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Cohen B. Allergic Rhinitis. Pediatr Rev 2023; 44:537-550. [PMID: 37777655 DOI: 10.1542/pir.2022-005618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/02/2023]
Abstract
Allergic rhinitis (AR) affects more than 400 million people worldwide, making it 1 of the most prevalent chronic diseases. Childhood AR is increasing, and almost half of patients with AR develop symptoms before age 6 years. Although a diagnosis of AR is associated with higher socioeconomic status, underserved and urban populations have more indoor aeroallergen sensitizations and are likely underdiagnosed with AR, further exacerbating health-care disparities. AR negatively impacts quality of life, school performance, and overall health outcomes. Untreated AR in children increases the risk for poor asthma control, increased asthma severity, and exacerbations. Many patients believe that they have seasonal allergies only but in reality have both perennial and seasonal AR, which may change the approach to allergen avoidance measures and treatment recommendations. Pharmacotherapy of AR has expanded, with many intranasal corticosteroids, intranasal antihistamines, and second-generation oral antihistamines approved for pediatric use. Allergen immunotherapy, including both subcutaneous and sublingual forms, are approved for children and are disease modifying, potentially reducing further allergen sensitization and progression to asthma. Many of the currently available biological therapies indicated for pediatric asthma and/or atopic diseases reduce AR symptoms as well. Children with moderate to severe or refractory AR or those with comorbidities should be referred to allergists for diagnostic testing and expanded management options, including immunotherapy and potential biological treatment.
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Affiliation(s)
- Barrie Cohen
- Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ
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Chung JY, Park N, Kim MH, Yang WM. Abies holophylla Leaf Essential Oil Alleviates Allergic Rhinitis Based on Network Pharmacology. Pharmaceutics 2023; 15:pharmaceutics15041195. [PMID: 37111680 PMCID: PMC10146622 DOI: 10.3390/pharmaceutics15041195] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/28/2023] [Accepted: 04/04/2023] [Indexed: 04/29/2023] Open
Abstract
Abies holophylla is an evergreen coniferous species that has been widely used for treating pulmonary diseases and colds. Previous research has demonstrated the anti-inflammatory effect of Abies species and the anti-asthmatic activities of Abies holophylla leaf essential oil (AEO). As asthma and allergic rhinitis (AR) share pathophysiology and pharmacotherapeutic interventions, AEO inhalation can also ameliorate upper respiratory allergic diseases. This study explored the protective effects of AEO on AR with network pharmacological pathway prediction. The potential target pathways of AEO were analyzed by a network pharmacological approach. The BALB/c mice were sensitized by ovalbumin (OVA) and 10 μm particular matter (PM10) to induce allergic rhinitis. Aerosolized AEO 0.0003% and 0.03% were delivered by nebulizer for 5 min a day, 3 times a week for 7 weeks. Nasal symptoms (sneezing and rubbing), histopathological changes in nasal tissues, serum IgE, and zonula occludens-1 (ZO-1) expressions on nasal tissues were analyzed. After AR induction with OVA+PM10 and inhalation of AEO 0.0003% and 0.03% treatment, AEO significantly decreased allergic symptoms (sneezing and rubbing), hyperplasia of nasal epithelial thickness, goblet cell counts, and serum IgE level. The network analysis demonstrated that the possible molecular mechanism of AEO is highly associated with the IL-17 signaling pathway and tight junction. The target pathway of AEO was investigated in RPMI 2650 nasal epithelial cells. Treatment of AEO on PM10-treated nasal epithelial cells significantly reduced the production of inflammatory mediators related to the IL-17 signaling pathway, NF-κB, and the MAPK signaling pathway and prevented the reduction in TJ-related factors. When taken together, AEO inhalation may be considered as a potential treatment for AR by alleviating nasal inflammation and recovering the tight junction.
