[Regulation of the expression of interleukin-4 and interleukin-5 by the signal pathway of PKC-NF-kappaB in T lymphocyte of allergic rhinitis]

OBJECTIVE

To explore the role of nuclear factor-kappaB (NF-kappaB) in the signal pathway of protein kinase C (PKC) regulating the expression of interleukin-4 (IL-4) and interleukin-5 (IL-5) by T lymphocyte in allergic rhinitis.

METHOD

Twenty-four allergic rhinitis patients and 24 normal control persons participated in the study. T lymphocytes were isolated and purified from blood of each person and divided into 3 groups: cells of 1st group were control group(Normal control and AR control),cells of 2nd group were stimulated with phorbol 12-myristate 13-acetate (Normal PMA and AR PMA),cells of 3rd group were stimulated with PMA and pyrrolidine dithiocarbamate (Normal PMA/PDTC and AR PMA/PDTC). The expression of NF-kappaB were observed by immunocytochemical staining, IL-4 and IL-5 protein in supernatants were measured by ELISA.

RESULT

The percentage of cells of active NF-kappaB, IL-4 and IL-5 protein in supernatants of allergic rhinitis T lymphocyte stimulated with PMA were significantly higher than those of allergic rhinitis T lymphocyte stimulated without PMA ( P < 0.01) and with PMA and PDTC ( P < 0.01); than those of normal control T lymphocyte stimulated with PMA ( P < 0.01), with PMA and PDTC ( P < 0.01) and without PMA. The percentage of cells of active NF-kappaB, IL-4 and IL-5 protein in supernatants of allergic rhinitis T lymphocyte stimulated with PMA and PDTC were significantly lower than those of allergic rhinitis T lymphocyte stimulated with PMA (P < 0.01); but significantly higher than those of allergic rhinitis T lymphocyte stimulated without PMA and those of normal T lymphocyte stimulated. There were good positive correlation between the percentage of cells of active NF-kappaB and IL-4 and IL-5 protein in supernatants (r = 0.88,0.85, P < 0.01, respectively).

CONCLUSION

The active PKC of allergic rhinitis T lymphocyte increasing the expression of IL-4 and IL-5 may be mediated by activating NF-kappaB, the activation of PKC-NF-kappaB signal pathway of T lymphocyte NF-kappaB may play an important role in the pathogenesis of allergic rhinitis.

Upregulation of oncostatin m in allergic rhinitis

OBJECTIVES

Oncostatin M is a multifunctional cytokine belonging to the interleukin-6 family of cytokines. It has been implicated as an important modulator of lower airway remodeling in the setting of asthma. However, there have been few studies regarding a similar role for the upper airway epithelium in the setting of allergic rhinitis. This study was undertaken to investigate the expression of oncostatin M mRNA and protein in normal and allergic rhinitis nasal mucosa and to localize the expression of the oncostatin M protein in allergic rhinitis.

MATERIALS AND METHODS

Inferior turbinate mucosa samples from 20 patients with perennial allergic rhinitis and 20 matched normal control subjects were obtained. Oncostatin M mRNA was extracted from the inferior turbinate mucosae, then reverse transcriptase-polymerase chain reaction was performed and analyzed semiquantitatively. Differences in expression levels of oncostatin M protein between samples from allergic rhinitis patients and normal control subjects were analyzed through Western blot, and oncostatin M protein was localized immunohistochemically.

RESULTS

The expression levels of oncostatin M mRNA and protein were significantly upregulated in patients with allergic rhinitis mucosa. Oncostatin M protein was predominantly localized in the surface epithelium, infiltrating inflammatory cells, vascular endothelium, and submucosal glands and was more strongly expressed in the nasal mucosa of patients with allergic rhinitis than in normal control subjects.

CONCLUSIONS

Oncostatin M is expressed in the human nasal mucosa and is upregulated in the setting of allergic nasal inflammation. These results suggest a possible contribution of oncostatin M in the remodeling of the nasal mucosa in allergic rhinitis.

[The use of serum and nasal eosinophilic cationic protein in the evaluation of the effectiveness of immunotherapy in patients with allergic rhinitis]

OBJECTIVES

We investigated the use of eosinophilic cationic protein (ECP) as an indicator of clinical efficiency of specific immunotherapy (SIT) in patients with allergic rhinitis sensitive to house dust mites.

