Effects of Cetirizine on Substance P Release in Patients with Perennial Allergic Rhinitis

To evaluate the effect of cetirizine hydrochloride on substance P release in allergic rhinitis, we performed a single-blind placebo-controlled study of 14 patients with perennial allergic rhinitis (7 treated with cetirizine and 7 with placebo). After an initial nasal allergen challenge with lavages, the subjects received treatment with placebo or cetirizine hydrochloride (10 mg by mouth daily) for 1 week, followed by the second nasal allergen challenge with lavages. The levels of albumin, histamine, and substance P in nasal lavages before and after allergen challenge were quantified by enzyme-linked immunosorbent assay. Pretreatment of subjects with cetirizine reduced the level of substance P induced by antigen challenge, but did not significantly reduce levels of histamine. These results suggest that cetirizine may reduce nasal neurogenic inflammation by modulating the release of substance P in allergic rhinitis.

[Effect of specific immunotherapy on GM-CSF and IL-5 in the tissues of recurrent nasal polyps]

OBJECTIVE

To study the mechanism and clinical significance of specific immunotherapy (SIT) on the expression changes of GM-CSF and IL-5 in the tissue samples of recurrent nasal polyps.

METHOD

Perennial allergic rhinitis patients with recurrent nasal polyps were randomly divided into 2 groups. The experimental group of 19 patients was treated by SIT and standardized treatment (glucocorticoid nasal spray) , and the control group of 17 patients was only treated by standardized treatment (glucocorticoid nasal spray). We measured the expression levels of GM-CSF and IL-5 in the tissue samples of the nasal polyps by ELISA, and compared the results obtained before treatment with expression levels detected at 6 months and 1 year after the treatment.

RESULT

The expression of GM-CSF and IL-5 in the recurrent nasal polyps reduced significantly (P < 0.05) in both groups after 6 months and 1 year post-treatment compared with pre-treatment, and the expression of GM-CSF and IL-5 in the experimental group was much lower than that of the control group.

CONCLUSION

SIT decreases the expression of GM-CSF and IL-5 and reduces the inflammatory reaction in the tissue samples of recurrent nasal polyps.

Mono-allergic and poly-allergic rhinitis patients have comparable numbers of mucosal Foxp3+CD4+ T lymphocytes

BACKGROUND

We previously found that allergic rhinitis patients with an isolated pollen sensitization responded more strongly to a nasal provocation with grass pollen (GP) than patients who had an additional house dust mite (HDM) sensitization. To elucidate this phenomenon, we investigated the dynamics of Foxp3+CD4+ T lymphocytes in allergic rhinitis patients with distinct allergen sensitizations.

METHODS

Three groups of allergic rhinitis patients with skin prick test confirmed allergic sensitizations were investigated and compared to 14 healthy controls: 14 subjects with an isolated grass pollen sensitization (Mono-GP); 9 subjects with isolated housedust mite sensitization (Mono-HDM); 29 subjects with grass pollen and house dust mite sensitization (poly-sensitized). Subjects in the Mono-GP group were challenged with grass pollen extract, subjects in the Mono-HDM group were challenged with house dust mite extract, subjects in the poly-sensitized group and the healthy controls were randomly challenged with either grass pollen or house dust mite. Nasal biopsies were taken before and after nasal provocation. We compared the distribution of FoxP3+CD4+ cells in nasal biopsies before and after nasal provocation using immunohistochemistry.

RESULTS

There was no difference in the number of FoxP3+CD4+ cells between healthy and the three allergic groups at baseline.Nasal provocation did result in an increase in eosinophils in the three allergic groups, but did not result in a change in the number of FoxP3+CD4+ cells in any of the groups or induced differences between any of the groups.

CONCLUSION

Clinical differences in the response between mono-GP and multiple-sensitized allergic individuals are not related to differences in the number of regulatory T cells in the nasal mucosa.

Japanese traditional medicine, Senn-kinn-naidaku-sann up-regulates Toll-like receptor 4 and reduces murine allergic rhinitis

OBJECTIVE

To determine the mechanisms by which a traditional herbal medicine, Senkinnaidakusan (SKNS), controls Th2 responses, we examined the production of IL-12 by murine macrophages treated with SKNS.

RESULTS

Treatment with SKNS significantly increased TLR4 mRNA in macrophages. Furthermore, pre-treatment with SKNS enhanced the production of IL-12 by macrophages stimulated with LPS. When SKNS was orally administered to C3H/HeN mice at the induction phase after OVA sensitization, the serum levels of OVA-specific immunoglobulin (Ig)E and IgG1 decreased, Interleukin (IL)-4 production by spleen T cells in response to OVA was significantly suppressed, while interferon (IFN)-gamma production was increased. After nasal challenge of OVA, eosinophilic infiltration in the nasal mucosa and the number of sneezes were significantly inhibited in SKNS-treated mice compared with control mice. Besides, expression of IL-5 in the nasal mucosa was also inhibited. Using another strain of mice, C3H/HeJ (TLR4 negative), there was no difference in OVA-specific Igs or splenic cytokine production between the SKNS treatment and non-treatment groups. The eosinophilic infiltration in the nasal mucosa, the number of sneezes and IL-5 expression in the nasal mucosa were also not effected even after SKNS treatment.