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Affiliation(s)
- Jae Yoon Chung
- Department of Convergence Korean Medical Science, College of Korean Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea
| | - Nayoung Park
- Department of Convergence Korean Medical Science, College of Korean Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea
| | - Mi Hye Kim
- Department of Convergence Korean Medical Science, College of Korean Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea
| | - Woong Mo Yang
- Department of Convergence Korean Medical Science, College of Korean Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea
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The Association between Ambient Air Pollution and Allergic Rhinitis: Further Epidemiological Evidence from Changchun, Northeastern China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14030226. [PMID: 28241509 PMCID: PMC5369062 DOI: 10.3390/ijerph14030226] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 02/09/2017] [Accepted: 02/13/2017] [Indexed: 01/01/2023]
Abstract
With the continuous rapid urbanization process over the last three decades, outdoors air pollution has become a progressively more serious public health hazard in China. To investigate the possible associations, lag effects and seasonal differences of urban air quality on respiratory health (allergic rhinitis) in Changchun, a city in Northeastern China, we carried out a time-series analysis of the incidents of allergic rhinitis (AR) from 2013 to 2015. Environmental monitoring showed that PM2.5 and PM10 were the major air pollutants in Changchun, followed by SO2, NO2 and O3. The results also demonstrated that the daily concentrations of air pollutants had obvious seasonal differences. PM10 had higher daily mean concentrations in spring (May, dust storms), autumn (October, straw burning) and winter (November to April, coal burning). The mean daily number of outpatient AR visits in the warm season was higher than in the cold season. The prevalence of allergic rhinitis was significantly associated with PM2.5, PM10, SO2 and NO2, and the increased mobility was 10.2% (95% CI, 5.5%–15.1%), 4.9% (95% CI, 0.8%–9.2%), 8.5% (95% CI, −1.8%–19.8%) and 11.1% (95% CI, 5.8%–16.5%) for exposure to each 1-Standard Deviation (1-SD) increase of pollutant, respectively. Weakly or no significant associations were observed for CO and O3. As for lag effects, the highest Relative Risks (RRs) of AR from SO2, NO2, PM10 and PM2.5 were on the same day, and the highest RR from CO was on day 4 (L4). The results also indicated that the concentration of air pollutants might contribute to the development of AR. To summarize, this study provides further evidence of the significant association between ambient particulate pollutants (PM2.5 and PM10, which are usually present in high concentrations) and the prevalence of respiratory effects (allergic rhinitis) in the city of Changchun, located in Northeastern China. Environmental control and public health strategies should be enforced to address this increasingly challenging problem.
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Chung YJ, Kim HY, Chung SK, Dhong HJ. A time course study on the development of allergen-induced nasal airway remodeling in a rat model. Am J Rhinol Allergy 2013; 26:421-7. [PMID: 23232190 DOI: 10.2500/ajra.2012.26.3823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Only a few studies have investigated the airway remodeling process in allergic rhinitis (AR), and the results reported are conflicting. We established an allergen-induced nasal remodeling model for AR using brown Norway rats and investigated time-dependent histological changes and the reversibility of the epithelial and subepithelial changes. METHODS Ovalbumin (OVA)-sensitized rats were exposed to OVA daily and then assigned to one of five groups depending on the duration of the challenge. Groups I, II, III, and IV rats were exposed for 1, 4, 8, and 12 weeks, respectively. Group V rats were exposed for 12 weeks and then protected from challenge for 4 weeks. Matched control rats were exposed to saline. Histological parameters of the nasal mucosa such as epithelial and subepithelial thickness, goblet cell hyperplasia, eosinophil infiltration, submucosal gland hypertrophy, and expression of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) were compared between groups. RESULTS Repeated challenges for 12 weeks resulted in the characteristic features of nasal airway remodeling. All parameters except epithelial thickness increased markedly. Goblet cell hyperplasia and eosinophil infiltration decreased to control group levels after cessation of challenge for 4 weeks. Subepithelial changes such as subepithelial thickening, submucosal gland hypertrophy, and increased expression of MMP-9 and TIMP-1 were still observed after 4 weeks without challenge. CONCLUSION Our results indicate that prolonged OVA challenge can induce nasal remodeling. Epithelial changes were minimal or absent after cessation of the challenge, but subepithelial changes were resistant to reversal.
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Affiliation(s)
- Young-Jun Chung
- Department of Otorhinolaryngology-Head and Neck Surgery, Dankook University College of Medicine, Cheonan, Korea
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Venema CM, Williams KJ, Gershwin LJ, Reinero CR, Carey SA. Histopathologic and morphometric evaluation of the nasal and pulmonary airways of cats with experimentally induced asthma. Int Arch Allergy Immunol 2012. [PMID: 23183217 DOI: 10.1159/000342992] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Allergic rhinitis frequently occurs as a comorbid condition in asthmatic people, suggesting that the upper and lower airways may be immunologically linked. Our research group has developed an experimental aeroallergen model of asthma in cats. We hypothesized that aeroallergen sensitization and challenge would induce morphologic changes in the nasal airways of cats that mimic those observed in the bronchial airways. METHODS Five mixed breed cats were sensitized to Bermuda grass allergen and then serially challenged with aerosolized Bermuda grass allergen to induce an asthmatic phenotype. Four control cats were similarly treated with saline vehicle. Nasal tissues and lungs were processed for histopathological and morphometric analyses. RESULTS Eosinophilic inflammation, epithelial hypertrophy and mucous cell metaplasia were observed along the pulmonary axial airway mucosa of allergen-sensitized (asthmatic) cats. Mild eosinophilic inflammation was observed in the nasal airways of asthmatic cats. This alteration was confined primarily to the anterior nasal cavity, resulting in an increase in tissue eosinophils at this site compared to controls (p < 0.05). A marked increase in tissue mast cells was observed throughout all regions of the nasal airways of asthmatic cats compared to control cats (p < 0.05). There was no difference in intraepithelial mucosubstances between the nasal airways of controls and asthmatic cats. There was no correlation between upper and lower airway eosinophils or mast cells. CONCLUSION Cats with experimentally induced asthma exhibit morphologic changes in the nasal airways that are distinct from the alterations observed in the lungs. These results are similar to those observed in people with comorbid asthma and allergic rhinitis.
