Changes in muscarinic cholinergic receptor expression in human peripheral blood lymphocytes in allergic rhinitis patients

BACKGROUND

Parasympathetic nerves provide the dominant autonomic innervation of the upper and lower airways. They release acetylcholine that, activating post-junctional muscarinic receptors, causes bronchoconstriction, mucous secretion and vasodilation. Dysfunction of the upper and lower airways frequently coexist, and they appear to share key elements of pathogenesis.

OBJECTIVE

The present study has assessed the expression and pattern of cholinergic muscarinic receptor subtypes in peripheral blood lymphocytes harvested from allergic rhinitis patients with different degree of bronchial hyperresponsiveness detected by methacholine challenge test.

METHODS

Radioligand binding assay for determining the density of muscarinic cholinergic receptor subtypes; immunoblot analysis for assessing the characteristic of muscarinic cholinergic receptor subtype protein and immunocytochemical techniques for investigating the cellular localization of receptors.

RESULTS

An increased expression of M2 and M5 receptor proteins was observed in peripheral blood lymphocytes of allergic rhinitis patients in comparison with healthy control individuals. M3 receptor subtype decreased in allergic rhinitis patients with normal or mild responses to methacholine. A trend versus a return to normal value was found in moderate and severe responders. No changes of the M4 receptor subtype were found.

CONCLUSIONS AND CLINICAL IMPLICATIONS

Increase in M2 receptor expression correlated with disease severity and bronchial hyperreactivity. Changes in muscarinic cholinergic receptor expression in allergic rhinitis underline a role of cholinergic system of immune cells in allergic airway disease.

CAPSULE SUMMARY

Studies addressed to rhinitis and asthma have identified many similarities. Our results indicate that changes in peripheral blood lymphocyte muscarinic receptor expression may reflect the cholinergic involvement into allergic airway diseases.

Nasal levels of nitric oxide as an outcome variable in allergic upper respiratory tract disease: Influence of atopy and hayfever on nNO

BACKGROUND

The role of nasal levels of nitric oxide (nNO) as noninvasive marker of inflammation and as an outcome variable in allergic upper respiratory tract disease has not been defined. Our aim is to determine in patients with perennial allergic rhinitis (i) whether nNO is elevated, (ii) whether increased nNO is correlated with upper respiratory tract symptoms (discrimination), and (iii) whether changes in symptom scores are associated with changes in nNO levels (responsiveness).

METHODS

Subjects (n = 38) with perennial rhinitis were studied weekly for 3 weeks. At each visit they completed a validated symptom questionnaire and had expired NO and nNO measured.

RESULTS

Nasal NO levels were higher in those allergic to house-dust mite and cat. Nasal NO levels in subjects with perennial rhinitis were not elevated compared with non-atopic asymptomatic subjects. The intra-week reproducibility of nNO measurements was poor. There was no relationship between the symptom scores and nasal NO levels (discrimination). When analysis was confined to nasal symptoms, a weak but negative correlation was identified. Changes in symptom scores from week to week were not correlated with changes in nNO levels (responsiveness).

CONCLUSIONS

Nasal NO levels were not elevated in subjects with perennial rhinitis, and nNO levels were neither discriminatory nor responsive. The measurement of nNO therefore appears not to be a useful marker of disease activity in subjects with allergic rhinitis.

Surfactant Protein D Expression in Chronic Rhinosinusitis Patients and Immune Responses In Vitro to Aspergillus and Alternaria in a Nasal Explant Model

OBJECTIVES/HYPOTHESIS

Common fungi have been implicated in the pathogenesis of chronic rhinosinusitis (CRS) with eosinophilic mucus (EMCRS). Surfactant protein (SP)-D plays an important role in the immune response to Aspergillus fumigatus in the lungs. We sought to determine whether SP-D is expressed in nasal mucosa and investigated the response of SP-D in vitro to fungal allergens.

STUDY DESIGN AND METHODS

1) Nasal biopsies from 59 CRS and EMCRS patients, stratified into allergic fungal sinusitis (AFS), nonallergic fungal eosinophilic sinusitis (NAFES), and nonallergic nonfungal eosinophilic sinusitis (NANFES) were studied by quantitative reverse-transcriptase polymerase chain reaction (qRT-PCR), immunostaining and enzyme-linked immunosorbent assay (ELISA). 2) Nasal tissue from three CRS and three NANFES patients was cultured with fungal allergens in a nasal explant in vitro model for 24 hours at increasing concentrations and mRNA SP-D secreted SP-D protein levels in response to the fungi determined by qRT-PCR and ELISA.

RESULTS

Staining for SP-D was detected in the submucosal glands from the nasal biopsies in all patient groups except for AFS. By ELISA, SP-D was undetectable in AFS and decreased in NAFES, NANFES, and CRS compared with controls. CRS patients in vitro cultured with Aspergillus and Alternaria allergens in a nasal tissue explant model induced up-regulation of SP-D by qRT-PCR. In contrast, NANFES nasal tissue explants cultured with Aspergillus allergens induced down-regulation of SP-D.

