Near-Road Exposure and Impact of Air Pollution on Allergic Diseases in Elementary School Children: A Cross-Sectional Study

PURPOSE

The study aims to classify schools based on traffic pollutants and their complex sources, to assess the environment, to determine the state of allergic diseases among students using the International Study of Asthma and Allergies in children (ISAAC) questionnaire, and to assess their connection to air pollutants.

MATERIALS AND METHODS

A total of seven schools were divided into three categories according to the characteristics of their surrounding environments: three schools in traffic-related zones, two schools in complex source zones I (urban), and two schools in complex source zones II (industrial complex). ISAAC questionnaires were administered and the 4404 completed questionnaires were analyzed.

RESULTS

The frequency of asthma treatment during the past 12 months showed a significant increase (p<0.05) with exposure to NO₂ [1.67, 95% confidence intervals (CIs) 1.03-2.71] in the complex source zones. The frequency of allergic rhinitis treatment during the past 12 months increased significantly with exposure to Black Carbon (1.60, 95% CIs 1.36-1.90) (p<0.001), SO₂ (1.09, 95% CIs 1.01-1.17) (p<0.05), NO₂ (1.18, 95% CIs 1.07-1.30) (p<0.01) for all subjects.

CONCLUSION

In terms of supporting children's health, care, and prevention related to major spaces for children, such as school zones, spaces used in coming to and leaving school, playgrounds, and classrooms are essential to ensuring not only the safety of children from traffic accidents but also their protection from local traffic pollutants and various hazardous environmental factors.

Weighted road density and allergic disease in children at high risk of developing asthma

Background

Evidence for an association between traffic-related air pollution and allergic disease is inconsistent, possibly because the adverse effects may be limited to susceptible subgroups and these have not been identified. This study examined children in the Childhood Asthma Prevention Study (CAPS), potentially susceptible to air pollution effects because of a family history of asthma.

Methods

We examined cross-sectional associations at age eight years between road density within 75 m and 50 m of home address weighted by road type (traffic density), as a proxy for traffic-related air pollution, on the following allergic and respiratory outcomes: skin prick tests (SPTs), total and specific serum IgE, pre- and post-bronchodilator lung function, airway hyperresponsiveness, exhaled NO, and reported asthma and rhinitis.

Results

Weighted road density was positively associated with allergic sensitisation and allergic rhinitis. Adjusted relative risk (RR) for house dust mite (HDM) positive SPT was 1.25 (95% CI: 1.06–1.48), for detectable house dust mite-specific IgE was 1.19 (95% CI: 1.01–1.41) and for allergic rhinitis was 1.30 (95% CI: 1.03–1.63) per 100 m local road or 33.3 m motorway within 50 m of home. Associations were also seen with small decrements of peak and mid-expiratory flows and increased risk of asthma, current wheeze and rhinitis in atopic children.

Conclusion

Associations between road density and allergic disease were found in a potentially susceptible subgroup of children at high risk of developing atopy and asthma.

[Some features of development and course of bronchial asthma in children in azerbaijan]

According to the international "ISAAC" program, we studied the peculiarities of bronchial asthma in children at the age of 13-14 years, in various climatic and geographic regions of Azerbaijan. At the first stage of investigation, 14693 eighth class pupils of high school from the four various regions were surveyed: the I region (n=4979) - an industrial city, placed in a semi-desert area; the II region (n=3010) - rural areas, located in a semi-desert climatic zone; the III region (n=3133) - areas, located in a subtropical climatic zone; the IV region (n=3571) - an ecologically clean mountainous region, located along southern slopes of the Greater Caucasian ridge. At the second stage of the investigation allergological, clinical-functional examinations were carried out in children with symptoms of allergic diseases. It was established that prevalence of BA was reliably more frequent in the industrial city (4,6%) than in other three, especially rural areas. In subtropical climatic area 2,8%, in rural semi-desert area - 2,5%, in mountainous region - 1,8% of examined children were suffering from BA. Study of the clinical course of diseases in children with allergic diseases and their allergic status revealed that structure and expressiveness of sensitization to domestic, pollen, fungous and food allergens depends on residing area.

Stress and anxiety effects on positive skin test responses in young adults with allergic rhinitis

BACKGROUND

Anxiety and psychological stress affect allergy-related immune function. How these relations influence the evaluations of patients with allergic rhinitis is unknown.

OBJECTIVE

To examine whether anxiety and stress exposure affect skin prick test (SPT) responses to common allergens for which patients with atopy showed no prior positive SPT response.

METHODS

Patients with allergic rhinitis, evidenced by clinical history and SPT results, were admitted twice to a hospital research unit for 4 hours. In a crossover design, SPT wheals were assessed before and after the Trier Social Stress Test and then the following morning; for comparison, SPT wheals were assessed before and after a laboratory session without a stressor. Analyses focused on wheal responses for common allergens that tested negative (wheal size <3 mm larger than saline) from SPTs performed at multiple baseline assessments.

RESULTS

After the Trier Social Stress Test, more anxious patients with atopy had a higher incidence of positive SPT reactions to antigens that previously tested negative. Anxiety was unrelated to positive SPT incidence under nonstressful conditions. Based on clinical symptom reports, newly positive SPT reactions after the stressor were apparently corrections of previously false-negative SPT reactions. The SPT wheal responses for allergens previously testing negative were enhanced after a stressor. Histamine (positive control) or saline (negative control) SPT responses were not affected.

CONCLUSION

A laboratory stressor affected allergen SPT responses in more anxious patients with allergic rhinitis. In addition to clinical history, assessment of anxiety and current stress at the time of the SPT may provide valuable information about a patient's allergic status and aid in clinical decision making.

[Anti-allergic effects of xuebijing and potential role of heme oxygenase-1 against ovalbumin-induced murine allergic rhinitis model]

OBJECTIVE

In this study, we investigated the anti-inflammation effects of Xuebijing in OVA-induced murine allergic rhinitis model. Furthermore, we determined whether heme oxygenase (HO)-1 is required for the protective activity of Xuebijing.

METHOD

Airways of OVA-sensitized mice exposed to OVA challenge developed eosinophilia, mucus hypersecretion and increased cytokine levels. Levels of interleukin IL-4, IL-5, IL-13, and tumor necrosis factor (TNF)-alpha in nasal lavage fluid were measured using enzyme-linked immunosorbent assays (ELISAs). Lung tissue and nasal mucosa sections were stained with Mayer's hematoxylin and eosin for assessment of cell infiltration and mucus production, Immunohistochemistry, Real-time PCR and Western Blot analyses for HO-1 protein expression.

RESULT

Orally administered Xuebijing significantly inhibited the number of OVA-induced inflammatory cells and IgE production, along with reduced T-helper (Th) 2 cytokine levels, such as IL-4, IL-5 and IL-13, improved the level of IFN-gamma, in nasal lavage fluid. In addition, Xuebijing induced a marked decrease in OVA-induced inflammatory cell infiltration and mucus production in nasal and lung tissues. These effects were correlated with HO-1 mRNA and protein induction.

CONCLUSION

Our results indicate that Xuebijing protects against OVA-induced airway inflammation, at least in part, via HO-1 upregulation.