PATIENTS AND METHODS

Specific immunotherapy was administered to 49 patients (20 males, 29 females; mean age 34.2 years; range 16 to 66 years) with perennial allergic rhinitis. Nasal secretion and serum ECP levels were measured before, at the 6th month of, and two years after completion of, treatment. Comparisons were made within the patient group and with a control group of 16 healthy subjects (10 males, 6 females; mean age 23 years; range 17 to 26 years).

RESULTS

Pretreatment nasal ECP levels were significantly higher than those found after the treatment (p<0.001). Nasal ECP levels measured before SIT were significantly different from those of the control group (p<0.05). However, serum ECP levels did not differ significantly between the two groups (p>0.05). Serum ECP levels in the patient group tended to decrease with treatment (p>0.05).

CONCLUSION

We conclude that, in addition to the symptoms and clinical findings, nasal ECP measurement may be a reliable and suitable laboratory method to monitor and evaluate the effectiveness of treatment.

[Inhibition of histamine-induced wheal, flare and doppler laser flowmetry during long-term (180 days) of cetirizine 10 mg per day treatment]

THE AIM

of the study was to estimate the skin microcirculation reactivity after histamine administration in patients treated with 10mg daily dose of cetirizine for 180 days.

MATERIAL AND METHODS

Twenty six patients suffering from persistent rhinitis (28+11 years) were randomized into two groups which received 10 mg/day of cetirizine or placebo respectively. Twenty patients completed the study. The skin microcirculation reaction after 10 mg/ml histamine administration was estimated visually on the forearm (diameter of wheal and flare) and by laser Doppler flowmetry before and after study drug or placebo administration 24 hours and every 30 days during the time of the study. The blood flow was measured by Periflux PF3, using a skin probe 5 mm away from the histamine-induced point.

RESULTS

Statistically significant inhibition of skin reaction (over 90%) and blood flow (over 80%) in relation to the start values in cetirizine group as well as between the groups which received cetirizine or placebo (p<0,001), remained at the same level all the time during the examination.

CONCLUSION

Tachyphylaxis phenomenon for antihistamine effect of 10 mg/day cetirizine wasn't observed during the whole 180-days treatment.

Detection of amino acids in human nasal mucosa using microdialysis technique: increased glutamate in allergic rhinitis

Amino acids, the smaller basic biochemical units of neuropeptides, have not been evaluated in the nasal cavity. The purpose of this study was to measure the concentration of neurotransmitting amino acids of the central nervous system, glutamate, aspartate, serine, taurine (2-aminoethane sulfonic acid; a conditionally essential amino acids), and GABA (gamma-amino-butyric acid; an amino acid produced in the brain), in nasal mucosa of allergic rhinitis patients and normal controls using a microdialysis technique. A microdialysis probe appropriate for use on human nasal mucosa was developed using Cuprophan hollow fiber. Glutamate concentration in allergy group was significantly higher (p = 0.004) than in control group, while the concentrations of the other four amino acids showed no significant difference between the two groups. Our findings and review of the literature suggest that glutamate is one of the most potent neurotransmitters associated with the parasympathetic nerve in the nasal cavity, and that the microdialysis technique is useful in studying the pharmacokinetics in situ and local organ chemistry of the nasal cavity.

Regulation of NGF and BDNF by dexamethasone and theophylline in human peripheral eosinophils in allergics and non-allergics

BACKGROUND

Recent studies have shown that the neurotrophins NGF and BDNF are produced by eosinophils. The influence of neurotrophins in allergic diseases including asthma has been described. The regulation by pharmacological substance remains unclear.

OBJECTIVES

The aim of this study was to assess whether approved pharmacological substances in the treatment of asthma such as corticosteroids or theophylline regulate neurotrophins on a cellular level.

METHODS

Eosinophils were purified by negative immunoselection from allergics and non-allergic donors. Eosinophils were incubated with dexamethasone and theophylline and supernatants were collected for measurement of neurotrophic factors. The content of neurotrophins in eosinophil lysates was determined by ELISA. Regulation of stored NGF and BDNF was demonstrated by Western-blotting and flow cytometry while influence on transcription level was demonstrated by RT-PCR.

RESULTS

Eosinophils produce and release the neurotrophins NGF and BDNF at different levels in allergics and non-allergics. Dexamethason lead to a significant downregulation of NGF in eosinophils of allergics. The levels of BDNF were not significantly reduced. Theophylline did not influence the levels of NGF nor BDNF significantly.