CONCLUSIONS

We report for the first time the expression of SP-D in both diseased and normal nasal mucosa. SP-D expression in CRS patients is up-regulated by fungal allergens in an in vitro model. These results may provide potential novel therapy for treatment of CRS.

Effects on nasal nitric oxide production of 2 mechanisms of vasoconstriction

BACKGROUND

Vasoconstrictor drugs reduce nitric oxide (NO) production in vitro by inhibiting the enzyme involved in the regulation of inducible and constitutive NO synthases (iNOS and cNOS). Intranasal vasoconstrictors also decrease nasal NO concentration in vivo. It is as yet unclear if this last finding is due to the effects of the drug on the enzyme or on the vessels. Physical exercise also induces nasal vasoconstriction and reduces nasal resistance.

OBJECTIVES

The aim of this study was to clarify the mechanisms involved in xylometazoline-induced reduction of nasal NO concentration.

METHODS

We compared 2 randomized groups of patients with moderate--severe persistent allergic rhinitis. The first group (n = 24) underwent a physiological nasal vasoconstrictor stimulus (exercise) whereas the second group (n = 29) was treated with a nasal vasoconstrictor drug (topical xylometazoline). Nasal volume and NO were determined at baseline and 15 to 20 minutes after the end of each stimulus using acoustic rhinometry and chemiluminescence, respectively.

RESULTS

Baseline values of nasal volume and NO did not differ between the 2 groups. Nasal volume increased by 57% (P = .0001) after exercise and 71% (P = .0001) after xylometazoline. Nasal NO decreased (25%, P = .001) after xylometazoline, but not after exercise.

CONCLUSION

Physical exercise and topical xylometazoline cause vasoconstriction and similar effects on nasal volume. In contrast nasal NO decreased with xylometazoline but not after exercise. These findings suggest that vasoconstrictor drugs reduce nasal NO by mechanisms other than vasoconstriction.

T lymphocytes expressing CCR3 are increased in allergic rhinitis compared with non-allergic controls and following allergen immunotherapy

BACKGROUND

In T cell-associated allergic inflammation, homing of T-helper 2 (Th2) effector cells to mucosal sites may be influenced by chemokine receptor expression. Previous studies have identified CCR3 and CCR4 as putative markers of Th2 cells and CCR5 and CXCR3 as markers of Th1 cells. The aim of this study was to assess differential chemokine receptor expression from symptomatic atopic grass pollen-sensitive subjects, compared with patients on high-dose allergen injection immunotherapy (IT) and healthy controls.

METHODS

We examined chemokine receptor expression (CCR1-7 and CXCR1-4) by flow cytometry of peripheral blood CD4+ and CD8+ T cells. We also depleted peripheral blood mononuclear cell (PBMC) populations of CCR3+ CD4+ cells by magnetic bead separation and cells were stimulated with grass pollen allergen for 6 days. Cytokine production was measured by enzyme-linked immunosorbent assay.

RESULTS

On freshly isolated PBMC, atopic individuals exhibited increased numbers of CCR3+ CD4+ cells compared with normal controls (P < 0.01). CCR3 expression in IT patients was reduced compared with matched atopic rhinitic controls (P < 0.05) and comparable with that observed in normal subjects. Depletion of CCR3+ CD4+ cells from allergen-stimulated PBMC cultures resulted in decreased interleukin (IL)-5 production compared with whole CD4+ populations (P < 0.05). Freshly isolated CCR3+ CD4+ cells have significantly higher intracellular IL-4 and lower IFN-gamma levels than CCR3- CD4+ cells. CD4+ T cells cultured from both peripheral cells and nasal biopsies demonstrated increased expression of CCR3 in the presence of IL-4 (P < 0.05).

CONCLUSION

CCR3+ CD4+ T cells are increased in allergic rhinitis, are reduced by allergen IT, have a Th2 phenotype and contribute to allergen-specific responses. Strategies against CCR3+ T cells may be effective in human allergic diseases.

P38 MAP-kinase pathway is involved in the production of CLC-3 in nasal epithelial cells with allergic rhinitis induced by interleukin-4

OBJECTIVE

The objective of this study was to evaluate the role of p38 MAP-kinase (MAPK) pathway on CLC-3 expression after interleukin-4 (IL-4) induction in primary cultured human nasal epithelial cells (HNECs) from patients with allergic rhinitis (AR).

METHODS

Cultured HNECs from five patients with AR were treated with IL-4 (20 ng/mL) with or without SB203580, a selective inhibitor of p38 MAPK, at different concentrations and durations. CLC-3 was detected in HNECs by immunohistochemistry and real-time quantitative reverse transcription-polymerase chain reaction. p38 MAPK and phosphorylated p38 MAPK (pp38 MAPK) was examined by Western blotting.

