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Vo-Thi-Kim A, Van-Quang T, Nguyen-Thanh B, Dao-Van D, Duong-Quy S. The effect of medical treatment on nasal exhaled nitric oxide (NO) in patients with persistent allergic rhinitis: A randomized control study. Adv Med Sci 2020; 65:182-188. [PMID: 31978697 DOI: 10.1016/j.advms.2019.12.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 07/19/2019] [Accepted: 12/14/2019] [Indexed: 12/19/2022]
Abstract
PURPOSE This study aimed to evaluate the role of nasal nitric oxide (NO) in the management of patients with persistent allergic rhinitis (PER). METHODS It was a randomized and comparative study. The study subjects were classified as controls (healthy subjects) or patients with PER based on defined criteria. All clinical, functional and biological data were collected for analyzing. Nasal fractional exhaled nitric oxide (FENO) was measured by electroluminescence device. Patients with PER were randomized for treatment with antihistamine (ATH) combined with leukotriene receptor antagonists (LRA) or only with intranasal steroids (INS). RESULTS During two years, 501 subjects were included: 234 control subjects and 267 patients with PER. The levels of nasal NO, total IgE, blood eosinophil counts, and apnea-hypopnea index (AHI) in patients with PER were higher than controls (P < 0.001; P < 0.05; P < 0.05; P < 0.01; respectively). There were statistically significant correlations between nasal NO, nasal peak flows, total IgE, and blood eosinophil counts in patients with PER (R = -0.687 and P = 0.0012; R = -0.643 and P = 0.0018; R = 0.432 and P = 0.0024; R = 0.445 and P = 0.002; respectively). After 6 months of treatment, patients treated with INS had greater improvement of clinical symptoms and reduction of nasal NO values than patients treated with ATH + LRA (985 ± 253 vs. 732 ± 298 ppb; P < 0.05). CONCLUSION Nasal NO measurement is a useful tool for the follow-up of patients with PER. It also helps clinicians to estimate the level of response to treatment in patients with PER.
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Affiliation(s)
- Anh Vo-Thi-Kim
- Health of Sciences Department, Thang Long University, Hanoi City, Viet Nam
| | - Tan Van-Quang
- ENT Department, Binh Duong General Hospital, Binhduong Province, Viet Nam
| | - Binh Nguyen-Thanh
- Internal Medicine Department, Ho Chi Minh University of Medicine and Pharmacy, Hochiminh City, Viet Nam
| | - Dung Dao-Van
- Health of Sciences Department, Thang Long University, Hanoi City, Viet Nam
| | - Sy Duong-Quy
- Clinical Research Center, Lam Dong Medical College, Dalat City, Viet Nam; Department of Immuno-Allergology, Penn State Medical College, Hershey, USA.
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Bella Z, Kiricsi Á, Viharosné ÉDR, Dallos A, Perényi Á, Kiss M, Koreck A, Kemény L, Jóri J, Rovó L, Kadocsa E. Rhinophototherapy in persistent allergic rhinitis. Eur Arch Otorhinolaryngol 2016; 274:1543-1550. [PMID: 27864672 DOI: 10.1007/s00405-016-4358-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 10/21/2016] [Indexed: 10/20/2022]
Abstract
Previous published results have revealed that Rhinolight® intranasal phototherapy is safe and effective in intermittent allergic rhinitis. The present objective was to assess whether phototherapy is also safe and effective in persistent allergic rhinitis. Thirty-four patients with persistent allergic rhinitis were randomized into two groups; twenty-five subjects completed the study. The Rhinolight® group was treated with a combination of UV-B, UV-A, and high-intensity visible light, while the placebo group received low-intensity visible white light intranasal phototherapy on a total of 13 occasions in 6 weeks. The assessment was based on the diary of symptoms, nasal inspiratory peak flow, quantitative smell threshold, mucociliary transport function, and ICAM-1 expression of the epithelial cells. All nasal symptom scores and nasal inspiratory peak flow measurements improved significantly in the Rhinolight® group relative to the placebo group and this finding persisted after 4 weeks of follow-up. The smell and mucociliary functions did not change significantly in either group. The number of ICAM-1 positive cells decreased non-significantly in the Rhinolight® group. No severe side-effects were reported during the treatment period. These results suggest that Rhinolight® treatment is safe and effective in persistent allergic rhinitis.