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Affiliation(s)
- Christine M Venema
- Department of Small Animal Clinical Sciences, Michigan State University College of Veterinary Medicine, D208 Veterinary Medical Center, East Lansing, MI 48824, USA
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Evaluation of nasal airways by objective methods in chronic otitis media. Eur Arch Otorhinolaryngol 2012; 270:1263-6. [PMID: 22847774 DOI: 10.1007/s00405-012-2122-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Accepted: 07/17/2012] [Indexed: 10/28/2022]
Abstract
Otitis media (OM) is a common health problem. Nasal airways play an important role in etiopathogenesis of OM. The aim of this study is to evaluate nasal airways by objective methods in chronic otitis media (COM) cases. The relationship between the course of the disease and nasal parameters is also investigated. Fifty-six patients who had chosen an operation for chronic otitis media were included in the study. The control group was composed of 30 healthy patients. Patients were subjected to acoustic rhinometry and rhinomanometry. Nasal airway resistance and cross-sectional area measurements were taken. The results of the COM group and the control group were compared. Cases were classified by the course of the disease such as suppurative/progressive/active and non-suppurative/inactive and the nasal parameters of these sub-groups were compared. In cases with unilateral COM, nasal cavity results from both sides were compared. The nasal airway resistance of the COM group was statistically significantly higher than the control group (p < 0.05). However, there was no difference in cross-sectional area measurements. There was no significant difference between the suppurative/progressive/active and non-suppurative/inactive groups. However, the suppurative group had higher nasal resistance (p > 0.05). There was no statistical difference between the measurements of each side in unilateral COM cases. This study found that COM cases have greater nasal airway resistance. No significant difference was found in cross-sectional area measurements so the increase in resistance may be linked to mucosal rather than structural changes. There was no evidence for a relationship between the course of the OM and nasal airway parameters.
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Wang B, Tang X, Xu J, Yao H. Differential expression of Immunoglobulin A in the adenoids of children with and without exudative otitis media. Int J Pediatr Otorhinolaryngol 2012; 76:728-30. [PMID: 22425064 DOI: 10.1016/j.ijporl.2012.02.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Revised: 02/08/2012] [Accepted: 02/11/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To evaluate the variation of Immunoglobulin A (IgA) levels in the adenoids of children with otitis media with effusion (OME) and the correlation to age. METHODS A total of 129 children were enrolled in this study, including 60 children with OME and 69 children without OME. The children were divided into two groups according to age: aged ≤ 4 years (33 children with OME and 39 children without OME) and aged > 4 years (27 children with OME and 30 children without OME). The samples were collected from hypertrophic adenoids, which could cause obstructive symptoms and/or OME. The IgA concentrations were analyzed by immunohistochemistry in the two groups. RESULTS The expression of IgA in the adenoids of children ≤ 4 years was significantly lower than in those aged > 4 years. Among children > 4 years, lower levels of IgA in the adenoids were observed in patients with OME than in patients without OME. However, no statistically significant differences in the IgA levels were found between patients aged ≤ 4 years with and without OME. CONCLUSIONS The differential expression of IgA in the adenoids between patients with and without OME was correlated to age.