RESULTS

After exposure to SB203580, CLC-3 expression induced by IL-4 was downregulated in HNECs in a concentration and time-dependent manner. This downregulation was associated with a decrease in pp38 MAPK.

CONCLUSION

These results confirmed that IL-4 can induce CLC-3 production in HNECs with AR through a p38 MAPK-dependent pathway. Inhibitors of p38 MAPK may become an important strategy for the treatment of AR.

Up-regulation of peroxisome proliferator-activated receptor gamma in perennial allergic rhinitis

OBJECTIVES

To investigate the expression of peroxisome proliferator-activated receptor gamma (PPAR-gamma) messenger RNA and protein and to localize the PPAR-gamma protein in the nasal mucosa of patients with allergic rhinitis and control subjects.

DESIGN

Prospective study.

SETTING

Tertiary academic institution. Patients Twenty patients with perennial allergic rhinitis and 20 matched nonallergic patients.

INTERVENTIONS

Inferior turbinate mucosa samples were obtained from 20 patients with perennial allergic rhinitis and 20 matched nonallegic patients. Peroxisome proliferator-activated receptor gamma messenger RNA was extracted from the inferior turbinate mucosae, and then reverse transcription-polymerase chain reaction was performed. Western blot testing was used to analyze differences in PPAR-gamma protein expression levels between patients with allergic rhinitis and normal controls, and the PPAR-gamma protein was localized immunohistochemically.

RESULTS

The expression levels of PPAR-gamma messenger RNA and protein in the nasal mucosa was significantly increased in patients with perennial allergic rhinitis compared with controls. Peroxisome proliferator-activated receptor gamma protein was expressed in the epithelium, infiltrating inflammatory cells, and submucosal glands.

CONCLUSIONS

Peroxisome proliferator-activated receptor gamma is expressed in the human nasal mucosa and is up-regulated in perennial allergic rhinitis. These results suggest a possible contribution for PPAR-gamma in chronic inflammation of the nasal mucosa in perennial allergic rhinitis.

[MRNA expression of complement C3 and C4 in rat nasal mucosa with allergic rhinitis]

OBJECTIVE

To investigate the level of mRNA expression of complement C3 and C4 in rat nasal mucosa and to reveal the relationship with the pathogenesis of allergic rhinitis (AR) .

METHODS

Twenty healthy SD rats were randomly divided into AR group and control group, 10 rats for each group. Ten rats was sensitized and intranasally challenged by ovalbumin and Al (OH)3 (as supplement) as allergic rhinitis models, and the control group was treated by saline. RT-PCR was performed to investigate the level of mRNA expression of complement C3 and C4 in nasal mucosa of both groups.

RESULTS

C3 and C4 mRNA were detected in both groups. The relative intensity of gene expression was measured. The relative intensity of C3 mRNA expression was 6183+/-1376 in AR group, 4444+/-989 in control group, C4 mRNA was 4398 +/-948 in AR group, and 2771+/-407 in control group. Expression of C3 and C4 in AR group was higher than that of the controls ( P < 0. 05) .

CONCLUSION

The high level of C3 and C4 mRNA expression in nasal mucosa of rats with allergic rhinitis suggests that C3 and C4 are involved in the immunopathology of allergic rhinitis. The result implies that complement system involved in the rat's allergic rhinitis is possibly activated through the classical pathway.

[The effect of TNF-alpha & IL-8 in the pathogenesis of allergic rhinitis]

OBJECTIVE

To survey the effects of TNF-alpha and IL-8 in the pathogenesis of allergic rhinitis.

METHOD

The serum levels of TNF-alpha and IL-8 in 102 cases of seasonal or non-seasonal allergic rhinitis were detected pre and post specific immunotherapy (SIT), and the results were statistically analyzed.

RESULT

The levels of TNF-alpha and IL-8 in experiment group were significant higher than that in the health control. And the levels of TNF-alpha and IL-8 significantly decreased post SIT in the experiment group.

CONCLUSION

TNF-alpha and IL-8 play important roles in the pathogenesis of allergic rhinitis.

Presence and characterization of prostaglandin D2-related molecules in nasal mucosa of patients with allergic rhinitis

BACKGROUND

Prostaglandin D2 (PGD2) is the major prostanoid produced in the acute phase of allergic reactions. However, its pathophysiological role in addition to the pathway of production in allergic rhinitis remains unclear. We sought to determine the expression of synthases and receptors for PGD2 in human nasal mucosa. These expressions were compared between allergic and nonallergic patients.

METHODS

The expression and localization of hematopoietic-type (h)-PGD2 synthase (PGDS) and lipocalin-type (l)-PGDS were detected by immunohistochemistry. The expression of D prostanoid (DP) receptor and chemoattractant receptor-homologous molecule expressed on Th2 cells (CRTH2) was determined by quantitative real-time PCR.