CONCLUSION

These results suggest that oral administration of SKNS inhibits Th2 responses by enhancement of IL-12 release from macrophages via up-regulation of TLR4 expression.

Barrier-enforcing measures as treatment principle in allergic rhinitis: a systematic review

BACKGROUND AND OBJECTIVES

Barrier-enforcing measures have been suggested as treatment options for allergic rhinitis. This review identifies and describes the literature on the subject.

METHODS

Relevant publications were searched for in the PubMed database (search entries: 'allergic rhinitis' and 'treatment'). The evaluation comprised condition (seasonal or perennial allergic rhinitis), type of intervention, duration of treatment, study design, peer review status or not, number of test subjects, type of allergen exposure, and outcome in terms of effects or not on nasal symptoms of allergic rhinitis.

RESULTS

Fifteen studies were either identified in the PubMed database search or from the reference lists of identified publications. Seven were placebo-controlled, randomized, and peer-reviewed, and symptom-reducing effects were reported by all of these reports. Limitations of this review reflect that the remainder of the studies had inferior designs, particularly lack of placebo control.

CONCLUSIONS

Barrier-enforcing measures as achieved by nasal administrations of cellulose powder and microemulsions, respectively, have symptom-reducing effects in allergic rhinitis.

[Therapeutic effect and mechanism of Phoenix roebelenii pollen vaccine for treatment of mice with allergic rhinitis]

OBJECTIVE

To apply Phoenix roebelenii pollen vaccine to murine models of allergic rhinitis and observe the pathological changes of allergic rhinitis in mice, and to study the efficacy and mechanism of the vaccine for the treatment of allergic rhinitis.

METHODS

BALB/c mice models of allergic rhinitis were established by intraperitoneal injection, and then treated with immunotherapy of allergen vaccine by subcutaneous injection. The mice were examined for the levels of airway hyperresponsiveness by a noninvasive lung function detector, for the specific antibodies IgE and IgG2a in serum and cytokines by indirect ELISA, and for the pathological changes of ultrastructure of nasal mucosa of the mice by transmission electron microscopy before and after the treatment.

RESULTS

After the immunotherapy, nasal symptoms and airway hyperresponsiveness of the mice were relieved. The level of specificity antibody IgG2a in serum was elevated, and IgE dropped significantly. In the culture supernatant of spleen cells, INF-γ and IL-10 levels increased and the production of IL-4 decreased.

CONCLUSION

The recombinant profilin of the Phoenix roebelenii pollen as vaccine has a certain therapeutic effect for the pollen allergic rhinitis, and it works maybe through promoting the transition of Th2 to Th1 and regulating the balance of helper T cells.

IL-33, but not IL-25, is crucial for the development of house dust mite antigen-induced allergic rhinitis

Both interleukin (IL)-33 and IL-25 induce Th2 cytokine production by various cell types, suggesting that they contribute to development of allergic disorders. However, the precise roles of IL-33 and IL-25 in house dust mite (HDM)-induced allergic rhinitis (AR) remain unclear. Both IL-33 and IL-25 were produced mainly by nasal epithelial cells during HDM-induced AR. Eosinophil and goblet cell counts in the nose and IL-5 levels in lymph node cell culture supernatants were significantly decreased in IL-33-deficient, but not IL-25-deficient, mice compared with wild-type mice during HDM-induced AR, but the serum IgE and IgG1 levels did not differ. On the other hand, HDM-induced AR developed similarly in wild-type mice transferred with either IL-33-deficient BM cells or wild-type BM cells. IL-33, but not IL-25, produced by nasal epithelial cells was crucial for the development of murine HDM-induced AR. These observations suggest that IL-33 neutralization may be a potential approach for treatment of HDM-induced AR in humans.

Variance of melatonin and cortisol rhythm in patients with allergic rhinitis

OBJECTIVE

Allergic rhinitis is an IgE-mediated inflammatory disease which effects 10%-50% of the normal population. The mechanism of its formation and the circadian rhythm of cortisol and melatonin in allergic rhinitis have not been investigated.

STUDY DESIGN

Salivary levels of melatonin and cortisol were measured by radioimmunoassay in 35 newly diagnosed allergic rhinitis patients and in 23 control subjects matched for age and gender.

