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Necker-Brown A, Kooi C, Thorne AJ, Bansal A, Mostafa MM, Chandramohan P, Gao A, Kalyanaraman K, Milani A, Gill S, Georgescu A, Sasse SK, Gerber AN, Leigh R, Newton R. Inducible gene expression of IκB-kinase ε is dependent on nuclear factor-κB in human pulmonary epithelial cells. Biochem J 2024; 481:959-980. [PMID: 38941070 DOI: 10.1042/bcj20230461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 06/19/2024] [Accepted: 06/28/2024] [Indexed: 06/29/2024]
Abstract
While IκB-kinase-ε (IKKε) induces immunomodulatory genes following viral stimuli, its up-regulation by inflammatory cytokines remains under-explored. Since airway epithelial cells respond to airborne insults and potentiate inflammation, IKKε expression was characterized in pulmonary epithelial cell lines (A549, BEAS-2B) and primary human bronchial epithelial cells grown as submersion or differentiated air-liquid interface cultures. IKKε expression was up-regulated by the pro-inflammatory cytokines, interleukin-1β (IL-1β) and tumour necrosis factor-α (TNFα). Thus, mechanistic interrogations in A549 cells were used to demonstrate the NF-κB dependence of cytokine-induced IKKε. Furthermore, chromatin immunoprecipitation in A549 and BEAS-2B cells revealed robust recruitment of the NF-κB subunit, p65, to one 5' and two intronic regions within the IKKε locus (IKBKE). In addition, IL-1β and TNFα induced strong RNA polymerase 2 recruitment to the 5' region, the first intron, and the transcription start site. Stable transfection of the p65-binding regions into A549 cells revealed IL-1β- and TNFα-inducible reporter activity that required NF-κB, but was not repressed by glucocorticoid. While critical NF-κB motifs were identified in the 5' and downstream intronic regions, the first intronic region did not contain functional NF-κB motifs. Thus, IL-1β- and TNFα-induced IKKε expression involves three NF-κB-binding regions, containing multiple functional NF-κB motifs, and potentially other mechanisms of p65 binding through non-classical NF-κB binding motifs. By enhancing IKKε expression, IL-1β may prime, or potentiate, responses to alternative stimuli, as modelled by IKKε phosphorylation induced by phorbol 12-myristate 13-acetate. However, since IKKε expression was only partially repressed by glucocorticoid, IKKε-dependent responses could contribute to glucocorticoid-resistant disease.
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Affiliation(s)
- Amandah Necker-Brown
- Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada
| | - Cora Kooi
- Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada
- Department of Medicine, Lung Health Research Group. Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Andrew J Thorne
- Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada
| | - Akanksha Bansal
- Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada
| | - Mahmoud M Mostafa
- Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada
| | - Priyanka Chandramohan
- Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada
| | - Alex Gao
- Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada
| | | | - Arya Milani
- Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada
| | - Sachman Gill
- Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada
| | - Andrei Georgescu
- Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada
| | - Sarah K Sasse
- Department of Medicine, National Jewish Health, Denver, CO, U.S.A
| | - Anthony N Gerber
- Department of Medicine, National Jewish Health, Denver, CO, U.S.A
- Department of Immunology and Genomic Medicine, National Jewish Health, Denver, CO, U.S.A
| | - Richard Leigh
- Department of Medicine, Lung Health Research Group. Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Robert Newton
- Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada
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Okamoto Y, Kato M, Ishii K, Sato Y, Hata T, Asaka Y. Safety and effectiveness of a 300 IR house dust mite sublingual tablet: descriptive 4-year final analysis of a post-marketing surveillance in Japan. Immunotherapy 2023; 15:1401-1414. [PMID: 37727966 DOI: 10.2217/imt-2023-0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023] Open
Abstract
Background: Data are limited for clinical outcomes with house dust mite (HDM) allergen immunotherapy beyond 2 years' observation. Materials & methods: A post-marketing drug-use survey assessed the safety and effectiveness of the 300 index of reactivity (IR) HDM tablet during use for up to 4 years in Japan. Results: 538 patients were evaluable for safety and 383 for effectiveness. Most adverse drug reactions (ADRs) occurred early and were local reactions; 5.6% of 249 total events were reported during years 2 to 4 as new ADRs after the interim analysis. The CAP-RAST score was identified as a potential risk factor for ADRs. The proportion of evaluable patients with severe allergic rhinitis symptoms decreased from 46.4% at baseline (n = 317) to 1.0% at 4 years (n = 104). Patients (n = 16) who discontinued 300 IR HDM tablet due to symptomatic improvement had sustained improvement relative to baseline 1 to 2 years later. Conclusion: Long-term use of the 300 IR HDM tablet is safe and effective.
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Affiliation(s)
- Yoshitaka Okamoto
- Chiba University, Chiba, 260-8670 & Chiba Rosai Hospital, Chiba, 290-0003, Japan
| | - Moe Kato
- Shionogi Pharmacovigilance Center Co., Ltd, Osaka, 541-0045, Japan
| | - Kiyonori Ishii
- Shionogi Pharmacovigilance Center Co., Ltd, Osaka, 541-0045, Japan
| | - Yumi Sato
- Medical Affairs Department, Shionogi & Co., Ltd, Osaka, 541-0045, Japan
| | - Tomohisa Hata
- Pharmacovigilance Department, Shionogi & Co., Ltd, Osaka, 541-0042, Japan
| | - Yuta Asaka
- Pharmacovigilance Department, Shionogi & Co., Ltd, Osaka, 541-0042, Japan
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Efficacy of Montelukast in Allergic Rhinitis Treatment: A Systematic Review and Meta-Analysis. Drugs 2021; 80:1831-1851. [PMID: 32915441 DOI: 10.1007/s40265-020-01406-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND In treating allergic rhinitis, montelukast has the potential to be used as an alternative or addition to an oral antihistamine or intranasal corticosteroid. OBJECTIVE The objective of this systematic review was to assess the effectiveness of montelukast in treating allergic rhinitis. METHODS An electronic literature search was performed using the Cochrane Central Register of Controlled Trials, EMBASE, and MEDLINE from 1966 to 21 January 2019. The eligibility criteria were randomized controlled trials comparing montelukast with placebo or other standard treatments. The primary outcomes assessed were daytime nasal symptom score (DNS) and night-time nasal symptom score (NNS). The secondary outcomes assessed were composite nasal symptom score (CSS), daytime eyes symptom score (DES), and rhinoconjunctivitis quality-of-life questionnaires (RQLQ). The meta-analysis was conducted using Review Manager 5.3 software based on the random-effects model. RESULTS Fifteen studies of 10387 participants met the inclusion criteria. Montelukast was more effective than placebo in improving DNS (mean difference [MD] - 0.12, 95% confidence interval [CI] - 0.15 to - 0.08; p < 0.001), NNS (MD - 0.09, 95% CI - 0.13 to - 0.05; p < 0.001), CSS (MD - 0.08, 95% CI - 0.11 to - 0.06; p < 0.001), DES (MD - 0.17, 95% CI - 0.33 to - 0.02; p < 0.030), and RQLQ (MD - 0.34, 95% CI - 0.49 to - 0.20; p < 0.001). Oral antihistamine was superior to montelukast in improving DNS (MD 0.08, 95% CI 0.03-0.13; p = 0.002), CSS (MD 0.03, 95% CI - 0.02 to 0.07; p = 0.27), DES (MD 0.06, 95% CI 0-0.12; p = 0.040), and RQLQ (MD 0.03, 95% CI - 0.05 to 0.12; p = 0.430). Montelukast was superior to oral antihistamine in improving NNS (MD -0.03, 95% CI - 0.08 to 0.03; p = 0.330). Intranasal fluticasone spray was superior to montelukast in improving DNS (MD 0.71, 95% CI 0.44-0.99; p < 0.001) and NNS (MD 0.63, 95% CI 0.29-0.97; p < 0.001). Combined montelukast and oral antihistamine was superior to oral antihistamine in improving DNS (MD - 0.15, 95% CI - 0.27 to - 0.03; p = 0.010), NNS (MD - 0.16, 95% CI - 0.28 to - 0.05; p = 0.006), CSS (MD - 0.12, 95% CI - 0.25 to - 0.01; p = 0.070), DES (MD - 0.12, 95% CI - 0.30 to 0.06; p = 0.180), and RQLQ (MD - 0.10, 95% CI - 0.28 to 0.08; p = 0.290). Combined montelukast and OAH was superior to montelukast in improving DNS (MD 0.15, 95% CI 0.08-0.21; p < 0.001), NNS (MD 0.05, 95% CI - 0.09 to 0.19; p = 0.510), CSS (MD 0.1, 95% CI 0.03-0.17; p = 0.007), DES (MD 0.18, 95% CI 0-0.36; p = 0.050), and RQLQ (MD 0.07 95% CI - 0.15 to 0.29; p = 0.530). CONCLUSIONS Montelukast is more effective than placebo in treating the overall symptoms of allergic rhinitis while the combined therapy of montelukast and an oral antihistamine is superior to either montelukast or an oral antihistamine alone.
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Kitamura Y, Kamimura S, Fujii T, Mizuguchi H, Naito K, Kondo E, Matsuda K, Azuma T, Sato G, Fukui H, Takeda N. Effects of corticosteroid on mRNA levels of histamine H1 receptor in nasal mucosa of healthy participants and HeLa cells. THE JOURNAL OF MEDICAL INVESTIGATION 2020; 67:311-314. [PMID: 33148907 DOI: 10.2152/jmi.67.311] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The purpose of this study is to examine the effect of intranasal corticosteroid (INCS) administration on histamine H1 receptor (H1R) gene expression in the nasal mucosa of healthy participants and the effects of dexamethasone on basal and histamine-induced H1R mRNA expression, and histamine-induced phosphorylation of extracellular signal-regulated kinase (ERK) in HeLa cells. Sixteen healthy participants were given INCS once daily for a week. After pretreatment of dexamethasone, HeLa cells were treated with histamine. Levels of H1R mRNA and phosphorylation of ERK were measured using real time PCR and immunoblot analysis, respectively. Levels of H1R mRNA in the nasal mucosa of healthy participants receiving INCS was significantly decreased. Dexamethasone suppressed basal levels of H1R mRNA, and histamine-induced up-regulation of H1R mRNA and ERK phosphorylation in HeLa cells. These data suggested that corticosteroid inhibited both basal transcription and histamine-induced transcriptional activation of H1R through its suppression of ERK phosphorylation in the signaling pathway involved in H1R gene transcription. It is further suggested that pre-seasonal prophylactic administration of INCS suppresses both basal and pollen-induced upregulation of H1R gene expression in the nasal mucosa of patients with pollinosis, leading to prevention of the exacerbation of nasal symptoms during peak pollen season. J. Med. Invest. 67 : 311-314, August, 2020.
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Affiliation(s)
- Yoshiaki Kitamura
- Departments of Otolaryngology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Seiichiro Kamimura
- Departments of Otolaryngology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Tatsuya Fujii
- Departments of Otolaryngology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Hiroyuki Mizuguchi
- Laboratory of Pharmacology, Faculty of Pharmacy, Osaka Ohtani University, Osaka, Japan
| | - Keisuke Naito
- Departments of Otolaryngology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Eiji Kondo
- Departments of Otolaryngology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Kazunori Matsuda
- Departments of Otolaryngology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Takahiro Azuma
- Departments of Otolaryngology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Go Sato
- Departments of Otolaryngology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Hiroyuki Fukui
- Departments of Molecular Studies for Incurable Diseases, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Noriaki Takeda
- Departments of Otolaryngology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
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Soma T, Uchida Y, Nakagome K, Hoshi R, Nagata M. Eicosanoids seasonally impact pulmonary function in asthmatic patients with Japanese cedar pollinosis. Allergol Int 2020; 69:594-600. [PMID: 32600924 DOI: 10.1016/j.alit.2020.04.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 03/21/2020] [Accepted: 04/04/2020] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Condition of asthma in patients with asthma and concomitant seasonal allergic rhinitis (SAR) deteriorates during the Japanese cedar pollen (JCP) season. However, the underlying mechanisms remain unclear. METHODS We analyzed seasonal variations in eicosanoid levels in the airways of patients with asthma and concomitant SAR sensitized to JCP (N = 29, BA-SAR-JCP group) and those not sensitized (N = 13, BA-AR-non-JCP group) during the JCP season. The association between changes in eicosanoid concentrations and pulmonary function was assessed. Exhaled breath condensate (EBC) was collected, and pulmonary function tests were performed during the JCP and non-JCP seasons. The cysteinyl leukotriene (CysLT), thromboxane B2 (TXB2), prostaglandin D2-methoxime (PGD2-MOX), and leukotriene B4 (LTB4) levels in the collected EBC were measured via enzyme-linked immunosorbent immunoassays. RESULTS The log CysLT levels significantly increased in the BA-SAR-JCP group during the JCP season compared with the non-JCP season (1.78 ± 0.55, 1.39 ± 0.63 pg/mL, mean ± standard deviation, respectively, p = 0.01) and those in the BA-AR-non-JCP group during the JCP season (1.39 ± 0.38 pg/mL, p = 0.04). Moreover, the log TXB2 levels seemed to increase. However, the log LTB4 and log PGD2-MOX levels did not increase. The changes in the log CysLT levels during the two seasons were negatively correlated to forced expiratory volume in one second (FEV1) in the BA-SAR-JCP group (r = -0.52, p < 0.01). CONCLUSIONS In the BA-SAR-JCP group, seasonal increases in eicosanoid levels in the airway likely promoted deterioration in pulmonary function despite optimal maintenance treatment.