CONCLUSIONS

The production of the neurotrophin NGF was downregulated by an established substance such as dexamethasone. This might further contribute to the pharmacological potential of corticosteroids in allergic asthma.

The role of the eosinophil in nasal diseases

PURPOSE OF REVIEW

The eosinophil is involved in physiologic and pathologic processes, such as asthma, parasitic diseases, granulomatous disorders, fibrosis, malignant tumors and several sino-nasal diseases.

RECENT DEVELOPMENTS

Recent data on the structure and function of the eosinophil provides additional information regarding the pathophysiology and the treatment options of these diseases. In this paper the most recently acquired data on the role of the eosinophil in allergic rhinitis (with or without bronchial asthma), chronic sinusitis (with or without nasal polyposis) and allergic fungal sinusitis are reviewed.

SUMMARY

The data provides evidence regarding the pivotal role of the eosinophil in sino-nasal diseases. Possible ways to target the eosinophils are discussed.

Expression and localization of platelet-activating factor receptor in human nasal mucosa

BACKGROUND

Platelet-activating factor (PAF) has been thought to be a potent mediator of allergic rhinitis because PAF was recovered from the nasal lavage fluid of patients with allergic rhinitis after allergen provocation. Furthermore, PAF receptor antagonist attenuates the antigen-induced increase in nasal airway resistance and nasal vascular permeability in sensitized guinea pigs.

OBJECTIVE

To clarify the expression of PAF receptor in human nasal mucosa by investigating PAF receptor messenger RNA (mRNA) expression and its protein localization using polymerase chain reaction (PCR) and immunohistochemical analyses, respectively.

METHODS

Human turbinates were obtained after turbinectomy from 6 patients with nasal obstruction refractory to medical therapy. Total RNA was isolated from human nasal mucosa, and PAF receptor mRNA was detected in these tissues by using reverse transcriptase-PCR analysis. To identify the cells expressing PAF receptor protein, double immunostaining was performed using anti-PAF receptor antibody and monoclonal antileukocyte antibodies.

RESULTS

Reverse transcriptase-PCR analysis of total nasal RNA demonstrated the expression of PAF receptor mRNA. The immunohistochemical studies revealed that anti-PAF receptor antibody-labeled eosinophils, macrophages, neutrophils, mast cells, lymphocytes, vascular endothelial cells, epithelial cells, and submucosal glands in nasal mucosa.

CONCLUSIONS

These results may have important clinical implications for understanding the role of PAF receptor on upper airway diseases such as allergic and nonallergic rhinitis.

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.

Three-year follow-up of clinical and inflammation parameters in children monosensitized to mites undergoing sub-lingual immunotherapy

Parallel follow-up of clinical and inflammatory markers during sub-lingual immunotherapy (SLIT) is highly beneficial. Twenty-four children (age 4-16) monosensitized to house dust mite were randomized to receive either active or placebo SLIT for 1 yr in a double-blind placebo controlled design (Marcucci et al., Allergy 2003: 58: 657-62). Thereafter, for 2 yr they all received active treatment. Symptom scores for rhinitis, asthma, and drug usage were daily recorded. Eosinophil cationic protein (ECP) and tryptase in sputum and nasal secretions, serum and nasal mite-specific immunoglobulin E (IgE) were recorded before treatment and at 10-12 months intervals. Nasal ECP and nasal tryptase after specific nasal provocation tests were significantly reduced as compared to baseline values (p = 0.0043 and 0.0195, respectively) in the third year of active treatment. None of the other inflammatory parameters was increased. In placebo treated patients all these parameters tended to decrease only after switching to active treatment. Clinical scores did not improve in treated vs. placebo patients in the double-blind placebo-controlled phase of the study. In both cohorts a clinical benefit was observed as intra-group score reduction as compared to baseline. A significant difference was reached in patients treated for 2 yr for rhinitis and asthma (p = 0.0009 and 0.0019, respectively) but not for drug usage and in patients treated for 3 yr for rhinitis, asthma, and drug usage (p = 0.0105, 0.0048, and 0.02, respectively). SLIT in children monosensitized to mites reverted the spontaneous increase in nasal IgE and in local parameters of allergic inflammation. These outcomes were followed by a consolidated clinical improvement in the second and third year of treatment.