RESULTS

In the study group; amplitude, baseline and peak levels of salivary melatonin were significantly decreased compared with healty controls (p<0.001). No differences were found in the acrophase and the peak duration of salivary melatonin between the study and control groups (p>0.05). In the study subjects, the circadian rhythm of cortisol was flattened when compared with the control group. The amplitude and the 24h mean levels of salivary cortisol in the study group were significantly lower than in the control group and the acrophase was delayed in patients compared with control subjects (p<0.001).

CONCLUSION

The circadian rhythms of salivary melatonin and cortisol were found to be disrupted in patients with allergic rhinitis. These results may also be contributive data to explain the pathogenesis of allergic rhinitis and also they can be applicable as adjunctive therapeutic tools in the future and melatonin drugs might be an alternative in the therapy of resistant allergic rhinitis patients or allergic rhinitis patients who cannot use cortisol drugs.

[A new approach to the treatment of patients presenting with bronchial asthma and concomitant allergic rhinitis]

The present study included 73 patients presenting with bronchial asthma (BA) and concomitant allergic rhinitis (AR). Based on the results of their examination, a program of their two-step treatment was proposed including elimination therapy during 5-7 days followed by the combined treatment with the use of physical factors, such as peloid therapy, supratonal frequency currents, inhalations, massage, and remedial gymnastics. This approach allows to significantly reduce the frequency of clinical manifestations of the primary and concomitant diseases. Specifically, the incidence of daytime choking fits decreased by 66.7%, coughing by 76.7%, nasal stiffness by 60%, and rhinorrhea by 62,6 with the simultaneous acceleration of the overall clinical effect by 3-4 days. The requirement for short-acting broncholytic agents decreased after the treatment by 56.7%. Its anti-inflammatory effect in the upper and lower respiratory tract was confirmed by the results of endoscopic examination of the nasal cavity (the occurrence of mucosal hyperemia and mucosal oedema decreased by 70% and 60% respectively whereas the presence of secretion in the nasal passages was recorded 76.7% less frequently than prior to the treatment). Cytological studies of surface epithelium revealed reduced neutrophilia and eosinophilia, decreased number of goblet cells in nasal mucosa, and lowered content of sialic acids, IL-1, and IL-6 in nasal lavage. Combined therapy improved the patency of both upper and lower respiratory tract. Moreover, the number of patients with the totally controlled clinical course of BA increased by 66.6%. It was shown that remission of BA and AR persisted within 10 and 8.2 months after the treatment respectively.

[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.

Localization and up-regulation of cysteinyl leukotriene-2 receptor in human allergic nasal mucosa

BACKGROUND

Cysteinyl leukotrienes (CysLTs) are lipid mediators that have been implicated in the pathogenesis of allergic rhinitis. Pharmacological studies using CysLTs indicate that 2 classes of receptors exist, namely, CysLT1 and CysLT2 receptors. The former class of receptors is sensitive to the CysLT1 antagonists currently used to treat asthma and allergic rhinitis, and its localization has been previously examined by our group using immunohistochemistry and in situ hybridization techniques. We investigated the expression and localization of the CysLT2 receptor in human nasal mucosa by western blot and immunohistochemical analyses.

METHODS

Human turbinates were obtained after turbinectomy from 16 patients with nasal obstruction refractory to medical therapy. To identify the cells expressing the CysLT2 receptor, double immunostaining was performed by using anti-CysLT2 receptor antibody and anti-CD31 (endothelial cell) antibody or anti-smooth muscle actin antibody.

RESULTS

A 39 kDa band was detected on the western blots of human turbinates samples by using the anti-CysLT2 receptor antibody. The expression level of the CysLT2 receptor in patients with nasal allergy was higher than that in patients with non-allergic rhinitis. The immunohistochemical study also showed an intense immunoreactivity for CysLT2 receptor in both vascular endothelial cells and vascular smooth muscles.

CONCLUSIONS

The results indicated that the CysLT2 receptor plays a primary role in the vascular responses in the upper respiratory tract.

Correlation of atopy and FeNO in allergic rhinitis: an Indian study

BACKGROUND

Fractional exhaled nitric oxide (FeNO) is a non-invasive marker of airway inflammation. Limited published data are available on the effect of atopy on FeNO in allergic rhinitis.

OBJECTIVES

To investigate the relationship between atopy and FeNO in patients with allergic rhinitis.

METHODS

Patients with allergic rhinitis were assessed for atopy and exhaled breath analysis of nitric oxide. Atopy was assessed by skin prick testing (SPT) against 58 common aero-allergens; a wheal size of 3mm or more as compared to buffer saline was considered positive. Patients were labelled to be atopic if they had at least one positive SPT result. The measurement of FeNO level was done by using NIOX chemiluminescence analyser.