RESULTS

The h-PGDS but not l-PGDS was clearly expressed in nasal mucosa. The expression of h-PGDS in allergic patients was significantly higher than in control patients without mucosal hypertrophy. A variety of infiltrating cells including mast cells, eosinophils, macrophages, and lymphocytes as well as constitutive cells such as epithelial cells and fibroblasts expressed h-PGDS. The expression of both DP and CRTH2 was confirmed also. Although either the amount of DP or the amount of CRTH2 was not correlated with serum levels of IgE, the amount of CRTH2 but not DP was highly and significantly correlated with the number of eosinophils infiltrating into nasal musosa.

CONCLUSION

These results suggest that PGD2 is released via the action of h-PGDS from various cells, and the expression of h-PGDS may be associated with the hypertrophic inflammation in the nose. In addition, ligation of PGD2 to CRTH2 appears to be selectively involved in eosinophil recruitment into the nose regardless of atopic status.

Differential expression of surfactant protein A in the nasal mucosa of patients with allergy symptoms

OBJECTIVE

To characterize surfactant protein A (SP-A) expression in human nasal tissue and correlate differential expression of SP-A with symptoms suggestive of allergic rhinitis.

DESIGN

Allergic rhinitis symptom data were prospectively collected in the form of the Rhinitis Symptom Utility Index, the Rhinoconjunctivitis Quality of Life Questionnaire, and a Visual Analog Scale. Immunohistochemical staining for SP-A was performed on resected nasal tissue. Quantitative polymerase chain reaction amplification of the SP-A gene referenced to beta-actin was performed on complementary DNA samples synthesized from total RNA isolates.

SETTING

Academic tertiary referral center, department of otolaryngology laboratories.

PATIENTS

Twenty-five consecutive patients undergoing nasal surgery.

MAIN OUTCOME MEASURES

Immunohistochemical staining of SP-A in human nasal mucosa and submucosa, polymerase chain reaction amplification of SP-A messenger RNA, and rhinitis symptom scores.

RESULTS

Immunostaining localized SP-A to the mucosa and submucosal glands in specimens. Quantitative polymerase chain reaction demonstrated correlation between SP-A messenger RNA concentration and the total Rhinitis Symptom Utility Index score (0.51, P = .009) as well as "sneezing over the previous week" (0.40, P = .049), "runny nose over the previous week" (0.55, P = .005), and "sneezing today" (0.47, P = .02).

CONCLUSIONS

To our knowledge, this is the first report of SP-A expression in human nasal tissue. Furthermore, the degree of expression correlated with severity of disease as measured by the Rhinitis Symptom Utility Index in patients with allergic rhinitis symptoms.

A correlative study of NF-kappaB activity and cytokines expression in human chronic nasal sinusitis

A growing body of literature suggests that cytokines play an important part in the pathogenesis of chronic nasal sinusitis. However, the mechanism by which the expression of cytokines in chronic nasal sinusitis is upregulated has not been well documented. The present study investigated the role of nuclear factor-kappa B (NF-kappaB) activation in upregulating the expression of interleukin-5, -6 and -8 (IL-5, IL-6 and IL-8). We titrated the levels of IL-5, IL-6 and IL-8 in nasal mucosa in 52 cases of chronic nasal sinusitis and 12 normal subjects using enzyme-linked immunosorbent assay. According to whether allergic rhinitis was associated or not, we subdivided the patients into the AR group (with allergic rhinitis) and the NAR group (without allergic rhinitis). Semi-quantitative reverse transcription-polymerase chain reaction and immunohistochemical staining were used to evaluate expression and activation of NF-kappaB P50 and P65 subunits in nasal mucosa. The correlation between activities of P50 and P65 and cytokines expression was analysed. Our results showed that IL-5, IL-6 and IL-8 in both the AR and NAR groups were strikingly elevated in comparison with the control group (all p < 0.01 for AR group; p < 0.05, 0.05, 0.01, respectively, for NAR group); and they were even higher in the AR group than those in the NAR group (p < 0.01, 0.05, 0.01, respectively). P50 and P65 mRNA levels in both AR and NAR groups were markedly greater than those in the control group (all p < 0.01); and the AR group had further higher levels as compared with the NAR group (both p < 0.05). Immunohistochemical study revealed that nucleus-positive rates of P50 and P65 in both AR and NAR groups were significantly higher than those of the control group (all p < 0.01), and they were much greater in the AR group in comparison with the NAR group (all p < 0.01). Pearson correlation analysis demonstrated that P50 and P65 nucleus-positive rates were closely correlated with IL-6 and IL-8 levels, but not IL-5, with a correlation coefficient of 0.49 for P50 and IL-6, 0.54 for P50 and IL-8, 0.61 for P65 and IL-6, and 0.66 for P65 and IL-8 (all p < 0.01). In conclusion, upregulated expression and activation of NF-kappaB P50 and P65 might be one of the mechanisms for induction of IL-6 and IL-8 expression in chronic nasal sinusitis. Association of allergic rhinitis with chronic nasal sinusitis further enhanced NF-kappaB activity, and subsequently lead to even stronger expression of IL-6 and IL-8. IL-5 expression appeared to be independent of NF-kappaB pathway in chronic nasal sinusitis.

