Decreased numbers of metachromatic cells in nasal swabs in Japanese cedar pollinosis following sublingual immunotherapy.

BACKGROUND AND OBJECTIVE: Nasal symptoms were reduced following allergen-specific sublingual immunotherapy (SLIT) for allergic rhinitis. The mechanisms underlying the effectiveness of SLIT for Japanese cedar pollinosis are poorly understood. We studied changes in the numbers of metachromatic cells, eosinophils, and neutrophils following SLIT for Japanese cedar pollinosis. METHODS: Nasal swabs were taken in the preseason (n = 32) and in pollinosis season (n = 49) from subjects given sublingual drop immunotherapy for an average duration of 1.5 years. The numbers of metachromatic cells (mast cells and basophils), eosinophils and neutrophils were determined and compared with those from untreated subjects in preseason (n = 65) and in season (n = 54). RESULTS: SLIT subjects had a significantly reduced frequency of moderate to most severe symptoms in comparison to untreated subjects in preseason (P < .001, the Mann-Whitney U test), and (P < .00001) in season. Metachromatic cell counts in nasal swabs of SLIT subjects in preseason and in season were lower than those of untreated subjects (P = .014, the Mann-Whitney U test) and (P = .00001) respectively. Eosinophil numbers in SLIT subjects were not significantly different than in untreated subjects in both preseason (P = .29) and in season (P = .09). However, when SLIT subjects in season were divided into those with greater than or equal to 1.5 years, or <1.5 years of SLIT duration, the degree of eosinophilia in those with SLIT greater than or equal to 1.5 years was significantly lower (P = .011) than in untreated patients, but not in those with SLIT less than 1.5 years (P = .9). There were no significant differences in neutrophil numbers in nasal swabs between untreated and SLIT subjects in preseason and in season. CONCLUSION: One of mechanisms underlying the effectiveness of sublingual drop immunotherapy for Japanese cedar pollinosis is a reduction of the number of metachromatic cells in preseason and in season. Eosinophilia was also reduced in season in those given SLIT for greater than or equal to 1.5 years.

Allergen-specific subcutaneous immunotherapy for Japanese cedar pollinosis decreases the number of metachromatic cells and eosinophils in nasal swabs during the preseason and in season.

BACKGROUND AND OBJECTIVE: Nasal symptoms of allergic rhinitis can be reduced with allergen-specific subcutaneous immunotherapy (SCIT). However, the mechanisms underlying the effectiveness of SCIT for Japanese cedar pollinosis are not well understood. We studied changes in the numbers of metachromatic cells, eosinophils and neutrophils in nasal swabs following SCIT for Japanese cedar pollinosis. METHODS: Subjects were either untreated or given SCIT for 0.5 to 13 years duration. For the 2019 seasons, nasal swabs were taken in the pollinosis preseason (immunotherapy n = 36; untreated control, n = 62) and in the pollinosis season (immunotherapy n = 45; untreated control n = 46) and the numbers of mast cells, eosinophils and neutrophils assessed by microscopy. RESULTS: There were significant improvements in symptom severities following SCIT in comparison to untreated subjects (P < .0003, the Mann-Whitney U test) in preseason, and (P < .00001) in season. Metachromatic cell counts from nasal swabs of SCIT subjects in preseason and in the season were lower than those of untreated subjects (P = .0029 and P = .031, respectively). Eosinophil numbers in nasal swabs of subjects given SCIT were lower than in untreated subjects (P = .0031) in season, but not in preseason. There were no significant differences in degrees of neutrophilia between untreated and SCIT subjects in preseason and in season. CONCLUSION: One mechanism underlying the effectiveness of SCIT for Japanese cedar pollinosis involves a reduction in the number of metachromatic cells in nasal swabs in the preseason and an inhibition of increases in the number of metachromatic cells and eosinophils in season.

Increased mast cells in endocervical smears of women with dysmenorrhea.

BACKGROUND: Mast cells are observed in peritoneal endometriosis which causes dysmenorrhea. However, there is no report about the relationship between endocervical mast cells and dysmenorrhea. The aim of this study is to evaluate the relationship using endocervical smears. MATERIALS AND METHODS: Between January 2016 and June 2016, patients filled out a questionnaire regarding dysmenorrhea and were classified into the dysmenorrhea or the control group (without dysmenorrhea). Patients underwent endocervical brushing and endocervical smears were obtained. The smears were stained with methylene blue to detect mast cells. The number of mast cells per slide was counted by microscopy and recorded. RESULTS: Eighty-nine patients were enrolled in this study (dysmenorrhea group, 34; control group, 55). The median number of mast cells present in the endocervical one slides was 35 (interquartile range, 17-58) and 2 (interquartile range, 0-6) in the dysmenorrhea and control groups, respectively. There was a significant difference in the number of mast cells between the two groups (P < 0.0001). CONCLUSION: More mast cells were observed in the endocervical smears of women with dysmenorrhea than in those of women without dysmenorrhea.