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Affiliation(s)
- Tomoyuki Soma
- Department of Respiratory Medicine, Saitama Medical University, Saitama, Japan; Allergy Center, Saitama Medical University, Saitama, Japan.
| | - Yoshitaka Uchida
- Department of Respiratory Medicine, Saitama Medical University, Saitama, Japan; Allergy Center, Saitama Medical University, Saitama, Japan
| | - Kazuyuki Nakagome
- Department of Respiratory Medicine, Saitama Medical University, Saitama, Japan; Allergy Center, Saitama Medical University, Saitama, Japan
| | - Rie Hoshi
- Allergy Center, Saitama Medical University, Saitama, Japan; Hoshi Clinic, Saitama, Japan
| | - Makoto Nagata
- Department of Respiratory Medicine, Saitama Medical University, Saitama, Japan; Allergy Center, Saitama Medical University, Saitama, Japan
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Xiong J, Yang J, Yuan T, Wang X, Jiang Y, Zhou X, Liao K, Xu L. Heat-sensitive moxibustion for anaphylactic rhinitis: A protocol of systematic review and meta-analysis of randomized clinical trials. Medicine (Baltimore) 2020; 99:e18557. [PMID: 31977848 PMCID: PMC7004650 DOI: 10.1097/md.0000000000018557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 12/03/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Anaphylactic rhinitis (AR) is one of the most common allergic disorders globally. Heat-sensitive moxibustion (HSM) is an effective method for AR without the occurrence of drug damage. This study aims to systematically investigate the effectiveness and safety of HSM for patients with AR. METHODS Seven relevant electronic databases from inception until January 2020 including PubMed, Embase, Cochrane Library, the China National Knowledge Infrastructure Database, Wanfang Database, Chinese Biomedical Literature Database, and Chinese Scientific Journal Database will be searched. All relevant randomized clinical trials published in English and Chinese about HSM for AR regardless of blinding or publication types can be included. The Cochrane Central Register of Controlled Trials and other potential articles in the reference list of included studies will also be searched. We recommend total nasal symptom score as primary outcomes. Secondary outcomes includes rhinoconjunctivitis quality of life questionnaire, IgE, visual analogue scale, laboratory examination, and side effects. Study selection, data extraction, and quality assessment will be performed independently by 2 reviewers. Assessment of risk of bias and data synthesis will be conducted by RevMan 5.3 software. ETHICS AND DISSEMINATION Ethical approval is not required for no personal data involved. The results of this SR will be disseminated through peer-reviewed publications according to the Preferred Reporting Items for Systematic reviews and Meta Analysis Protocols guidelines. RESULTS The results will be published in a peer-reviewed journal. CONCLUSION The findings will provide further evidence for the management of AR. PROSPERO REGISTRATION NUMBER CRD42019140723.
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Affiliation(s)
- Jun Xiong
- Affiliated Hospital of Jiangxi University of TCM
| | - Jun Yang
- Jiangxi University of TCM, Nanchang, Jiangxi, PR China
| | - Ting Yuan
- Jiangxi University of TCM, Nanchang, Jiangxi, PR China
| | - Xue Wang
- Jiangxi University of TCM, Nanchang, Jiangxi, PR China
| | | | | | - Kai Liao
- Affiliated Hospital of Jiangxi University of TCM
| | - Lingling Xu
- Affiliated Hospital of Jiangxi University of TCM
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Ando Y, Miyamoto M, Kato M, Nakayama M, Fukuda H, Yoshihara S. Pru p 7 Predicts Severe Reactions after Ingestion of Peach in Japanese Children and Adolescents. Int Arch Allergy Immunol 2019; 181:183-190. [DOI: 10.1159/000504367] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 10/25/2019] [Indexed: 11/19/2022] Open
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Çoban K, Öz I, Topçu Dİ, Aydın E. The Impact of Serum 25-Hydroxyvitamin D3 Levels on Allergic Rhinitis. EAR, NOSE & THROAT JOURNAL 2019; 100:NP236-NP241. [DOI: 10.1177/0145561319874310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
We aimed to clarify the relation between allergic rhinitis and the serum levels of 25-hydroxivitamin D in the adult population. The study group consisted of 86 patients with allergic rhinitis who were diagnosed with the help of history of allergy, positive signs for allergy, blood samples, and positive skin prick tests; while the control group included 43 age- and sex-matched healthy volunteers with negative skin prick tests. The demographic data, medical history, findings in the physical examinations, serum levels of total immunoglobulin E (IgE) and 25-hydroxyvitamin D, and skin prick test results of the groups were noted. A total of 129 patients fulfilling the necessary criteria were enrolled. The median serum 25-hydroxyvitamin D levels in the study group were significantly lower compared to the control group ( P = .014). In the study group, median serum vitamin D levels were significantly higher in men, compared to women ( P = .03). There was a significant negative correlation between IgE and vitamin D levels in the allergic rhinitis group ( P = .028, r = −0.246). This study showed that patients with allergic rhinitis might be more vulnerable to have lower serum levels of vitamin D. Thus, vitamin D supplementation as an adjunctive therapy may be considered in those patients.
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Affiliation(s)
- Kübra Çoban
- Başkent University Medical Faculty, Otorhinolaryngology Department, Ankara, Turkey
| | - Işılay Öz
- Başkent University Medical Faculty, Otorhinolaryngology Department, Ankara, Turkey
| | - Deniz İlhan Topçu
- Başkent University Medical Faculty, Biochemistry Department, Ankara, Turkey
| | - Erdinç Aydın
- Başkent University Medical Faculty, Otorhinolaryngology Department, Ankara, Turkey
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Kang T, Sung CM, Yang HC. Radiofrequency ablation of turbinates after septoplasty has no effect on allergic rhinitis symptoms other than nasal obstruction. Int Forum Allergy Rhinol 2019; 9:1257-1262. [PMID: 31449735 DOI: 10.1002/alr.22420] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 08/06/2019] [Accepted: 08/09/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND In this study we evaluated the effects of inferior turbinate radiofrequency ablation (RFA), performed after septoplasty, on patients with allergic rhinitis (AR) symptoms. METHODS This was a prospective, randomized, controlled study involving 60 patients with both a deviated nasal septum (DNS) and AR. Those who underwent septoplasty/sham surgery constituted the Septo-Sham group and those who underwent septoplasty/RFA formed the Septo-RFA group. Demographic factors, pre- and postoperative symptom scores for allergic rhinitis (SFARs), and Nasal Obstruction and Septoplasty Effectiveness Scale (NOSE) scores were calculated. We subdivided the total SFAR (tSFAR) scores into scores for nasal obstruction (SFAR-NO) and scores for symptoms other than nasal obstruction (SFAR-SONO); the latter included rhinorrhea, itching, and sneezing. RESULTS The baseline characteristics were similar between the groups. The 2 types of surgery improved both the NOSE and SFAR scores. In subgroup analysis according to the type of symptoms, both types of surgery showed improvement in SFAR-NO and SFAR-SONO scores. However, the extent of improvement did not differ between the groups, regardless of the type of symptoms. CONCLUSION For patients with both DNS and AR, both types of surgery afford postoperative symptomatic improvement. Both types of surgery yielded improvement in both nasal obstruction and symptoms other than nasal obstruction. However, performing RFA after septoplasty did not afford further short-term symptomatic improvements. Thus, septoplasty without RFA may be optimal for patients with both DNS and AR.
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Affiliation(s)
- Taegu Kang
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School and Chonnam National University Hospital, Gwangju, South Korea
| | - Chung Man Sung
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School and Chonnam National University Hospital, Gwangju, South Korea
| | - Hyung Chae Yang
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School and Chonnam National University Hospital, Gwangju, South Korea
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Ogi K, Manabe Y, Mori S, Kimura Y, Tokunaga T, Kato Y, Takabayashi T, Narita N, Fujieda S. Long-Term Effects of Combined Submucous Turbinectomy and Posterior Nasal Neurectomy in Patients with Allergic Rhinitis. ACTA ACUST UNITED AC 2019. [DOI: 10.1007/s42399-019-00091-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Kaya Z, Yayla M, Cinar I, Celebi D, Toktay E, Bayraktutan Z, Bilici D. Effect of Montelukast, a Cysteinyl Leukotriene Receptor-1 Antagonist, on a Rat Model of Acute Bacterial Sinonasal Inflammation. Am J Rhinol Allergy 2019; 33:559-566. [PMID: 31129976 DOI: 10.1177/1945892419852576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Aim This study aimed to investigate montelukast (MONT), a leukotriene receptor antagonist, as a potential treatment protocol and/or supportive therapy against acute bacterial sinonasal inflammation by histopathological and molecular analyses. Material and Methods A total of 30 rats were used in the study. The nasal dorsum was sterilized, and gelatin sponges were inserted into the right nasal cavities. The nostrils were then inoculated with Staphylococcus aureus (SA) for rhinosinusitis (RS) induction. Rats were treated once daily for 7 days with an injection of saline, either cefazolin sodium (CEFA) or MONT. Tissue samples were collected for examination. Results To evaluate whether CEFA and MONT were able to attenuate the SA-induced nasal inflammation, we analyzed the proinflammatory cytokine levels in the nasal tissue of rats by real-time polymerase chain reaction (PCR). The inflammatory cytokines tumor necrosis factor-α ( P ≤ .05) and interleukin-1α (IL-1α) ( P ≤ .05) increased in the SA-induced group, when compared with the healthy control. MONT treatment significantly reversed these elevations, especially IL-1α messenger RNA expression levels induced by SA. Also, CEFA administration significantly changed the proinflammatory cytokine levels when compared to the SA group, but this effect was not as strong as MONT. Also, histopathological findings supported the beneficial effects of MONT. Conclusion This study histopathologically and molecularly showed that MONT significantly ameliorated the SA-associated sinonasal inflammatory reaction, both alone and in combination with CEFA. These results may suggest that MONT may block the inflammatory reaction underlying RS even more significantly by antioxidative or anti-inflammatory effects. This study suggests MONT as a future potential therapeutic agent for RS treatment.
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Affiliation(s)
- Zülküf Kaya
- 1 Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Muhammed Yayla
- 2 Department of Pharmacology, Faculty of Medicine, Kafkas University, Kars, Turkey
| | - Irfan Cinar
- 2 Department of Pharmacology, Faculty of Medicine, Kafkas University, Kars, Turkey
| | - Demet Celebi
- 3 Department of Microbiology, Faculty of Veterinary, Ataturk University, Erzurum, Turkey
| | - Erdem Toktay
- 4 Department of Histology and Embryology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Zafer Bayraktutan
- 5 Department of Biochemistry, Faculty of Pharmacy, Ataturk University, Erzurum, Turkey
| | - Dilek Bilici
- 6 Department of Microbiology, Erzurum Training and Research Hospital, Erzurum, Turkey
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Okubo K, Suzuki T, Tanaka A, Aoki H. Efficacy and safety of rupatadine in Japanese patients with seasonal allergic rhinitis: A double-blind, randomized, multicenter, placebo-controlled clinical trial. Allergol Int 2019; 68:207-215. [PMID: 30391169 DOI: 10.1016/j.alit.2018.08.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 08/22/2018] [Accepted: 08/31/2018] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Rupatadine is a novel non-sedating second-generation H1-antihistamine with antiplatelet-activating factor activity, first marketed in Spain in 2003. It is used for treating allergic rhinitis in more than 80 countries. This study investigated its efficacy and safety in Japanese patients with seasonal allergic rhinitis (SAR). METHODS This was a randomized, placebo-controlled, double-blind study conducted at 4 medical institutions in Japan (JapicCTI-152785). Adolescent and adult SAR outpatients aged 12-64 years entered a 1-week placebo run-in period. After eligibility was confirmed, patients orally received placebo, rupatadine 10 mg, or 20 mg once daily for 2 weeks. The primary endpoint was a change from baseline to second week of treatment in total 4 nasal symptom score (T4NSS). RESULTS Nine hundred patients were randomly assigned to placebo, rupatadine 10 mg, or rupatadine 20 mg (302, 298, and 300 patients, respectively). The least squares mean difference in the primary endpoint between rupatadine and placebo was -1.085 for 10 mg, and -1.415 for 20 mg (analysis of covariance, both P < 0.001). The rates of adverse events were 6.6%, 14.1%, and 15.0% for placebo, rupatadine 10 mg, and rupatadine 20 mg, respectively. Somnolence was most frequently reported: 7.0% for rupatadine 10 mg and 7.3% for rupatadine 20 mg. No serious adverse drug reactions were observed, and no adverse events resulted in premature discontinuation. CONCLUSIONS Rupatadine 10 and 20 mg were significantly superior to placebo in improving nasal and ocular symptoms of SAR, and were well tolerated.
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Affiliation(s)
- Kimihiro Okubo
- Department of Otorhinolaryngology, Nippon Medical School, Tokyo, Japan.
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Sasaki K, Ohshiro T, Sakio R, Toriumi M, Hatano A, Fukazawa E, Kono T, Yoshihama K, Ogawa K, Ohshiro T. Efficacy of seasonal allergic rhinitis using an 810 nm diode laser system. Laser Ther 2019; 28:11-18. [PMID: 31190693 DOI: 10.5978/islsm.28_19-or-01] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 02/22/2019] [Indexed: 11/06/2022]
Abstract
Background and Aims Allergic rhinitis annually reach epidemic proportions in Japan. Approximately 30 to 40% of the population suffers from allergic rhinitis during the spring season. Symptoms comprise rhinorrhea, nasal congestion, and sneezing accompanied by irritation and itching of the eyes. The Ohshiro Clinic started using the conventional Nd:YAG laser for the treatment of allergic rhinitis in 1993, and from 2005 we started using a diode laser-pumped Nd:YAG laser. From 2010, we adopted a novel 810 nm diode laser, and the present retrospective study examined the efficacy rate of the treatment of allergic rhinitis in the 2018 season with this system, compared with a previous study in 2011. We aimed to confirm the degree of improvement for each symptom to evaluate effectiveness of the diode laser treatment. Subjects and methods Between January 8, 2018 and April 30, 2018, a large number of patients consulted our clinic with the major complaint of seasonal allergic rhinitis. They underwent a blood test, and the antigen-specific serum IgE antibody titers were measured for a definitive diagnosis of cedar pollinosis. A total of 211 target patients were treated during the trial period. The average age of the target group was 36.3 years, 134 males, and 77 females. The target patients were treated with lower nasal turbinate mucosal irradiation using a diode laser (ADL-20, Asuka Medical) delivering 810 nm at 7.5 W, with a total energy per treatment of 240 J/cm2. We adopted a five-step evaluation in accordance with the Japanese Guidelines for Allergic Rhinitis 2014 for the symptoms of rhinorrhea, sneezing and nasal obstruction. We assessed the degree of improvement in the severity of these symptoms following diode laser treatment from baseline to one month after treatment, in addition to assessing patient satisfaction with the degree of improvement in their quality of life (QOL). Results The 211 patients positive for cedar pollinosis by the antigen-specific serum IgE antibody tests were broken down by month by number and by improvement, no change or exacerbation as follows. January, 18 patients: 33.4%, 44.4% and 22.2%, respectively. February, 29: 10.4%, 44.4% and 22.2%, respectively. March, 146: 60.3%, 31.5% and 8.2%, respectively. April, 18: 77.8%, 16.7% and 5.5%, respectively. The monthly respective improvement, no change or worse patient QOL as percentages were as follows: January: 16.7%, 44.4% and 38.9%. February: 17.3%, 13.8% and 68.9%. March: 61.6%, 29.5% and 8.9%. April: 94.4%, 0.0% and 5.6%. The values for prevention of exacerbation versus exacerbation for each month were: January, 77.8% vs 22.2%; February, 41.4% vs 58.6%; March, 91.8% vs 8.2%; and April, 94.4% vs 5.6%. The mean efficacy rate for the trial period in the present study was therefore 52.6% which compared very favorably with the mean efficacy rate in the 2011 study of 53.4%. Conclusions The results showed that the 810 nm diode laser offered a safe and effective solution for the uncomfortable symptoms of allergic rhinitis and could be well applied during the season of Japanese cedar pollen dispersion. Furthermore, a tendency towards high efficacy was demonstrated for laser treatment in class 6 cedar pollinosis patients, based on the specific IgE antibody test.