Analysis of the association between air pollution and allergic diseases exposure from nearby sources of ambient air pollution within elementary school zones in four Korean cities

The objectives of this study were to survey elementary school students regarding the environmental conditions of their elementary schools and to assess the relationship between air pollution and allergic disease using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Therefore, this study was designed as a cross-sectional study. In this study, seven elementary schools were selected and they were classified into three categories. The selection included one school with no traffic-related or other pollutants, three with traffic-related pollutants, and three with traffic-related and other pollutants from industrial and filling station sources. The ISAAC questionnaire survey was given to all of the students except to those in the 1st grade who were presumed to be less likely to be exposed to the school environment than the remainder of the students attending those seven schools. The assessment of allergic disease was conducted on a total of 4,545 students. Three school zones with critical exposure were selected within each school and they were evaluated based on the levels of black carbon (BC), PM10, SO2, NO2, and O3. There was a significant increase in the risks based on the odds ratios of treatment experiences (within 1 year) for allergy-related diseases such as asthma and allergic rhinitis (a) in the school group with traffic-related pollutants and the school group with complex pollutants were 2.12 (1.41-3.19) and 1.59 (1.06-2.37), respectively, in comparison to the school groups with no exposure to pollutants. This was determined based on the odds ratio of symptoms and treatment experiences for allergy-related diseases by group based on the home town zone as a reference. Also, in the case of atopic dermatitis, the odds ratio of treatment experiences (within 1 year) was 1.42 (1.02-1.97), which indicated elevated risks compared to the students in the S1 school. A regression analysis was used to assess the relationship between the substances and the symptomatic experiences within the last year. There were significant increases in the odds ratio of the symptoms associated with allergic rhinitis and the BC and SO2 in the complex pollution areas. The results of the assessment of the relationship between atopic dermatitis-associated symptoms and O3 showed that the odds ratio increased with statistical significance.

Genomic and non-genomic effects of glucocorticoids on allergic rhinitis model in mice

Glucocorticoids (GCs) are well known for their anti-inflammatory effects, which are elicited through a transcriptional mechanism via a cytosolic glucocorticoid receptor (cGR)-mediated genomic effect. However, recent in vitro studies report that GCs can act as a membrane glucocorticoid receptor (mGR). This study aimed to examine whether mometasone furoate (MF) influences the nasal symptoms induced by histamine, substance P, ATP. Furthermore, the influences of various compounds on MF action were studied in vivo. The mice were intranasally administered with nasal symptom-inciting agents, and the occurrences of sneezing and nasal rubbing were counted. MF repressed the nasal symptoms caused when it was administered 10, 30 and 60min before the induction of nasal symptoms. The repressive effect observed 10min after the administration of MF was inhibited by RU486, a GR antagonist, but not by actinomycin D, a transcriptional inhibitor. In contrast, the repressive effect observed 60min after the administration of MF was inhibited by RU486 and actinomycin D. Therefore, the effects observed 10 and 60min after the MF administration were classified as non-genomic and genomic effects, respectively. The non-genomic effect suppressed the nasal symptoms induced by m-3M3FBS, a phospholipase C (PLC) activator, and was inhibited by U-73122, a PLC inhibitor. The genomic effect was inhibited by N-(p-amylcinnamoyl) anthranilic acid, a phospholipase A2 (PLA2) inhibitor. These results indicate that MF has a non-genomic effect through repression of the activation of PLC via the mGR, and MF has also a genomic effect that was influenced by the inhibition of PLA2 through transcriptional regulation via cGR.

Allergic asthma caused by exposure to bacterial alpha-amylase Termamyl®

BACKGROUND

Airborne enzymes behave as potent respiratory allergens. Till date, allergic disorders caused by genetically engineered enzymes widely used in the industry, have not been reported.

RESULTS AND CONCLUSIONS

We describe a worker employed in the detergent industry who developed asthma and rhinitis from IgE-mediated sensitization to the thermostable endo-alpha-amylase Termamyl® and to the protease Savinase®. This is the first report showing that Termamyl® elicits allergic respiratory disorders in humans.

[Development of allergic airway disease model in mice]

OBJECTIVE

To investigate the method of development of allergic airway disease model in mice.

METHODS

Ten BALB/c mice were devided into the model group and the control group. Each group contained 5 mice. Ovalbumin (OVA) was used as allergen. OVA was emulsified with aluminum hydroxide and injected intraperitoneally for sensitization. Afterwards the mice from model group were challenged with aerosolized 5% OVA and subsequently instilled with OVA intranasally. For the blank control group the mice were sensitized and challenged with phosphate buffer saline (PBS). After final challenge, the nasal symptoms were scored, and mice were sacrificed for evaluation of eosinophilia of nasal septum, peribronchial inflammation and goblet cell hyperplasia. Mice serum was collected for measurement of OVA-specific IgE concentration, and levels of IL-4 and IL-5 from bronchoalveolar fluids were also tested.

RESULTS

Compared with blank control mice, mice from model group displayed typical sneezing and nasal scratching symptoms. The histopathological changes, such as eosinophilia of nasal septum mucosa, infiltration of peribronchial inflammatory cells and hyperplasia of goblet cells were successfully induced by OVA sensitization and challenge. Moreover, mice in model group showed higher level of OVA-specific IgE in serum and IL-4 and IL-5 cytokines in bronchoalveolar fluids[mice from model group: IgE (1237.00 ± 153.20) pg/ml, IL-4 (46.50 ± 10.15) pg/ml, IL-5 (50.81 ± 11.41) pg/ml; mice from control group: IgE (191.90 ± 43.20) pg/ml, IL-4 (7.96 ± 1.80) pg/ml, IL-5 (7.53 ± 2.23) pg/ml;t value were 6.569, 3.738 and 3.724, respectively, all P < 0.05].

CONCLUSION

The method using OVA as allergen could effectively develop a mouse model of allergic airway disease which could be used for pathogenesis study and drug effect evaluation.

Consumption of artificially-sweetened soft drinks in pregnancy and risk of child asthma and allergic rhinitis

BACKGROUND

Past evidence has suggested a role of artificial sweeteners in allergic disease; yet, the evidence has been inconsistent and unclear.

OBJECTIVE

To examine relation of intake of artificially-sweetened beverages during pregnancy with child asthma and allergic rhinitis at 18 months and 7 years.

METHODS

We analyzed data from 60,466 women enrolled during pregnancy in the prospective longitudinal Danish National Birth Cohort between 1996 and 2003. At the 25th week of gestation we administered a validated Food Frequency Questionnaire which asked in detail about intake of artificially-sweetened soft drinks. At 18 months, we evaluated child asthma using interview data. We also assessed asthma and allergic rhinitis through a questionnaire at age 7 and by using national registries. Current asthma was defined as self-reported asthma diagnosis and wheeze in the past 12 months. We examined the relation between intake of artificially-sweetened soft drinks and child allergic disease outcomes and present here odds ratios with 95% CI comparing daily vs. no intake.

RESULTS

At 18 months, we found that mothers who consumed more artificially-sweetened non-carbonated soft drinks were 1.23 (95% CI: 1.13, 1.33) times more likely to report a child asthma diagnosis compared to non-consumers. Similar results were found for child wheeze. Consumers of artificially-sweetened carbonated drinks were more likely to have a child asthma diagnosis in the patient (1.30, 95% CI: 1.01, 1.66) and medication (1.13, 95% CI: 0.98, 1.29) registry, as well as self-reported allergic rhinitis (1.31, 95% CI: 0.98, 1.74) during the first 7 years of follow-up. We found no associations for sugar-sweetened soft drinks.

CONCLUSION

Carbonated artificially-sweetened soft drinks were associated with registry-based asthma and self-reported allergic rhinitis, while early childhood outcomes were related to non-carbonated soft drinks. These results suggest that consumption of artificially-sweetened soft drinks during pregnancy may play a role in offspring allergic disease development.

Parental smoking, nasal resistance and rhinitis in children

AIM

To determine whether parent-reported perennial rhinitis or objectively measured nasal resistance is more common in children from smoking families. To assess tonsillar size, nasopharyngeal airway and upper airway surgery frequency in children with smoking and non-smoking parents.