Sublingual immunotherapy induces spirometric improvement associated with IL-10 production: Preliminary reports

BACKGROUND

Sublingual immunotherapy (SLIT) has been demonstrated to be able of inducing immunologic changes as evidenced by IL-10 production. Forced expiratory flow between 25% and 75% of the vital capacity (FEF(25-75)) may be considered a good marker of early bronchial involvement in patients with pure allergic rhinitis.

OBJECTIVE

The aim of this study was to evaluate the possible association of IL-10 production with FEF(25-75) values in patients with perennial allergic rhinitis (PAR) successfully treated with SLIT.

METHODS

19 patients with PAR were studied: 9 successfully assumed SLIT for 3 years, 10 were considered as control. In vitro IL-10 production was evaluated after SLIT. Spirometry and bronchodilation test were performed in all subjects at baseline and after 3 years.

RESULTS

After 3 years, FEF(25-75) values significantly (p=0.0131) increased in SLIT group (80.5+/-6.7), whereas they significantly (p=0.0021) decreased in non-treated patients (60.8+/-2.62). In addition, SLIT-induced increase of FEF(25-75) values is significantly associated with IL-10 production (p=0.0025).

CONCLUSIONS

This study provides the first evidence that SLIT is capable of improving early bronchial involvement in patients with pure allergic rhinitis and this functional effect may be associated with immunological changes, such as the induction of IL-10 production.

[The expression of transforming growth factor beta1, interleukin-6, 11 and 17 in nasal mucosa of allergic rhinitis patients]

OBJECTIVE

To explore the protein expression of transforming growth factor (TGF)-beta1, interleukin (IL)-6, 11, and 17 in the nasal mucosa of allergic rhinitis patients.

METHOD

The protein expression of TGF-beta1, IL-6, 11, and 17 in the inferior turbinate tissues from 19 allergic rhinitis patients and from 21 non-allergic patients underwent nasal septum operation was detected by enzyme-linked immunosorbent assay.

RESULT

(1) Compared with tissues from non-allergic patients, the expression of TGF-beta1 protein was significant increased in the tissues from allergic rhinitis patients (P < 0.01); (2) As to the protein expression of IL-6, 11 and 17, there was no significant difference between allergic rhinitis patients and non-allergic patients (P > 0.05); (3) The expression of TGF-beta1, IL-6, 11, and 17 was similar between the allergic rhinitis patients with and without asthma (P > 0.05).

CONCLUSION

TGF-beta1 , while not IL-6, 11 and 17, may play a role in the tissue remodeling processes in allergic rhinitis. This expression profile may contribute to the difference in the tissue remodeling between allergic rhinitis and asthma.

Suppressive effect of fluticasone propionate on MMP expression in the nasal mucosa of allergic rhinitis patients in vivo

The effects of intranasal corticosteroids on matrix metalloproteinases (MMPs) and their inhibitors (tissue inhibitors of metalloproteinases (TIMPs)) in the nasal mucosa of patients with allergic rhinitis (AR) are not known. Nasal mucosa biopsy specimens were obtained from AR patients, with or without the administration of fluticasone propionate (FP) nose drops, and from healthy volunteers as controls. The specimens were analyzed by immuno-histochemistry and ELISA for MMP-2, MMP-9, TIMP-1 and TIMP-2. The MMP-9 levels in nasal mucosa extracts in the AR patients were significantly higher than in the controls. A significant suppressive effect of FP on the MMP-9 levels was shown. The control subjects showed no MMP- or TIMP-positive cells, whereas such positive cells were clearly present in the AR patients. No MMP- or TIMP-positive cells were detected after topical application of FP. These results suggest that the suppressive effect of FP on MMP expression is, in part, responsible for its clinical efficacy in AR.

Nasal nitric oxide and nasal allergy

Measurements of nasal nitric oxide (nNO) are attractive because they are completely noninvasive and can easily be performed. The measurements may be useful in the early diagnosis of patients with chronic airway disorders such as Kartager's syndrome and cystic fibrosis. The possible use of nNO measurements in the diagnosis and treatment of allergic rhinitis still needs to be further evaluated because of the variable and also contradicting findings of nNO concentrations in this disease. In this review we will discuss the origin, production and measurement of nNO as well as the effect of allergic rhinitis, nasal allergen challenge and medication on nNO. Subsequently, we examine published data on allergic rhinitis and nNO, and summarize the effect of treatment of rhinitis on nNO. Finally, we discuss the potential future role for nNO in the diagnosis and management of allergic rhinitis.