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Affiliation(s)
| | | | | | - Masahiro Toriumi
- Dept. of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo
| | - Asako Hatano
- Dept. of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo
| | - Emi Fukazawa
- Dept. of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo
| | - Takeyuki Kono
- Dept. of ENT, Keio University School of Medicine, Tokyo
| | | | - Kaoru Ogawa
- Dept. of ENT, Keio University School of Medicine, Tokyo
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Nagashima K, Tominaga K, Fukushi K, Kanamori A, Sasai T, Hiraishi H. Recent trends in the occurrence of bleeding gastric and duodenal ulcers under the Japanese evidence-based clinical practice guideline for peptic ulcer disease. JGH Open 2018; 2:255-261. [PMID: 30619934 PMCID: PMC6308079 DOI: 10.1002/jgh3.12078] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 06/29/2018] [Accepted: 07/08/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND Gastrointestinal hemorrhage occurs frequently. We reviewed the tendency of occurrence of bleeding gastric and duodenal ulcers and their association with antithrombotic therapy before and after the widespread use of Evidence-Based Clinical Practice Guidelines for Peptic Ulcer 2009 (1st edition), which was published to improve treatment outcomes and prevent peptic ulcers. METHODS The study enrolled 1105 patients with bleeding gastric and duodenal ulcers treated at our hospital between January 2000 and March 2016. They were divided into the preguideline group (807 patients treated between January 2000 and December 2010) and the postguideline group (298 patients treated between January 2011 and March 2016). The use of medications, severity, the incidence of Helicobacter pylori infection, the presence of any underlying disease, and other factors were compared between the pre- and postguideline groups. RESULTS The number of patients receiving antithrombotic therapy was slightly higher in the postguideline group without a significant difference (P = 0.50). The incidence of H. pylori infection was significantly lower in the postguideline group (P < 0.001). The rate of premedication with a proton pump inhibitor (PPI) and the rate of severe ulcers were significantly higher in the postguideline group (P = 0.001 and P < 0.001, respectively). The rebleeding rate showed no significant difference, whereas the recurrence rate was significantly higher in the postguideline group (P = 0.041). CONCLUSIONS The major cause of hemorrhagic gastroduodenal ulcers seems to be shifting from H. pylori infection to the administration of drugs with gastrointestinal risk. Antithrombotic therapy tends to be associated with severe ulcers but without statistical significance.
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Affiliation(s)
| | - Keiichi Tominaga
- Department of GastroenterologyDokkyo Medical UniversityTochigiJapan
| | - Koh Fukushi
- Department of GastroenterologyDokkyo Medical UniversityTochigiJapan
| | - Akira Kanamori
- Department of GastroenterologyDokkyo Medical UniversityTochigiJapan
| | - Takako Sasai
- Department of GastroenterologyDokkyo Medical UniversityTochigiJapan
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15
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Bao H, Si D, Gao L, Sun H, Shi Q, Yan Y, Damchaaperenlei D, Li C, Yu M, Li Y. Acupuncture for the treatment of allergic rhinitis: A systematic review protocol. Medicine (Baltimore) 2018; 97:e13772. [PMID: 30572530 PMCID: PMC6320097 DOI: 10.1097/md.0000000000013772] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 11/30/2018] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Allergic rhinitis is a major chronic inflammatory disease of the respiratory tract. A large number of epidemiological investigations have shown that the prevalence of allergic rhinitis (AR) is increasing, resulting in a large burden of disease. Desensitizing drugs such as nasal glucocorticoids and antihistamines are commonly used to treat allergic rhinitis, but this method has a long treatment period and is prone to repeated attacks, and there are certain adverse reactions. Acupuncture can be used to treat a wide variety of diseases including allergic rhinitis without the occurrence of drug damage. We aim to evaluate the efficacy and safety of acupuncture in the treatment of allergic rhinitis. METHODS Relevant databases include the English databases incorporating Web of science, PubMed, Springer, Medline, Cochrane Library, EBASE, WHO International Clinical Trials Registry Platform (ICTRP), as well as the Chinese databases like the China National Knowledge Infrastructure Database (CNKI), Chinese Scientific Journal Database (VIP), Wanfang Database, and Chinese Biomedical Literature Database will be searched normatively according to the rule of each database from the inception to September 1, 2018. Reference list of identified studies, potential gray literatures, relevant conference abstracts, and clinical trial registrations will also be searched. The literature screening, data extraction, and quality assessment will be conducted by 2 researchers independently. Data will be synthesized by either the fixed-effects or random-effects model according to a heterogeneity test. Symptom score will be assessed as the primary outcome. Rhinoconjunctivitis quality of life questionnaire (RQLQ), participants with asthma can use asthma control test (ACT), medicine usage and scoring, laboratory examination, and side effects or adverse events will be evaluated as the secondary outcome. Meta-analysis will be performed using RevMan5.3.5 software provided by the Cochrane Collaboration. RESULTS This study will provide high-quality synthesis based on current evidence of acupuncture treatment for allergic rhinitis in several aspects, including symptom score, drug score, quality of life score, asthma control score, side effects and laboratory examination such as nasal function test, serum total immunoglobulin (IgE), nasal secretion smear, etc. CONCLUSION:: The results of this study will provide updated evidence for weather acupuncture is an effective and safe intervention for allergic rhinitis. ETHICS AND DISSEMINATION It is not necessary for this systematic review to acquire an ethical approval. This review will be disseminated in a peer-reviewed journal or conference presentation. PROSPERO REGISTRATION NUMBER PROSPERO CRD42018109105.
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Affiliation(s)
| | - Dongxu Si
- Beijing University of Chinese Medicine
| | | | | | - Qi Shi
- The 2nd Department of Pulmonary Disease in TCM, The Key Unit of SATCM Pneumonopathy Chronic Cough and Dyspnea, Beijing Key Laboratory of Prevention and Treatment of Allergic Diseases with TCM (No. BZ0321), Center of Respiratory Medicine, China-Japan Friendship Hospital; National Clinical Research Center for Respiratory Diseases, Beijing100029, China
| | - Yue Yan
- The 2nd Department of Pulmonary Disease in TCM, The Key Unit of SATCM Pneumonopathy Chronic Cough and Dyspnea, Beijing Key Laboratory of Prevention and Treatment of Allergic Diseases with TCM (No. BZ0321), Center of Respiratory Medicine, China-Japan Friendship Hospital; National Clinical Research Center for Respiratory Diseases, Beijing100029, China
| | | | - Chunlei Li
- The 2nd Department of Pulmonary Disease in TCM, The Key Unit of SATCM Pneumonopathy Chronic Cough and Dyspnea, Beijing Key Laboratory of Prevention and Treatment of Allergic Diseases with TCM (No. BZ0321), Center of Respiratory Medicine, China-Japan Friendship Hospital; National Clinical Research Center for Respiratory Diseases, Beijing100029, China
| | | | - Youlin Li
- The 2nd Department of Pulmonary Disease in TCM, The Key Unit of SATCM Pneumonopathy Chronic Cough and Dyspnea, Beijing Key Laboratory of Prevention and Treatment of Allergic Diseases with TCM (No. BZ0321), Center of Respiratory Medicine, China-Japan Friendship Hospital; National Clinical Research Center for Respiratory Diseases, Beijing100029, China
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Shen C, Chen F, Wang H, Zhang X, Li G, Wen Z. Individualized treatment for allergic rhinitis based on key nasal clinical manifestations combined with histamine and leukotriene D4 levels. Braz J Otorhinolaryngol 2018; 86:63-73. [PMID: 30467056 PMCID: PMC9422539 DOI: 10.1016/j.bjorl.2018.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 05/24/2018] [Accepted: 09/25/2018] [Indexed: 12/02/2022] Open
Abstract
Introduction The types of allergic rhinitis are roughly classified based on the causative antigens, disease types, predilection time, and symptom severity. Objective To examine the clinical typing and individualized treatment approach for allergic rhinitis and to determine the optimal treatment method for this disease using various drug combination therapies. Methods A total of 108 participants with allergic rhinitis were divided into three groups based on symptoms. Subsequently, each group was further categorized into four subgroups based on the medications received. The efficacy of the treatments was evaluated using the visual analog scale VAS scores of the total and individual nasal symptoms, decline index of the symptom score, histamine and leukotriene levels, and mRNA and protein expression levels of histamine 1 and cysteinyl leukotriene 1 receptors. Results Loratadine + mometasone furoate and loratadine + mometasone furoate + montelukast significantly improved the sneezing symptom and reduced the histamine levels compared with the other combination therapies (p < 0.05). Meanwhile, montelukast + mometasone furoate and montelukast + mometasone furoate + loratadine considerably improved the nasal obstruction symptom and decreased the leukotriene D4 levels compared with the other combination therapies (p < 0.05). Conclusion Clinical symptom evaluation combined with experimental detection of histamine and leukotriene levels can be an objective and accurate method to clinically classify the allergic rhinitis types. Furthermore, individualized treatment based on allergic rhinitis classification can result in a good treatment efficacy.
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Affiliation(s)
- Congxiang Shen
- Department of Otorhinolaryngology Head and Neck Surgery, Southern Medical University, Zhujiang Hospital, Guangzhou, China
| | - Fang Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Southern Medical University, Zhujiang Hospital, Guangzhou, China
| | - Huigang Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Southern Medical University, Zhujiang Hospital, Guangzhou, China
| | - Xinyu Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Southern Medical University, Zhujiang Hospital, Guangzhou, China
| | - Guanxue Li
- Department of Otorhinolaryngology Head and Neck Surgery, Southern Medical University, Zhujiang Hospital, Guangzhou, China
| | - Zhong Wen
- Department of Otorhinolaryngology Head and Neck Surgery, Southern Medical University, Zhujiang Hospital, Guangzhou, China.
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Cheng L, Chen J, Fu Q, He S, Li H, Liu Z, Tan G, Tao Z, Wang D, Wen W, Xu R, Xu Y, Yang Q, Zhang C, Zhang G, Zhang R, Zhang Y, Zhou B, Zhu D, Chen L, Cui X, Deng Y, Guo Z, Huang Z, Huang Z, Li H, Li J, Li W, Li Y, Xi L, Lou H, Lu M, Ouyang Y, Shi W, Tao X, Tian H, Wang C, Wang M, Wang N, Wang X, Xie H, Yu S, Zhao R, Zheng M, Zhou H, Zhu L, Zhang L. Chinese Society of Allergy Guidelines for Diagnosis and Treatment of Allergic Rhinitis. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2018; 10:300-353. [PMID: 29949830 PMCID: PMC6021586 DOI: 10.4168/aair.2018.10.4.300] [Citation(s) in RCA: 178] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 09/17/2017] [Accepted: 10/05/2017] [Indexed: 11/20/2022]
Abstract
Allergic rhinitis (AR) is a global health problem that causes major illnesses and disabilities worldwide. Epidemiologic studies have demonstrated that the prevalence of AR has increased progressively over the last few decades in more developed countries and currently affects up to 40% of the population worldwide. Likewise, a rising trend of AR has also been observed over the last 2-3 decades in developing countries including China, with the prevalence of AR varying widely in these countries. A survey of self-reported AR over a 6-year period in the general Chinese adult population reported that the standardized prevalence of adult AR increased from 11.1% in 2005 to 17.6% in 2011. An increasing number of Journal Articles and imporclinical trials on the epidemiology, pathophysiologic mechanisms, diagnosis, management and comorbidities of AR in Chinese subjects have been published in international peer-reviewed journals over the past 2 decades, and substantially added to our understanding of this disease as a global problem. Although guidelines for the diagnosis and treatment of AR in Chinese subjects have also been published, they have not been translated into English and therefore not generally accessible for reference to non-Chinese speaking international medical communities. Moreover, methods for the diagnosis and treatment of AR in China have not been standardized entirely and some patients are still treated according to regional preferences. Thus, the present guidelines have been developed by the Chinese Society of Allergy to be accessible to both national and international medical communities involved in the management of AR patients. These guidelines have been prepared in line with existing international guidelines to provide evidence-based recommendations for the diagnosis and management of AR in China.
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Affiliation(s)
- Lei Cheng
- Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China
- International Centre for Allergy Research, Nanjing Medical University, Nanjing, China
| | - Jianjun Chen
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qingling Fu
- Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Shaoheng He
- Allergy and Clinical Immunology Research Centre, the First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Huabin Li
- Department of Otolaryngology Head Neck Surgery, Eye & ENT Hospital of Fudan University, Shanghai, China
| | - Zheng Liu
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Guolin Tan
- Department of Otolaryngology Head Neck Surgery, Third Xiangya Hospital, Central South University, Changsha, China
| | - Zezhang Tao
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital, Wuhan University, Wuhan, China
| | - Dehui Wang
- Department of Otolaryngology Head Neck Surgery, Eye & ENT Hospital of Fudan University, Shanghai, China
| | - Weiping Wen
- Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Rui Xu
- Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yu Xu
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital, Wuhan University, Wuhan, China
| | - Qintai Yang
- Department of Otolaryngology Head and Neck Surgery, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chonghua Zhang
- Department of Otolaryngology Head Neck Surgery, Eye & ENT Hospital of Fudan University, Shanghai, China
| | - Gehua Zhang
- Department of Otolaryngology Head and Neck Surgery, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ruxin Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Huadong Hospital, Fudan University, Shanghai, China
| | - Yuan Zhang
- Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
- Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, China
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Bing Zhou
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Dongdong Zhu
- Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Luquan Chen
- Department of Traditional Chinese Medicine, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Xinyan Cui
- Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Yuqin Deng
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital, Wuhan University, Wuhan, China
| | - Zhiqiang Guo
- Department of Otorhinolaryngology Head and Neck Surgery, Huadong Hospital, Fudan University, Shanghai, China
| | - Zhenxiao Huang
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Zizhen Huang
- Department of Otolaryngology Head and Neck Surgery, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Houyong Li
- Department of Otolaryngology Head Neck Surgery, Eye & ENT Hospital of Fudan University, Shanghai, China
| | - Jingyun Li
- Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
| | - Wenting Li
- Department of Otolaryngology Head and Neck Surgery, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yanqing Li
- Department of Otolaryngology Head Neck Surgery, Eye & ENT Hospital of Fudan University, Shanghai, China
| | - Lin Xi
- Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
| | - Hongfei Lou
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Meiping Lu
- Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Yuhui Ouyang
- Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
| | - Wendan Shi
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital, Wuhan University, Wuhan, China
| | - Xiaoyao Tao
- Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Huiqin Tian
- Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Chengshuo Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Min Wang
- Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
| | - Nan Wang
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiangdong Wang
- Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
- Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, China
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Hui Xie
- Department of Otorhinolaryngology, Affiliated Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shaoqing Yu
- Department of Otolaryngology Head and Neck Surgery, Tongji Hospital, Tongji University, Shanghai, China
| | - Renwu Zhao
- Department of Otorhinolaryngology Head and Neck Surgery, Huadong Hospital, Fudan University, Shanghai, China
| | - Ming Zheng
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Han Zhou
- Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Luping Zhu
- Department of Otorhinolaryngology, The Second Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Luo Zhang
- Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
- Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, China
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China.