RESULTS

Forty-nine participants (26 males) aged between 8-50 years were studied and 31 of them were found to be atopic. The average value of FeNO in the subjects studied (n = 49) was 26.0 +/- 22.7 parts per billion (ppb) with significantly higher values being observed in atopic group as compared to non-atopic group (34.2 +/- 24.3 versus 11.9 +/- 9.0 ppb; p < 0.05).

CONCLUSION

As FeNO is a marker of lower airway inflammation, significantly higher FeNO levels in atopic allergic rhinitis patients suggest that it may be a predictor for onset of asthma in these patients.

[The expression of NOD1 and NOD2 and the regulation of glucocorticoids on them in allergic rhinitis]

OBJECTIVE

To investigate the expression of NOD1 and NOD2 in the nasal mucosa of healthy individuals and allergic rhinitis(AR), and explored the regulation of glucocorticoids on them.

METHOD

RT-PCR and immunohistochemistry were used to detect the expression of NOD1 and NOD2 in nasal mucosa from healthy control and AR. Nasal explant culture was used to explore the effect of glucocorticoids on NOD1 and NOD2 expression.

RESULT

NOD1 and NOD2 mRNA expression level was significantly increased in AR compared with control. Immunohistochemical staining demonstrated that NOD1 and NOD2 were mainly expressed by epithelial cells and some unknown cells in lamina propria and there were significantly more positive staining cells were observed in AR tissue when compared with control. Glucocorticoids down-regulated NOD1 and NOD2 expression in AR.

CONCLUSION

NOD1 and NOD2 as two PRRs may take part in the pathogenesis of AR, glucocorticoids may play a therapeutical role on allergic rhinitis through down-regulated the expression of NOD1 and NOD2.

[Changes of extracellular matrix of nasal mucosa in guinea pig model of prolonged allergic-induced rhinitis]

OBJECTIVE

The aim of this study was to explore the changes of the extracellular matrix in nasal mucosa by a guinea pig model of prolonged allergic-induced rhinitis.

METHOD

Thirty-two male Hartley guinea pigs were randomly divided into four groups: allergen challenged groups (Group 2 w, Group 6 w and Group 12 w) and a control group. Ovalbumin-sensitized guinea pigs were repeatedly challenged with allergen twice a week from 2 weeks to 12 weeks. Matched control groups were challenged with physiological saline. Nasal mucosa were obtained from the animals killed. Hematoxylin-Eosin, Masson's trichrome, and immunohistochemical staining against transforming growth factor-beta1 (TGF-beta1), Collagen III and Collagen I were performed to nasal mucosa.

RESULT

(1) Pathological examination showed obvious infiltration of eosinophils and the enlarged thickness of epithelial layer of nasal mucosa in the experiment groups. (2) The area ratios of blue stained in the extracellular matrix of nasal mucosa were increased. The area ratios of blue stained were statistically different in Group 6 w and Group 12 w compared with the control group. (3) The increasing absorbance of TGF-beta1 were statistically different in the experiment groups with the control group. The absorbance of Collagen III and Collagen I showed a rising trend along prolonged allergen challenged in the experiment groups.

CONCLUSION

Prolonged allergen challenge and the inflammation of nasal mucosa, can lead to the increasing of the inflammation relevant factors and the deposit of collagen in the extracellular matrix of nasal mucosa.

[Expression and significance of pulmonary surfactant protein D and IL-16 in allergic rhinitis and nasal polyps]

OBJECTIVE

To detect the expression and distribution of the lung surfactant protein D (surfactant protein D,SP-D ) and IL-16 in nasal mucosa of allergic rhinitis and nasal polyps, and then probe into their significance in the pathology of allergic rhinitis and nasal polyps.

METHOD

Fifteen cases of allergic rhinitis, fifteen cases of nasal polyps and fifteen cases of inferior turbinate mucosa were studied to detect the expression of SP-D and IL-16 by immunohistochemistry method.

RESULT

The expression of SP-D and IL-16 in allergic rhinitis and nasal polyps were dramatically higher in controls (P < 0.01). There was no remarkable difference in the expression of SP-D and IL-16 between allergic rhinitis and nasal polyps (P > 0.05).

CONCLUSION

Both normal tissue and diseased tissue express SP-D and IL-16. SP-D is likely to play key roles in the inflammatory reaction process of allergic rhinitis and nasal polyps. IL-16 is an important eosinophil chemokine in the process of allergic rhinitis and nasal polyps,and it can also enhance the local role of eosinophils,thus it can involve in the process of allergic rhinitis and nasal polyps disease.

Expression of pendrin and periostin in allergic rhinitis and chronic rhinosinusitis

BACKGROUND

Pendrin and periostin are newly identified mediators of the inflammatory process. The expression of these proteins in human sinonasal tissue and their roles in allergic rhinitis and chronic rhinosinusitis remain to be elucidated. This study investigated the expression of pendrin and periostin in sinonasal tissue of patients with allergic rhinitis, chronic rhinosinusitis, and aspirin-induced asthma. Prospective control study conducted at Yamagata University, Japan.