METHODS

Ninety-five children (age 3-6 years, median 68 months) participated in this prospective cross-sectional clinical study. History of nasal symptoms was obtained, and all underwent an ear-nose-throat examination, anterior rhinomanometry and a lateral cephalogram. Regular smoking by either parent and their child's snoring was inquired about with a parental questionnaire. We compared children with a parental smoker and children without a parental smoker in the family.

RESULTS

Smoking in the family led to increased risk for perennial rhinitis in the children up to 2.76-fold (aOR, 95%CI 1.00-7.67), but with no difference in nasal resistance between children from smoking and non-smoking households. Neither tonsillar size, nasopharyngeal airway nor upper airway surgery was associated with parental smoking.

CONCLUSIONS

Parental smoking is associated with symptoms of perennial rhinitis in children. The possible role of environmental tobacco smoke should be taken into account in parent counselling and in evaluation of children being treated for symptoms of rhinitis and nasal obstruction.

Differential properties of mucous glycoproteins produced by allergic inflammation and lipopolysaccharide stimulation in rat nasal epithelium

To examine the differential properties of mucous glycoproteins, we produced hyperplastic and metaplastic changes in goblet cells of rat nasal epithelium by intranasal instillation of ovalbumin (OVA) in OVA-sensitized rats, and by intranasal lipopolysaccharides (LPS) instillation. The epithelial mucosubstance was quantitatively examined by AB-PAS and lectin histochemistry. The newly produced mucin after OVA challenge or LPS instillation contained a high amount of sulfomucin and a low amount of neutral glycoprotein: LPS-induced mucin contained more sulfomucin (70.1% of total) and less neutral glycoprotein (8.6%) than OVA-induced mucin (sulfomucin 33.6%, neutral glycoprotein 41.8%). Four of the lectins, PNA, MAL II, SNA, UEA I, stained some of the mucosubstance, indicating the presence of galactose-N-acetylgalactosamine, α2,3-linked and α2,6-linked sialic acid-galactose, and fucose residues. After LPS instillation, the reactivity was higher for galactose-N-acetylgalactosamine (64.8% of total) and α2,3-linked sialic acid-galactose (75.8%) than after saline instillation (3.5 and 19.1%, respectively) or OVA challenge (5.8 and 32.3%). A 2-fold increase in mucin mRNA (rat Muc5ac) expression was induced after LPS instillation or OVA challenge. These results indicate that mucin mRNA expression increases similarly after LPS instillation or OVA challenge, however, carbohydrate compositions of newly produced mucin are different between the two groups.

Tissue-type plasminogen activator depletion affects the nasal mucosa matrix reconstruction in allergic rhinitis mice

BACKGROUND

The present study was designed to assess the function of tissue plasminogen activator (t-PA) expression in allergic rhinitis.

METHODS

Age-matched t-PA gene knock out (t-PA(-/-)) and wild type (WT) mice were sensitised four times, and then challenged for six weeks with ovalbumin. The controls were treated with saline instead of ovalbumin. The structural change in the nasal mucosa was investigated with haematoxylin and eosin stain and van Gieson staining. u-PA (urokinase-type plasminogen activator) and PAI-1 (plasminogen activator inhibitor) gene expression were measured by real time PCR. Matrix metalloproteinase-9 (MMP-9) expression was tested with Western blotting and with real time PCR.

RESULTS

After ovalbumin challenge for six weeks, compared with the WT group, t-PA depletion increased collagen deposition and gland hyperplasia. u-PA and PAI-1 gene expression increased both in t-PA(-/-) and in WT mice after ovalbumin treatment. MMP-9 expression decreased greatly after ovalbumin challenge in t-PA(-/-) mice.

CONCLUSION

t-PA affects the nasal mucosa matrix reconstruction process in allergic rhinitis, with which MMP-9 is involved.

Evaluation impact of long-term usage of inhaled fluticasone propionate on ocular functions in children with asthma

OBJECTIVE

Although systemic, topical, and periocular corticosteroid administration have long been associated with ocular side effects, there has been little evidence to suggest that long-term inhaled corticosteroids can cause ocular side effects. The aim of this study was to evaluate the effects of long term treatment inhaled fluticasone propionate spray usage the recommended dose on some ocular functions in pediatric patients with asthma.

METHODS

The study group consisted of 266 prepubertal children with asthma who had used inhaled fluticasone propionate spray at 3-6 years intermittently. One hundred and sixty children who were newly diagnosed with asthma without any treatment made up the control group. Schirmer test results, central corneal thickness, visual acuity, intraocular pressure, cataract formation, keratometry and tear break-up time compared between study and control groups.

RESULTS

The ages of the 266 study patients (150 male) were between 7 and 11 years. The average age (±SEM) was 8.2±1.7 years, and the mean (±SEM) a daily dose of 323 μg (range 250-450 μg) inhaled fluticasone propionate spray, with 865.2±215 g total steroid use during treatment. Eye functions including cataract formation, corneal ectasia, ocular hypertension or glaucoma, and dry eye were not observed in any of the patients in the study group and were not correlated with total steroid dosage (t=0.150, p=0.384).

CONCLUSION

Our findings suggest that long-term intermittent treatment for 3-6 years with inhaled fluticasone propionate spray, as much as average 320 μg daily, in children with asthma seems to be safe for some eye functions.

[Occupational allergic "march". Rapid evolution of contact dermatitis to ammonium persulfate into airborne contact dermatitis with rhinitis and asthma in a hairdresser]

BACKGROUND

Hairdressers are exposed to irritants and allergenic compounds that may cause contact dermatitis, rhinitis and asthma.

OBJECTIVES

In this paper we describe the case of a female, age 33 years, who developed contact dermatitis after 10 years of exposure to ammonium persulfate.

METHODS

After 7 months of progressively extensive and persistent skin lesions, respiratory symptoms appeared that were related to the occupational exposure (on-off test). SIDAPA and specific occupational patch test for hairdressers and occupational challenge with ammonium persulfate were performed. Clinical parameters of inflammation, ECP (eosinophil cationic protein) and exhaled nitric oxide (FeNO) were detected before and after the specific bronchial challenge.

RESULTS

The patch test was positive to ammonium persulfate (++), and bronchial challenge for ammonium persulfate showed a significant late response (FEV1 decrease--33%). Both FeNO and ECP showed a significant increase after 24 hours. Dermatitis, urticaria and angioedema occurred on the uncovered skin due to airborne contact. Topic steroids and anti-histaminic drugs resolved the clinical symptoms.

CONCLUSIONS

Bronchial challenge is, in fact, considered to be the gold standard for the diagnosis of occupational asthma, although new inflammatory parameters can contribute to the diagnosis and can be useful for monitoring after a specific inhalation test with occupational agents. The described case summarizes the evolution from contact dermatitis to inhalation allergy, suggesting the occurrence of an allergic "march" for occupational allergy.

Paracetamol use in early life and asthma: prospective birth cohort study

OBJECTIVE

To determine if use of paracetamol in early life is an independent risk factor for childhood asthma.

DESIGN

Prospective birth cohort study.

SETTING

Melbourne Atopy Cohort Study.

PARTICIPANTS

620 children with a family history of allergic disease, with paracetamol use prospectively documented on 18 occasions from birth to 2 years of age, followed until age 7 years.

MAIN OUTCOME MEASURES

The primary outcome was childhood asthma, ascertained by questionnaire at 6 and 7 years. Secondary outcomes were infantile wheeze, allergic rhinitis, eczema, and skin prick test positivity.