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Affiliation(s)
- Bing Wang
- Department of Otolaryngology, Children's Hospital of Chongqing Medical University, Chongqing, China
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Dhong HJ. Angiogenic factors play a significant role in nasal airway remodeling in allergic rhinitis. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2011; 4:2-4. [PMID: 22211163 PMCID: PMC3242056 DOI: 10.4168/aair.2012.4.1.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Hun-Jong Dhong
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Remodeling of the lower and upper airways. Braz J Otorhinolaryngol 2010; 75:151-6. [PMID: 19488576 PMCID: PMC9442173 DOI: 10.1016/s1808-8694(15)30847-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2007] [Accepted: 03/15/2007] [Indexed: 12/22/2022] Open
Abstract
Remodeling is defined as modeling again or differently, as reconstructing. Remodeling is a critical aspect of wound repair in all organs; it represents a dynamic process that associates the production and degradation of matrix in reaction to inflammation. This leads to normal reconstruction or a pathologic process. Aim and Methods: To compare data in the current literature on upper and lower airways. Results: Asthma is a chronic inflammatory disease associated with abnormal airways remodeling. In allergic rhinitis, another chronic inflammatory disease, remodeling is still poorly understood. Even though inflammation is similar in allergic rhinitis and asthma, the pathologic extent of nasal remodeling, as well as its clinical consequences, might be different from those in bronchi. Conclusion: Remodeling occurs less in upper airways compared to lower airways; it is apparent, however, that the structure of the rhinitic nose is not normal.
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Ciprandi G, Cirillo I, Pistorio A, La Grutta S. Relationship between rhinitis duration and worsening of nasal function. Otolaryngol Head Neck Surg 2008; 138:725-9. [PMID: 18503843 DOI: 10.1016/j.otohns.2008.03.027] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2007] [Revised: 03/11/2008] [Accepted: 03/24/2008] [Indexed: 01/02/2023]
Abstract
BACKGROUND While it is well known that asthma is characterized by airway remodeling, few studies instead have investigated this issue in patients with allergic rhinitis (AR). OBJECTIVE The aim of the study was to evaluate nasal function, ie, nasal airflow, in a cohort of patients with persistent AR (PER). METHODS One hundred patients, 50 with short-term and 50 with long-term PER, were prospectively and consecutively evaluated, clinically evaluated by visit, skin prick test, and rhinomanometry. RESULTS Nasal airflow values were significantly lower (median flow: 348 mL/sec) in patients with long-term rhinitis (median duration nine years) as compared to patients with short-term (median duration one year) rhinitis (median flow: 466 mL/sec) (P < 0.0001). CONCLUSION This study provides the first evidence that patients with PER may show a progressive worsening of nasal airflow depending on the duration of the disorder.
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Affiliation(s)
- Giorgio Ciprandi
- Department of Internal Medicine, Azienda Ospedaliera Universitaria San Martino, Genoa, Italy.
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Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, Zuberbier T, Baena-Cagnani CE, Canonica GW, van Weel C, Agache I, Aït-Khaled N, Bachert C, Blaiss MS, Bonini S, Boulet LP, Bousquet PJ, Camargos P, Carlsen KH, Chen Y, Custovic A, Dahl R, Demoly P, Douagui H, Durham SR, van Wijk RG, Kalayci O, Kaliner MA, Kim YY, Kowalski ML, Kuna P, Le LTT, Lemiere C, Li J, Lockey RF, Mavale-Manuel S, Meltzer EO, Mohammad Y, Mullol J, Naclerio R, O'Hehir RE, Ohta K, Ouedraogo S, Palkonen S, Papadopoulos N, Passalacqua G, Pawankar R, Popov TA, Rabe KF, Rosado-Pinto J, Scadding GK, Simons FER, Toskala E, Valovirta E, van Cauwenberge P, Wang DY, Wickman M, Yawn BP, Yorgancioglu A, Yusuf OM, Zar H, Annesi-Maesano I, Bateman ED, Ben Kheder A, Boakye DA, Bouchard J, Burney P, Busse WW, Chan-Yeung M, Chavannes NH, Chuchalin A, Dolen WK, Emuzyte R, Grouse L, Humbert M, Jackson C, Johnston SL, Keith PK, Kemp JP, Klossek JM, Larenas-Linnemann D, Lipworth B, Malo JL, Marshall GD, Naspitz C, Nekam K, Niggemann B, Nizankowska-Mogilnicka E, Okamoto Y, Orru MP, Potter P, Price D, Stoloff SW, Vandenplas O, Viegi G, Williams D. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy 2008; 63 Suppl 86:8-160. [PMID: 18331513 DOI: 10.1111/j.1398-9995.2007.01620.x] [Citation(s) in RCA: 3050] [Impact Index Per Article: 190.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
MESH Headings
- Adolescent
- Asthma/epidemiology
- Asthma/etiology
- Asthma/therapy
- Child
- Global Health
- Humans
- Prevalence
- Rhinitis, Allergic, Perennial/complications