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Affiliation(s)
- Zsolt Bella
- Department of Otorhinolarygology and Head and Neck Surgery, Faculty of Medicine, University of Szeged, Tisza Lajos krt 111, Szeged, 6725, Hungary.
| | - Ágnes Kiricsi
- Department of Otorhinolarygology and Head and Neck Surgery, Faculty of Medicine, University of Szeged, Tisza Lajos krt 111, Szeged, 6725, Hungary
| | - Éva Dósa-Rácz Viharosné
- Department of Dermatology and Allergology, Faculty of Medicine, University of Szeged, Korányi fasor 6, Szeged, 6720, Hungary
| | - Attila Dallos
- Department of Dermatology and Allergology, Faculty of Medicine, University of Szeged, Korányi fasor 6, Szeged, 6720, Hungary
| | - Ádám Perényi
- Department of Otorhinolarygology and Head and Neck Surgery, Faculty of Medicine, University of Szeged, Tisza Lajos krt 111, Szeged, 6725, Hungary
| | - Mária Kiss
- Department of Dermatology and Allergology, Faculty of Medicine, University of Szeged, Korányi fasor 6, Szeged, 6720, Hungary
| | - Andrea Koreck
- Department of Dermatology and Allergology, Faculty of Medicine, University of Szeged, Korányi fasor 6, Szeged, 6720, Hungary
| | - Lajos Kemény
- Department of Dermatology and Allergology, Faculty of Medicine, University of Szeged, Korányi fasor 6, Szeged, 6720, Hungary
| | - József Jóri
- Department of Otorhinolarygology and Head and Neck Surgery, Faculty of Medicine, University of Szeged, Tisza Lajos krt 111, Szeged, 6725, Hungary
| | - László Rovó
- Department of Otorhinolarygology and Head and Neck Surgery, Faculty of Medicine, University of Szeged, Tisza Lajos krt 111, Szeged, 6725, Hungary
| | - Edit Kadocsa
- Department of Otorhinolarygology and Head and Neck Surgery, Faculty of Medicine, University of Szeged, Tisza Lajos krt 111, Szeged, 6725, Hungary
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Sun Y, Zhao H, Ye Y, Nie W, Bai W, Liu J, Li S, Wang F, Han M, He L. Efficacy and safety of using a warming needle for persistent allergic rhinitis: study protocol for a randomized controlled trial. Trials 2016; 17:305. [PMID: 27363578 PMCID: PMC4929718 DOI: 10.1186/s13063-016-1432-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 06/08/2016] [Indexed: 11/26/2022] Open
Abstract
Background Many previous studies have shown the potential therapeutic effect of acupuncture for allergic rhinitis. Most of these studies, however, were limited by the short duration of observations and lack of sham acupuncture as the control group. Our preliminary experiments showed that the use of a warm needling achieved a much more persistent effect in the treatment of allergic rhinitis (AR) compared with simple acupuncture therapy. Hence, we have designed a multicenter, randomized controlled trial (RCT) in which the first-line medication loratadine will be used as the control group, and the effect of warm needling therapy will be evaluated through long-term observation. Methods/design The trial is designed as a multicenter, parallel-group, randomized, single-blinded (outcome assessors), non-inferiority trial. A total of 98 patients with persistent AR will be randomly assigned into two groups. Patients in the treatment group will be treated with warm needling at GV14 and acupuncture at EX-HN3, ST2, LI20, EX-HN8, GV23, LU7, LU5 and LI4 three times a week, for a total of 4 weeks. Patients in the control group will be treated with oral loratadine 10 mg/day for 4 weeks. The primary outcome will be the change in the Total Nasal Symptom Score (TNSS) from baseline to that at 6 months after treatment during the follow-up period. The secondary outcomes will include the Total Non-nasal Symptom Score and the Rhinoconjunctivitis Quality of Life Questionnaire, changes in the TNSS from baseline to that at 2 and 4 weeks during treatment, and 3 months after treatment during the follow-up period. Outcomes will be measured at 2 and 4 weeks, and 3 and 6 months after treatment. Any side effects of treatment will be observed and recorded. Discussion We expect that the study results will provide evidence to determine the effects of warm needling compared with loratadine. Our final goal of the study is to evaluate the difference in the short-term and long-term effects between the two therapeutic methods, especially the long-term effect of warm needling. Trial registration ClinicalTrials.gov NCT02339714. Registered on 14 January 2015. Electronic supplementary material The online version of this article (doi:10.1186/s13063-016-1432-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yuxiu Sun
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.,Hubei University of Chinese Medicine, Wuhan, 430061, China
| | - Hong Zhao
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
| | - Yongming Ye
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Wenbin Nie
- Mentougou Hospital of TCM, Beijing, 102300, China
| | - Wenjing Bai
- China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Jia Liu
- China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Sinuo Li
