity after population distribution adjustment 11.7%. Morbidity of perennial allergic rhinitis after adjustment for population distribution was 19.8% was slightly higher than that of pollinosis. By age, morbidity increased sharply at 5 to 9 years of age, being highest in the young than in cedar pollinosis; no decrease in morbidity after age 60 was seen. Unlike cedar pollinosis, perennial allergic rhinitis showed no difference in morbidity by area or housing environment. The present survey using otorhinolaryngologists and their families nationwide as subjects enabled us to find areawise differences in morbidity for cedar pollinosis and perennial allergic rhinitis. Ours is useful epidemiologically in allergic rhinitis mainly for cedar pollinosis in Japan because it is superior to other questionnaires in response and because reply reliability is high.

A study among related pairs of Japanese patients with familial Behçet's disease: group comparisons by interval of disease onsets.

OBJECTIVE: To investigate the relationship between clinical features and the interval between onset of disease in pairs of related Japanese patients with Behçet's disease (BD). METHODS: Questionnaires were sent to hospitals in which patients with familial occurrence of BD had been treated according to previous nationwide hospital surveys, and to an additional 341 hospitals selected at random. RESULTS: A total of 35 patients (19 male, 16 female) in 17 families (19 related pairs) were reported. The positive rate of HLA-B51 was 60.9% (14/23). The familial pairs were divided into 2 groups, with the mean interval between disease onset between each pair being either < or = 9 years or > or = 10 years. Among the short interval group, the total number of clinical findings and difference in age of onset was significantly larger than the long interval group. The interval between onsets had a high positive correlation with concordance of clinical findings and a high negative correlation with the difference in onset age. Difference in onset age had a higher negative correlation with same sex. Moreover, age difference had a high negative correlation with HLA-B5 (B51). Analysis of data showed that the related pairs with the short interval between onsets had larger difference in onset age and greater concordance of symptoms than the long interval patients. CONCLUSION: Although our findings did not show any direct evidence of an environmental cause in the etiology of BD, we speculate that there may be a multifactorial etiology including genetic factors such as HLA-B51 positivity.