- Rhinitis, Allergic, Perennial/diagnosis
- Rhinitis, Allergic, Perennial/epidemiology
- Rhinitis, Allergic, Perennial/therapy
- Rhinitis, Allergic, Seasonal/complications
- Rhinitis, Allergic, Seasonal/diagnosis
- Rhinitis, Allergic, Seasonal/epidemiology
- Rhinitis, Allergic, Seasonal/therapy
- Risk Factors
- World Health Organization
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Affiliation(s)
- J Bousquet
- University Hospital and INSERM, Hôpital Arnaud de Villeneuve, Montpellier, France
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Nakaya M, Dohi M, Okunishi K, Nakagome K, Tanaka R, Imamura M, Yamamoto K, Kaga K. Prolonged allergen challenge in murine nasal allergic rhinitis: nasal airway remodeling and adaptation of nasal airway responsiveness. Laryngoscope 2007; 117:881-5. [PMID: 17473688 DOI: 10.1097/mlg.0b013e318033f9b0] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Nasal airway remodeling exists in allergic rhinitis, but it appears to be far less extensive than in asthma. However, there has been little study about nasal airway remodeling and no study using mice models. It has been reported that airway hyperresponsiveness decreased after prolonged allergen challenge in a chronic murine asthma model together with the progression of remodeling. However, there has been no study of the relation of remodeling and airway responsiveness in nasal allergy. Therefore, we have undertaken this investigation to characterize nasal airway structural changes after prolonged allergen challenge and to examine the relationship between nasal airway hyperresponsivity and remodeling. METHODS We prepared murine allergic rhinitis for ovalbumin. Mice were subsequently challenged three times a week with ovalbumin from day 19 to days 53, 88, and 130. We examined allergen-induced nasal symptoms and objective nasal hyperresponsiveness using the enhanced pause system. Moreover, the pathologic changes were investigated after allergen challenge. RESULTS The extended allergen challenge protocol caused significant nasal airway remodeling. Specifically, remodeling was characterized by goblet cell hyperplasia and deposition of collagen in the submucosal area. Allergen-induced nasal hyperresponsiveness was first increased but gradually decreased in nasal symptoms and Penh after prolonged allergen challenge. CONCLUSIONS We have demonstrated that a remodeling of nasal mucosa in a murine allergic rhinitis model prolonged allergen exposure. Moreover, prolonged allergen exposure induced a reduction of nasal hyperresponsiveness together with a progression of nasal remodeling.
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Affiliation(s)
- Muneo Nakaya
- Department of Otolaryngology, Faculty of Medicine, University of Tokyo, Tokyo, Japan.
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Lim YS, Won TB, Shim WS, Kim YM, Kim JW, Lee CH, Min YG, Rhee CS. Induction of airway remodeling of nasal mucosa by repetitive allergen challenge in a murine model of allergic rhinitis. Ann Allergy Asthma Immunol 2007; 98:22-31. [PMID: 17225716 DOI: 10.1016/s1081-1206(10)60855-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Although many studies regarding airway remodeling in asthma have been reported, only a few studies have investigated airway remodeling in allergic rhinitis. OBJECTIVES To determine whether repetitive allergen challenge could induce airway remodeling in the nose and evaluate the effect of steroids using a murine model of allergic rhinitis. METHODS To develop a mouse model of airway remodeling, ovalbumin-sensitized mice were repeatedly exposed to inhaled ovalbumin administration twice a week for 1 month and 3 months. Matched control mice were challenged with phosphate-buffered saline, and the treatment group received intraperitoneal dexamethasone injection. Trichrome, periodic acid-Schiff, hematoxylin-eosin, and immunohistochemical staining against matrix metalloproteinase 9 and tissue inhibitors of metalloproteinase 1 were performed to nasal and lung tissues, and the level of transforming growth factor beta in the nasal lavage fluid was analyzed. RESULTS Repetitive ovalbumin challenge for 3 months induced circumferential peribronchial fibrosis in the lung. In the nose, subepithelial fibrosis, increased matrix metalloproteinase 9 and tissue inhibitors of metalloproteinase 1 expression, goblet cell hyperplasia, and submucous gland hypertrophy were observed compared with the control group. Features of airway remodeling were more prominent in the lung tissue. Administration of dexamethasone significantly inhibited these histologic changes. CONCLUSION Airway remodeling associated with long-term allergen challenge can occur in the nasal mucosa and the lung. Steroid treatment prevents airway inflammation in response to acute allergen challenge, as well as airway remodeling by long-term allergen challenge.