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Manabe A, Furukawa C, Endo S, Marunaka K, Nishiyama T, Fujii N, Tabuchi Y, Matsunaga T, Ikari A. Chlorpheniramine Increases Paracellular Permeability to Marker Fluorescein Lucifer Yellow Mediated by Internalization of Occludin in Murine Colonic Epithelial Cells. Biol Pharm Bull 2018; 40:1299-1305. [PMID: 28769011 DOI: 10.1248/bpb.b17-00244] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Ions, small molecules, and drugs are absorbed in the intestinal epithelium mediated by transcellular and paracellular pathways. The function of various transporters expressing in the apical and basolateral membranes of intestinal epithelial cells has been well characterized. In contrast, claudins and occludin, components of the tight junctions (TJs), determine the paracellular permeability to ions and low molecular weight compounds, but the properties for permeability has not been clarified in detail. In the present study, we examined the effects of anti-histamine drugs, chlorpheniramine and diphenhydramine, on transepithelial electrical resistance (TER) and permeability to lucifer yellow (LY), a marker of paracellular permeability, using murine colonic MCE301 cells. Chlorpheniramine significantly decreased the steady state of TER and increased permeability to LY, whereas the effects of diphenhydramine were not significant. The mRNAs of occludin and claudin-1-claudin-8 except for claudin-5 were expressed in MCE301 cells. Both anti-histamine drugs did not change solubility of claudins to 0.5% Triton X-100 solution. In contrast, the detergent solubility and intracellular localization of occludin were significantly increased by chlorpheniramine. These results indicate that occludin is dissociated from the TJs by chlorpheniramine. Chlorpheniramine increased protein phosphatase-2A (PP-2A) activity, which was inhibited by cantharidin, a potent PP-2A inhibitor. Furthermore, the changes of TER, permeability to LY, and de-phosphorylation and tight junctional localization of occludin caused by chlorpheniramine were recovered by cantharidin. These results suggest that chlorpheniramine could increase paracellular permeability to low molecular weight compounds mediated by the activation of PP-2A and internalization of occludin in the colonic epithelial cells.
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Affiliation(s)
- Aya Manabe
- From the Laboratory of Biochemistry, Department of Biopharmaceutical Sciences, Gifu Pharmaceutical University
| | - Chisa Furukawa
- From the Laboratory of Biochemistry, Department of Biopharmaceutical Sciences, Gifu Pharmaceutical University
| | - Satoshi Endo
- From the Laboratory of Biochemistry, Department of Biopharmaceutical Sciences, Gifu Pharmaceutical University
| | - Kana Marunaka
- From the Laboratory of Biochemistry, Department of Biopharmaceutical Sciences, Gifu Pharmaceutical University
| | - Tsubasa Nishiyama
- From the Laboratory of Biochemistry, Department of Biopharmaceutical Sciences, Gifu Pharmaceutical University
| | - Naoko Fujii
- From the Laboratory of Biochemistry, Department of Biopharmaceutical Sciences, Gifu Pharmaceutical University
| | | | - Toshiyuki Matsunaga
- From the Laboratory of Biochemistry, Department of Biopharmaceutical Sciences, Gifu Pharmaceutical University
| | - Akira Ikari
- From the Laboratory of Biochemistry, Department of Biopharmaceutical Sciences, Gifu Pharmaceutical University
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MA Y, BU H, LI X, LÜ H, ZHANG X. Acupuncture–moxibustion therapy of "banking up original qi and consolidating the foundation" for prevention and treatment of seasonal allergic rhinitis: A randomized controlled trial. WORLD JOURNAL OF ACUPUNCTURE-MOXIBUSTION 2018. [DOI: 10.1016/j.wjam.2018.03.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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20
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Environmental factors associated with allergic rhinitis symptoms in Japanese university students: A cross-sectional study. Auris Nasus Larynx 2018; 45:1006-1013. [PMID: 29475765 DOI: 10.1016/j.anl.2018.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 02/07/2018] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Numerous studies have reported that various environmental factors during early life are key determinants for developing allergic disease. Herein, we aimed to investigate the impact of environmental factors on allergic rhinitis. METHODS This cross-sectional study was conducted in a single university in Japan (from April to June, in 2015 and 2016). Students voluntarily answered online questionnaires regarding their allergic rhinitis symptoms and their exposure to various environmental factors during preschool-age. RESULTS Overall, 3075 students participated the questionnaire. After excluding those with incomplete datasets, 3016 students were eligible. Of these, 49% had allergic rhinitis symptoms. Female sex was associated with a lower risk of allergic rhinitis symptoms (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.68-0.99). Comorbidity of asthma or atopic dermatitis and a family history of allergy (asthma, atopic dermatitis, or allergic rhinitis) were associated with higher risks of allergic rhinitis symptoms. Regarding the number of household members, compared with subjects with <3 people, those with 5 (OR, 0.74; 95% CI, 0.57-0.97) and ≥6 people (OR, 0.66; 95% CI, 0.49-0.88) in their household showed lower incidences of allergic rhinitis symptoms. No other environmental factors, including birth order, number of siblings, living environment, passive smoking, furry pet ownership, housing, bedding, breastfeeding, dairy product intake, preschool setting, and starting age of preschool, was associated with the incidence of allergic rhinitis symptoms. CONCLUSION Sex, current asthma and atopic dermatitis symptoms, family history of allergies, and the number of people in the household at preschool-age were associated with the incidence of allergic rhinitis symptoms.
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Fujii R, Hishida A, Wu MC, Kondo T, Hattori Y, Naito M, Endoh K, Nakatochi M, Hamajima N, Kubo M, Kuriki K, Wakai K. Genome-wide association study for pollinosis identified two novel loci in interleukin (IL)-1B in a Japanese population. NAGOYA JOURNAL OF MEDICAL SCIENCE 2018; 80:109-120. [PMID: 29581620 PMCID: PMC5857507 DOI: 10.18999/nagjms.80.1.109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 10/30/2017] [Indexed: 11/30/2022]
Abstract
The number of pollinosis patients in Japan has significantly increased over the past 20 years. The majority of genome-wide association studies (GWAS) on pollinosis have been conducted in subjects of European descent, with few studies in Japanese populations. The aim of our GWAS was to identify genetic loci associated with self-reported pollinosis in a Japanese population and to understand its molecular background using a combination of single nucleotide polymorphisms (SNPs) and gene- and pathway-based analyses. A total of 731 and 560 individuals who were recruited as participants of the Japan Multi-Institutional Collaborative Cohort Study participated in the discovery and replication phases, respectively. The phenotype of pollinosis was based on the information from a self-administered questionnaire. In the single-SNP analysis, four SNPs (rs11975199, rs11979076, rs11979422, and rs12669708) reached suggestive significance level (P < 1 × 10-4) and had effects in the same direction in both phases of the study. The pathway-based analysis identified two suggestive pathways (nucleotide-binding oligomerization domain -like receptor and tumor necrosis factor signaling pathways). Both rs1143633 and rs3917368 in the interleukin-1B gene showed associations in the retrace (from pathway to gene and SNP) analysis. We performed single-SNP, gene, and pathway analysis and shed light on the molecular mechanisms underlying pollinosis in a Japanese population.
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Affiliation(s)
- Ryosuke Fujii
- Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Asahi Hishida
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Michael C Wu
- Biostatistics and Biomathematics Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, United States
| | - Takaaki Kondo
- Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yuta Hattori
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Labour Force Statistics Office, Statistics Bureau, Ministry of Internal Affairs and Communications, Tokyo, Japan
| | - Mariko Naito
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kaori Endoh
- Laboratory of Public Health, Graduate School of Integrated Pharmaceutical and Nutritional Sciences, University of Shizuoka, Shizuoka, Japan
| | - Masahiro Nakatochi
- Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan
| | - Nobuyuki Hamajima
- Department of Health Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Michiaki Kubo
- Laboratory for Genotyping Development, Center of Genomic Medicine, RIKEN, Yokohama, Japan
| | - Kiyonori Kuriki
- Laboratory of Public Health, Graduate School of Integrated Pharmaceutical and Nutritional Sciences, University of Shizuoka, Shizuoka, Japan
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Iinuma T, Okamoto Y, Morimoto Y, Arai T, Sakurai T, Yonekura S, Sakurai D, Hirahara K, Nakayama T. Pathogenicity of memory Th2 cells is linked to stage of allergic rhinitis. Allergy 2018; 73:479-489. [PMID: 28857184 DOI: 10.1111/all.13295] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND Allergic rhinitis (AR) consists of three developmental stages that are based on the presence/absence of antigen-specific IgE and symptoms. The pathogenic Th2 (Tpath2) cells constitute a population of Th2 cells with additional potentially pathogenic characteristics. We examined the relationship between Tpath2 cells and the stages of allergic rhinitis by focusing on ST2, which is an IL-33 receptor. METHODS Patients with Japanese cedar pollen-induced AR (JCP-AR) and healthy volunteers were divided into "nonsensitized," "asymptomatic sensitized (AS)," and "JCP-AR" groups. We analyzed the ST2 expression and the Th2 function of cultured CD4+ T cells. Next, we observed the progress of patients in the AS stage around the time of seasonal pollen dispersal, with the characteristics of Th2 cells. RESULTS The ST2 expression of T cells was only upregulated in the AR group. The production of IL-4 and IL-13 was found in CD4+ T cells obtained from AS by stimulation with JCP, but reactivity to IL-33 was not observed. Although IL-33 did not induce the elevation of IL-4 production in the JCP-AR group, IL-33 substantially increased the production of IL-5 and IL-13 in comparison with antigen stimulation alone. In newly afflicted patients, the increased expression of ST2 and elevated reactivity to IL-33 was observed, even before the pollen dispersal season. CONCLUSIONS Our study demonstrated that the pathogenicity of memory Th2 cells is linked to sensitization and the stage of allergic rhinitis. Therefore, Tpath2 cells may provide useful insights into the mechanism of the onset and progression of allergic rhinitis.
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Affiliation(s)
- T. Iinuma
- Department of Otorhinolaryngology, Head and Neck Surgery Chiba University Graduate School of Medicine Chiba Japan
| | - Y. Okamoto
- Department of Otorhinolaryngology, Head and Neck Surgery Chiba University Graduate School of Medicine Chiba Japan
| | - Y. Morimoto
- Department of Otorhinolaryngology, Head and Neck Surgery Chiba University Graduate School of Medicine Chiba Japan
| | - T. Arai
- Department of Otorhinolaryngology, Head and Neck Surgery Chiba University Graduate School of Medicine Chiba Japan
| | - T. Sakurai
- Department of Otorhinolaryngology, Head and Neck Surgery Chiba University Graduate School of Medicine Chiba Japan
| | - S. Yonekura
- Department of Otorhinolaryngology, Head and Neck Surgery Chiba University Graduate School of Medicine Chiba Japan
| | - D. Sakurai
- Department of Otorhinolaryngology, Head and Neck Surgery Chiba University Graduate School of Medicine Chiba Japan
| | - K. Hirahara
- Department of Immunology Chiba University Graduate School of Medicine Chiba Japan
| | - T. Nakayama
- Department of Immunology Chiba University Graduate School of Medicine Chiba Japan
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Liu G, Zhou X, Chen J, Liu F. Oral Antihistamines Alone vs in Combination with Leukotriene Receptor Antagonists for Allergic Rhinitis: A Meta-analysis. Otolaryngol Head Neck Surg 2018; 158:450-458. [PMID: 29337654 DOI: 10.1177/0194599817752624] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Objective To evaluate whether an adjuvant therapy of leukotriene receptor antagonists (LTRAs) based on oral H1-antihistamines (H1) can increase efficacy of allergic rhinitis (AR) treatment. Data Sources The search involved databases of PubMed, EMBASE, and Cochrane Central Register of Controlled Trials, from inception up to September 23, 2017. Randomized controlled trials (RCTs) that compared efficacy of LTRAs + H1 vs H1 alone were eligible. Review Methods Pooled comparative effects were measured using weighted mean difference (WMD) and 95% confidence interval (CI). Subgroup analysis comparing seasonal vs perennial AR was prespecified to explore the source of heterogeneity. The evidence quality of each outcome was assessed by the GRADE approach. Results A total of 8 RCTs were included (n = 1886), and all measured outcomes used scaled scores. Compared with H1 alone, H1 + LTRAs were superior to improve overall daytime (WMD, -0.11; 95% CI, -0.19 to -0.03, high quality) and composite (WMD, -0.12; 95% CI, -0.23 to -0.01; low quality) nasal symptoms. Specifically, H1 + LTRAs had better efficacy against composite nasal rhinorrhea, sneezing, and daytime itching but not congestion. The effects were more pronounced in patients with perennial AR compared to those with seasonal AR. There were no significant differences in nighttime nasal symptoms and eye symptoms between the 2 groups. Conclusion The current evidence suggests that LTRAs + H1 can increase the therapeutic efficacy against daytime and composite nasal symptoms, including rhinorrhea, sneezing, and itching; however, it does not affect nighttime nasal symptoms and eye symptoms. The patients with perennial AR may benefit more from the combination therapy.
