ABSTRACT
BACKGROUND: Serum levels of IL-16, IL-33 and the decoy receptor of IL-33, soluble ST2, are elevated in allergic rhinitis. Recent studies show that IL-16, soluble ST2 or anti-IL-33 reduce type 2 cytokines (such as IL-5) and eosinophilia in murine models of allergic asthma or allergic rhinitis respectively. OBJECTIVE: In this study, we studied the release of IL-5, IL-16, IL-33 and soluble ST2 in allergic rhinitis patients after nasal allergen challenge and natural pollen exposure. METHODS: The nasal lavages of 15 allergic and 14 non-allergic volunteers were collected during the pollen allergy season. In addition, six allergic volunteers underwent unilateral nasal allergen and control challenge out of season and nasal secretions and sera were collected. IL-5, IL-16, IL-33 and soluble ST2 in nasal secretions and sera were measured by electrochemiluminescent assay or ELISA, respectively. RESULTS: Nasal IL-5, IL-16 and soluble ST2 levels were significantly increased in seasonally pollen exposed allergic volunteers compared to control subjects (P < 0.001, P = 0.018 and P = 0.002 respectively), whereas IL-33 remained undetectable. Nasal IL-16 showed a weak inverse correlation trend with nasal symptoms (r = -0.48, P = 0.07). Nasal soluble ST2 concentrations were inversely correlated with nasal symptoms (r = -0.61, P = 0.02) and positively correlated with IL-16 (r = 0.56, P = 0.03). Significant increases of nasal IL-5, IL-16 and ST2 but not IL-33 were observed after nasal allergen challenge. At 24 h after allergen challenge, local ST2 and IL-5 concentrations showed an inverse correlation trend (r = -0.83, P = 0.04). Serum levels of IL-5, IL-16 and soluble ST2 rose in at least five of six volunteers tested at 5 or 24 h post-challenge. CONCLUSIONS AND CLINICAL RELEVANCE: The observed upregulation of soluble ST2 and IL-16 after nasal allergen challenge and during peak pollination season suggests potential regulatory roles of these cytokines in the inflammatory reaction in allergic rhinitis.
Subject(s)
Interleukin-16/metabolism , Interleukins/metabolism , Nasal Lavage Fluid/chemistry , Receptors, Cell Surface/metabolism , Rhinitis, Allergic, Perennial/metabolism , Adult , Allergens/immunology , Female , Humans , Interleukin-1 Receptor-Like 1 Protein , Interleukin-16/blood , Interleukin-33 , Interleukin-5/blood , Male , Middle Aged , Nasal Lavage Fluid/immunology , Receptors, Cell Surface/blood , Rhinitis, Allergic , Rhinitis, Allergic, Perennial/immunology , Seasons , Severity of Illness Index , Young AdultABSTRACT
OBJECTIVE: This study investigates the education and training needs of health professionals and factors affecting participation in education and training. METHODS: A survey of health promotion professionals, health professionals, GPs and CEOs of community health centres, conducted across different settings and locations. Information was obtained on: involvement in health promotion activities, most useful content and format of past training, current preferences for education and training and barriers and incentives to education and training. RESULTS: Health promotion professionals were involved in the widest variety of health promotion activities, including more evaluation, research and planning than GPs and other health professionals who were involved in more client-focussed activities. Professionals' preference for training content reflected the type of activities in which they were most frequently involved. Practical courses, of short duration, delivered by experienced peers or health promotion experts were preferred over university and TAFE courses. Professionals in rural and provincial locations require both greater access to information on training and conveniently located training. More organisational support, funding and time release would encourage the training of professionals in government departments, community health centres and public hospitals. CONCLUSIONS: To be most effective, training must be tailored to suit the specific needs of different professionals involved in health promotion and take into consideration how factors, such as financial incentives and time release, influence participation across different settings and locations. IMPLICATIONS: Further development of the health promotion workforce will require recognition of its professional diversity and a more responsive and organised approach to education and training programs.