Relationship between exhaled nitric oxide and atopy in Asian young adults

OBJECTIVES

The relationship between exhaled nitric oxide and atopy is controversial. The aim of this study was to determine the relationship between exhaled nitric oxide (FE(NO)) and atopy in Asian young adults.

METHODOLOGY

Subjects were assessed by: (i) the International Study of Asthma and Allergies in Childhood questionnaire to differentiate asthmatic from nonasthmatic and rhinitis from non-rhinitis subjects; (ii) skin prick testing to 10 allergens; and (iii) FE(NO) measurements performed online at a flow rate of 50 mL/s.

RESULTS

Complete results were available for 84 subjects. FE(NO) values were highest in atopic asthmatics (n = 34; median FE(NO), 59.8 p.p.b.; interquartile range, 30.4-85.5 p.p.b), followed by atopic nonasthmatics (n = 34; median, 38.4 p.p.b.; range, 16.7-49.3 p.p.b), nonatopic asthmatics (n = 5; median, 19.1 p.p.b.; range, 17.9-33.4 p.p.b), and lowest in nonatopic nonasthmatics (n = 11; median, 15.7 p.p.b.; range, 11.5-21.7 p.p.b). FE(NO) values were significantly higher in atopic (n = 68; median, 44.7 p.p.b.; range, 27.3-75.2 p.p.b) compared to nonatopic subjects (n = 16; median, 17.0 p.p.b.; range, 11.7-23.8 p.p.b.; P < 0.0001), regardless of asthma and rhinitis status. FE(NO) levels correlated with the severity of atopy (wheal size) for both asthmatic (r = 0.44, P = 0.005) and nonasthmatic subjects (r = 0.48, P = 0.001). There was no significant difference in FE(NO) levels between nonatopic asthmatics and nonatopic nonasthmatic subjects (P = 0.25).

CONCLUSIONS

Increased FE(NO) levels are more reflective of atopy rather than asthma, and increased nitric oxide production may be predominantly a feature of atopy in asthmatics.

[Effect of kebimin decoction on serum levels of adhesion molecule and Th1/Th2 cytokines in patients with allergic rhinitis]

OBJECTIVE

To investigate the mechanisms of Kebimin decoction (KD) in treating allergic rhinitis (AR).

METHODS

Sixty patients with AR were randomly divided into two groups, patients in the treated group (TG) were treated with KD, those in the control group (CG) were given Xinfang rhinitis capsule. The serum levels of adhesion molecule (sICAM-1, P-selectin), Th1 cytokines, including interferon-gamma (IFN-gamma) and interleukin-2 (IL-2), and Th2 cytokines (IL-4 and IL-5) were determined by enzyme-linked immunosorbent assay (ELISA) before and after treatment, and compared with those in 30 healthy subjects as control.

RESULTS

The serum levels of adhesion molecule and Th2 cytokines were higher and Th1 cytokines were lower in AR patients than those in healthy control (P < 0.01). After treatment, these indexes were restored significantly (P < 0.01) in the treated group, but no significant change was found in the control group.

CONCLUSION

KD has definite effect in treating allergic rhinitis by inhibiting production of adhesion molecule and regulating the levels of Th1/Th2 cytokines to correct the imbalanced Th1/Th2 cytokines network.

[Alteration of cytokines and mucin in lower respiratory tract in allergic rhinitis model in rats]

OBJECTIVE

To investigate the relationship between allergic rhinitis (AR) and asthma as well as the mechanisms related with it.

METHODS

Sixty healthy rats were randomly divided into AR group and control group. AR model was established by intraperitoneal injection of ovalbumin (OVA) and nasal challenge with OVA. Nasal mucosa and lung tissue from both groups were stained with hematoxylin-eosin (HE), alcian-blue and periodic acid-schiff (AB-PAS), respectively. At the same time, the lung tissue was studied by transmission electron microscopy (TEM). Enzyme-linked immunosorbent assay (ELISA) and immunohistochemistry were used to examine the level of interleukin-4 (IL-4) in bronchial alveolus lavage fluid (BALF) and the expression of intercellular adhesion molecule-1 (ICAM-1) and MUC5AC in nasal and lung tissue, respectively.