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Affiliation(s)
- Guo Liu
- 1 Department of Otolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Xu Zhou
- 2 Evidence-based Medicine Research Center, School of Basic Medical Sciences, Jiangxi University of Traditional Chinese Medicine, Jiangxi, China
| | - Jianrong Chen
- 3 Department of Endocrinology, the Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Feng Liu
- 1 Department of Otolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
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Seasonal omalizumab reduces allergen-specific immunoglobulin E levels in patients with Japanese cedar pollinosis and asthma. REVISTA PORTUGUESA DE PNEUMOLOGIA 2017; 23:365-367. [PMID: 29042155 DOI: 10.1016/j.rppnen.2017.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 08/19/2017] [Accepted: 09/02/2017] [Indexed: 11/20/2022] Open
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Okubo K, Hashiguchi K, Takeda T, Baba K, Kitagoh H, Miho H, Tomomatsu H, Yamaguchi S, Odani M, Yamamotoya H. A randomized controlled phase II clinical trial comparing ONO-4053, a novel DP1 antagonist, with a leukotriene receptor antagonist pranlukast in patients with seasonal allergic rhinitis. Allergy 2017; 72:1565-1575. [PMID: 28378369 PMCID: PMC5638107 DOI: 10.1111/all.13174] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Prostaglandin D2 (PGD2 ) is primarily produced by mast cells and is contributing to the nasal symptoms including nasal obstruction and rhinorrhea. OBJECTIVE This study aimed to evaluate the efficacy and safety of a novel PGD2 receptor 1 (DP1) antagonist, ONO-4053, in patients with seasonal allergic rhinitis (SAR). METHODS This study was a multicenter, randomized, double-blind, parallel-group study of patients with SAR. Following a one-week period of placebo run-in, patients who met the study criteria were randomized to either the ONO-4053, leukotriene receptor antagonist pranlukast, or placebo group for a two-week treatment period. A total of 200 patients were planned to be randomly assigned to receive ONO-4053, pranlukast, or placebo in a 2:2:1 ratio. Nasal and eye symptoms were evaluated. RESULTS Both ONO-4053 and pranlukast had higher efficacy than placebo on all nasal and eye symptoms. ONO-4053 outperformed pranlukast in a total of three nasal symptom scores (T3NSS) as well as in individual scores for sneezing, rhinorrhea, and nasal itching. For T3NSS, the Bayesian posterior probabilities that pranlukast was better than placebo and ONO-4053 was better than pranlukast were 70.0% and 81.6%, respectively, suggesting that ONO-4053 has a higher efficacy compared with pranlukast. There was no safety-related issue in this study. CONCLUSIONS We demonstrated that the efficacy of ONO-4053 was greater than that of pranlukast with a similar safety profile. This study indicates the potential of ONO-4053 for use as a treatment for SAR (JapicCTI-142706).
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Affiliation(s)
- K. Okubo
- Department of OtorhinolaryngologyNippon Medical SchoolTokyoJapan
| | - K. Hashiguchi
- Department of OtorhinolaryngologyFutaba ClinicTokyoJapan
- Medical Corporation ShinanokaiSamoncho ClinicTokyoJapan
| | - T. Takeda
- Department of OtorhinolaryngologyTakeda ClinicSaitamaJapan
| | - K. Baba
- Department of OtorhinolaryngologyTakasaka ClinicSaitamaJapan
| | - H. Kitagoh
- Department of OtorhinolaryngologyKitagoh ClinicKanagawaJapan
| | - H. Miho
- Department of OtorhinolaryngologyMiho ClinicKanagawaJapan
| | - H. Tomomatsu
- Department of OtorhinolaryngologyTomomatsu ClinicTokyoJapan
| | - S. Yamaguchi
- Discovery Research Laboratories IIIOno Pharmaceutical Co., Ltd.OsakaJapan
| | - M. Odani
- Data ScienceOno Pharmaceutical Co., Ltd.OsakaJapan
| | - H. Yamamotoya
- Translational ScienceOno Pharmaceutical Co., Ltd.OsakaJapan
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Sung M, Kim SW, Kim JH, Lim DH. Regional Difference of Causative Pollen in Children with Allergic Rhinitis. J Korean Med Sci 2017; 32:926-932. [PMID: 28480649 PMCID: PMC5426238 DOI: 10.3346/jkms.2017.32.6.926] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 02/11/2017] [Indexed: 11/20/2022] Open
Abstract
The aim of this study was to investigate role of common pollen in Korean school-aged children with allergic rhinitis (AR) in 5 provinces (Incheon Metropolitan City-Gyeonggi Province, Chungcheongbuk-do, Gwangju Metropolitan City, Busan Metropolitan City, and Jeju Special Self-Governing Province), using a questionnaire and skin prick test, and to assess the differences among the residential regions. Among the enrolled 14,678 total children, 1,641 (22.0%) had AR. The sensitization rate to pollen (38.7%) was the second highest among examined allergens and significant differences were in the sensitization rates to trees, weeds, and grasses among the 5 provinces (P < 0.05). The sensitization to trees (25.2%) was the highest common among the pollen types and significant differences also were observed in the sensitization rates to alder, birch, Japanese cedar, oak, and elm among the 5 provinces. The sensitization rate to weeds (19.9%) was the second highest and significant differences were observed in the sensitization rate to Japanese hop, mugwort, and ragweed among the 5 provinces. The sensitization rate to house dust mite was 86.8%, the highest among examined allergens and that to Dermatophagoides farinae exhibited regional differences (P = 0.003) but not to D. farinae (P = 0.584). The sensitization rate to mold (13.5%) was the highest in Jeju and lowest in Busan, and a statistically significant difference was detected among the 5 provinces. These results support that examined pollen allergens are strongly associated with residential region due to regional causative pollen differences among children with AR within Korea to investigate the main pollen allergens.
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Affiliation(s)
- Myongsoon Sung
- Department of Pediatrics, CHA Gumi Medical Center, CHA University School of Medicine, Gumi, Korea
| | - Sung Won Kim
- Department of Pediatrics, Busan St. Mary Hospital, Busan, Korea
| | - Jeong Hee Kim
- Department of Pediatrics, Inha University School of Medicine, Incheon, Korea
- Environmental Health Center for Allergic Rhinitis, Inha University Hospital, Ministry of Environment, Incheon, Korea
| | - Dae Hyun Lim
- Department of Pediatrics, Inha University School of Medicine, Incheon, Korea
- Environmental Health Center for Allergic Rhinitis, Inha University Hospital, Ministry of Environment, Incheon, Korea.
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Okubo K, Gotoh M, Togawa M, Saito A, Ohashi Y. Long-term safety and efficacy of bilastine following up to 12 weeks or 52 weeks of treatment in Japanese patients with allergic rhinitis: Results of an open-label trial. Auris Nasus Larynx 2017; 44:294-301. [DOI: 10.1016/j.anl.2016.07.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 07/25/2016] [Accepted: 07/30/2016] [Indexed: 10/21/2022]
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Wakayama N, Matsune S, Okubo K. Delayed type of allergic skin reaction to Candida albicans in eosinophilic rhinosinusitis cases. Auris Nasus Larynx 2017; 45:111-115. [PMID: 28552275 DOI: 10.1016/j.anl.2017.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 05/11/2017] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Eosinophilic chronic rhinosinusitis (ECRS) is frequently complicated by asthma, and recognized as refractory and persistent rhinosinusitis. However, the detailed pathophysiology of ECRS has not been elucidated yet. In this study, we investigated the association between recurrent ECRS and intradermal testing to multi-antigens including Candida albicans. METHODS The subjects were 49 cases of bilateral chronic rhinosinusitis including 24 ECRS cases. They underwent endoscopic sinus surgery and submitted to pathological examination. Prior to surgery, peripheral blood eosinophil count, total and antigen-specific IgE levels (11 categories), and intradermal tests (5 categories) were carried out in all patients. These patients were followed-up for longer than 3 months. We compared the results of preoperative and postoperative clinical examination data between ECRS and non-ECRS (NECRS) cases. RESULTS Positive reaction of the delayed type of intradermal testing to C. albicans was significantly more often observed in ECRS than NECRS cases. (P<0.01) Additionally, these positive reaction cases exhibited significantly higher recurrence of nasal polyps and symptoms of ECRS (P<0.05). CONCLUSION These results suggest the involvement of (Coombs) type IV allergic reaction to C. albicans in the pathophysiology of ECRS.
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Affiliation(s)
- Nozomu Wakayama
- Department of Otolaryngology, Nippon Medical School Musashikosugi Hospital, 1-396, Kosugimachi, Nakahara-ku Kawasaki-shi, Kanagawa Prefecture 211-0063, Japan.
| | - Shoji Matsune
- Department of Otolaryngology, Nippon Medical School Musashikosugi Hospital, 1-396, Kosugimachi, Nakahara-ku Kawasaki-shi, Kanagawa Prefecture 211-0063, Japan
| | - Kimihiro Okubo
- Department of Otolaryngology, Nippon Medical School Musashikosugi Hospital, 1-396, Kosugimachi, Nakahara-ku Kawasaki-shi, Kanagawa Prefecture 211-0063, Japan
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Pinart M, Keller T, Reich A, Fröhlich M, Cabieses B, Hohmann C, Postma DS, Bousquet J, Antó JM, Keil T. Sex-Related Allergic Rhinitis Prevalence Switch from Childhood to Adulthood: A Systematic Review and Meta-Analysis. Int Arch Allergy Immunol 2017; 172:224-235. [PMID: 28456795 DOI: 10.1159/000464324] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 02/21/2017] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND A sex-related switch in the prevalence of asthma from childhood (male predominance) to adulthood (female predominance) has been described, but for allergic rhinitis this remains unclear. We aimed to examine sex- and age-group-specific differences in allergic rhinitis prevalence by systematically evaluating studies from across the globe. METHODS A systematic search of MEDLINE and Embase for population-based cross-sectional studies was performed regardless of the language of publication. The search was restricted to the present millennium (2000 to June 2014). Study quality was defined by the sampling method, response rate, sample size, and data collection method. To assess sex differences in the prevalence of self- or parent-reported symptoms of rhinitis, calculated pooled estimates of the male-female ratio (MFR) were obtained using random-effects model meta-analyses due to heterogeneity. A meta-regression analysis was also performed. RESULTS Out of 6,539 publications identified, 67 cross-sectional population-based studies (291,726 males and 301,781 females) were included in our meta-analysis. In children (<11 years of age) significantly more boys than girls had rhinitis symptoms (MFR 1.21, 95% CI 1.17-1.25), whereas in adolescents (11 to <18 years of age) males were significantly less often affected than females (MFR 0.90, 95% CI 0.85-0.95). No sex-specific prevalence difference was observed in adults (MFR 0.96, 95% CI 0.83-1.17). These findings were consistent in all continents except in Asia, where the male predominance remained beyond childhood. CONCLUSIONS The male predominance of rhinitis prevalence in childhood changed towards a female predominance in adolescence across the globe, except in Asia. Longitudinal studies are needed to confirm these cross-sectional data and examine possible determinants and underlying mechanisms.
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Affiliation(s)
- Mariona Pinart
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
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Yu CJ, Cui XY, Lu L, Yang J, Chen B, Zhu CW, Gao X. Effects of glucocorticoid on the expression and regulation of aquaporin 5 in the paranasal sinus of rats with chronic rhinosinusitis. Exp Ther Med 2017; 13:1753-1756. [PMID: 28565763 PMCID: PMC5443270 DOI: 10.3892/etm.2017.4215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 12/23/2016] [Indexed: 01/11/2023] Open
Abstract
Aquaporins (AQPs) are water-specific membrane channel proteins that regulate water homeostasis for cells and organisms. AQP5 serves an important role in the maintenance of mucosal water homeostasis, and potentially contributes to mucosal edema and inflammation formation in chronic rhinosinusitis (CRS). The aim of the present study was to explore the expression pattern of AQP5 and the effect of glucocorticoids on AQP5 expression in rats with CRS. The rats were randomly divided into three equal groups, as follows: CRS, dexamethasone (dexa) treatment and control groups. A polyvinyl acetal material containing Staphylococcus aureus was inserted into the left nasal cavity of each rat from the CRS and dexa groups. On the 90th post-operative day, the dexa group received dexamethasone (2 mg/kg/day) via intraperitoneal injection for 7 days. The controls did not receive any treatment. The expression of AQP5 in the sinonasal mucosa was determined using immunohistochemistry and quantitative PCR. The immunoreactivities of AQP5 were primarily noted in the epithelial lining and glandular cells, the vascular endothelium and in the goblet cells in the sinonasal mucosa. The AQP5 mRNA expression level was significantly higher in the dexa group than in the control and CRS groups (P=0.006 and P=0.014, respectively). However, no significant difference was indicated between the CRS and control groups (P=0.760). In conclusion, the current study suggests that glucocorticoids induce AQP5 expression in the sinonasal mucosa of CRS rats, which highlights AQP5 as a potential target in the diagnosis and treatment of CRS.
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Affiliation(s)
- Chen-Jie Yu
- Department of Otolaryngology, Drum Tower Clinical Medical School, Nanjing Medical University, Nanjing, Jiangsu 210008, P.R. China.,Department of Otolaryngology, Nanjing Drum Tower Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu 210008, P.R. China
| | - Xin-Yan Cui
- Department of Otolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Ling Lu
- Department of Otolaryngology, Nanjing Drum Tower Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu 210008, P.R. China
| | - Jun Yang
- Department of Pathology, Nanjing Drum Tower Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu 210008, P.R. China
| | - Bin Chen
- School of Medicine, Southeast University, Nanjing, Jiangsu 210009, P.R. China
| | - Cheng-Wen Zhu
- Department of Otolaryngology, Nanjing Drum Tower Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu 210008, P.R. China
| | - Xia Gao
- Department of Otolaryngology, Drum Tower Clinical Medical School, Nanjing Medical University, Nanjing, Jiangsu 210008, P.R. China.,Department of Otolaryngology, Nanjing Drum Tower Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu 210008, P.R. China
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Bilastine in symptomatic allergic rhinoconjunctivitis and urticaria: a guide to its use. DRUGS & THERAPY PERSPECTIVES 2017. [DOI: 10.1007/s40267-017-0381-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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32
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Okamoto Y, Fujieda S, Okano M, Yoshida Y, Kakudo S, Masuyama K. House dust mite sublingual tablet is effective and safe in patients with allergic rhinitis. Allergy 2017; 72:435-443. [PMID: 27471838 PMCID: PMC5324568 DOI: 10.1111/all.12996] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND House dust mite (HDM) is the major indoor allergen for allergic diseases such as allergic rhinitis (AR) and asthma. Although sublingual immunotherapy is a curative treatment for HDM-induced AR, data from large-scale studies are limited. We evaluated the efficacy and safety of HDM tablets in adolescent and adult patients (aged 12-64 years) with HDM-induced AR with or without intermittent asthma. METHODS In a double-blind trial in Japan, 968 subjects were randomized 1 : 1 : 1 to 300 index of reactivity (IR), 500 IR, or placebo groups. The primary endpoint was the Average Adjusted Symptom Score (AASS) in the last eight weeks of the 52-week treatment. Secondary endpoints included individual nasal and ocular symptom scores, rescue medication use, and the Japanese Rhinoconjunctivitis Quality of Life Questionnaire (JRQLQ) scores. RESULTS The AASS in the last eight weeks of treatment significantly improved in both the 300 IR and the 500 IR groups compared to that in the placebo group (P < 0.001). In the 300 IR group, the onset of action occurred at week 8-10. All four nasal symptoms significantly improved in both active treatment groups; rescue medication use and JRQLQ outcome improved in the 300 IR group. Most adverse events (AEs) were mild, and 16 serious AEs (SAEs) were reported; however, none of them were drug-related. CONCLUSIONS One-year treatment with 300 IR and 500 IR HDM tablets was effective without major safety concerns. The recommended therapeutic dose for AR is 300 IR.