METHODS

Surgical samples were investigated by means of real-time reverse transcription-polymerase chain reaction to evaluate the expression of pendrin and periostin mRNA. The presence and location of pendrin and periostin were determined by immunohistochemistry and Western blotting.

RESULTS

Pendrin and periostin production was significantly higher in patients with nasal disorders than in controls. Further significant increases in periostin expression were noted in patients with chronic rhinosinusitis with nasal polyps and in those with aspirin-induced asthma. Immunohistochemistry revealed positive staining for pendrin in epithelial cells and submucosal glands and for periostin in the basement membrane in all three disorders, and additionally for periostin in nasal polyp tissue in chronic rhinosinusitis and aspirin-induced asthma.

CONCLUSIONS

Production of pendrin and periostin is upregulated in allergic rhinitis, chronic rhinosinusitis with nasal polyps, and aspirin-induced asthma. These findings suggest that pendrin can induce mucus production and that periostin can induce tissue fibrosis and remodeling in the nasal mucosa. Therefore, these mediators may be therapeutic target candidates for allergic rhinitis, chronic rhinosinusitis with nasal polyps, and aspirin-induced asthma.

HIF-1α inhibition reduces nasal inflammation in a murine allergic rhinitis model

BACKGROUND

Hypoxia-inducible factor 1α (HIF-1α) is an important regulator of immune and inflammatory responses. We hypothesized that nasal allergic inflammation is attenuated by HIF-1α inhibition and strengthened by HIF-1α stabilization.

OBJECTIVE

To elucidate the role of HIF-1α in a murine model of allergic rhinitis (AR).

METHODS

Mice were pretreated with the HIF-1α inhibitor 2-methoxyestradiol (2ME2) or the HIF-1α inducer cobalt chloride (CoCl(2)) in an established AR murine model using ovalbumin (OVA)-sensitized BALB/c mice. HIF-1α and vascular endothelial growth factor (VEGF) expression in nasal mucosa was measured and multiple parameters of allergic responses were evaluated.

RESULTS

HIF-1α and VEGF levels were locally up-regulated in nasal mucosa during AR. Inflammatory responses to OVA challenge, including nasal symptoms, inflammatory cell infiltration, eosinophil recruitment, up-regulation of T-helper type 2 cytokines in nasal lavage fluid, and serum OVA-specific IgE levels were present in the OVA-challenged mice. 2ME2 effectively inhibited HIF-1α and VEGF expression and attenuated the inflammatory responses. Stabilization of HIF-1α by CoCl(2) facilitated nasal allergic inflammation. HIF-1α protein levels in nasal airways correlated with the severity of AR in mice.

CONCLUSIONS

HIF-1α is intimately involved in the pathogenesis of nasal allergies, and the inhibition of HIF-1α may be useful as a novel therapeutic approach for AR.

[Effects of tripterine on NF-kappaB and eotaxin in nasal mucosa of allergic rhinitis rat]

OBJECTIVE

To investigate the relationship among the expressions of NF-kappaB, Eotaxin and the effects of tripterine in nasal mucosa of allergic rhinitis rat and to discuss the possible mechanism of tripterine on allergic rhinitis.

METHOD

Forty healthy SD rats were randomly divided into four groups: OVA group,tripterine group (T group), DM group, and SC group. Allergic rhinitis model was established by OVA. The pathological changes were observed by HE staining. The expressions of NF-kappaB and Eotaxin were examined by SP immunohistochemical analysis.

RESULT

There was no pathological change in SC group. Nasal mucosa in T and DM group was swelling,and there were some inflammatory cells. Nasal mucosa in OVA group was highly swelling, and there were abundant inflammatory cells. NF-kappaB and Eotaxin expression in OVA group was significantly different from the other three groups (P<0.01). And no difference was observed between T and DM groups (P>0.05). The expression of NF-kappaB in OVA group had positive correlation with the expression of Eotaxin (r=0.908, P<0.01).

CONCLUSION

Tripterine can inhibit expression of Eotaxin by restraining the activation of NF-kappaB.

Effect of Tong Qiao drops on the expression of eotaxin, IL-13 in the nasal mucosa of rats with allergic rhinitis

BACKGROUND

In recent years, particularly in China, many Chinese medicines and prescriptions for treating allergic rhinitis have been evaluated for their clinical relevance. Studies have found that numerous herbs and their constituent compounds can significantly alleviate allergic symptoms and are effective treatments for allergic rhinitis. The purpose of this study was to examine the modulatory effect of Tong Qiao nose drops on allergy symptoms and the expression of cytokines in the nasal mucosa of rats with ovalbumin-induced allergic rhinitis.