RESULTS

Infiltration of inflammatory cells in nasal mucosa and lung tissue of AR model in rat was evident. Cilia destruction of bronchial epithelial cells of AR model was found. The level of IL4 in BALF of AR group (58.10 +/- 7.92) pg/ml was significant higher compared with that in control group (24.66 +/- 2.07) pg/ml. The expression of ICAM-1 (0.66 +/- 0.24) and MUC5AC (0.71 +/- 0.10) in lung tissue were both significantly higher than that in control group (0.23 +/- 0.02, 0.29 +/- 0.03).

CONCLUSIONS

Allergic inflammation in nasal mucosa not only leads to changes in both histopathology and immunology, but also initiates the inflammation in lower respiratory tract mainly causing the change of cytokines and mucin.

Exhaled nitric oxide, total serum IgE and allergic sensitization in childhood asthma and allergic rhinitis

Exhaled nitric oxide (eNO) levels are correlated with several markers of atopy and inflammatory activity in the airways, but the relationship between eNO and total serum IgE has not been fully elucidated in the context of allergic sensitization. The aim of this study was to investigate the relationship between eNO, total serum IgE and allergic sensitization in childhood asthma and allergic rhinitis. eNO levels, lung function, skin prick tests and total serum IgE were determined in 109 children (mean age, 10.4 yr) with mild intermittent asthma and in 41 children (mean age, 10.1 yr) with allergic rhinitis; 25 healthy non-atopic children were recruited as controls. eNO levels (median) were significantly higher in patients with asthma (22.7 p.p.b.) and in those with allergic rhinitis (15.3 p.p.b.) than in healthy controls (5.9 p.p.b.). Children with allergic asthma had higher eNO levels than children with allergic rhinitis. A significant positive correlation was found between eNO and total serum IgE (asthma, r = 0.42, p < 0.0001; allergic rhinitis, r = 0.31, p < 0.01), and between eNO and the number of positive skin prick tests (asthma, r = 0.31, p < 0.0001; allergic rhinitis, r = 0.39, p < 0.01). eNO levels were better correlated with total IgE than with the number of positive skin prick tests. This correlation was independent of allergic sensitization. High total serum IgE represents a specific and predictive marker of eNO increase in children with asthma or allergic rhinitis. This finding adds further support to the hypothesis that increased serum IgE could be a marker itself of airway inflammation in patients with allergic disease.

[Influence of Xinqin tablets on guinea-pig nasal hypersensitivity]

OBJECTIVE

To study the influence of Xinqin tablets on guinea-pig nasal hypersensitivity.

METHOD

2,4-Toluene Diisocyanate (TDI) was selected as antigen and used in nose to establish guinea-pig allergic rhinitis. The effects of Xinqin tablets on symptoms of nasal hypersensitivity in guinea-pigs, histamine content of nasal mucosa and activity of nitric oxide synthase (NOS) were examined.

RESULT

Xinqin tablets could significantly relieve the pathological symptoms of nasal hypersensitivity in guinea-pig, reduce histamine content of nasal mucosa and inhibit the activity of nitric oxide synthase.

CONCLUSION

Xinqin tablets have significant effect on nasal hypersensitivity, and prevent the occurrence of allergic rhinitis.

Discrepant nasal and bronchial nitric oxide kinetics during early and late phase allergic reactions

Late allergic reactions (LAR) following allergen challenge occur in different compartments. We studied the kinetics of nasal and bronchial nitric oxide (NO) in mild asthmatics after allergen challenge. Twelve males with intermittent asthma (28 yr, FEV1 97% of predicted, PC20methacholine <8 mg/ml) and known LAR after bronchial allergen challenge underwent nasal and bronchial allergen provocation using the same allergen separated by a washout of 3 weeks. Nasal and bronchial NO were measured before challenge, during early (EAR) and late phase reactions, and 24 h after allergen. The mean (sem) maximum fall of FEV1 at EAR was 31.9+/-3.2% (P=0.001), and 17.6+/-2.2% (P=0.004) during LAR. All patients developed nasal EAR (max. fall in nasal rhinomanometric flow 64.8+/-7.6% of baseline) after nasal challenge, and 10 patients demonstrated nasal LAR with a fall in nasal flow of 65.9+/-6.6% (both P=0.002, respectively). During EAR, there was stronger reduction of nasal (-19.2+/-6.2%,P=0.039) than bronchial NO (-6.9+/-5.2% of baseline, P=ns). In contrast, bronchial NO also tended to decrease during bronchial LAR (-8.8+/-6.8%,P=ns), while nasal NO slightly increased non-significantly (+17+/-10.8%, P=ns). After 24 h, bronchial NO was significantly elevated (+78.1+/-40.1%, P=0.039), whereas nasal NO was unchanged (+6.1+/-15.1%, P=ns). The intraindividual difference between bronchial and nasal changes of NO during LAR, but not EAR or after 24 h, was significant (lung vs. nose: -35.6+/-14.1% relative difference, P=0.039). Despite similar functional responses in nose and bronchi, nasal NO kinetics following allergen challenge differ from bronchial NO. The concise mechanisms accounting for this discrepancy warrant further investigations.