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Fang Wang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Mingjuan Han
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Liyun He
- China Academy of Chinese Medical Sciences, Beijing, 100700, China
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Antila MA, Castro FM, Sano F, Machado A, Fernandes F, Rosário Filho NA, Stelmach R. Mometasone furoate in the treatment of mild, moderate, or severe persistent allergic rhinitis: a non-inferiority study (PUMA). Braz J Otorhinolaryngol 2016; 82:580-8. [PMID: 26968623 DOI: 10.1016/j.bjorl.2015.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 10/29/2015] [Accepted: 11/02/2015] [Indexed: 11/21/2022] Open
Abstract
Introduction Allergic rhinitis is considered the most prevalent respiratory disease in Brazil and worldwide, with great impact on quality of life, affecting social life, sleep, and also performance at school and at work. Objective To compare the efficacy and safety of two formulations containing mometasone furoate in the treatment of mild, moderate, or severe persistent allergic rhinitis after four weeks of treatment. Methods Phase III, randomized, non-inferiority, national, open study comparing mometasone furoate in two presentations (control drug and investigational drug). The primary endpoint was the percentage of patients with reduction of at least 0.55 in nasal index score (NIS) after four weeks of treatment. Secondary outcomes included total nasal index score score after four and 12 weeks of treatment; individual scores for symptoms of nasal obstruction, rhinorrhea, sneezing, and nasal pruritus; as well as score for pruritus, lacrimation, and ocular redness after four and 12 weeks of treatment. The study was registered at clinicaltrials.gov with the reference number NCT01372865. Results The efficacy primary analysis demonstrated non-inferiority of the investigational drug in relation to the control drug, since the upper limit of the confidence interval (CI) of 95% for the difference between the success rates after four weeks of treatment (12.6%) was below the non-inferiority margin provided during the determination of the sample size (13.7%). Adverse events were infrequent and with mild intensity in most cases. Conclusion The efficacy and safety of investigational drug in the treatment of persistent allergic rhinitis were similar to the reference product, demonstrating its non-inferiority.
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Mozafarinia K, Abna M, Khanjani N. Effect of Botulinum Neurotoxin A Injection into the Submucoperichondrium of the Nasal Septum in Reducing Idiopathic Non-Allergic Rhinitis and Persistent Allergic Rhinitis. Iran J Otorhinolaryngol 2015; 27:253-9. [PMID: 26788472 PMCID: PMC4710876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Submucoperichondrial injection of botulinum neurotoxin A (BTA) in the nasal septum is a promising therapeutic option in the treatment of persistent allergic rhinitis (AR) and non-allergic rhinitis, and is safer and more effective than intraturbinate injection in reducing clinical symptoms. MATERIALS AND METHODS Forty patients diagnosed with persistent AR or non-allergic rhinitis referred to Shafa Medical Center affiliated to Kerman University of Medical Sciences were included in this study and were randomly allocated to the intervention or control groups. Patients received an injection of 80 units BTA (Dysport, Ipsen Ltd Company, UK) at a concentration of 200 mU/ml in normal saline on four spots in each side of the nose and were followed for 12 weeks. Data were analyzed using a chi-square or Fisher's test, and Mann Whitney U test. RESULTS The mean age of patients was 46.1±15.3 years, and the two groups did not differ significantly in demographic variables. The severity of rhinitis symptoms was reduced after 4 weeks of injections in the intervention group and then gradually decreased further until the 12th week. There was a statistically significant difference between the groups (P<0.05). No adverse effects were reported. CONCLUSION Submucoperichondrial BTA injection can be considered an effective therapeutic option in patients with persistent AR and idiopathic rhinitis. In comparison with other injection techniques, submucoperichondrial BTA injection has fewer side effects with a longer period of effectiveness, and is easy to perform and is more tolerable for the patient.
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Affiliation(s)
- Keramat Mozafarinia
- Department of Otorhinolaryngology,Medical School, Kerman University of Medical Sciences and Health Services, Kerman, Iran.
| | - Mehdi Abna
- Department of Otorhinolaryngology,Medical School, Kerman University of Medical Sciences and Health Services, Kerman, Iran.,Corresponding Author: Department of Otorhinolaryngology, Medical School, Kerman University of Medical Sciences and Health Services, Kerman, Iran Tel: 03412463851 , E-mail:
| | - Narges Khanjani
- Neurology, Research Center, Shafa Hospital, Kerman University of Medical Sciences and Health Services, Kerman, Iran.