METHODS

Sixty healthy male Sprague Dawley rats were randomly divided into three groups (n = 20): negative, control, and experimental. Rats in the control or experimental groups were sensitized with ovalbumin to induce allergic rhinitis. The sensitized rats in the experimental group were subsequently exposed to Tong Qiao nose drops, whereas the sensitized control rats were given saline nose drops. Negative control rats were only treated with saline. Allergic symptoms and the pathologic features of the nasal mucosa were observed. The expression of eotaxin in the mucous membrane of rat nasal septums was detected by immunohistochemical staining, and the expression levels of interleukin (IL)-5 and IL-13 were measured by enzyme-linked immunosorbent assay.

RESULTS

The symptom scores for the experimental group were significantly lower than those of control rats (p < 0.01). Histopathologic examination revealed pathologic changes of nasal mucosa edema in the experimental group was mild and the infiltration of eosinophils was insubstantial. The expression levels of eotaxin, IL-5, and IL-13 in the nasal mucosa from experimental rats were significantly lower than that of control rats (p < 0.01).

CONCLUSION

Tong Qiao nose drops alleviated the symptoms of allergic rhinitis in a rat model and lowered the expression levels of eotaxin, IL-5, and IL-13.

[Effect of combined use of sIL-5Rα and sIL-13Rα2 on VCAM-1 and IFN-γ in allergic rhinitis rats]

OBJECTIVE

To investigate the effects of sIL-5Rα and sIL-13Rα2 on VCAM-1 and IFN-γ in allergic rhinitis rats.

METHODS

A total of 50 Wistar rats were randomly divided into 5 groups: the normal group (group A), the allergic rhinitis model group (group B), the sIL-5Rα treatment group (group C), the sIL-13Rα2 treatment group (group D), the combination of sIL-5Rα and sIL-13Rα2 treatment group (group E or the combined treatment group). Rats in the latter 4 groups were sensitized with ovalbumin (OVA) and Al(OH)(3), and challenged with OVA to establish allergic rhinitis models, while rats in the normal group were treated with saline. Rats in the sIL-5Rα treatment group, the sIL-13Rα2 treatment group and the combined treatment group were absorbed on day 31 to day 38 once daily once nasal cavity with sIL-5Rα(100 µg), sIL-13Rα2 (100 µg) and the combination of sIL-5Rα (100 µg) and sIL-13Rα2 (100 µg) 30 min before challenged, while rats in the allergic rhinitis model group received PBS(50 µl). Then the levels of VCAM-1 and IFN-γ in serum and nasal lavage fluid (NLF) were measured by ELISA.

RESULTS

Compared with the normal group, the levels of VCAM-1 in the allergic rhinitis model group were higher, while IFN-γ were lower (all P < 0.01). Compared with the allergic rhinitis model group, the sIL-5Rα treatment group, the sIL-13Rα2 treatment group and the combined treatment group could effectively reduced serum and NLF VCAM-1 level [group E: (283.5 ± 5.7) µg/L, (101.8 ± 4.8) µg/L; group C: (311.5 ± 12.6) µg/L, (133.9 ± 5.8) µg/L; group D: (304.7 ± 6.6) µg/L, (128.5 ± 7.7) µg/L], and increased IFN-γ level [group E: (874.7 ± 9.6) pg/ml, (349.2 ± 12.1) pg/ml; group C: (600.2 ± 16.1) pg/ml, (195.5 ± 16.1) pg/ml; group D: (577.9 ± 9.6) pg/ml, (196.7 ± 9.9) pg/ml ]; compared with single treatment, the combined treatment group also had significant differences(P < 0.01).

CONCLUSIONS

Combined treatment with sIL-5Rα and sIL-13Rα2 to treat the allergic rhinitis rats can significantly reduce VCAM-1 levels in serum and NLF, and increase IFN-γ levels, thus, to achieve the purpose of mitigation and treatment of allergic rhinitis.

Olfactory dysfunction in seasonal and perennial allergic rhinitis

CONCLUSIONS

The limitation in olfactory function in patients with seasonal allergic rhinitis (AR) can be ascribed to an increase in eosinophilic and mast cell activity in the olfactory cleft. Therefore, the decrease in olfactory functions seems to be predominantly caused by the inflammation of the epithelium and not by the obstruction of the nose caused by the inflammation.

OBJECTIVE

Olfactory dysfunction is frequently seen in patients with AR; however, little is known about the underlying pathophysiological mechanisms. Therefore, the aim of the present study was to examine the olfactory function in patients with seasonal or perennial AR, and to correlate the results with data obtained by analysis of nasal secretion and obstruction.

METHODS

Olfactory function was tested using the Sniffin´Sticks test in patients with seasonal or perennial AR and in a control group. Nasal secretion analysis included eosinophilic cationic protein (ECP) and tryptase testing. Nasal obstruction was evaluated by rhinomanometry.