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Affiliation(s)
- Y. Okamoto
- Department of Otorhinolaryngology‐Head and Neck SurgeryGraduate School of MedicineChiba UniversityChibaJapan
| | - S. Fujieda
- Department of Otorhinolaryngology‐Head and Neck SurgeryUniversity of FukuiFukuiJapan
| | - M. Okano
- Department of Otolaryngology‐Head and Neck SurgeryOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOkayamaJapan
| | - Y. Yoshida
- Biostatistics DepartmentShionogi & Co., Ltd.OsakaJapan
| | - S. Kakudo
- Clinical Development DepartmentShionogi & Co., Ltd.OsakaJapan
| | - K. Masuyama
- Department of Otorhinolaryngology‐Head and Neck SurgeryGraduate School of Medical ScienceUniversity of YamanashiYamanashiJapan
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A Network Meta-analysis of Randomized Controlled Trials Focusing on Different Allergic Rhinitis Medications. Am J Ther 2017; 23:e1568-e1578. [PMID: 25867532 DOI: 10.1097/mjt.0000000000000242] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
This study is aimed to investigate the effectiveness of 4 allergic rhinitis (AR) drugs (loratadine, cetirizine, montelukast, and desloratadine) in reducing functional problems in patients, as indicated by rhinoconjunctivitis quality of life questionnaire scores. After an exhaustive search of electronic databases containing published scientific literature, high-quality randomized controlled trials relevant to our study were selected based on a stringent predefined inclusion and exclusion criteria. Statistical analyses were conducted using STATA 12.0 and comprehensive meta-analysis (CMA 2.0) software. The literature search broadly identified 386 studies, and after a multistep screening and elimination process, a total of 13 randomized controlled trials contributed to this network meta-analysis. These 13 high-quality studies contained a combined total of 6867 patients with AR on 4 different medications. The results of network meta-analysis revealed that, compared with placebo, all 4 mediations treated AR effectively [cetirizine: mean: -0.62, 95% confidence intervals (95% CI) = -0.90 to -0.34, P < 0.001; loratadine: mean: -0.32, 95% CI = -0.55 to -0.097, P = 0.005; montelukast: mean: -0.28, 95% CI = -0.54 to -0.023, P = 0.033; desloratadine: mean: -0.39, 95% CI = -0.60 to -0.18, P < 0.001]. A comparison of surface under the cumulative ranking curve values of these 4 interventions clearly showed that cetirizine is the most optimal medication for AR treatment. In conclusion, this network meta-analysis provides the first evidence that cetirizine is the most efficacious treatment for AR compared with loratadine, montelukast, and desloratadine, significantly reducing the functional problems in patients with AR.
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Kim DH, Park YS, Jang HJ, Kim JH, Lim DH. Prevalence and allergen of allergic rhinitis in Korean children. Am J Rhinol Allergy 2017; 30:72-8. [PMID: 27216339 DOI: 10.2500/ajra.2013.27.4317] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND In recent decades, the amount of data about allergic rhinitis (AR) in Korean National Health Insurance Service has increased. OBJECTIVE To investigate the prevalence and quality of sensitized allergens of AR in Korean children and adolescents. METHODS This study obtained the results of the Korean International Study of Asthma and Allergies in Childhood questionnaires and the skin-prick test (SPT) results of 14,356 students who participated in a health screening from 2010 to 2014. AR was defined as one with current symptoms of AR with at least one or more positive results of an SPT with inhalant allergens. RESULTS The prevalence of AR in children was 20.8%. Positive rates of the allergen group were 87.3% for house-dust mites, 37.0% for pollen, 12.4% for mold, and 8.4% for pets. The common allergens in descending order were Dermatophagoides pteronyssinus, Dermatophagoides farinae, Betula, Humulus, Alnus, and Alternaria. As the children became older, pollen-sensitization rates tended to increase (p value for trends, <0.001). In metropolitan and middle inland areas, weed pollen was the most common pollen. The rates of tree-pollen sensitization were the highest at the seaside and in the southern inland. The most common comorbid allergic diseases associated with AR were pollen allergy and allergic conjunctivitis at 37.0% and 34.5%, respectively. CONCLUSIONS This was the first study conducted in Korea to investigate the prevalence of AR in the general population by using both questionnaires and SPTs. The allergens used for the SPTs were chosen based on the common allergens in this study, and this current pollen data will contribute to establish the cause of increasing AR prevalence in Korea.
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Affiliation(s)
- Dong Hyun Kim
- Department of Pediatrics, Inha University School of Medicine, Incheon, Republic of Korea
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Hashiguchi K, Wakabayashi KI, Togawa M, Saito A, Okubo K. Therapeutic effect of bilastine in Japanese cedar pollinosis using an artificial exposure chamber (OHIO Chamber). Allergol Int 2017; 66:123-131. [PMID: 27475625 DOI: 10.1016/j.alit.2016.06.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 06/06/2016] [Accepted: 06/16/2016] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Environmental exposure chambers have been used to expose subjects to aeroallergens to investigate the efficacy of prophylactic treatment with symptomatic agents in Japan. We first examined the therapeutic effect of bilastine (BIL), a novel non-sedative second-generation H1-antihistamine, in subjects with Japanese cedar pollinosis using an artificial exposure chamber (OHIO Chamber). METHODS This was a randomized, double-blind, four-way crossover, placebo- and active-controlled phase II study (trial registration number JapicCTI-132213). Subjects were exposed to cedar pollen (8000 grains/m3) for 2 h on Day -1 and 4 h each on Day 1 and 2. BIL 10 or 20 mg, placebo, or fexofenadine hydrochloride (FEX) 60 mg was administered orally 1 h after the start of pollen exposure on Day 1. Placebo or FEX was administered 12 h after the first dosing. The primary efficacy endpoint was the sum of total nasal symptom score (TNSS) from 0 to 3 h after the Day 1 dosing. RESULTS We enrolled 136 subjects and the sum of TNSS on Day 1 of the three active treatments was significantly lower than that of placebo and was maintained up to 26 h after the first dosing (Day 2). The sum of TNSS or sneezing score on Day 1 after BIL 20 mg was more significantly decreased than after FEX. Moreover, BIL showed a faster onset of action than FEX. CONCLUSIONS We demonstrated the efficacy, rapid onset, and long duration of action of BIL in subjects with Japanese cedar pollinosis exposed to cedar pollen using the OHIO Chamber.
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Kim YH, Kim MA, Yang HJ, Choi JH, Kim DK, Yoo Y, Lee B, Kim BS, Kim WY, Kim JH, Park SY, Bae WY, Song K, Yang MS, Lee SM, Lee YM, Lee HJ, Cho JH, Jee HM, Park Y, Koh YI. Crinical diagnostic guidelines for allergic rhinitis: medical treatment. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2017. [DOI: 10.5124/jkma.2017.60.2.183] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Young Hyo Kim
- Department of Otorhinolaryngology, Inha University College of Medicine, Incheon, Korea
| | - Mi-Ae Kim
- Department of Pulmonology, Allergy and Critical Care Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Hyeon-Jong Yang
- Department of Pediatrics, Soonchunhyang University College of Medicine, Seoul, Korea
- SCH Biomedical Informatics Research Unit, Seoul, Korea
| | - Jeong-Hee Choi
- Department of Pulmonology and Allergy, Hallym University College of Medicine, Chuncheon, Korea
| | - Dong-Kyu Kim
- Departments of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Chuncheon, Korea
| | - Young Yoo
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
- Allergy Immunology Center, Korea University, Seoul, Korea
| | - Bora Lee
- Department of Biostatistics, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Bong-Seong Kim
- Department of Pediatrics, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | | | - Jeong Hee Kim
- Department of Pediatrics, Inha University College of Medicine, Incheon, Korea
| | | | - Woo Yong Bae
- Department of Otorhinolaryngology, Head and Neck Surgery, Dong-A University College of Medicine, Busan, Korea
| | - Keejae Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Catholic Kwandong Universtiy College of Medicine, Incheon, Korea
| | - Min-Suk Yang
- Department of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Sang Min Lee
- Division of Pulmonology and Allergy, Department of Internal Medicine, Gachon University College of Medicine, Incheon, Korea
| | | | | | | | - Hye Mi Jee
- Department of Pediatrics, CHA University School of Medicine, Seongnam, Korea
| | - Yang Park
- Department of Pediatrics, Sanbon Hospital, Wonkwang University College of Medicine, Gunpo, Korea
| | - Young-Il Koh
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
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Okubo K, Gotoh M, Asako M, Nomura Y, Togawa M, Saito A, Honda T, Ohashi Y. Efficacy and safety of bilastine in Japanese patients with perennial allergic rhinitis: A multicenter, randomized, double-blind, placebo-controlled, parallel-group phase III study. Allergol Int 2017; 66:97-105. [PMID: 27421817 DOI: 10.1016/j.alit.2016.05.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 05/16/2016] [Accepted: 05/25/2016] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Bilastine, a novel non-sedating second-generation H1 antihistamine, has been approved in most European countries since 2010. This study aimed to evaluate the superiority of bilastine over placebo in Japanese patients with perennial allergic rhinitis (PAR). METHODS This randomized, double-blind, placebo-controlled, parallel-group, phase III study (trial registration number JapicCTI-142600) evaluated the effect of a 2-week treatment period with bilastine (20 mg once daily), fexofenadine (60 mg twice daily), or a matched placebo (double dummy) in patients with PAR. All patients were instructed to record individual nasal and ocular symptoms in diaries daily. The primary endpoint was the mean change in total nasal symptom scores (TNSS) from baseline to Week 2 (Days 10-13). RESULTS A total of 765 patients were randomly allocated to receive bilastine, fexofenadine, or placebo (256, 254, and 255 patients, respectively). The mean change in TNSS from baseline at Week 2 was significantly decreased by bilastine (-0.98) compared to placebo (-0.63, P = 0.023). Bilastine and fexofenadine showed no significant difference in the primary endpoint. However, the mean change in TNSS from baseline on Day 1 was more significantly decreased by bilastine (-0.99) than by placebo (-0.28, P < 0.001) or fexofenadine (-0.62, P = 0.032). The active drugs also improved instantaneous TNSS 1 h after the first and before the second drug administration on Day 1 (P < 0.05). The study drugs were well tolerated. CONCLUSIONS After 2-week treatment period, bilastine 20 mg once daily was effective and tolerable in Japanese patients with PAR, and exhibited a rapid onset of action.
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Affiliation(s)
- Kimihiro Okubo
- Department of Otolaryngology-Head and Neck Surgery, Nippon Medical School, Tokyo, Japan.
| | - Minoru Gotoh
- Department of Otolaryngology, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan
| | - Mikiya Asako
- Department of Otolaryngology-Head and Neck Surgery, Kansai Medical University, Osaka, Japan
| | - Yasuyuki Nomura
- Department of Otolaryngology-Head and Neck Surgery, Nihon University, Tokyo, Japan
| | - Michinori Togawa
- Clinical Development Division, Taiho Pharmaceutical Co., Ltd., Tokyo, Japan
| | - Akihiro Saito
- Clinical Development Division, Taiho Pharmaceutical Co., Ltd., Tokyo, Japan
| | - Takayuki Honda
- Clinical Development Division, Taiho Pharmaceutical Co., Ltd., Tokyo, Japan
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Okubo K, Inoue Y, Numaguchi H, Tanaka K, Saito I, Oshima N, Matsumoto Y, Prohn M, Mehta A, Nishida C, Philip G. Montelukast in the treatment of perennial allergic rhinitis in paediatric Japanese patients; an open-label clinical trial. J Drug Assess 2016; 5:6-14. [PMID: 27785374 PMCID: PMC5040008 DOI: 10.1080/21556660.2016.1209507] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 06/30/2016] [Accepted: 07/01/2016] [Indexed: 11/04/2022] Open
Abstract
Background: This study was conducted to evaluate the safety and tolerability, and population pharmacokinetics (PPK) of montelukast as well as efficacy in the treatment of perennial allergic rhinitis (PAR) in paediatric Japanese patients aged between 1 and 15 years. Methods: In this multi-centre, open-label trial, 87 paediatric Japanese patients with PAR received montelukast 4 mg oral granules (OG) for 4 weeks (1-5-year-olds, N = 15), 4 mg OG for 12 weeks (1-5-year-olds, N = 36), 5 mg chewable tablets (CT) for 12 weeks (6-9-year-olds, N = 18), or 5 mg CT for12 weeks (10-15-year-olds, N = 18). Clinical exams and laboratory assessments were conducted at study visits, and adverse events (AE) were monitored throughout the study up to 14 days after the last visit. Population pharmacokinetic approach was used to estimate AUC0-∞, Cmax, Tmax and apparent elimination half-life in each age group. Efficacy was assessed based on global evaluations by the subject's caregiver. Results: There were no serious AEs and one discontinuation due to an AE. The most common AEs in any of the treatment groups were nasopharyngitis, pharyngitis, and acute sinusitis. Montelukast exposure (AUC0-∞) was similar in the 1-5-year-old group and the 6-9-year-old group, but 19% lower in the 10-15-year-old group. Among all patients, the total proportion of patients whose global evaluation was "very much better" was 5.7% (week 2), 11.5% (week 4), and 16.9% (week 12) reflecting improvement in symptoms over time. Conclusion: Montelukast was generally well tolerated in Japanese children with PAR. AUC0-∞was similar in 1-5 and 6-9-year-olds, while a lower exposure was observed in the 10-15-year-old group likely due to differences in bodyweight. The exposure in Japanese paediatric patients was generally consistent with that in non-Japanese paediatric and adult patients. As assessed by the patients' caregivers, montelukast also demonstrated symptomatic improvement based on global evaluations of PAR.