Assessing the onset of allergic rhinitis by nasal cytology and immunoglobulin E antibody levels in children.

BACKGROUND: It is difficult to identify the onset of allergic rhinitis in infants because making a conclusive diagnosis can be challenging. OBJECTIVE: We used a combination of cell differentials in nasal swabs and immunoglobulin E (sIgE) antibody values to food and inhalant allergens to make the diagnosis and identify relevant allergens for investigation of the onset of allergic rhinitis. METHODS: We studied 302 children, 2 to 120 months old, who visited our clinic for rhinorrhea. Nasal swabs were taken from all children, and neutrophils (N), eosinophils (Eo), and mast cells (Mc) were identified by nasal cytology and their numbers were estimated. Levels of sIgE antibodies to various food and inhalant allergens were determined in patients with nasal Eo and Mc. RESULTS: Percentages of participants with Eo-Mc and Eo-Mc-N at 2-14 (n = 84), 15-24 (n = 57), 25-60 (n = 73), and 61-120 months of age (n = 88) were 20, 23, 58, and 65%, respectively. There were no significant differences between the 2-14 and 15-24, and 25-60 and 61-120 months age groups, but there was a significant difference between the 15-24 and 25-60 months age groups (p = 0.00013). The percentages of participants with sIgE antibodies to food and inhalant allergens as solitary or main allergen were 12%/0% at 2-14 months old, 10.5%/7% at 15-24 months old, 1.3%/42.4% at 25-60 months old, and 0%/56.8% at 61-120 months old, respectively with a significant difference between 15-24 and 25-60 months old groups (p = 0.00025) for inhalant allergens. CONCLUSION: Allergic rhinitis associated with inhalant allergens in infants <15 months of age is rare, but it is tempting to postulate that symptoms of rhinitis in these infants may be associated with sIgE antibodies to food allergens. Transition of sIgE responses from food to inhalant allergens occurred after 15 months of age, and sIgE antibodies to inhalant allergens were predominant after 25 months.

Are respiratory viruses involved in preseasonal symptoms or severity in Japanese cedar pollinosis?

BACKGROUND: Respiratory virus infections are involved in asthma exacerbations. However, there are no reports of the relationship between respiratory virus infections and Japanese cedar pollinosis. OBJECTIVE: We studied the relationship between respiratory viral infection and the appearance of preseasonal symptoms and the severity of seasonal symptoms in Japanese cedar pollinosis. METHODS: In 36 patients with asthma and with no symptoms (PreAsyP) and 54 patients with asthma and with symptoms (PreSyP) before the cedar pollen shedding commenced (preseason), and 37 patients with mild-to-moderate severity (InMild/Mod) and 45 patients with severe to extreme severity (InSev/Ext) after cedar shedding commenced (in season), the occurrence of respiratory viruses and nasal smear cytology were examined. RESULTS: In total, seven infections with respiratory viruses were detected among the subjects. Human rhinovirus (HRV) C infection was detected in one subject in each of the PreAsyP and PreSyP groups, and one HRVA infection occurred in the InMild/Mod group. In the InSev/Ext group, one HRVA, one HRVC, one respiratory syncytial virus, and one human metapneumovirus were detected. There was no significant difference in the rate of detection of viral infections between the PreAsyP and the PreSyP groups (p = 0.077), and between the InMild/Mod group and the InSev/Ext group (p = 0.24, Wilcoxon rank sum test). When cells types in nasal smears were identified and their abundance examined, the rate of neutrophilia in the subjects in the PreSyP group was 54%, which was statistically higher (p < 0.01) than the subjects in the PreAsyP group (25%). Interestingly, in the subjects in the InSev/Ext group, the proportion of eosinophils (40%) was larger (p < 0.05) than in the subjects in the InMild/Mod group (19%). CONCLUSION: These results provided no evidence that respiratory virus infections contributed to preseasonal symptoms and severity in season of Japanese cedar pollinosis. Nasal neutrophilia was related to preseasonal symptoms, whereas nasal eosinophilia was related to severity of symptoms during the pollen season.