RESULTS

Paracetamol had been used in 51% (295/575) of children by 12 weeks of age and in 97% (556/575) by 2 years. Between 6 and 7 years, 80% (495/620) were followed up; 30% (148) had current asthma. Increasing frequency of paracetamol use was weakly associated with increased risk of childhood asthma (crude odds ratio 1.18, 95% confidence interval 1.00 to 1.39, per doubling of days of use). However, after adjustment for frequency of respiratory infections, this association essentially disappeared (odds ratio 1.08, 0.91 to 1.29). Paracetamol use for non-respiratory causes was not associated with asthma (crude odds ratio 0.95, 0.81 to 1.12).

CONCLUSIONS

In children with a family history of allergic diseases, no association was found between early paracetamol use and risk of subsequent allergic disease after adjustment for respiratory infections or when paracetamol use was restricted to non-respiratory tract infections. These findings suggest that early paracetamol use does not increase the risk of asthma.

Up-regulation of Orai1 in murine allergic rhinitis

Orai1 is an essential pore-forming subunit of the Ca(2+) release-activated Ca(2+) channels and plays a key role in the store-operated Ca(2+) entry. However, little is known about the function of this pathway in allergic airway diseases. In this study, we evaluated Orai1 expression in normal and allergic rhinitis (AR) mice airway and spleen. AR models were established by repetitive intraperitoneal sensitization followed by intranasal challenge with ovalbumin. Sneezing was counted, and eosinophils infiltration was analyzed through Luna stain. We performed the analysis of Orai1 protein in airway and spleen by immunohistochemical staining, Western blotting and enzyme-linked immunosorbent assay, and quantitatively examined Orai1 mRNA in the above tissues by real-time reverse transcription-polymerase chain reaction. Sneezes and eosinophil counts in the AR group were increased in comparison to those in the normal group. Orai1 protein was expressed in mucosal epithelium and submucosal glands epithelium of airway, and in immune cells of spleen. The immunostaining appeared stronger in AR mice than that in normal ones. Both the Orai1 protein and mRNA levels showed up-regulation in the AR group compared with those in the normal one. Our results indicate that Orai1 is up-regulated in the airway and spleen in allergic inflammation and may participate in the pathogenesis of allergic rhinitis.

Occupational immediate-type asthma and rhinitis due to rhodium salts

BACKGROUND

Whereas platinum salts are well known occupational allergens, rhodium salts have not been identified as inhalative sensitizing substances.

METHODS

A 27-year-old atopic operator of an electroplating plant developed work-related shortness of breath and runny nose with sneezing after exposure to rhodium salts. Quantitative skin prick tests (SPT) and bronchial challenge tests with a dosimeter protocol were performed with quadrupling doses of the sodium chloride salts of rhodium (Na(3)RhCl(6)) and platinum (Na(2)PtCl(6)).

RESULTS

The patient showed positive SPT reactions and positive bronchial immediate-type reactions with rhodium and platinum salts. Sensitivity to rhodium salt was much higher than to platinum salt; the molar concentrations differed by a factor of 256 in SPT and a factor of 16 in bronchial challenges.

CONCLUSIONS

Rhodium salts should be considered as occupational immediate-type allergens.

[Association of xenobiotic-metabolizing gene polymorphisms with childhood atopic diseases in Russian patients from the Republic of Bashkortostan]

Enzymes of biotransformation system involved in the metabolism of exogenous and endogenous compounds are effective mechanism of protection from negative environmental factors. Decreasing activity or insufficient synthesis of biotransformation system enzymes caused by genetic polymorphism form the risk of various complex diseases, including atopic. Using allele-specific hybridization on the biochip the frequencies of xenobiotic-metabolizing gene polymorphisms in Russian children with bronchial asthma, allergic rhinitisand healthy donors from the Republic of Bashkortostan have been determined. The analysis of polymorphisms in CYP1A1, GSTT1, GSTM1, NAT2, MTHFR, CYP2C9 and CYP2C19 genes didn't reveal any association with atopic diseases. The frequencies of CYP2D6*1934G/G genotype and CYP2D6*1934G allele were significantly higher among boys with rhinitis symptoms than in control group.

[Traffic-related pollutants and their impact on allergic respiratory diseases]

There is good evidence that urban air pollutants, and particularly diesel exhaust particles (DP), contribute to the increasing prevalence of asthma and allergic rhinitis. Diesel exhaust particles act as adjuvants in the immune response and may aggravate allergic inflammation. This was first suggested by epidemiological studies and has now been largely confirmed by numerous experimental studies in animals and humans. We review the different underlying mechanisms, including effects on cytokine and chemokine production and immune cell activation. We also discuss the metabolic and cellular activation pathways followed by polycyclic aromatic hydrocarbons and allergens, and their interaction with diesel particles, which act in synergy in this immune response, resulting in IgE production and triggering allergic inflammation.

Intraoral administration of a T-cell epitope peptide induces immunological tolerance in Cry j 2-sensitized mice

Sublingual immunotherapy using allergen-derived peptides is feasible as a novel specific immunotherapy, but its efficacy has not yet been demonstrated in either humans or animals. In addition, it remains obscure whether the oral immune system is involved in the mechanism of sublingual immunotherapy. Here, we show that the intraoral administration of the T-cell epitope peptide P2-246-259 derived from Cry j 2, a major Japanese cedar (Cryptomeria japonica) pollen allergen, to Cry j 2-sensitized mice induces immunological tolerance, and that ex vivo lymph node cell proliferation to P2-246-259 and Cry j 2 was inhibited. In addition, intraoral administration was shown to be superior to intragastric administration in terms of tolerance induction, suggesting that the oral immune system contributes to the induction of immunological tolerance. Therefore, the significant efficacy of sublingual immunotherapy using a peptide on allergen-specific T-cells was demonstrated in animals, and this may be potentiated by the oral mucosal immune system.

Acetaminophen use and the symptoms of asthma, allergic rhinitis and eczema in children

Allergic diseases are frequent in children and their prevalence and severity differ in the different regions of the world. A number of studies have been performed to determine the factors which are effective in the incidence of these diseases. One of the drugs that might have a role in incidence or intensity of the symptoms of allergic diseases is Acetaminophen. In our survey conducted with standardized method (International Study of Asthma and Allergies in Childhood), 3000 children 6-7 years old and 3000 teenagers 13-14 years old were questioned regarding asthma, allergic rhinitis and eczema. The prevalence of ever wheezing in the children of 6-7 years old who took acetaminophen in the first year of their life was 11.3%, which is more than other group (Odds Ratio=1.54, 95% Confidence Interval: 1-2.38, P=0.049) and the prevalence of ever wheezing in older age group who have taken acetaminophen at least once in a month was 25.1% which is more than those taken less acetaminophen (OR=1.7, 95%CI=1.43-2.04, P=0.000). Moreover taking more acetaminophen during past 12 months led to more prevalence of night dry coughs and the symptoms of rhinitis in children 6-7 years old and eczema and rhinitis symptoms in the 13-14 years old. Our findings suggest that taking more acetaminophen may be associated with increasing allergic symptoms in children.

Inhibition of experimental allergic airways disease by local application of a cell-penetrating dominant-negative STAT-6 peptide

Allergic airways disease is initiated and perpetuated by an aberrant Th2 inflammatory response regulated in part by the cytokines IL-4 and IL-13, each of which induces activation of the STAT-6 transcription factor. Data from murine models indicate that the clinical manifestations of acute asthma are STAT-6 dependent, and thus, STAT-6 is a target for drug development in allergic airways disease. We designed a novel chimeric peptide (STAT-6 inhibitory peptide (STAT-6-IP)) comprised of a sequence predicted to bind to and inhibit STAT-6, fused to a protein transduction domain, to facilitate cellular uptake of the STAT-6-binding peptide. Our data demonstrate that the STAT-6-IP inhibited OVA-induced production of Th2 cytokines IL-4 and IL-13 in vitro. In contrast, the STAT-6-IP did not affect production of IFN-gamma, demonstrating specificity for Th2 cytokine inhibition. Following intranasal administration, the STAT-6-IP was localized to epithelial cells in the airways. Finally, in in vivo murine models of allergic rhinitis and asthma, intranasal delivery of the STAT-6-IP inhibited OVA-induced lung inflammation and mucus production as well as accumulation of eosinophils and IL-13 in bronchoalveolar lavage fluid and OVA-dependent airway hyperresponsiveness. Together these data show that local application of cell-penetrating peptide inhibitors of STAT-6 has significant potential for the treatment of allergic rhinitis and asthma.