[Study on the sense neuropeptides of nasal mucosa in the allergic rhinitis animal model]

OBJECTIVE

To explore the roles of the sense neuropeptides in allergic rhinitis by observing their changes in the nasal mucosa after cutting the nasal autonomic nervous.

METHOD

(1) Twelve rabbits were divided into two groups: group A (sensitized) and group B (control). Four rabbits were killed respectively in one and four weeks in group A after being sensitized . Two rabbits were killed respectively at the same time in group B. Their nasal mucosa were collected for detecting substance P (SP) and calcitonin gene-related peptide (CGRP) by immunohistochemistry. (2) Twenty-four rabbits were divided into two groups: group A (sphenopalatine nerve was cut), group B (sympathetic nerve was cut). Four rabbits were killed respectively in one, two, and four weeks in group A and B. Their nasal mucosa were collected for immunohistochemistry examination.

RESULT

(1) SP and CGRP were apparently higher in allergic rabbits than non-allergic ones. (2) SP and CGRP decreased apparently in one and two weeks in group A and appeared no difference in four weeks. There were no apparently difference in group B among four weeks.

CONCLUSION

SP and CGRP are correlative with the occurring and developing of all allergic rhinitis.

[The expression and DNA sequence of recombination activating gene-1 in nasal membrane of allergic rhinitis]

OBJECTIVE

To study the mechanism of recombination activating gene-1 in pathogenesis of allergic rhinitis and its relation to interleukin-4 (IL-4), interleukin-10 (IL-10) and immunoglobin E (IgE).

METHOD

Three groups of allergic rats models were established with ovalbumin (OVA) and intervened with Dexamethasone (DEX). The times of sneeze were recorded, the cutaneous reaction of rats to the passive cutaneous allergen access (PCA) were investigated and the expression and DNA sequence of recombination activating gene-1 were examined and tested with reverse transcription-polymerase chain reaction (RT-PCR) and DNA analysator. The serum levels of IL-4, IL-10 and IgE were examined and tested with enzyme linked immunosorbent assay (ELISA) method in comparison with the controls.

RESULT

RAG-1 mRNA expression was not found in normal nasal membrane. Both in AR group and DEX intervention group were seen different expressions; DNA sequence determination didn't find mutation of RG1 genes. The serum level of IL-4[(106.31 +/- 12.90) ng/L] and IgE[(38.67 +/- 4.13) ng/L] in AR group were significantly higher than those in normal control [(93.65 +/- 7.78) ng/L, (23.27 +/- 1.36) ng/L respectively] (P < 0.05), but the IL-10 level [(38.15 +/- 4.89) ng/L] in AR group was significantly lower than those in normal control [(48.74 +/- 3.49) ng/L] (P < 0.05). After DEX intervention, the serum level of IL-4[(92.67 +/- 16.40) ng/L] and IgE[(24.23 +/- 4.38) ng/L] significantly dropped as compared with AR group (P < 0.05) while IL-10[(46.18 +/- 5.01) ng/L] significantly rose (P < 0.05).

CONCLUSION

It proves that the high expression of recombination activating genes is closely related to the pathogenesis of allergic rhinitis, which leads to the secretion of IL-4 and inhibits that of IL-10 and whose sequence is conservative in the nasal mucosa of AR. As glucocorticoid does not affect the expression of RAG-1 genes, it suggests that RAG-1 may be an immunomodulator on a higher level in the pathogenesis of AR.

Effect of tetanus immunization on t-helper cytokine production in adults with and without allergic rhinitis

Epidemiological evidence links T-helper type 2 (Th2) cytokine responses to the pathogenesis of atopy/asthma. It is hypothesized that certain immunizations may induce/amplify Th2 cytokine responses. The objective of this study was to determine whether Th cytokine responses to immunization with tetanus toxoid differ in adults with and without allergic rhinitis (AR). Thirty subjects were enrolled (15 AR and 15 non-AR subjects as confirmed by history and allergy skin testing). Blood was collected before (day 0) and on days 3, 7, 14, and 28 after immunization with tetanus toxoid. Peripheral blood mononuclear cells (PMNCs) were purified and cultured with either PHA or tetanus toxoid for 2 or 6 days, respectively. Supernatants were harvested and assayed for IFN-gamma and IL-13 levels (pg/mL) by EIA. Results were normalized by log transformation and analyzed by stepwise regression. Baseline (day 0) cytokine values were similar in both groups. PHA and tetanus-induced IFN-gamma were increased (p < 0.05) in non-AR (3.2 +/- 0.3 and 1.4 +/- 0.3 on day 7, and 3.5 +/- 0.2 and 1.9 +/- 0.2 on day 14, respectively) compared with AR subjects (2.3 +/- 0.3 and 0.9 +/- 0.3 on day 7, and 2.7 +/- 0.3 and 1.2 +/- 0.3 on day 14, respectively). PHA-induced, but not tetanus-induced, IL-13 production was increased (p < 0.05) in non-AR compared with AR subjects on day 7 (p < 0.05). PHA-induced IL-13 production was 3.1 +/- 0.2 in non-AR and 2.6 +/- 0.3 in AR subjects on day 7. These results indicate differential Th cytokine responses in AR and non-AR subjects after immunization with tetanus toxoid. Future studies are warranted and may result in the identification of potential prevention/treatment strategies for atopy/asthma.