[EFFECT OF PROPHYLACTIC TREATMENT BY LEUKOTORIENE RECEPTOR ANTAGONIST ON JAPANESE CEDAR POLLINOSIS OF PRE- AND POST-SCHOOL CHILDREN JAPANESE CEDAR POLLINOSIS].

UNLABELLED: Backgroud: It has already been reported that the prophylactic treatment by leukotoriene receptor antagonists is more effective on reducing symptoms of Japanese cedar pollinosis than the authentic treatment after the pollen dispersal. However, the treatment above has never evaluated in children cases around school age in ENT out-patient clinic. This study about the prophylactic treatment was planned to focus on the effect in the generation of pre- and post-elementary school entrance. METHODS: Children of pre- and post-elementary school entrance were enrolled for this study. This study was achieved in seasons of Japanese cedar pollinosis both in 2013 and 2014, and was designed as the comparison of clinical symptoms and quality of life in between two such groups as one group with the prophylactic treatment and another with the authentic treatment. RESULTS: Efficacy of prophylactic treatment by leukotoriene receptor antagonists was elucidated as follows; quality of sleep was significantly better both in 2013 and 2014, and more kinds of clinical symptoms or quality of life impairments were significantly more suppressed than in the group with the authentic treatment in 2014 when less pollen was dispersed. CONCLUSION: Even in the children of pre- and post-elementary school entrance, the prophylactic treatment by leukotoriene receptor antagonists is more effective on reducing symptoms of Japanese cedar pollinosis than the authentic treatment.

Involvement of Staphylococcus aureus and Moraxella catarrhalis in Japanese cedar pollinosis.

BACKGROUND AND OBJECTIVE: From mid February to the end of March, each year ∼30% of Japanese have Japanese cedar pollinosis. Moreover, 10-50% of patients with this pollinosis exhibit nasal manifestations in the preseason. These patients have a predominance of neutrophils but not eosinophils in nasal swabs and high carriage of Staphylococcus aureus. We hypothesized that S. aureus or other bacteria and associated neutrophilia were involved in preseasonal symptoms. METHODS: Cytology and bacterial colony growth were assessed in nasal swabs in the groups of asymptomatic patients in the preseason (PreAsP) (n = 53) and symptomatic patients in the preseason (PreSyP) (n = 60), and in group of symptomatic patients in season (InSyP) (n = 72). RESULTS: In the preseason, high neutrophilia was present in only 20% of the PreAsP group but in 47% of the PreSyP group (p < 0.01). Nasal carriage of S. aureus in the PreAsP and PreSyP groups were 79%, 75%, respectively, whereas, for Moraxella catarrhalis, these were 9% versus 25% (PreAsP versus PreSyP group; p < 0.05). In patients with positive results for S. aureus and M. catarrhalis, the degrees of neutrophilia (-, ±, +, 2+, 3+) in the PreSyP group were larger than in the PreAsP groups (p < 0.01). In the PreSyP group, the magnitude of neutrophilia was greater (p < 0.05) in subgroups with more colonies of S. aureus than in subgroups with fewer colonies. CONCLUSION: Nasal symptoms in the preseason are associated with neutrophilia and nasal colonization with S. aureus and M. catarrhalis. Patients with symptoms in the preseason had improved symptom scores when given prophylactic treatment early in season but had more-severe symptom scores late in season than asymptomatic patients in the preseason. Neutrophil-associated tissue damage related to bacterial colonization may underlie these associations.

[Analysis of bacterial culture and cytology in nasal smear of Japanese ceder pollinosis in pre-season and in season].

BACKGROUND: Previously, we reported that nasal symptom appeared in some patients of Japanese cedar pollinosis (JCP) before season. Over than 50% of them had neutrophils (no eosinophil) in their nasal smear (less than 10%; eosinophils), and Staphylococcus aureus or epidermis by culture were detected in more than 90% of them. We thought the attack caused from rhinitis by Staphylococcus. METHOD: For more details of these bacterium in JCP, we enforced bacterial culture in the nose and cytology in the nasal smear in asymptomatic (PreAs), symptomatic in pre-season (PreSy), and symptomatic in season (InSy) of JCP in 2011. RESULTS: Positive rates of Staphylococcus aureus were 79%, 75%, 53%, Staphylococcus epidermis; 15%, 10%, 16%, Moraxella catarrhalis; 9%, 25%, 19%, and Streptococcus Pneumonia; 7%, 12%, 16% in PreAs (n=53), PreSy (60), and InSy (70) respectively. Cytology showed that 45% of PreAs (n=53), 65% of PreSy (60) with statistical higher in latter group, and 8% of InSy (72) were only neutrophils in nasal smear. Six% of PreAs, 2% of PreSy, and 51% of InSy were eosinophils. Forty-three% of PreAs with statistical higher than 22% of PreSy and 7% of InSy were nasal cell free. CONCLUSION: These results mean the inflammation by Staphylococcus species or Moraxella catarrhalis might involve symptom appearance in pre-season.