Inhalation of toluene diisocyanate vapor induces allergic rhinitis in mice

Diisocyanates are the leading cause of occupational asthma, and epidemiological evidence suggests that occupational rhinitis is a comorbid and preceding condition in patients who develop asthma. The goal of the present studies was to develop and characterize a murine model of toluene diisocyanate (TDI)-induced rhinitis. Female C57BL/6 mice were exposed to workplace-relevant concentrations of TDI vapor via inhalation for 4 h/day for 12 days with or without a 2-wk rest period and TDI challenge. Mice exposed 12 consecutive weekdays to 50 parts per billion TDI vapor showed elevated total serum IgE and increased TDI-specific IgG titers. Breathing rates were decreased corresponding with increased inspiratory time. TDI exposure elevated IL-4, IL-5, IL-13, and IFN-gamma mRNA expression in the nasal mucosa, suggesting a mixed Th1/Th2 immune response. Expressions of mRNA for proinflammatory cytokines and adhesion molecules were also up-regulated. These cytokine changes corresponded with a marked influx of inflammatory cells into the nasal mucosa, eosinophils being the predominant cell type. Removal from exposure for 2 wk resulted in reduced Ab production, cytokine mRNA expression, and cellular inflammation. Subsequent challenge with 50 parts per billion TDI vapor resulted in robust up-regulation of Ab production, cytokine gene expression, as well as eosinophilic inflammation in the nasal mucosa. There were no associated changes in the lung. The present model shows that TDI inhalation induces immune-mediated allergic rhinitis, displaying the major features observed in human disease. Future studies will use this model to define disease mechanisms and examine the temporal/dose relationship between TDI-induced rhinitis and asthma.

[Study on mechanism of biminne in treating allergic rhinitis]

OBJECTIVE

To investigate the effect and mechanism of Biminne, a Chinese herbal compound preparation, for treatment of allergic rhinitis (AR).

METHODS

AR model of mouse was induced by intraperitoneal injection of ovalbumin (OVA), and the changes in behavior, proliferative activity of splenic lymphocyte, serum levels of total IgE and OVA specific IgE were observed.

RESULTS

Biminne showed effects in reducing the frequency of sneezing and nasal rubbing, inhibiting the proliferation of splenic lymphocyte stimulated by phyto-hemagglutinin (PHA) and OVA, and lowering the levels of serum total IgE and OVA specific IgE.

CONCLUSION

Biminne could inhibit the proliferation of splenic lymphocyte and reduce serum level of IgE in mice with AR.

Occupational asthma and rhinitis in workers from a lasamide production line

OBJECTIVES

A wide range of low-molecular-weight agents can cause occupational asthma. The chemical industry is an environment in which numerous hazardous substances are used. Lasamide (2,4-dichloro-5-sulfamoylbenzoic acid) is one of them (along with its precursors).

METHODS

Five patients from a lasamide production line with suspected occupational asthma and rhinitis were examined. During the first visit, skin prick tests, total immunoglobulin E (IgE), a nonspecific bronchoprovocation test, and specific bronchoprovocation tests using occupational agents were performed to confirm the diagnosis of allergic diseases. During the follow-up visit (1-3 years after removal from exposure), all of the tests (except the specific bronchoprovocation test) were performed again.

RESULTS

At the first hospitalization, the total IgE levels were increased in three patients. In addition, skin prick tests and the nonspecific bronchoprovocation test were positive for three patients. After the specific bronchoprovocation test, serious bronchoconstriction occurred in three patients; symptoms of rhinitis were present in all five patients. Several years after removal from exposure to the occupational agents, normalization (with respect to the parameters followed) was not yet complete for all of the patients.

CONCLUSIONS

The process of lasamide production seems to be hazardous and is likely to cause allergic respiratory disease. The prognosis of allergic diseases caused by these products is not very favorable. Allergic symptoms (despite the removal from occupational allergen exposure) persisted even after several years.

Association of allergic rhinitis with pesticide use among grape farmers in Crete, Greece

OBJECTIVE

To explore the association of allergic rhinitis with the use of pesticides among grape farmers in Crete.

METHODS

A cross-sectional study of 120 grape farmers and 100 controls at the Malevisi region in Northern Crete was conducted. The protocol consisted of a questionnaire, skin prick tests for 16 common allergens, measurement of specific IgE antibodies against 8 allergens, and spirometry before and after bronchodilatation.

RESULTS

Grape farmers who used pesticides had higher prevalence rates of allergic rhinitis symptoms (OR, 3.0; 95% CI, 1.4 to 6.2) compared with grape farmers who reported no current use of pesticides, and control subjects. Logistic regression models controlling for age, sex and smoking status showed that 6 of the 12 predefined groups of major pesticides were significantly related to allergic rhinitis symptoms. The highest risks were observed for paraquat and other bipyridyl herbicides (OR, 2.2; 95% CI, 1.0 to 4.8), dithiocarbamate fungicides (OR, 2.5; 95% CI, 1.1 to 5.3) and carbamate insecticides (OR, 3.0; 95% CI, 1.4 to 6.5). A factor analysis of pesticides used identified 3 distinct factors. The most common factor was that of multiple pesticide use that included 9 pesticides and was significantly associated with allergic rhinitis (OR, 1.5; 95% CI, 1.0 to 2.3). ORs were higher when allergic rhinitis was defined using both questionnaire data on symptoms and atopy.

CONCLUSIONS

Occupational exposure to multiple agricultural chemicals could be related to allergic rhinitis in grape farmers.

[Effect of biminne on vascular permeability of nasal mucosa in allergic rhinitis rats]

OBJECTIVE

To investigate whether the effect of Biminne on allergic rhinitis (AR) was through improving vascular permeability of nasal mucosa.

METHODS

Rat's model in Biminne-treated group and model group was induced by intraperitoneal injection of ovalbumin (OVA) and aluminum hydroxide gel suspension Biminne-treated rats were orally given Biminne suspension from the 8th day to the 17th day. On the 18th day, Evan's blue dye (EBD) in the nasal perfusate was detected to assess the vascular permeability.

RESULTS

EBD concentration was higher in the model rats than that in the normal rats, and lower in the Biminne-treated rats than that in the model rats (both P < 0.01).

CONCLUSION

Biminne could improve vascular permeability of nasal mucosa in sensitized rats, which may be the mechanism of its clinical effect on AR.

Antileukotriene treatment and allergic rhinitis-related cough in guinea pigs

Experimental allergic rhinitis produces enhanced cough response in awake guinea pigs. Leukotriene receptor antagonists, as anti-inflammatory agents, have been effective in treatment of asthma and allergic rhinitis to inhibit the early and late allergic response. In the present study, we evaluated the effect of montelukast (Singulair, Merck, USA) on the cough reflex in an experimental model of allergen-induced rhinitis in guinea pigs. Guinea pigs (n=16) were sensitized with intraperitoneal ovalbumin (OVA). The animals were then used to develop a model of allergic rhinitis by repeated intranasal instillation of 0.5% OVA at weekly intervals for 8 weeks. Allergic rhinitis was evaluated from the occurrence of typical clinical symptoms including sneezing, conjunctival and nasal secretion, or nasal acoustic phenomenon. Between the 6(th) and 8(th) nasal challenge (NCh) the animals (n=8) were treated daily for 14 days with oral montelukast (10mg/kg). Cough was induced by citric acid aerosol inhalation in gradually increasing concentration (0.05-1.6 M) and was evaluated before sensitization and then after the 1(st), 6(th), and 8(th) nasal challenge when rhinitis symptoms were most conspicuous. The intensity of cough was significantly increased after the first and repeated nasal OVA challenges, and reduced after the 8(th) NCh that was preceded with montelukast treatment [9(6-14) vs. 16.5(14-22) vs. 25.5(23-42) vs. 8.5(8-13); P=0.0003]. We conclude that antileukotriene therapy suppresses the stimulating effect of experimental allergic rhinitis on the chemically-induced cough in awake guinea pigs.