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Affiliation(s)
- Kimihiro Okubo
- Department of Otorhinolaryngology, Nippon Medical School Hospital,
Tokyo,
Japan
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Denervation of nasal mucosa induced by posterior nasal neurectomy suppresses nasal secretion, not hypersensitivity, in an allergic rhinitis rat model. J Transl Med 2016; 96:981-93. [PMID: 27322954 DOI: 10.1038/labinvest.2016.72] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 05/02/2016] [Accepted: 05/25/2016] [Indexed: 12/28/2022] Open
Abstract
The posterior nasal nerve is the dominant source of the parasympathetic, sympathetic, and sensory fibers that innervate the nasal respiratory mucosa. Therefore, a posterior nasal neurectomy (PNN) is thought to induce denervation of the nasal mucosa and relieve the nasal symptoms of allergic rhinitis. However, the underlying mechanisms and therapeutic action of PNN remain unknown. To investigate the impact of PNN-induced denervation of the nasal mucosa on allergic rhinitis, we developed a rat model of PNN and examined the effects of PNN on allergic rhinitis in ovalbumin-sensitized rats. This rat model of PNN was characterized by the depletion of nerve fibers, choline acetyltransferase, and neuropeptides (eg, substance P, calcitonin gene-related peptide, vasoactive intestinal peptide, and neuropeptide Y) in the nasal respiratory mucosa. These animals exhibited nasal gland and goblet cell hypertrophy in the septal mucosa and atrophy of the submucosal gland in the lateral nasal wall, as well as reduced nasal secretion due to deficient acetylcholine synthesis. In an ovalbumin-sensitized model of allergic rhinitis, PNN also induced the depletion of nerve fibers, choline acetyltransferase, and neuropeptides in the nasal mucosa and suppressed nasal secretion. However, PNN did not affect mucosal thickening, eosinophil and mast cell infiltration, interleukin-4 and interferon-γ mRNA expression, and allergic symptoms (ie, sneezing and nasal scratching). These results suggest that the peripheral nerves and corresponding neuropeptides regulate nasal secretion, but not hypersensitivity, in allergic rhinitis, and that allergic rhinitis-related mucosal reactions occur in a highly denervated mucosa after PNN. Posterior nasal neurectomy may be a therapeutic option for the treatment of hyperrhinorrhea, but not allergic rhinitis hypersensitivity.
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Fujishima H, Okada N, Matsumoto K, Fukagawa K, Igarashi A, Matsuda A, Ono J, Ohta S, Mukai H, Yoshikawa M, Izuhara K. The usefulness of measuring tear periostin for the diagnosis and management of ocular allergic diseases. J Allergy Clin Immunol 2016; 138:459-467.e2. [DOI: 10.1016/j.jaci.2015.11.039] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 10/29/2015] [Accepted: 11/18/2015] [Indexed: 12/14/2022]
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Noyama Y, Okano M, Fujiwara T, Kariya S, Makihara SI, Haruna T, Kanai K, Higaki T, Nishizaki K. Effect of intranasal corticosteroid on pre-onset activation of eosinophils and mast cells in experimental Japanese cedar pollinosis. Allergol Int 2016; 65:259-65. [PMID: 26907728 DOI: 10.1016/j.alit.2015.12.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Revised: 11/27/2015] [Accepted: 12/14/2015] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Minimal persistent inflammation (MPI) contributes to hyperreactivity in allergic rhinitis. However, little is known regarding whether pre-onset activation of eosinophils and mast cells is present or not in Japanese cedar pollinosis (JCP). Furthermore, a prophylactic effect of intranasal corticosteroids on such MPI in JCP has not been investigated. METHODS We designed a double-blinded, randomized, placebo-controlled, crossover trial. Twenty patients with JCP were examined outside the pollen season (UMIN000008410). Nasal provocation with paper discs containing extracts of Japanese cedar pollen was performed once a day for 3 consecutive days. Onset of nasal symptoms was monitored over 15 min after each provocation. The levels of eosinophil cationic protein (ECP) and tryptase in nasal secretions were examined. Fluticasone furoate nasal spray or placebo treatment was started one day before the first provocation. RESULTS In the placebo group, 25% of the patients showed onset of nasal symptoms following provocation on the first day. In addition, 75% and 68% of the patients showed symptom onset on the second and third day of provocation, respectively. After the first provocation, the levels of ECP and tryptase in nasal secretions were significantly increased. These increases were seen not only in symptomatic but also in asymptomatic subjects in response to provocation, and the levels were similar between these subjects. Prophylactic treatment with fluticasone significantly suppressed the increase in nasal ECP and tryptase associated with repeated provocations. CONCLUSIONS These results suggest that pre-onset activation of eosinophils and mast cells is present in experimental JCP, and that prophylactic treatment with intranasal corticosteroids has the potential to control such activation.
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Affiliation(s)
- Yasuyuki Noyama
- Department of Otolaryngology-Head & Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Mitsuhiro Okano
- Department of Otolaryngology-Head & Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
| | - Tazuko Fujiwara
- Department of Otolaryngology-Head & Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Shin Kariya
- Department of Otolaryngology-Head & Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | | | - Takenori Haruna
- Department of Otolaryngology-Head & Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kengo Kanai
- Department Otorhinolaryngology, Kagawa Prefectural Central Hospital, Kagawa, Japan
| | - Takaya Higaki
- Department of Otolaryngology-Head & Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kazunori Nishizaki
- Department of Otolaryngology-Head & Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Izuhara Y, Matsumoto H, Nagasaki T, Kanemitsu Y, Murase K, Ito I, Oguma T, Muro S, Asai K, Tabara Y, Takahashi K, Bessho K, Sekine A, Kosugi S, Yamada R, Nakayama T, Matsuda F, Niimi A, Chin K, Mishima M. Mouth breathing, another risk factor for asthma: the Nagahama Study. Allergy 2016; 71:1031-6. [PMID: 26991116 DOI: 10.1111/all.12885] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Allergic rhinitis, a known risk factor for asthma onset, often accompanies mouth breathing. Mouth breathing may bypass the protective function of the nose and is anecdotally considered to increase asthma morbidity. However, there is no epidemiological evidence that mouth breathing is independently associated with asthma morbidity and sensitization to allergens. In this study, we aimed to clarify the association between mouth breathing and asthma morbidity and allergic/eosinophilic inflammation, while considering the effect of allergic rhinitis. METHODS This community-based cohort study, the Nagahama Study, contained a self-reporting questionnaire on mouth breathing and medical history, blood tests, and pulmonary function testing. We enrolled 9804 general citizens of Nagahama City in the Shiga Prefecture, Japan. RESULTS Mouth breathing was reported by 17% of the population and was independently associated with asthma morbidity. The odds ratio for asthma morbidity was 1.85 (95% CI, 1.27-2.62) and 2.20 (95% CI, 1.72-2.80) in subjects with mouth breathing alone and allergic rhinitis alone, which additively increased to 4.09 (95% CI, 3.01-5.52) when mouth breathing and allergic rhinitis coexisted. Mouth breathing in nonasthmatics was a risk for house dust mite sensitization, higher blood eosinophil counts, and lower pulmonary function after adjusting for allergic rhinitis. CONCLUSION Mouth breathing may increase asthma morbidity, potentially through increased sensitization to inhaled allergens, which highlights the risk of mouth-bypass breathing in the 'one airway, one disease' concept. The risk of mouth breathing should be well recognized in subjects with allergic rhinitis and in the general population.
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Affiliation(s)
- Y. Izuhara
- Department of Respiratory Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - H. Matsumoto
- Department of Respiratory Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - T. Nagasaki
- Department of Respiratory Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - Y. Kanemitsu
- Department of Respiratory Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - K. Murase
- Department of Respiratory Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - I. Ito
- Department of Respiratory Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - T. Oguma
- Department of Respiratory Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - S. Muro
- Department of Respiratory Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - K. Asai
- Department of Oral and Maxillofacial Surgery; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - Y. Tabara
- Center for Genomic Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - K. Takahashi
- Department of Oral and Maxillofacial Surgery; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - K. Bessho
- Department of Oral and Maxillofacial Surgery; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - A. Sekine
- Pharmacogenomics Project; Kyoto University Graduate School of Medicine; Kyoto Japan
- Center for Preventive Medical Science; Chiba University; Chiba Japan
| | - S. Kosugi
- Department of Medical Ethics and Medical Genetics; Kyoto University School of Public Health; Kyoto Japan
| | - R. Yamada
- Center for Genomic Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - T. Nakayama
- Department of Health Informatics; Kyoto University School of Public Health; Kyoto Japan
| | - F. Matsuda
- Center for Genomic Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - A. Niimi
- Department of Respiratory Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
- Department of Respiratory Medicine Allergy and Clinical Immunology; Nagoya City University School of Medical Sciences; Aichi Japan
| | - K. Chin
- Department of Respiratory Care and Sleep Control Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - M. Mishima
- Department of Respiratory Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
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Wang W, Huang X, Chen Z, Zheng R, Chen Y, Zhang G, Yang Q. Prevalence and trends of sensitisation to aeroallergens in patients with allergic rhinitis in Guangzhou, China: a 10-year retrospective study. BMJ Open 2016; 6:e011085. [PMID: 27188812 PMCID: PMC4874158 DOI: 10.1136/bmjopen-2016-011085] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 04/19/2016] [Accepted: 04/25/2016] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To investigate the prevalence and trends of sensitisation to common aeroallergens among outpatients with allergic rhinitis (AR) in Guangzhou, China, over the past decade. DESIGN A retrospective study; linear-by-linear association and simple linear regression were used to determine the trends in the prevalence of aeroallergen sensitisation. SETTING One grade-A hospital in Guangzhou, the largest city in southern China. PARTICIPANTS A total of 5486 patients (2297 males and 2489 females) who visited the ear, nose and throat outpatient clinic, from January 2005 to December 2014, were enrolled. All patients who presented with nasal hyper-reactive symptoms and who completed serological allergy testing, measuring specific IgE (sIgE) in the serum, were included. Among them, 4085 participants (2269 males and 1816 females) were diagnosed as being patients with AR. OUTCOME MEASURES Prevalence and trends of sensitisation to various types of aeroallergens were assessed. RESULTS The overall prevalence of sIgE-mediated sensitisation to aeroallergens in these patients with AR were as follows: 84.4% for house dust mites (HDMs), 23.4% for pet allergens, 21.1% for cockroaches, 9.1% for mould allergens, 7.7% for tree pollen and 6.0% for weed pollen. When all patients with nasal hyper-reactivity were stratified by decade of age, increasing age was associated with a decrease in sIgE positivity by ∼5.13% (95% CI -7.28% to -2.98%, p<0.01). Within the past decade, the prevalence of sensitisation to pet allergens in patients with AR increased at an annual rate of 1.3% (95% CI 0.85% to 1.67%, p<0.01). CONCLUSIONS This study demonstrated that HDMs comprised the most common aeroallergen in Guangzhou. The prevalence of sensitisation to aeroallergens decreased with increasing age. During the past decade, the prevalence of sensitisation to pet allergens showed an upward trend, suggesting an urgent need for its prevention and treatment.
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Affiliation(s)
- Weihao Wang
- Department of Otorhinolaryngology—Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Xuekun Huang
- Department of Otorhinolaryngology—Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Zhuanggui Chen
- Department of Pediatrics, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Rui Zheng
- Department of Otorhinolaryngology—Head and Neck Surgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Yulian Chen
- Department of Otorhinolaryngology—Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Gehua Zhang
- Department of Otorhinolaryngology—Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Qintai Yang
- Department of Otorhinolaryngology—Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
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Lyseng-Williamson KA. House dust mite sublingual tablets (Actair®): a guide to their use as allergy immunotherapy for house dust mite-induced allergic rhinitis. DRUGS & THERAPY PERSPECTIVES 2016. [DOI: 10.1007/s40267-016-0305-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Otsuka H, Takanashi I, Tokunou S, Endo S, Okubo K. Involvement of Staphylococcus aureus and Moraxella catarrhalis in Japanese cedar pollinosis. Am J Rhinol Allergy 2016; 30:99-106. [PMID: 26877537 DOI: 10.2500/ajra.2016.30.4283] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND OBJECTIVE From mid February to the end of March, each year ∼30% of Japanese have Japanese cedar pollinosis. Moreover, 10-50% of patients with this pollinosis exhibit nasal manifestations in the preseason. These patients have a predominance of neutrophils but not eosinophils in nasal swabs and high carriage of Staphylococcus aureus. We hypothesized that S. aureus or other bacteria and associated neutrophilia were involved in preseasonal symptoms. METHODS Cytology and bacterial colony growth were assessed in nasal swabs in the groups of asymptomatic patients in the preseason (PreAsP) (n = 53) and symptomatic patients in the preseason (PreSyP) (n = 60), and in group of symptomatic patients in season (InSyP) (n = 72). RESULTS In the preseason, high neutrophilia was present in only 20% of the PreAsP group but in 47% of the PreSyP group (p < 0.01). Nasal carriage of S. aureus in the PreAsP and PreSyP groups were 79%, 75%, respectively, whereas, for Moraxella catarrhalis, these were 9% versus 25% (PreAsP versus PreSyP group; p < 0.05). In patients with positive results for S. aureus and M. catarrhalis, the degrees of neutrophilia (-, ±, +, 2+, 3+) in the PreSyP group were larger than in the PreAsP groups (p < 0.01). In the PreSyP group, the magnitude of neutrophilia was greater (p < 0.05) in subgroups with more colonies of S. aureus than in subgroups with fewer colonies. CONCLUSION Nasal symptoms in the preseason are associated with neutrophilia and nasal colonization with S. aureus and M. catarrhalis. Patients with symptoms in the preseason had improved symptom scores when given prophylactic treatment early in season but had more-severe symptom scores late in season than asymptomatic patients in the preseason. Neutrophil-associated tissue damage related to bacterial colonization may underlie these associations.
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Antihistamines suppress upregulation of histidine decarboxylase gene expression with potencies different from their binding affinities for histamine H1 receptor in toluene 2,4-diisocyanate-sensitized rats. J Pharmacol Sci 2016; 130:212-8. [PMID: 26980430 DOI: 10.1016/j.jphs.2016.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 02/01/2016] [Accepted: 02/04/2016] [Indexed: 11/22/2022] Open
Abstract
Antihistamines inhibit histamine signaling by blocking histamine H1 receptor (H1R) or suppressing H1R signaling as inverse agonists. The H1R gene is upregulated in patients with pollinosis, and its expression level is correlated with the severity of nasal symptoms. Here, we show that antihistamine suppressed upregulation of histidine decarboxylase (HDC) mRNA expression in patients with pollinosis, and its expression level was correlated with that of H1R mRNA. Certain antihistamines, including mepyramine and diphenhydramine, suppress toluene-2,4-diisocyanate (TDI)-induced upregulation of HDC gene expression and increase HDC activity in TDI-sensitized rats. However, d-chlorpheniramine did not demonstrate any effect. The potencies of antihistamine suppressive effects on HDC mRNA elevation were different from their H1R receptor binding affinities. In TDI-sensitized rats, the potencies of antihistamine inhibitory effects on sneezing in the early phase were related to H1R binding. In contrast, the potencies of their inhibitory effects on sneezing in the late phase were correlated with those of suppressive effects on HDC mRNA elevation. Data suggest that in addition to the antihistaminic and inverse agonistic activities, certain antihistamines possess additional properties unrelated to receptor binding and alleviate nasal symptoms in the late phase by inhibiting synthesis and release of histamine by suppressing HDC gene transcription.