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Affiliation(s)
- Yune Sung Lim
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
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Gluck U, Martin U, Bosse B, Reimer K, Mueller S. A clinical study on the tolerability of a liposomal povidone-iodine nasal spray: implications for further development. ORL J Otorhinolaryngol Relat Spec 2006; 69:92-9. [PMID: 17148942 DOI: 10.1159/000097758] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2006] [Accepted: 09/21/2006] [Indexed: 11/19/2022]
Abstract
PURPOSE OF STUDY This phase I study assessed tolerability and local effect of a liposome dispersion with povidone-iodine (polyvinylpyrrolidone-iodine, PVP-I) as nasal spray. PROCEDURES Three groups received liposomal dispersion with PVP-I (2.2, 4.4 and 0% as control) in single and repeated use (3 days, three times a day). A set of functional and cytological tests as well as safety assessments were performed. RESULTS No safety-relevant finding or serious adverse events were reported, no evidence for cyto- nor genotoxicity obtained. No clinically relevant changes in mucosa appearance, nor in olfactory sense, nor in ciliary activity (sensitive indicator of local tolerance) occurred and no complaints about nasal airflow obstruction were observed. All liposomal formulations had a positive effect on the nasal mucosa, challenged by allergy in some volunteers. CONCLUSIONS AND MESSAGE: Application of liposomal PVP-I spray to the nasal mucosa does not result in any demonstrable limitation of the nasal function nor in detectable damage to the multilayer ciliated epithelium of the nose. Improvement of various parameters of nasal function under liposomal PVP-I suggest improved mucociliary clearance. Explanation could be humidification, improved surfactant (phospholipid) level and/or sufficient mucolytic activity of iodide due to local application of the constituents.
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Affiliation(s)
- U Gluck
- ENT Unit, Division of Occupational Medicine, Suva Swiss National Accident Insurance Institute, Lucerne, Switzerland.
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Lúdvíksson BR, Arason GJ, Thorarensen O, Ardal B, Valdimarsson H. Allergic diseases and asthma in relation to serum immunoglobulins and salivary immunoglobulin A in pre-school children: a follow-up community-based study. Clin Exp Allergy 2005; 35:64-9. [PMID: 15649268 DOI: 10.1111/j.1365-2222.2005.02141.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND We have previously reported an association between low IgA and allergic manifestations in early childhood (0-2 years) and have now followed our cohort for an additional 2 years. OBJECTIVE To evaluate in a longitudinal community-based cohort study the association between maturation of Ig production and allergic manifestations in the first 4 years of life. METHODS A cohort of 161 randomly selected children was followed from birth to the age of 42-48 months and evaluated at 18-23 months (EV1; n = 179) and again at the age of 42-48 months (EV2; n = 161). Diagnoses were made with the help of a clinical questionnaire, physical examination and skin prick tests (SPTs) to 10 common allergens. Serum immunoglobulins were measured at EV1 and EV2, and salivary IgA (sal-IgA) at EV2. RESULTS Serum IgA, IgE, IgG1, IgG2 and IgG4 increased from 2 to 4 years of age (P < 0.001) and their levels showed close correlations (P < or = 0.01 for most comparisons). Children with one or more positive SPTs had lower serum IgA (P = 0.004) and IgG4 (P = 0.05) at EV2 than those who did not respond, and children who developed allergic rhinitis between EV1 and EV2 had low sal-IgA (P = 0.006) and IgG3 (P < 0.05) at EV2. Atopic eczema was associated with low sal-IgA at EV2, and children who developed eczema between EV1 and EV2 had significantly lower sal-IgA than those who recovered after EV1 (P = 0.02). CONCLUSION Allergic manifestations in predisposed children may be influenced by the rate of maturation of immunological components that counteract sensitization or inhibit effector mechanisms of allergy.
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Affiliation(s)
- B R Lúdvíksson
- Department of Immunology, Institute of Laboratory Medicine, Landspítali University Hospital, Reykjavík, Iceland.
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Cheng L, Enomoto T, Hirota T, Shimizu M, Takahashi N, Akahoshi M, Matsuda A, Dake Y, Doi S, Enomoto K, Yamasaki A, Fukuda S, Mao XQ, Hopkin JM, Tamari M, Shirakawa T. Polymorphisms in ADAM33 are associated with allergic rhinitis due to Japanese cedar pollen. Clin Exp Allergy 2004; 34:1192-201. [PMID: 15298558 DOI: 10.1111/j.1365-2222.2004.02008.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND A recent report provided evidence that a disintegrin and metalloprotease domain 33 (ADAM33), a member of the ADAM family, is a novel susceptibility gene in asthma linked to bronchial hyper-responsiveness. However, there has been no investigation of the genetic role of ADAM33 variants in nasal allergy. OBJECTIVE The purpose of this study was to test the association between ADAM33 polymorphisms and Japanese cedar pollinosis (JCPsis), a most common seasonal allergic rhinitis in Japan. METHODS We conducted a case-control association study among a Japanese population, involving 95 adult individuals with JCPsis and 95 normal healthy controls. A total of 22 single-nucleotide polymorphisms (SNPs) in ADAM33 were genotyped using PCR-based molecular methods. RESULTS Six SNPs of ADAM33 gene, three in introns (7575G/A, 9073G/A and 12540C/T) and three in the coding region (10918G/C, 12433T/C and 12462C/T), were strongly associated with JCPsis (P = 0.0002-0.022 for absolute allele frequencies) and most of the SNPs were in linkage disequilibrium with each other. A higher frequency of the common alleles of these SNPs was noted for the subjects with JCPsis in comparison with healthy controls. We also identified a haplotype associated with the disease susceptibility. In addition, associations were found between ADAM33 polymorphisms and various cedar pollinosis phenotypes including clinical severity, eosinophil counts in nasal secretion and allergen-specific IgE levels in sera, but not total serum IgE levels. CONCLUSION These results indicate that polymorphisms in the ADAM33 gene are associated with susceptibility to allergic rhinitis due to Japanese cedar pollen, but the functional relationship still needs clarification.