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

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

OBJECTIVE

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

METHOD

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

RESULT

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

CONCLUSION

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

Quantitative expression levels of regulated on activation, normal T cell expressed and secreted and eotaxin transcripts in toluene diisocyanate-induced allergic rats

CONCLUSION

These results suggest that eotaxin may play a predominant role in controlling antigen-induced eosinophil recruitment into tissue. Objective To investigate the expression levels of regulated on activation, normal T cell expressed and secreted (RANTES) mRNA and eotaxin mRNA in the nasal mucosa of toluene diisocyanate (TDI)-induced allergic rats and to evaluate which of them is primarily related to selective eosinophilic infiltration by comparing their expression levels with the numbers of infiltrated eosinophils and vascular cell adhesion molecule-1 (VCAM-1).

MATERIAL AND METHODS

We quantified the expression levels of two strong eosinophilic CC chemokines (RANTES and eotaxin) and VCAM-1 at mRNA levels in the nasal mucosa of TDI-induced allergic rats using competitive polymerase chain reaction and compared their expression levels with the number of infiltrated eosinophils.

RESULTS

The number of infiltrated eosinophils was significantly increased between 3 h and Day 4 in TDI-induced allergic rats, but had decreased by Day 5. VCAM-1 mRNA expression was also increased between 3 h and Day 4. The number of infiltrated eosinophils correlated with the expression levels of VCAM-1 mRNA (p < 0.01). In contrast, expression of RANTES mRNA and eotaxin mRNA was increased between 3 h and Day 2, peaked between Days 1 and 2 and then declined. Although the expression of both chemokines correlated with the numbers of infiltrated eosinophils (p < 0.01), peak expression levels of eotaxin mRNA were 14-fold higher than baseline levels whereas RANTES mRNA expression increased 3-fold.

[Experimental study of spirulina platensis in treating allergic rhinitis in rats]

OBJECTIVE

To determine the therapeutic effect of spirulina platensis in allergic rhinitis (AR).

METHODS

Ovalbumin sensitized white rats used as AR animals were treated with spirulina platensis (SPP). At the end of the treatment, the differences in the behavior science were observed; the changes in the nasal mucosa and mast cell degranulation were studied pathologically; and the levels of serum histamine and total immunoglobulin (Ig) E were determined by enzyme-linked immune sorbent assay.

RESULTS

The behavior science score of the SPP treatment group was lower than that of the negative control group (P < 0.01 ) ; inflammatory reaction of nasal mucosa in the SPP treatment group were remarkably relieved; the number of nasal mucosa mastocyte and mast cell degranulation in the SPP treatment group were lower than that of the negative control group (P <0.01 ). The levels of serum histamine and total IgE in the SPP treatment group were lower than that of the negative control group (P <0.01 ). It had no significant difference in the positive control group and the SPP treatment group and the blank control group (P > 0.05 ).

CONCLUSION

Spirulina platensis can prevent and treat AR in rats, which implies the possibility of using spirulina platensis for AR patients in the future.

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

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

Nasal allergy-like symptoms aggravated by ozone exposure in a concentration-dependent manner in guinea pigs

Our previous study revealed that exposure to 0.4 ppm ozone (O(3)) enhanced nasal allergy-like reactions in guinea pigs. In the present study, we investigated the concentration-dependency of the effects of exposure to O(3) on the aggravation of nasal allergy-like reactions induced by repeated nasal administration of antigen. Guinea pigs were exposed to filtered air or 0.1-0.6 ppm O(3) for 5 weeks. After each weekly administration of ovalbumin (OVA), sneezes and nasal secretions were measured. The number of eosinophils infiltrating the nasal septum and the titers of OVA-specific antibody were measured 24h after the last administration. Ozone increased sneezing and nasal secretion induced by OVA, nasal responsiveness to physical stimuli, and the number of infiltrating eosinophils in a concentration-dependent manner. The titer of anti-OVA-IgG was increased in animals exposed to 0.6 ppm O(3). Thus, exposure to O(3) aggravated nasal allergy-like symptoms concentration dependently. The aggravation was caused by induction of nasal hyperresponsiveness, the infiltration of eosinophils, and the increase in the production of anti-OVA-IgG. The estimated maximum likelihood estimation concentrations (MLECs) and bench mark concentrations (BMCs) of O(3) for these indices were in the range of 0.09-0.18 and 0.02-0.06 ppm, respectively.

Tolerability of three selective cyclo-oxygenase-2 inhibitors, meloxicam, celecoxib and rofecoxib in NSAID-sensitive patients

BACKGROUND

Patients with aspirin-sensitive respiratory and cutaneous diseases experience cross reactions to all nonsteroidal anti-inflammatory drugs (NSAIDs) which inhibit cyclo-oxigenase (COX) enzymes. As are now available drugs which selectively inhibit COX-2, questions are raised whether cross-reactivity occurs between aspirin and these COX 2 inhibitors.

OBJECTIVE

The aim of this study was to evaluate the tolerability of three COX-2 inhibitors (meloxicam, celecoxib and rofecoxib) in subjects with previous pseudoallergic respiratory and cutaneous reactions to NSAIDs.

METHODS

76 subjects with documented previous cutaneous and respiratory pseudoallergic reactions to aspirin and/or other NSAIDs underwent a single blind challenge with celecoxib, meloxicam and rofecoxib.

RESULTS

All subjects with previous respiratory reactions tolerated all drugs. Three subjects with multiple-drug induced urticaria complained of a generalized reaction after challenge (Two due to celecoxib and one due to meloxicam). Among the group of patients with NSAIDs-induced urticaria five complained of a relapse of the disease due to rofecoxib (one subject), celecoxib (two subjects and meloxicam (two subjects).

CONCLUSIONS

According to these results the cross-reactivity between aspirin and these COX-2 inhibitors does not occur in subjects with previous respiratory pseudoallergic reactions. A good safety profile was also demonstrated in patients with cutaneous reactions, being few reactions observed. However for this reason a controlled oral challenge with these drugs is useful for the proper management of patients sensitive to classic NSAIDs.