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Mizuguchi H, Orimoto N, Kadota T, Kominami T, Das AK, Sawada A, Tamada M, Miyagi K, Adachi T, Matsumoto M, Kosaka T, Kitamura Y, Takeda N, Fukui H. Suplatast tosilate alleviates nasal symptoms through the suppression of nuclear factor of activated T-cells-mediated IL-9 gene expression in toluene-2,4-diisocyanate-sensitized rats. J Pharmacol Sci 2016; 130:151-8. [PMID: 26874672 DOI: 10.1016/j.jphs.2015.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 12/26/2015] [Accepted: 12/28/2015] [Indexed: 10/22/2022] Open
Abstract
Histamine H1 receptor (H1R) gene is upregulated in patients with pollinosis; its expression level is highly correlated with the nasal symptom severity. Antihistamines are widely used as allergy treatments because they inhibit histamine signaling by blocking H1R or suppressing H1R signaling as inverse agonists. However, long-term treatment with antihistamines does not completely resolve toluene-2,4-diisocyanate (TDI)-induced nasal symptoms, although it can decrease H1R gene expression to the basal level, suggesting additional signaling is responsible for the pathogenesis of the allergic symptoms. Here, we show that treatment with suplatast tosilate in combination with antihistamines markedly alleviates nasal symptoms in TDI-sensitized rats. Suplatast suppressed TDI-induced upregulation of IL-9 gene expression. Suplatast also suppressed ionomycin/phorbol-12-myristate-13-acetate-induced upregulation of IL-2 gene expression in Jurkat cells, in which calcineurin (CN)/nuclear factor of activated T-cells (NFAT) signaling is known to be involved. Immunoblot analysis demonstrated that suplatast inhibited binding of NFAT to DNA. Furthermore, suplatast suppressed ionomycin-induced IL-9 mRNA upregulation in RBL-2H3 cells, in which CN/NFAT signaling is also involved. These data suggest that suplatast suppressed NFAT-mediated IL-9 gene expression in TDI-sensitized rats and this might be the underlying mechanism of the therapeutic effects of combined therapy of suplatast with antihistamine.
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Affiliation(s)
- Hiroyuki Mizuguchi
- Department of Molecular Pharmacology, Institute of Biomedical Sciences, Tokushima University Graduate School, Sho-machi, Tokushima 770-8505, Japan.
| | - Naoki Orimoto
- Department of Molecular Pharmacology, Institute of Biomedical Sciences, Tokushima University Graduate School, Sho-machi, Tokushima 770-8505, Japan; Taiho Pharmaceutical Co. LTD., 224-2, Ebisuno Hiraishi, Kawauchi-cho, Tokushima 771-0194, Japan
| | - Takuya Kadota
- Department of Molecular Pharmacology, Institute of Biomedical Sciences, Tokushima University Graduate School, Sho-machi, Tokushima 770-8505, Japan
| | - Takahiro Kominami
- Department of Molecular Pharmacology, Institute of Biomedical Sciences, Tokushima University Graduate School, Sho-machi, Tokushima 770-8505, Japan
| | - Asish K Das
- Department of Molecular Pharmacology, Institute of Biomedical Sciences, Tokushima University Graduate School, Sho-machi, Tokushima 770-8505, Japan
| | - Akiho Sawada
- Department of Molecular Pharmacology, Institute of Biomedical Sciences, Tokushima University Graduate School, Sho-machi, Tokushima 770-8505, Japan
| | - Misaki Tamada
- Department of Molecular Pharmacology, Institute of Biomedical Sciences, Tokushima University Graduate School, Sho-machi, Tokushima 770-8505, Japan
| | - Kohei Miyagi
- Department of Molecular Pharmacology, Institute of Biomedical Sciences, Tokushima University Graduate School, Sho-machi, Tokushima 770-8505, Japan
| | - Tsubasa Adachi
- Department of Molecular Pharmacology, Institute of Biomedical Sciences, Tokushima University Graduate School, Sho-machi, Tokushima 770-8505, Japan
| | - Mayumi Matsumoto
- Department of Molecular Pharmacology, Institute of Biomedical Sciences, Tokushima University Graduate School, Sho-machi, Tokushima 770-8505, Japan
| | - Tomoya Kosaka
- Department of Molecular Pharmacology, Institute of Biomedical Sciences, Tokushima University Graduate School, Sho-machi, Tokushima 770-8505, Japan
| | - Yoshiaki Kitamura
- Department of Otolaryngology, Institute of Biomedical Sciences, Tokushima University Graduate School, Kuramoto, Tokushima 770-8503, Japan
| | - Noriaki Takeda
- Department of Otolaryngology, Institute of Biomedical Sciences, Tokushima University Graduate School, Kuramoto, Tokushima 770-8503, Japan
| | - Hiroyuki Fukui
- Department of Molecular Studies for Incurable Diseases, Institute of Biomedical Sciences, Tokushima University Graduate School, Kuramoto, Tokushima 770-8503, Japan
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Otsuka H, Tsukagoshi H, Kimura H, Takanashi I, Okubo K. Are respiratory viruses involved in preseasonal symptoms or severity in Japanese cedar pollinosis? ALLERGY & RHINOLOGY (PROVIDENCE, R.I.) 2016; 7:62-8. [PMID: 27658182 PMCID: PMC5010434 DOI: 10.2500/ar.2016.7.0157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Respiratory virus infections are involved in asthma exacerbations. However, there are no reports of the relationship between respiratory virus infections and Japanese cedar pollinosis. OBJECTIVE We studied the relationship between respiratory viral infection and the appearance of preseasonal symptoms and the severity of seasonal symptoms in Japanese cedar pollinosis. METHODS In 36 patients with asthma and with no symptoms (PreAsyP) and 54 patients with asthma and with symptoms (PreSyP) before the cedar pollen shedding commenced (preseason), and 37 patients with mild-to-moderate severity (InMild/Mod) and 45 patients with severe to extreme severity (InSev/Ext) after cedar shedding commenced (in season), the occurrence of respiratory viruses and nasal smear cytology were examined. RESULTS In total, seven infections with respiratory viruses were detected among the subjects. Human rhinovirus (HRV) C infection was detected in one subject in each of the PreAsyP and PreSyP groups, and one HRVA infection occurred in the InMild/Mod group. In the InSev/Ext group, one HRVA, one HRVC, one respiratory syncytial virus, and one human metapneumovirus were detected. There was no significant difference in the rate of detection of viral infections between the PreAsyP and the PreSyP groups (p = 0.077), and between the InMild/Mod group and the InSev/Ext group (p = 0.24, Wilcoxon rank sum test). When cells types in nasal smears were identified and their abundance examined, the rate of neutrophilia in the subjects in the PreSyP group was 54%, which was statistically higher (p < 0.01) than the subjects in the PreAsyP group (25%). Interestingly, in the subjects in the InSev/Ext group, the proportion of eosinophils (40%) was larger (p < 0.05) than in the subjects in the InMild/Mod group (19%). CONCLUSION These results provided no evidence that respiratory virus infections contributed to preseasonal symptoms and severity in season of Japanese cedar pollinosis. Nasal neutrophilia was related to preseasonal symptoms, whereas nasal eosinophilia was related to severity of symptoms during the pollen season.
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Affiliation(s)
- Hirokuni Otsuka
- From the Otsuka ENT Clinic, Kanagawa, Japan
- Otorhinolaryngology and Head and Neck Surgery, Nippon Medical School, Musashi-Kosugi Hospital, Kawasaki, Kanagawa, Japan
| | - Hiroyuki Tsukagoshi
- Gunma Prefectural Institute of Public Health and Environmental Sciences, Maebashi, Gunma, Japan
| | - Hirokazu Kimura
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Musashimurayama, Tokyo, Japan
- Yokohama City University, School of Medicine, Yokohama, Kanagawa, Japan
| | - Ikuo Takanashi
- Kanagawa General High School, Science Division, Yokohama, Kanagawa, Japan, and
| | - Kimihiro Okubo
- Otorhinolaryngology and Head and Neck Surgery, Nippon Medical School, Tokyo, Japan
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Masuyama K, Goto M, Takeno S, Ohta N, Okano M, Kamijo A, Suzuki M, Terada T, Sakurai D, Horiguchi S, Honda K, Matsune S, Yamada T, Sakashita M, Yuta A, Fuchiwaki T, Miyanohara I, Nakayama T, Okamoto Y, Fujieda S. Guiding principles of sublingual immunotherapy for allergic rhinitis in Japanese patients. Auris Nasus Larynx 2015; 43:1-9. [PMID: 26615715 DOI: 10.1016/j.anl.2015.08.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 08/03/2015] [Accepted: 08/26/2015] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Sublingual immunotherapy (SLIT) appears to offer practical advantages for the treatment of allergic rhinitis (AR). Based on a review of the scientific literature, we present recommendations as guiding principles to administer SLIT safely. METHODS Clinical questions concerning SLIT were prepared. Literature published between January 2003 and December 2012 was searched from PubMed, the Cochrane Library, and Japana Centra Revuo Medicina. Qualified studies were analyzed and the results were evaluated, consolidated, and codified. We answered 17 clinical questions and, based on this, presented evidence-based recommendations. RESULTS Sublingual immunotherapy improved symptoms (e.g., quality of life [QOL]) and reduced medication scores in seasonal AR and perennial AR. Most SLIT-induced adverse effects were local oral reactions, although systemic adverse effects such as gastrointestinal symptoms, urticaria, and asthma are occasionally reported. There have been no reports of lethal anaphylactic reactions by SLIT. When SLIT is continued for 3-4 years, its effect persists long after discontinuation. CONCLUSION A correct diagnosis of AR and sufficient informed consent from patients are required before initiating SLIT. Sublingual immunotherapy should be continued for 3 years or longer. The initial administration of SLIT during the uptitration of an allergen vaccine and the general condition of patients are critical for the safe performance of SLIT.
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Affiliation(s)
- Keisuke Masuyama
- Department of Otorhinolaryngology, University of Yamanashi, Japan
| | - Minoru Goto
- Department of Otorhinolaryngology - Head and Neck Surgery, Nippon Medical School, Japan
| | - Sachio Takeno
- Department of Otolaryngology - Head and Neck Surgery, Hiroshima University, Japan
| | - Nobuo Ohta
- Department of Otolaryngology - Head and Neck Surgery, Yamagata University, Japan
| | - Mitsuhiro Okano
- Department of Otolaryngology - Head and Neck Surgery, Okayama University, Okayama, Japan
| | - Atsushi Kamijo
- Otorhinolaryngology/Allergy Center, Saitama Medical University, Japan
| | - Motohiko Suzuki
- Department of Otolaryngology - Head and Neck Surgery, Nagoya City University, Japan
| | - Tetsuya Terada
- Department of Otorhinolaryngology, Osaka Medical University, Japan
| | - Daiju Sakurai
- Department of Otolaryngology - Head and Neck Surgery, Chiba University, Japan
| | | | - Kohei Honda
- Department of Otorhinolaryngology - Head and Neck Surgery, Akita University, Japan
| | - Shoji Matsune
- Department of Otolaryngology Nippon Medical School, Musashikosugi Hospital, Japan
| | - Takechiyo Yamada
- Department of Otolaryngology - Head and Neck Surgery, University of Fukui, Japan
| | - Masafumi Sakashita
- Department of Otolaryngology - Head and Neck Surgery, University of Fukui, Japan
| | | | | | - Ikuyo Miyanohara
- Department of Otolaryngology - Head and Neck Surgery, Kagoshima University, Japan
| | - Takeo Nakayama
- Department of Health Informatics, Kyoto University School of Public Health, Japan
| | - Yoshitaka Okamoto
- Department of Otolaryngology - Head and Neck Surgery, Chiba University, Japan
| | - Shigeharu Fujieda
- Department of Otolaryngology - Head and Neck Surgery, University of Fukui, Japan.
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Nariai Y, Mizuguchi H, Ogasawara T, Nagai H, Sasaki Y, Okamoto Y, Yoshimura Y, Kitamura Y, Nemoto H, Takeda N, Fukui H. Disruption of Heat Shock Protein 90 (Hsp90)-Protein Kinase Cδ (PKCδ) Interaction by (-)-Maackiain Suppresses Histamine H1 Receptor Gene Transcription in HeLa Cells. J Biol Chem 2015; 290:27393-27402. [PMID: 26391399 PMCID: PMC4646370 DOI: 10.1074/jbc.m115.657023] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 09/10/2015] [Indexed: 12/22/2022] Open
Abstract
The histamine H1 receptor (H1R) gene is an allergic disease sensitive gene, and its expression level is strongly correlated with the severity of allergic symptoms. (-)-Maackiain was identified as a Kujin-derived anti-allergic compound that suppresses the up-regulation of the H1R gene. However, the underlying mechanism of H1R gene suppression remains unknown. Here, we sought to identify a target protein of (-)-maackiain and investigate its mechanism of action. A fluorescence quenching assay and immunoblot analysis identified heat shock protein 90 (Hsp90) as a target protein of (-)-maackiain. A pull-down assay revealed that (-)-maackiain disrupted the interaction of Hsp90 with PKCδ, resulting in the suppression of phorbol 12-myristate 13-acetate (PMA)-induced up-regulation of H1R gene expression in HeLa cells. Additional Hsp90 inhibitors, including 17-(allylamino)-17-demethoxygeldanamycin, celastrol, and novobiocin also suppressed PMA-induced H1R gene up-regulation. 17-(Allylamino)-17-demethoxygeldanamycin inhibited PKCδ translocation to the Golgi and phosphorylation of Tyr(311) on PKCδ. These data suggest that (-)-maackiain is a novel Hsp90 pathway inhibitor. The underlying mechanism of the suppression of PMA-induced up-regulation of H1R gene expression by (-)-maackiain and Hsp90 inhibitors is the inhibition of PKCδ activation through the disruption of Hsp90-PKCδ interaction. Involvement of Hsp90 in H1R gene up-regulation suggests that suppression of the Hsp90 pathway could be a novel therapeutic strategy for allergic rhinitis.
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Affiliation(s)
- Yuki Nariai
- Departments of Molecular Pharmacology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8505, Japan
| | - Hiroyuki Mizuguchi
- Departments of Molecular Pharmacology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8505, Japan.
| | - Takeyasu Ogasawara
- Departments of Molecular Pharmacology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8505, Japan
| | - Hiroaki Nagai
- Departments of Molecular Pharmacology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8505, Japan
| | - Yohei Sasaki
- Departments of Molecular Pharmacology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8505, Japan
| | - Yasunobu Okamoto
- Departments of Molecular Pharmacology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8505, Japan
| | - Yoshiyuki Yoshimura
- Departments of Clinical Pharmacy, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8505, Japan
| | - Yoshiaki Kitamura
- Departments of Otolaryngology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8505, Japan
| | - Hisao Nemoto
- Departments of Pharmaceutical Chemistry, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8505, Japan
| | - Noriaki Takeda
- Departments of Otolaryngology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8505, Japan
| | - Hiroyuki Fukui
- Departments of Molecular Studies for Incurable Diseases, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8505, Japan
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