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Affiliation(s)
- L Cheng
- Department of Health Promotion and Human Behaviour, Kyoto University Graduate School of Public Health, Kyoto, Japan
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Skorohod N, Yeates DB. Superoxide dismutase failed to attenuate allergen-induced nasal congestion in ragweed-sensitized dogs. J Appl Physiol (1985) 2004; 98:1478-86. [PMID: 15608092 DOI: 10.1152/japplphysiol.00910.2004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
We hypothesized that augmentation of antioxidant defenses with exogenous superoxide dismutase (SOD), an enzyme that provides an initial defense against oxidative injury, would attenuate allergen-induced nasal congestion in the canine model of allergic rhinitis. Nasal congestion was evaluated by the measurements of nasal resistance and the volume of the nasal passage. In five nonsensitized dogs, 30,000 U of SOD from bovine erythrocytes delivered by aerosol to the nasal passages before histamine challenge reduced the histamine-induced nasal congestion. At 30 min postchallenge, nasal resistance was 1.14 +/- 0.2 cmH2O.l(-1).min(-1) in the saline pretreatment study vs. 0.36 +/- 0.02 cmH2O.l(-1).min(-1) in the SOD pretreatment study (P < 0.05), and volume of nasal passage was 10.9 +/- 0.5 cm3 vs. 17.4 +/- 1.3 cm3 (P < 0.05), respectively. In five sensitized dogs, however, neither an analogous pretreatment with SOD nor intranasal aerosolized pretreatment with 30,000 U of SOD conjugated to polyethylene glycol attenuated ragweed-induced nasal congestion. Also, systemic application of SOD did not attenuate responses to challenges with histamine and ragweed in nonsensitized and sensitized dogs, respectively. The antioxidant-induced attenuation of nasal congestion in nonsensitized dogs confirms validity of the model and indicates the involvement of free radical-mediated damage in the genesis of the histamine-induced congestion. In sensitized dogs, the data do not support the hypothesis that oxidative stress is a clinically significant component of acute ragweed-induced nasal congestion. The data do not support the use of SOD for acute protection against allergic rhinitis.
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Affiliation(s)
- Natalia Skorohod
- Dept. of Medicine, M/C 788, Univ. of Illinois at Chicago, Chicago, IL 60612, USA
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18
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Glück U, Gebbers JO. Local pathogenic bacteria in allergic rhinitis: a novel concept of its pathogenesis. ORL J Otorhinolaryngol Relat Spec 2004; 65:202-5. [PMID: 14564093 DOI: 10.1159/000073115] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2003] [Accepted: 07/17/2003] [Indexed: 11/19/2022]
Abstract
BACKGROUND It is still unclear to what extent microorganisms are involved in the pathogenesis of allergic rhinitis. OBJECTIVE Therefore, we examined the mucosal colonization with potential pathogenic bacteria (PPB) of the nasal cavity in allergic and nonallergic subjects. METHODS In an open prospective study of 389 office workers (297 men, mean age 42.5 years, and 92 women, mean age 36.7 years), bacterial swabs were taken selectively from both nasal cavities. Standard skin tests for various aeroallergens and negative control tests were conducted in parallel in these subjects. RESULTS In the 389 subjects, we found positive skin tests in 58 (15%); 37 of these revealed a high level of sensitivity, whilst the other 21 persons had low to moderate levels. Ninety percent of the 58 sensitive persons had PPB in their nasal cavity while only 36% (119) of the remaining 331 subjects with negative skin tests were shown to have PPB in nasal cultures (p < 0.001). Sixty-four percent of the sensitized subjects with PPB were found to have more than 2 PPB species and a positive correlation with the intensity of the skin reaction. In contrast, only 18% (22) of the 119 nonallergic test persons with PPB had more than 1 PPB species. CONCLUSIONS This finding of an unusually high frequency of nasal PPB in subjects with positive skin tests to aeroallergens may indicate an involvement of PPB in the pathogenesis of allergic rhinitis. Yet, further data are still lacking to support this novel concept.