Allergic rhinitis induced by intranasal sensitization and challenge with trimellitic anhydride but not with dinitrochlorobenzene or oxazolone in A/J mice

Allergic airway diseases induced by low molecular weight (LMW) chemicals, including trimellitic anhydride (TMA), are characterized by airway mucus hypersecretion and an infiltration of eosinophils and lymphocytes. Many experimental models have linked LMW chemical-induced allergic airway disease to Th2 cytokines. Most murine models, however, use dermal exposure to sensitize mice. The present study was designed to test the hypothesis that intranasal sensitization and challenge with the known chemical respiratory allergen TMA, but not the nonrespiratory sensitizers dinitrochlorobenzene (DNCB) and oxazolone (OXA), will induce characteristic features of LMW chemical-induced allergic airway disease in the nasal and pulmonary airways. A/J mice were intranasally sensitized and challenged with TMA, DNCB, or OXA. Only mice that were intranasally sensitized and challenged with TMA had a marked allergic rhinitis with an influx of eosinophils, lymphocytes, and plasma cells, increased intraepithelial mucusubstances, and a regenerative hyperplasia. Cytokine mRNA levels in the nasal airway of TMA treated mice also revealed an increase in the mRNA levels of the Th2 cytokines IL-4, IL-5, and IL-13, but no change in the level of the Th1 cytokine IFN-gamma. No lesions were found in the nasal airways of mice exposed to DNCB or OXA. TMA increased lung-derived IL-5 mRNA while DNCB and OXA caused no change in lung-derived cytokine mRNA levels. Both TMA and DNCB caused increases in total serum IgE, unlike OXA-exposed mice. However, no adverse alterations were found microscopically in the lungs of mice treated with TMA, DNCB, or OXA. This study is the first to demonstrate that intranasal administration of a known chemical respiratory allergen is an effective method of sensitization resulting in the hallmark features of allergic rhinitis after challenge with a concomitant increase in nasal airway-derived Th2 cytokine mRNA, lung-derived IL-5 mRNA, and total serum IgE. In contrast, DNCB and OXA failed to elicit the pathologic changes in the nasal airways and cytokine changes in the lung. This model may be useful for identifying other chemical respiratory allergens.

[Experimental studies for botulinum toxin type A on allergic rhinitis in the rat]

OBJECTIVE

To study the effect of botulinum toxin-A on inhibiting rhinorrhea, on expression of VIP at nasal mucosa, on morphometrical change with an immunohistochemical and histological methods in rats allergic rhinitis.

METHODS

Ovalbumin sensitized the rat as animal model of allergic rhinitis. Animals were divided into control group (n = 8), allergic group (n = 12), allergic animal treated by BTX-A group (n = 6). VIP immunoreactivity at nasal mucosa in the rat allergic rhinitis was studied by immunohistochemical. The morphometrical changes at nasal mucosa were observed by histological staining methods.

RESULTS

The results showed that the symptoms of allergic rhinitis, nasal rhinorrhea and sneezing, were remarkably relieved after ovalbumin application in the rat. The nasal rhinorrhea symptom diminished after BTX-A treated. The quantity of nasal secretion were significantly reduced(P < 0.05) in allergic one treated by BTX-A group as compared with allergic group. Hematoxylin and eosin staining demonstrated that no edema, small vessels were found in the nasal mucosa and after BTX-A treatment, but edema, vasodilational and inflammational cell infiltration were observed in the allergic group. Immunohistochemical study revealed that VIP immunoreactive fibers in the nasal mucosa showed a marked decrease after BTX-A application, but the density and a large number of VIP fibers were significantly found in the allergic group.

CONCLUSION

The results suggested that local BTX-A treatment was a selective and non-traumatic method to reduce a long lasting desensitization of the nasal mucosa, to alleviate nasal congestion, rhinorrhea and sneezing, and to reduce the sensory neuron sensitivity of the mucosa.

[Interleukin-5 regulate the bone marrow response in the model of allergic rhinitis]

OBJECTIVE

To elucidate the mechanism of bone marrow response regulated by interleukin-5 (IL-5) in the model of allergic rhinitis.

METHODS

Twenty SD rats were randomly divided into allergic rhinitis (AR) group and control group. The leucocytes in the smears of bone marrow and peripheral blood were counted, and the expression of IL-5 was detected by immunohistochemistry.

RESULTS

The ratio of eosinophils to white cells in bone marrow smears of AR group was significantly higher than that of control group(P < 0.01). The ratio of basophils to white cells in bone marrow smears of AR group was significantly higher than that of control group(P < 0.01). The ratio of eosinophils to white cells in peripheral blood smears of AR group was significantly higher than that of control group(P < 0.01). The ratio of IL-5 positive cells to white cells in bone marrow smears of AR group was significantly higher than that of control group (P < 0.05). The ratio of IL-5 positive cells to white cells was significantly positively correlated with the ratio of eosinophils to white cells in bone marrow smears of AR group (R = 0.85, P < 0.01).

CONCLUSION

IL-5 regulates the proliferation and differentiation of eosinophils in bone marrow.

Inhibition of experimental allergic rhinitis by the n-butanol fraction from the anomalous fruits of Gleditsia sinensis

This study was conducted to clarify the effect of the n-butanol fraction from the anomalous fruits of Gleditsia sinensis LAM. (NBGS) on experimental allergic rhinitis. NBGS (100, 200, 400 mg/kg, p.o.) dose-dependently inhibited nasal symptoms (sneezing and nasal rubbing) and dye leakage induced by antigen challenge into the nasal cavity of actively sensitized rats. Significant effects were observed at doses of 200 and 400 mg/kg. NBGS (200, 400 mg/kg) also showed a clear inhibition of sneezing and an inhibitory tendency on nasal rubbing induced by histamine in normal rats. At 400 mg/kg, it significantly reduced dye leakage induced by histamine into the nasal cavity of rats. Terfenadine (10 mg/kg, p.o.), an antihistaminic drug, clearly inhibited the nasal symptoms and the amount of dye leakage induced by antigen or histamine. Furthermore, NBGS significantly reduced in vitro histamine release from rat peritoneal mast cells triggered by compound 48/80 at concentrations of 30 and 100 microg/ml. These results suggest that NBGS may be clinically effective in alleviating the nasal symptoms of allergic rhinitis, probably by inhibiting both histamine release from mast cells and nasal vascular permeability.

Berufliche Beifuß-Allergie

BACKGROUND

Mugwort (Artemisia vulgaris) has traditionally been used as a spice, vegetable and as a herbal medicine. The main representatives of the Artemisia family besides Artemisia vulgaris include Artemisia absinthum and Artemisia dracunculus (estragon). Mugwort pollen allergens are important in triggering late summer and fall pollinosis; in addition cross reactivity occurs between Artemisia vulgaris pollen allergens and celery, carrottes and certain spices belonging to the family of Umbelliferae.

PATIENTS

A florist with a pre-existing sunflower allergy developed a life-threatening glottal edema after occupational contact with mugwort. She did not suffer from an oral allergy syndrome towards mugwort pollen cross allergens.

RESULTS

Skin testing (prick and scratch testing) revealed a strong sensitisation against mugwort and estragon. Specific IgE antibodies against mugwort, sunflower, carrots, celery, fennel and anis were elevated in the peripheral blood.

CONCLUSIONS

The observation of a severe mugwort allergy with life-threatening complications in a florist underscores the high allergenic potential of Artemisia vulgaris and documents for the first time the occupational significance of this allergy.

Therapeutic effects of interleukin-1 receptor antagonist on allergic rhinitis of guinea pig

AIM

To determine the effect of interleukin-1 receptor antagonist (IL-1ra) on allergic rhinitis.

METHODS

Allergic rhinitis was induced by toluene-2,4-diisocyanate (TDI). At the end of the treatment, the pathological changes in the nasal mucosa were observed. The concentrations of histamine in the nasal mucosa and IgE in the blood were determined as well.

RESULT

Symptoms of allergic rhinitis were remarkably relieved after IL-1ra treatment. Hematoxylin and eosin staining demonstrated that less edema was found in the nasal mucosa and small vessel was normal after IL-1ra application, but edema,vasodilation, and inflammatory cell infiltration were discovered in the model group. The concentrations of histamine in the nasal mucosa and IgE in the blood were less than those in the control group.

CONCLUSION

IL-1ra im administration selectively and non-traumatically alleviated nasal congestion, rhinorrhea, and sneezing.