[The effect of desloratadine on the TXB2 and leukotrienes levels in the nasal lavage fluid of allergic rhinitis animal model]

OBJECTIVE

To observe the thromboxane (TX)B2 and cysteinyl leukotrienes (LTs) levels in the nasal lavage fluid of allergic rhinitis model and to observe the effect of desloratadine on the mediators.

METHOD

In the positive control group, 8-12 week old male or female guinea pigs were intranasal sensitized and challenged with ovalbumin solution. The antihistamine treatment group was treated with desloratadine and the negative control group was sham-sensitized and sham-challenged. The nasal lavage fluid of each group was collected 5 hours after challenge and the levels of TXB2 and LTs in the nasal lavage fluid were measured.

RESULT

In the positive control group, the TXB2 and LTs levels were the highest of the three groups and the desloratadine treated group had lower level (P < 0.05 and P < 0.01). The negative control showed the lowest level.

CONCLUSION

Our study demonstrated that in this model of allergic rhinitis, the levels of TXB2 and LTs in nasal lavage fluid increased dominantly after allergen challenge and desloratadine could inhibit the release of TXB2 and LTs, which implied that the therapeutic mechanism of desloratadine might contribute to the inhibitory effect on TXB2 and LTs production or release in allergic rhinitis subjects.

[Expression and its significance of aquaporin 5 in rat nasal mucosa of experimental allergic rhinitis]

OBJECTIVE

To confirm the expression and distribution of aquaporin 5 (AQP5) in rat nasal mucosa of experimental allergic rhinitis and to investigate the relationship between AQP5 and allergic rhinitis.

METHODS

Twenty-four healthy Wistar rats both male and female weighting 200-300 g were divided into two groups randomly, one was testing group (n = 12), the other was comparing group (n = 12). Generally sensitized rats in testing group were given repeated local booster sensitization into nasal cavity. Twelve normal rat nasal mucosa and twelve nasal mucosa from rat with allergic rhinitis were used. The distribution of AQP5 in normal rat nasal mucosa and nasal mucosa in rat with allergic rhinitis were observed by immunofluorescence technique. Furthermore, the expression of AQP5 in normal rat nasal mucosa and nasal mucosa from rat with allergic rhinitis were studied by immunohistochemical staining.

RESULTS

Hematoxylin and eosin staining showed that there was obvious inflammation reaction, a large quantity of glands hyperplasia and acidophils soaked in nasal mucosa from rat with allergic rhinitis. (2) Both immunofluorescence technique and immunohistochemical staining showed that the distribution of AQP5 in normal rat nasal mucosa was in accordance with that in nasal mucosa from rat with allergic rhinitis on the whole. AQP5 expressed mainly in the membrane and cytoplasm of the epithelium in the glands, ducts and cilia. (3) The statistical analysis of the immunohistochemical staining showed that the quantity of AQP5 in rat nasal mucosa with allergic rhinitis (156.37 +/- 1.93) was obviously higher than that in the normal rat nasal mucosa (178.52 +/- 1.94). There was statistical significance between the two groups (t = 28.08, P < 0.01).

CONCLUSIONS

The hypersecretion of glands has a close relationship with the high expression of AQP5 in allergic rhinitis.

[The relationship between skin test results and serum eosinophilic cationic protein, nasal eosinophilia, and total IgE values in patients with allergic rhinitis]

OBJECTIVES

We investigated the relationship between positive skin test results and serum eosinophilic cationic protein (ECP), nasal eosinophilia, and total IgE levels in patients with allergic rhinitis.