[Analysis of cytology in nasal smear of Japanese ceder pollinosis before and in season].

BACKGROUND: In Japanese cedar pollinosis (JCP), some patients attacked nasal symptoms similar to pollinosis before season. Nobody knows the reason. We analyzed the nasal cytology from patients before and in season in 2010. METHODS: Cytology of nasal smear by taking with nasal swab and Hansel's staining was performed. Degree of infiltrating cells are graded, and five types are divided; neutrophil only (N), neutrophil predominant (N> Eo/Mc), Eo/Mc outnumber or equal neutrophil (Eo/Mc≥ N), either Eosinophil or mast cell (Eo/Mc), and no infiltrating cells Cell-). Bacterial culture was enforced symptomatic patients of JCP with neutrophil predominant before season. Chi-square test was used for statistic analysis between before and in season, and among symptomatic JCP (SyJP), combined JCP with HD or other allergy (SyCJP), and asymptomatic JCP and CJCP (AsJP/CJP). RESULTS: Before season, 58% of SyJP (n=83) was N with significantly higher (p< 0.005) compared to 21% of SyCJP (n=42) and 10% of AsJP/CJP (n=19). And before season, 45% of SyCJP was Eo/Mc with significantly higher (p< 0.005) than 9.6% of SyJP (n=83) and 10% of AsJP/CJP (n=19). In season (March), percentage of Eo/Mc in SyJP (n=42) and SyCJP (n=64) was of 58%, 56% respectively with statistically higher than before season in both groups. Fifty seven percentage of AsJP/CJP (n=19) was Cell- with much higher (p< 0.005) than SyJP and SyCJP (0∼7%) before and in season. Staphylococcus aureus in 25 and Staphylococcus epidermis in 12 patients were detected from 39 patients. CONCLUSION: These results mean Staphylococcus species might involve symptom appearance of SyJP before season.

Comparison of antigen-induced leukotriene and histamine release from nasal scrapings in allergic rhinitis.

BACKGROUND: In the early phase response of allergic rhinitis, the nasal mucosa produces important mediators including histamine and leukotrienes. OBJECTIVE: To investigate the relationship between antigen-induced leukotriene release and histamine secretion in nasal scrapings. METHODS: Using nasal mucosal scrapings from patients sensitized to only house dust mite, we studied the time course of antigen-induced leukotriene release and its relationship to histamine release. RESULTS: Cumulative peptydyl leukotriene (LT) production from nasal scrapings increased from 10 min to approximately 90 min following exposure to mite antigen. The rate of LT release was small (<5 pg/10 min) until 10 min following antigen exposure, increased to approximately 250 to 350 pg LT/10 min from 10 to 45 min post exposure, was reduced to <100 pg/10 min by 60 to 150 min, and by 180 min LT production was negligible. By contrast, histamine secretion began 30 sec after antigen exposure and was complete within approximately 10 min. Net antigen-induced LT secretion strongly correlated (R=0.72) with net antigen induced histamine secretion with a ratio of 1:8.7. In addition, net LT/ng histamine and total LT secretion correlated well with antigen-specific IgE in serum, and with the patients' symptoms. CONCLUSION: There is a close relationship between amounts of histamine and LT secretion from antigen challenged nasal mucosa, although the time course of LT release is delayed. In the early phase response, LT are likely to be generated from mucosal mast cells, and thus, mast cell activation will provide an important therapeutic target.

[Stem cell factor production from cultured nasal epithelial cells--effect on SCF production by drugs].

We studied whether epithelial cells cultured in serum-free medium contained other cells or not, there were differences in SCF production from cultured nasal epithelial cells between groups of nonallergic and allergic patients, and among degrees of serum mite-CAP RAST classes of allergic patients, and how drugs inhibited SCF production. As a result, no other contaminating cells except mast cell existed in cultured cells. There was a significant difference in SCF production of cultured cells between nonallergic and class 1-2, 3-4, 5-6, and between class 1-2 and 3-4, 5-6 of mite CAP-RAST class. Cyclosporin, prednisolone, fluticasone, ketotifen, and clemastine inhibited SCF production from cultured epithelial cells, but cromoglicate and suplatast did not. Inhibition means the reduction of SCF from cells, not the growth of cultured nasal epithelial cells.