Nuclear factor-kappaB activity is down-regulated in nasal polyps from aspirin-sensitive asthmatics

BACKGROUND

We examined whether a decreased activity of nuclear factor(NF)-kappaB), a transcriptional regulator of cyclooxygenase-2 (COX-2), could account for down-regulation of COX-2 in nasal polyps of aspirin-sensitive asthmatics.

METHODS

Nasal polyps were obtained from 17 aspirin-intolerant asthma/rhinitis patients (AIAR; 7 men, mean age 48 +/- 12 years) and 23 aspirin-tolerant asthma/rhinitis patients (ATAR; 12 men, mean age 65 +/- 11 years). COX-2 mRNA expression was measured using semiquantitative reverse transcriptase competitive polymerase chain reaction (RT-PCR), and the results were expressed as mean +/- standard error of 106 molecules of mRNA/ micro g of total RNA. NF-kappaB binding was measured with 32P-labeled oligonucleotides and electrophoretic mobility shift assay (EMSA), and the results were expressed as a percentage with respect to the mean EMSA obtained in 19 healthy nasal mucosa.

RESULTS

The mean levels of COX-2 mRNA expression (0.25 +/- 0.06) and NF-kappaB activity (89 +/- 13) in nasal polyps from AIAR were significantly lower than in polyps from ATAR (COX-2 = 1.58 +/- 0.50, and NF-kappaB = 143 +/- 12, P < 0.01 and P < 0.05, respectively). Levels of COX-2 mRNA and NF-kappaB activity in polyps from patients on corticosteroid therapy did not differ statistically from those who were not on this therapy before polypectomy.

CONCLUSION

This study shows that the low expression of COX-2 mRNA in nasal polyps from aspirin-sensitive patients is associated with a down-regulation of NF-kappaB activity.

Dentist's occupational asthma, rhinoconjunctivitis, and allergic contact dermatitis from methacrylates

BACKGROUND

Allergic contact dermatitis (ACD) caused by (meth)acrylates (MA) is common in dental personnel. MAs have also caused asthma and rhinoconjunctivitis, but asthma, rhinoconjunctivitis and ACD caused by MAs in the same patient appears to be very rare.

METHODS

Occupational asthma and rhinoconjunctivitis were diagnosed in a dentist according to patient history, PEF monitoring, and a work-simulated bronchial provocation test. ACD was diagnosed by skin-patch testing with MAs with the occlusive Finn Chamber-technique.

RESULTS

The patient's skin-prick test reactions to common environmental allergens and MAs were negative. The total IgE was not elevated. Occupational asthma was diagnosed by a specific inhalation challenge test in which the patient handled liquid dental MAs for 30 min causing a delayed 23% reduction in FEV1. The provocation test also resulted in rhinoconjunctivitis. On patch testing, positive reactions were provoked by several MAs including 2-hydroxyethyl methacrylate (2-HEMA) to which the patient was occupationally exposed. The patient has not been able to continue her work with dental MAs.

CONCLUSIONS

A case of occupational asthma, rhinoconjunctivitis and ACD caused by dental acrylate compounds is presented. Patients with respiratory hypersensitivity from MAs have to stop working with MAs, whereas patients with ACD from MAs need to avoid direct contact with MAs, but can often continue in their present job if they use no-touch techniques.

Enhancement of nasal inflammatory and epithelial responses after ozone and allergen coexposure in Brown Norway rats

Repeated exposures to ozone cause inflammation and mucous cell metaplasia (MCM) in the nasal mucosa of laboratory animals. Similar cellular responses occur in humans during allergic rhinitis. We tested the hypothesis that exposure to ozone will enhance the inflammatory and epithelial responses associated with allergic rhinitis. Ovalbumin (OVA)-sensitized Brown Norway rats were exposed to ozone (0.5 ppm, 8 h/day) for 1 day or 3 consecutive days. Immediately after each ozone exposure, animals were challenged intranasally (IN) with either sterile saline or OVA dissolved in saline (1%, 50 microg/nasal passage). Twenty-four h after the last IN challenge rats were sacrificed; nasal tissues were removed and processed for light microscopic examination and morphometric analysis of numeric densities of inflammatory and epithelial cell populations and volume densities of intraepithelial mucosubstances. A single OVA challenge caused a significant influx of neutrophils and eosinophils into the submucosa of all nasal tissues. Ozone exposure further enhanced the appearance of eosinophils in the maxilloturbinates of OVA-challenged rats but did not increase inflammation in other nasal tissues. After 3 days of ozone/OVA coexposures, the nasal transitional epithelium lining the maxilloturbinates had increased numbers of epithelial cells as well as the appearance of mucus-containing cells in areas normally absent of these secretory cells (i.e., MCM). Multiple challenges with OVA caused increased epithelial mucosubstances in the respiratory epithelium lining the septum without increasing the number of epithelial cells. Multiple exposures to both ozone and OVA caused greater increases in intraepithelial mucosubstances in the septum than those elicited by OVA alone. These results demonstrate that exposure to ozone exacerbates epithelial and inflammatory responses associated with allergen challenge. In addition, coexposure of these agents enhanced the induced production of nasal mucosubstances caused by either agent alone.

[Hairdressers live dangerously. Daily exposure to chemicals can cause respiratory tract problems]

Hairdressers are regularly exposed to toxic chemicals contained in bleach, hair spray, permanent wave solutions and hair dyes. Adequate ventilation and appropriate working procedures can reduce exposure, but never completely eliminate the risk for respiratory disease.

Evaluation of cytokines in nasal secretions after nasal antigen challenge: lack of influence of antihistamines

BACKGROUND

Previous studies of inflammation in allergic rhinitis using nasal irrication have been unsatisfactory because of 1) poor reproducibility; 2) the tendency of irrigation to overdilute mediators; and 3) the failure of this technique to evaluate interstitial concentrations of relevant mediators. For this study we used filter paper as a matrix to collect nasal secretions in patients undergoing nasal antigen challenge.

OBJECTIVE

To evaluate inflammatory mediators of allergen-induced rhinitis during a clinical trial of fexofenadine.

METHODS

Subjects evaluated at a referral medical center were placed on traditional dosing of fexofenadine at 60 mg, twice daily, or placebo in a double-blind, crossover fashion for 1 week before the nasal challenge. Nasal challenge was performed with nasal insufflation of either 1,000 AU timothy or 0.1 mL ragweed (1:100 wt/vol) extract outside the pollen season. Nasal secretions were collected at baseline and then at 2, 4, and 6 hours after nasal challenge. Secretions were evaluated for expression of the cellular adhesion molecule-1, tumor necrosis factor (TNF)-alpha, interleukin (IL)-4, IL-10, macrophage inflammatory protein (MIP)-1alpha, and granulocyte-macrophage colony-stimulating factor (GM-CSF) using commercially available enzyme-linked immunoadsorbent assay kits. Patients' symptom scores were evaluated during the nasal challenge.

RESULTS

Significantly (P < 0.05) increased peak levels of TNF-alpha, IL-4, IL-10, and MIP-1alpha were detected after antigen challenge as compared with baseline levels. There was a nonsignificant trend toward an increase in GM-CSF after antigen challenge (P = 0.07). There was no difference in the peak levels of TNF-alpha, IL-4, IL-10, MIP-1alpha, or GM-CSF measured when patients were on fexofenadine versus placebo. Finally, there were no significant differences in patients' symptom scores during antigen challenge when subjects were on fexofenadine versus placebo.

CONCLUSIONS

Collection of nasal secretions using a filter paper matrix provides a reproducible model for accurately detecting and evaluating changes in cytokine levels after nasal challenge. Cytokine levels tend to peak 3 to 4 hours after antigen challenge. Standard doses of fexofenadine do not seem to have a mitigating effect on the production of these cytokines. Symptoms of allergic rhinitis using this type of antigen challenge did not differ from treatment with fexofenadine versus placebo.