RESULTS

Patients with AR (seasonal and perennial) showed impaired olfactory functions in comparison with the control group. Nasal secretion analysis showed increased values of ECP and tryptase in the seasonal group in comparison with controls. Rhinomanometry showed no differences in nasal flow between the three groups.

Blocking interleukin-17 attenuates enhanced inflammation by staphylococcal enterotoxin B in murine allergic rhinitis model

CONCLUSION

The results of this study suggest that staphylococcal enterotoxin B (SEB) enhances inflammation in allergic rhinitis (AR) and interleukin (IL)-17 may play a significant role in regulation of the inflammatory process induced by SEB.

OBJECTIVES

Exposure to SEB is associated with severe symptoms in AR patients. However, how SEB influences the inflammatory process in AR has not been elucidated so far. The aim of this study was to identify the role of SEB and IL-17 in AR.

METHODS

BALB/c and IL-17-deficient mice were divided into three groups: control, OVA, and SEB groups. The control group was challenged with phosphate-buffered saline, the AR group was challenged with ovalbumin (OVA), and the SEB group was treated with SEB before OVA challenge. Nasal symptoms, eosinophil infiltration, serum total and OVA-specific immunoglobulin E levels, and cytokine levels including IL-1β, IL-4, IL-6, and interferon (IFN)-γ in splenocyte culture were compared between the groups.

RESULTS

The SEB group produced significantly greater amounts of cytokines such as IL-1β, IL-4, IL-6, and IFN-γ than the OVA group in wild-type mice. However, these enhanced inflammatory responses in the SEB group compared with the OVA group were not observed in IL-17-deficient mice.

[Histologic expressions of IL-4/STAT6 in nasal mucosa of guinea pig allergic rhinitis models and effect of glucocorticoid on them]

OBJECTIVE

To investigate the relation between IL-4/STAT6 and allergic rhinitis by comparing expressions of IL-4 and STAT6 in normal nasal mucosa and allergic rhinitis models, to explore the influence of glucocorticoid on IL-4, and STAT6 expression, and then to elucidate further the pathogenesis of AR and the mechanism of glucocorticoid.

METHOD

Forty-five guinea pigs were divided into three groups: normal control (NC) group, allergic rhinitis group (AR) and glucocorticoid (Glu) group (15 each). Animals in AR and Glu groups were sensitized with egg albumin, and in NC group were treated with normal saline as control. After sensitization and reproduction of AR model, rats in AR group received no treatment, while those in Glu group were treated with glucocorticoid (50 microl/one side/time, once a day) for 5 days. The changes in behavior was examined, and pathology of nasal mucosa were observed with HE staining, and the protein expressions of IL-4 and STAT6 in the nasal mucosa were detected by immunohistochemical technique.

RESULT

Compared with NC group, the frequency of sneezing and nose-scratching, and the expressions of IL-4 and STAT6 were increased obviously, but the opposite findings were observed in Glu group.

CONCLUSION

IL-4 and STAT6 are related to the pathogenesis of allergic rhinitis and may be the main factors for eosinophil infiltration in allergic rhinitis. Glucocorticoid may produce a therapeutic effect by intervening the expression of IL-4 and STAT6.

Evaluation of bronchial hyperreactivity with mannitol dry powder challenge test in a paediatric population with intermittent allergic asthma or allergic rhinitis

We evaluated the bronchial hyperreactivity (BHR) with a new bronchial challenge test, mannitol dry powder, in a paediatric population with intermittent allergic asthma or allergic rhinitis who did not respond to an exercise challenge test. We selected 50 children, aged 9-16 years, with intermittent allergic bronchial asthma (Group 1) or allergic rhinitis without clinical manifestation of asthma for at least 12 months (Group 2). All patients performed the following tests in three different days (&#x2265; 48 hours apart): Day 1: exhaled nitric oxide (FeNO) determination followed by baseline spirometry and reversibility to inhaled beta2-agonists; Day 2: exercise challenge test followed by FeNO determination; Day 3: mannitol challenge test followed by FeNO determination. Forty children completed the study. Eighteen subjects of Group 1 (90 percent) and 5 subjects of Group 2 (25 percent) resulted positive to the mannitol test. Positive mannitol challenge subjects showed no statistically significant differences compared to negative subjects as regard baseline spirometry, reversibility to salbutamol and response to the exercise challenge test, but they had significantly higher FeNO values. In conclusion, the mannitol challenge test can be a diagnostic tool more useful than the exercise challenge test to identify BHR in a paediatric population with intermittent allergic asthma or allergic rhinitis because it is better reproducible, quick and easy to perform and well tolerated.

Total antioxidant status and oxidative stress and their relationship to total IgE levels and eosinophil counts in children with allergic rhinitis

BACKGROUND

Oxidative stress may play a role in the pathophysiology of several diseases including allergic rhinitis.