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Affiliation(s)
- Ulrich Glück
- ENT Unit, Division of Occupational Medicine, Suva Swiss National Accident Insurance Institute, Luzern, Switzerland.
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Abstract
Mucus hypersecretion is a prominent feature of allergic rhinitis and asthma. Biologic targets for suppression of hypersecretion range from the inflammatory cells that initiate airway inflammation, to specific cellular elements such as calcium-activated chloride (CLCA) channels, epidermal growth factor receptor tyrosine kinase, and antiapoptotic factors (eg, Bcl-2). Identification of these targets is driving development of new pharmacotherapeutic compounds. Aside from specific instances in which a single mediator has a major impact on hypersecretion--for example, histamine in rhinitis--it is likely that compounds with broad-spectrum anti-inflammatory activity are more effective than compounds with restricted activity. However, certain highly specific targets, such as CLCA channels, seem to be intimately associated with development of a hypersecretory phenotype. Data from clinical trials with blockers of these targets are awaited with great interest, not only for disease management but also to determine the clinical benefit of selective inhibition of airway hypersecretion.
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Affiliation(s)
- Duncan F Rogers
- Thoracic Medicine, National Heart & Lung Institute, Imperial College, Dovehouse St, London SW3 6LY, UK.
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de Marco R, Poli A, Ferrari M, Accordini S, Giammanco G, Bugiani M, Villani S, Ponzio M, Bono R, Carrozzi L, Cavallini R, Cazzoletti L, Dallari R, Ginesu F, Lauriola P, Mandrioli P, Perfetti L, Pignato S, Pirina P, Struzzo P. The impact of climate and traffic-related NO2 on the prevalence of asthma and allergic rhinitis in Italy. Clin Exp Allergy 2002; 32:1405-12. [PMID: 12372117 DOI: 10.1046/j.1365-2745.2002.01466.x] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Environmental factors are likely to be involved in explaining the wide geographical variation in asthma and atopic diseases that has been documented in many recent epidemiological studies. AIM To evaluate to what extent climate and outdoor NO2 pollution can explain the geographical variation in the prevalence of asthma and allergic rhinitis, and to estimate the relative risk for exposure to different levels of these two factors. METHODS The impact of climate and long-term exposure to nitrogen dioxide (NO2) pollution on asthma and allergic rhinitis was assessed in a cross-sectional study, carried out during 1998 to 2000 on young adults aged 20 to 44 years (n = 18 873), living in 13 areas from two different Italian climatic regions (subcontinental and Mediterranean). RESULTS Mediterranean areas had a significantly higher prevalence of asthma-like symptoms (P < 0.001), higher annual mean temperature (16.2 degrees C vs. 12.9 degrees C), lower temperature range (16.0 C degrees vs. 22.1 degrees C) and lower NO2 levels (31.46 microg/m3 vs. 57.99 microg/m3) than subcontinental ones. Mediterranean climate was associated with an increased risk of wheeze (OR = 1.23; 95% CI 1.13 to 1.35), tightness in the chest (OR = 1.21; 95% CI 1.11 to 1.33), shortness of breath (OR = 1.21; 95% CI 1.08 to 1.36) and asthma attacks (OR = 1.19; 95% CI 1.07 to 1.31). After adjusting for climate, an increase of 18.3 microg/m3 in NO2 levels moderately increased the risk of asthma attacks (OR = 1.13; 95% CI 0.98 to 1.32), tightness in the chest (OR = 1.11; 95% CI 0.98 to 1.26) and wheeze (OR = 1.11; 95% CI 0.96 to 1.28). When the levels of outdoor NO2 exposure rose, the prevalence of allergic rhinitis increased significantly in the Mediterranean region (OR = 1.38; 95% CI 1.12 to 1.69), but not in the subcontinental one (OR = 1.03; 95% CI 0.83 to 1.28). CONCLUSION Our results show that the prevalence of asthma increases when annual mean temperature increases and temperature range decreases. Furthermore, climate interacts with NO2 outdoor exposure, increasing the risk for allergic rhinitis in people exposed to high stable temperatures. A long-term role for the effect of traffic pollution on asthma is also suggested.
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Affiliation(s)
- R de Marco
- Unit of Epidemiology and Medical Statistics, Department of Medicine and Public Health, University of Verona, Verona, Italy.
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