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Yılmaz I, Bayraktar N, Ceyhan K, Seçil D, Yüksel S, Mısırlıgil Z, Bavbek S. Evaluation of vascular endothelial growth factor-A and Endostatin levels in induced sputum and relationship to bronchial hyperreactivity in patients with persistent allergic rhinitis monosensitized to house dust. Rev Port Pneumol (2006) 2015; 21:S2173-5115(15)00094-9. [PMID: 26051834 DOI: 10.1016/j.rppnen.2015.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2014] [Revised: 03/11/2015] [Accepted: 04/30/2015] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Studies about the pathogenesis of bronchial hyperreactivity (BHR) in patients with persistent allergic rhinitis (PAR) and its relationship with lower airway remodeling are extremely limited. OBJECTIVE This study evaluated bronchial vascular remodeling via the measurement of angiogenic factor, vascular endothelial growth factor-A (VEGF-A), and anti-angiogenic factor, Endostatin, and evaluated their relationship with BHR in patients with PAR. METHODS The study group consisted of 30 patients with PAR monosensitized to house dust mites and 14 non-allergic healthy controls. All subjects underwent induced sputum and methacholine (M) bronchial provocation tests. VEGF-A and Endostatin levels were measured by ELISA in induced sputum supernatants. RESULTS The percentages of eosinophils in induced sputum were significantly increased in patients with PAR compared with healthy controls. There were no significant differences between patients with PAR and healthy controls in terms of levels of VEGF (37.9pg/ml, min-max: 5-373pg/ml vs. 24.9, min-max: 8-67pg/ml, p=0.8 respectively), Endostatin (532.5pg/ml, min-max: 150-2125pg/ml vs. 644, min-max: 223-1123pg/ml, p=0.2 respectively) and VEGF/Endostatin ratio (0.057 vs. 0.045, p=0.8 respectively). In addition, there were no significant differences between patients who are BHR positive (n=8), or negative to M (n=22) in terms of levels of VEGF, Endostatin and VEGF/Endostatin ratio and no correlations among value of PD20 to M and levels of VEGF, Endostatin and VEGF/Endostatin ratio. CONCLUSION We conclude that VEGF-A and Endostatin did not differ between patients with PAR and healthy controls regardless of BHR to M.
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Affiliation(s)
- I Yılmaz
- Ankara University, School of Medicine, Department of Chest Diseases, Division of Immunology and Allergic Diseases, Ankara, Turkey.
| | - N Bayraktar
- Baskent University, Department of Biochemistry, Ankara, Turkey
| | - K Ceyhan
- Ankara University, School of Medicine, Department of Pathology, Division of Clinical Cytology, Ankara, Turkey
| | - D Seçil
- Ankara University, School of Medicine, Department of Chest Diseases, Division of Immunology and Allergic Diseases, Ankara, Turkey
| | - S Yüksel
- Ankara University, Department of Biostatistics, Ankara, Turkey
| | - Z Mısırlıgil
- Ankara University, School of Medicine, Department of Chest Diseases, Division of Immunology and Allergic Diseases, Ankara, Turkey
| | - S Bavbek
- Ankara University, School of Medicine, Department of Chest Diseases, Division of Immunology and Allergic Diseases, Ankara, Turkey
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Zicari AM, Occasi F, Montanari G, Indinnimeo L, De Castro G, Tancredi G, Duse M. Intranasal budesonide in children affected by persistent allergic rhinitis and its effect on nasal patency and Nasal Obstruction Symptom Evaluation (NOSE) score. Curr Med Res Opin 2015; 31:391-6. [PMID: 25629793 DOI: 10.1185/03007995.2015.1009532] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Intranasal steroids are recognized as an effective treatment for allergic rhinitis (AR) although their effect on nasal patency has never been evaluated with an objective instrument such as anterior rhinomanometry in children. Moreover this effect has been widely assessed with total Nasal Symptom Scores (NSS) including all symptoms of allergic rhinitis and not with scores specifically focused on nasal obstruction such as the Nasal Obstruction Symptom Evaluation score (NOSE). MATERIALS AND METHODS Sixty children (42 males and 18 female) aged 6-10 years, affected by persistent AR, were randomized and divided in two groups of 30 children to be included in an unblinded trial: one group treated with intranasal budesonide and isotonic nasal saline for 2 weeks and the other group treated only with isotonic nasal saline for 2 weeks. Each child underwent rhinomanometry and completed the NSS and the NOSE scores before and after treatment. RESULTS At the baseline nasal patency and NSS total score, NOSE total scores were correlated (r=-0.29, p<0.001; r=-60, p<0.001). After 2 weeks of treatment improvements in nasal patency, NSS and NOSE were seen (Δ NSS 4.13 ± 1.38 vs 1.33 ± 1.93, p<0.001; Δ NOSE 34 ± 17.97 vs 9 ± 18.21, p<0.001; Δ nasal patency -26.13 ± 25.25 vs -11.83 ± 11.31, p<0.001). Correlations were found between rhinitis duration and Δ nasal patency and Δ NOSE (r=-0.84, p<0.001; r=0.43, p<0.01). CONCLUSION Intranasal budesonide is effective in increasing nasal patency in children. Moreover the NOSE score was strongly correlated with nasal flow and, hence, this score should be regarded as a valid and reliable instrument in children.
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Affiliation(s)
- Anna Maria Zicari
- 'Sapienza' University of Rome, Department of Pediatrics , Rome , Italy
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