PATIENTS AND METHODS

The study included 36 patients with allergic rhinitis (26 females, 10 males; mean age 32.8 years; range 17 to 60 years) and with a positive skin test result. Serum ECP, nasal eosinophilia, and serum total IgE levels were assessed and compared with a control group of 18 healthy volunteers (15 females, 3 males; mean age 30.3 years; range 20 to 49 years) and correlation was sought with skin test results.

RESULTS

Twenty-five patients were sensitive to only seasonal, four patients to only perennial, and seven patients to both seasonal and perennial allergens. Twelve patients were sensitive to one allergen, seven patients to two, and 17 patients to three or more allergens. Compared to controls, the mean serum ECP, nasal eosinophilia, and serum total IgE values were significantly higher in the patient group (p<0.05). These parameters did not show significant relationship with the type and number of allergens (p>0.05).

CONCLUSION

Serum ECP, nasal eosinophilia, and serum total IgE levels increase in patients with allergic rhinitis. These parameters are not affected by sensitivity to seasonal or perennial allergens.

Inflammatory mediators in allergic rhinitis

Allergic rhinitis (AR) is part of a systemic disease complex. There is a close relationship between AR and asthma, which has led to the "one airway, one disease" concept. Both conditions share common immunopathology and pathophysiology. In patients with AR, allergen-triggered early and late responses are mediated by a series of inflammatory cells. Within minutes of contact with allergen, IgE-sensitized mast cells degranulate, releasing both preformed and newly synthesized mediators. Immunologic processes in both nasal and bronchial tissue involve T H 2 lymphocytes and eosinophils. Eosinophils are the predominant cell in the chronic inflammatory process characteristic of the late-phase allergic response. Eosinophils release an array of proinflammatory mediators, including cysteinyl leukotrienes, cationic proteins, eosinophil peroxidase, and major basic protein, and might serve as a major source of IL-3, IL-5, GM-CSF, and IL-13. Neuropeptides also appear to contribute to the pathophysiology of AR symptoms. Both AR and asthma exhibit marked day-night variation in symptom severity. Acknowledging both the chronobiology of AR and circadian rhythm-dependent attributes of antiallergy medications might enhance the beneficial effects of allergy therapies.

Prostaglandins, leukotrienes and perennial rhinitis

Prostaglandins and leukotrienes are implicated in conditions of both the upper and lower airways. In the former they are deranged in nasal polyposis, intrinsic rhinitis and allergic rhinitis while in the latter they are involved in the pathogenesis of asthma. The aim of the present study was to measure mucosal eicosanoid levels in the three types of rhinitis and compare with controls. In addition, the effect of topical steroids on eicosanoid levels in rhinitis was examined. The levels of prostaglandins E(2) (PGE(2)) and D(2) (PGD(2)) and of leukotrienes E(4) (LTE(4)) and B(4) (LTB(4)) were measured in nasal biopsies from the inferior turbinates of patients suffering from perennial rhinitis and a control group. Rhinitis patients were classified into three categories: perennial allergic rhinitis (PAR), non-allergic rhinitis with eosinophilia (NARES) and noneosinophilic non-allergic rhinitis (NENAR) on the basis of symptoms, secretion eosinophilia, nasal resistance and allergy testing. Patients with rhinitis were randomized into two groups. One received fluticasone propionate nasal spray (FPANS) and the other a placebo (PNS) over a period of six weeks prior to the biopsies. One hundred and one patients with PAR, NARES or NENAR were recruited sequentially and the control group consisted of 21 patients with no evidence of rhinitis but with nasal obstruction due to septal deviation. Untreated rhinitics had significantly lower levels of PGE(2), PGD(2) and LTE(4) than non-rhinitic controls. Six-weeks' treatment with FPANS significantly increased the levels of those eicosanoids in patients with PAR and NARES but they were still significantly below normal. Levels of LTB(4) in all three rhinitis groups were not significantly different from controls and treatment with topical steroids had no effect. Their findings are contrary to current thinking that increased levels of eicosanoids, in particular cysteinyl-leukotrienes, play an important role in the pathogenesis of chronic, non-infective upper airway inflammation.

[Expression of CD30 in nasal mucosa of patients with allergic rhinitis]

OBJECTIVE

To study the role of CD30 in the pathogenesis of allergic rhinitis.

METHOD

The specimens of thirty-one patients with allergic rhinitis and twenty-six control subjects were studied by immunohistochemical method to detect CD30 cell. A mean numbers of positive cells per high field (10 x 40) were counted. All data were analyzed with t-test.