IL-15 prevents allergic rhinitis through reactivation of antigen-specific CD8+ cells

BACKGROUND

Allergic rhinitis is one of the most common allergic inflammatory diseases characterized by a predominant TH2 response with antigen-specific IgE synthesis. IL-15 plays important roles in activation and maintenance of memory CD8+T cells capable of producing IFN-gamma, which regulates TH2 responses.

OBJECTIVE

To investigate the roles of endogenous IL-15 in allergic inflammation, we examined allergic rhinitis in IL-15 knockout (KO) mice sensitized with ovalbumin followed by intranasal rechallenge with ovalbumin.

METHODS

IL-15KO mice were sensitized intraperitoneally with ovalbumin/complete Freund's adjuvant on day 0 and ovalbumin/IFA on day 7, and then were intranasally challenged with ovalbumin on days 21, 22, 23, 24, and 25. Nasal symptoms and histologic changes were examined. IgE production and TH2 responses were measured by ELISA. Purified CD8+T cells or recombinant IL-15 were administered into ovalbumin-sensitized mice.

RESULTS

The levels of IgE production and TH2 responses in IL-15KO mice were comparable to those in control mice after ovalbumin sensitization. However, sneezing, infiltration of eosinophils into the nasal mucosa, and TH2 cytokine production were aggravated in ovalbumin-sensitized IL-15KO mice after intranasal challenge with ovalbumin. Adoptive transfer of CD8+6 T cells from ovalbumin-sensitized mice suppressed the TH2 responses in mice but not in IL-15KO mice. Administration of IL-15 with ovalbumin significantly prevented the development of allergic rhinitis in ovalbumin-sensitized mice.

CONCLUSION

We demonstrate with IL-15KO mice that endogenous IL-15 plays an important role in suppression of allergic rhinitis at effector phase. Intranasal administration of IL-15 is useful as a therapeutic approach to control allergic rhinitis.

CLINICAL IMPLICATIONS

Intranasal administration of recombinant IL-15 might become new immunotherapy for allergic rhinitis.

[Expression of cell adhesion molecule and nitric oxide synthase in nasal mucosa in allergic rhinitis]

OBJECTIVE

To explore the role of cell adhesion molecules (CAMs) and nitric oxide synthase (NOS) in the pathological mechanism of allergic rhinitis.

METHOD

Three kinds of CAMs, which are intercellular adhesion molecule-1 (ICAM-1), vascular cellular adhesion molecule-1 (VCAM-1) and lymphocyte function antigen-1 (LFA-1), as well as three kinds of NOS, which are neuronal nitric oxide synthase (nNOS), inducible isoform of nitric oxide synthase (iNOS) and endothelial nitric oxide synthase (eNOS) were orthotopic detected by strept avidin-biotin complex (SABC) immunohistochemistry method in 40 cases of inferior nasal concha of allergic rhinitis.

RESULT

There are only small number of ICAM-1, VCAM-1 and LFA-1 positive cells in the normal concha mucosa epithelial but more positive cells in allergic rhinitis. The number of positive cell of ICAM-1, LFA-1, VCAM-1 in the concha mucosa was [(14.4+/-2.2), (17.2+/-3.3), (11.5+/-2.7) per scope (x400) +/-s] respectively; in the control group the number of positive cell of ICAM-1, LFA-1, VCAM-1 in the concha mucosa was (8.7+/-1.8), (10.3+/-2.1), (6.9+/-1.8) respectively. The statistic differences were significant (t = 11.57, 10.02, 8.07 respectively; P<0.01). A certain number of nNOS positive cells were found in the concha mucosa in allergic rhinitis patients, it was mainly expressed in mucosa epithelial and submucosa glandular; a large number of iNOS positive cells were found in the concha mucosa in allergic rhinitis patients, iNOS was mainly expressed in mucosa epithelial, submucosa glandular, endothelial and submucosa inflammatory cell; the number of eNOS positive cell was few. In the normal control, few positive cells of nNOS, iNOS or eNOS could be found. Between the allergic rhinitis patients and the normal control, the number of nNOS positive cell was [(9.4+/-1.7), (4.7+/-1.3) per scope (x400)] respectively, t = 12.62 (P<0.01); the number of iNOS positive cell was (27.5+/-3.2), (4.3+/-1.7) respectively, t = 36.03 (P<0.01) the number of eNOS positive cell was (6.5+/-2.1), (6.2+/-1.9) respectively, t = 0.62 (P>0.05).