RESULT

The number of CD30+ cells in the nasal mucosa of patients with allergic rhinitis was significantly more than that in the controls (P < 0.05).

CONCLUSION

This study suggests a T-helper 2-dominated mucosal reaction in the allergic rhinitis compared to the nonallergic groups,and the expression level of CD30 can reflect the T-helper 2-dominated mucosal reaction.

Pulmonary retention of particulate matter is associated with airway inflammation in allergic rats exposed to air pollution in urban Detroit

A collaborative research study was conducted in order to improve our understanding of the source-to-receptor pathway for ambient fine particulate matter (aerodynamic diameter < or = 2.5 mu m; PM2.5) and subsequently to investigate the identity and sources of toxic components in PM2.5 responsible for adverse health effects in allergic humans. This research used a Harvard fine particle concentrator to expose Brown Norway rats, with and without ovalbumin-induced allergic airway disease, to concentrated air particles (CAPs) generated from ambient air in an urban Detroit community where the pediatric asthma rate was three times higher than the national average. Rats were exposed to CAPs during the exposure periods in July (mean = 676 microg/m3) and September (313 microg/m3) of 2000. Twenty-four hours after exposures lung lobes were either lavaged with saline to determine cellularity and protein in bronchoalveolar lavage fluid (BALF), or removed for analysis by inductively coupled plasma-mass spectrometry (ICP-MS) to detect ambient PM2.5-derived trace element retention. PM2.5 trace elements of anthropogenic origin, lanthanum (La), vanadium (V), manganese (Mn), and sulfur (S), were recovered from the lung tissues of CAPs-exposed rats. Recovery of those pulmonary anthropogenic particles was further increased in rats with allergic airways. In addition, eosinophils and protein in BALF were increased only in allergic animals exposed to CAPs. These results demonstrate preferential retention in allergic airways of air particulates derived from identified local combustion sources after a short-term exposure. Our findings suggest that the enhancement of allergic airway responses by exposure to PM2.5 is mediated in part by increased pulmonary deposition and localization of potentially toxic elements in urban air.

[Relationship between levels of intercellular adhesion molecule-1, interleukin-6 and airway hyperresponsiveness in patients with allergic rhinitis]

OBJECTIVE

To investigate the relation between levels of intercellular adhesion molecule-1, interleukin-6 and airway hyperresponsiveness in patients with allergic rhinitis.

METHODS

Fifty-four patients with allergic rhinitis (AR) and 20 controls were included in the study. The levels of intercellular adhesion molecule-1 (ICAM-1) and interleukin-6 (IL-6) in nasal lavage fluid, gathered 1 hour after specific allergen nasal provocation test (SANPT), were detected by sandwich enzyme-linked immunosorbent assay (ELISA) technique. The pulmonary function (FEV1) and nonspecific bronchial provocation test were measured in 54 patients with AR, 36 patients with AR and bronchial asthma (BA) and 20 controls. At the same time, the correlation between levels of ICAM-1 and IL-6 in nasal lavage fluid and pulmonary function (FEV1) was studied.

RESULTS

The levels of ICAM-1 and IL-6 in nasal lavage fluid from patients with AR were (272.75 +/- 32.25) pg/ml and (52.11 +/- 16.54) pg/ml, significantly higher than those the controls, which were (158.82 +/- 33.88) pg/ml and (25.64 +/- 10.14) pg/ml (P < 0.01). The pulmonary function (FEV1) in patients with AR and BA was (78.82 +/- 7.41)%. It was obviously lower than that in patients with AR [(83.90 +/- 4.87)%], much lower than that in normal controls [(90.25 +/- 4.69)%]. The difference among them was significant. In patients with AR, the positive percentage of bronchial provocation test was 64.81%, in patients with AR and BA, it was 83.33% in normal controls, it was 0. The differences among them had very significant meaning. The levels of ICAM-1 and IL-6 in nasal provocation fluid had closely negative correlation with pulmonary function (FEV1), r = -0.7071, -0.6248, P < 0.01.

CONCLUSIONS

The close correlation was observed in upper and lower airway for allergic inflammation. The pulmonary function of patients with AR was lower, and 64. 8% of them had airway hyperresponsiveness, so that they had the potent possibility to have bronchial asthma.