CONCLUSION

These adhesion molecules might be involved in edema, exudation and infiltration of inflammatory cells of nasal mucosa in allergic rhinitis patients. The number of nNOS, iNOS positive cell in inferior concha mucosa in allergic rhinitis patients was significant higher than in normal control. It suggests that nNOS and iNOS might be involved in the pathogenesis of allergic rhinitis.

[Effect of immunostimulatory sequence on the expression of EOTAXIN of experimental allergic rhinitis]

OBJECTIVE

To investigate the effect of CpG DNA applied intraperitoneally on the expression of EOTAXIN of allergic rhinitis model.

METHOD

CpG DNA was injected intraperitoneally to rat at the same time of the basic intraperitoneal immunized. The symptoms, expression of eosinophil (EOS) in nasal cavity and expression of EOTAXIN in the nasal mucosa were measured.

RESULT

After the CpG DNA was applied, the symptom scores, eosinophil (EOS) in nasal cavity and expression of EOTAXIN were weaken.

CONCLUSION

There was great reverse effect of CpG DNA on the foundation of rat model of experimental allergic rhinitis, suppression of EOTAXIN may be one of the mechanisms.

Signals through CD40 play a critical role in the pathophysiology of Schistosoma mansoni egg antigen--induced allergic rhinitis in mice

BACKGROUND

Interaction between CD40 and CD40L is thought to regulate immune responses in several allergic diseases. However, little is known about its in vivo role in the pathophysiology of allergic rhinitis. We sought to determine whether the lack of signals through CD40 affects the pathophysiology of allergic rhinitis using a murine model.

METHODS

Wild type (WT) and CD40-deficient BALB/c (CD40-/-) mice were sensitized intranasally to Schistosoma mansoni egg antigen (SEA). After repeated sensitization, histamine responsiveness, serum antibody titer including immunoglobulin E (IgE), nasal eosinophilia, and cytokine production by nasal mononuclear cells were determined in each group.

RESULTS

Intranasal sensitization with SEA in WT mice elicited a strong Th2 response including SEA-specific IgE production, nasal eosinophilia, and interleukin (IL)-4, and IL-5 production by nasal mononuclear cells after antigen challenge. Production of SEA-specific IgE and IgG1 was abolished in SEA-sensitized CD40-/- mice. These mice showed impaired nasal eosinophilia and displayed markedly reduced histamine-induced nasal hyperresponsiveness as compared with WT mice. Furthermore, reduced production of IL-4 and IL-5 by nasal mononuclear cells was seen in CD40-/- mice.

CONCLUSION

These results show that signals through CD40 play a critical role in not only IgE production but also pathophysiology of allergic rhinitis such as nasal hyperresponsiveness and nasal eosinophilia.

[The expression and significance of eotaxin gene in nasal mucosa and CCR3 in bone marrow in model of allergic rhinitis]

OBJECTIVE

To study the expression and significance of Eotaxin gene in nasal mucosa and CCR3 in bone marrow in model of allergic rhinitis.

METHOD

Twenty SD rats were randomly divided into allergic rhinitis (AR) group and normal control group. Ovalbumin (OVA) sensitized and challenged rats were used as the model of allergic rhinitis. The leucocytes in the smears of bone marrow and peripheral blood were counted, and the expression of CCR3 in bone marrow was detected by immunohistochemistry. The pathologic samples of nasal mucosa were stained with HE. The expression of Eotaxin mRNA in nasal mucosa was detected by in situ hybridization (ISH), and the expression of Eotaxin in nasal mucosa was detected by immunohistochemistry.

RESULT

The ratio of eosinophils to white cells in bone marrow smears of AR group was significantly higher than that of normal control group (P < 0.01). The ratio of eosinophils to white cells in peripheral bloods mears of AR group was significantly higher than that of normal control group (P < 0.01). Eotaxin positive cell and the expression of Eotaxin mRNA in nasal mucosa of AR group were significantly higher than that of normal control group (P < 0.01). The expression of Eotaxin mRNA significantly positively correlated with the expression of Eotaxin (r = 0.804, P < 0.01). The number of Eotaxin positive cells in nasal mucosa was significantly positively correlated with the number of eosinophils in nasal mucosa of AR group (r = 0.795, P < 0.01). The ratio of CCR3 positive cells to white cells in bone marrow smears of AR group was significantly higher than that of normal control group (P < 0.01). The ratio of CCR3 positive cells to white cells was significantly positively correlated with the ratio of eosinophils to white cells in bone marrow smears of AR group (r = 0.736, P < 0.05).

CONCLUSION

The expression of Eotaxin and Eotaxin mRNA in nasal mucosa increased, and the expression of CCR3 in bone marrow increased in the model of allergic rhinitis. It supplies a cooperation between CCR3 and Eotaxin to allow rapid mobilization of a pool of bone marrow eosinophils followed by recruitment to the nasal mucosa.