OBJECTIVES

To evaluate whether plasma total oxidant status (TOS) in the form of plasma reactive oxidants differs between children with allergic rhinitis and healthy controls and to investigate associations between plasma antioxidants and other allergic rhinitis-related immunological markers.

MATERIALS AND METHODS

Plasma total antioxidant status (TAS), TOS, total eosinophil count, and total serum immunoglobulin (Ig) E levels were measured in 106 children newly diagnosed with allergic rhinitis and 70 nonallergic children (7-12 years of age). Plasma TAS and TOS were measured using novel automated measurement methods. Blood eosinophils (absolute counts and percentage of total white blood cells) and total IgE were elevated in children with allergic rhinitis after adjusting for age and sex.

RESULTS

TAS and TOS were higher in the patient group than in the control group (P<.001 and P<.002, respectively). The association between plasma TAS and TOS and allergic rhinitis status was similar when eosinophils, total IgE, and allergic sensitization were included as possible confounders in logistic regression models. Multivariate logistic regression identified allergic rhinitis as the only independent factor contributing to TOS.

CONCLUSION

Plasma TAS and TOS levels are elevated in children with allergic rhinitis. Moreover, the high level of TOS indicates that these patients are exposed to severe oxidative stress. This stress factor may have a role in the pathogenesis of allergic rhinitis.

[Peculiar features of mucosal immunity in the children presenting with allergic rhinitis]

The objective of the present study was to improve the efficacy of diagnostics of various forms of allergic rhinitis (AR) in the children based on the results of investigations into specific features of mucosal immunity. Determination of IgM, IgG, IgA, sIgA and IgE, TNF-alpha, IL-1-beta, BL-4, and IFN-gamma in the nasal lavage of the children presenting with allergic rhinitis. The IgE, IgA, IgM, IgG, and albumin levels in the nasal secretion were significantly elevated during the period of exacerbation of AR in the children. Simultaneously, the production of IL-4 and TNF-alpha was enhanced whereas the TNF-gamma content remained unaltered. The efficacious treatment of allergic rhinitis resulted in the normalization of albumin, TNF-alpha, IgA, IgM, and IgG content in the nasal secretion whereas the concentration of IgE and IL-4 decreased and that of TNF-gamma increased. A failure of therapy was associated with the high level of IgE and IL-4. It is concluded that quantitative analysis of humoral immunity factors in the nasal lavage is a highly informative tool for diagnostics of allergic rhinitis in the children.

Effects of acupuncture and moxibustion in a mouse model of allergic rhinitis

OBJECTIVE

In this study, the authors examined the effects of acupuncture and moxibustion on the expression of various inflammatory cells and mediators in the nasal mucosa of an allergic rhinitis (AR) animal model.

STUDY DESIGN

Randomized controlled animal study.

SETTING

Animal laboratory in a Dongguk University.

SUBJECTS AND METHODS

Twenty-eight BALB/c mice were divided into 4 groups: control, levocetirizine (Lcz), moxibustion (Mox), and acupuncture (Acu). To induce AR, mice were intraperitoneally sensitized to ovalbumin (OVA) and challenged with intranasal OVA. At 7 days following the final sensitization and every day for a further 7 days, the Lcz group was orally administered levocetirizine (50 mg/kg), the Mox group was subjected to 5 seconds of moxibustion stimulation at the juncture of the medial canthus and nostril, and the Acu group was subjected to 30 seconds of acupuncture stimuli at the same point. The authors measured the degree of positive reaction to substance P, STAT6, nuclear factor kappa B (NFκB), and iNOS via immunohistochemical staining of the nasal mucosa.

RESULTS

The degree of positive reaction to substance P, STAT6, NFκB, and iNOS was markedly decreased in the treatment groups compared to that in the control group. Notably, the above indices were most significantly decreased in the Acu group, followed by the Mox group and then the Lcz group (P = .000).

CONCLUSION

In an allergic rhinitis animal model, acupuncture and moxibustion are shown to exhibit an antiallergic effect and exert their effects by reducing the expression of substance P, STAT6, NFκB, and iNOS.

[A preliminary study on the regulation mechanism of p38MAPK on MUC5AC in allergic rhinitis]

OBJECTIVE

To detect the effect of p38 mitogen activated protein kinase (p38MAPK) and cyclooxygenase-2 (COX-2) on the expression of mucin5AC (MUC5AC) in human nasal mucosa induced by histamine in vitro, and to investigate the pathogenesis of mucus hypersecretion in allergic rhinitis (AR).

METHOD

Western blot was performed to detect the protein expressions of p38MAPK, COX-2 and MUC5AC in nasal mucosa induced by histamine or blocked by selective inhibitors of p38MAPK and COX-2 of different concentration gradient.

RESULT

Weak expressions of p38MAPK. COX-2 and MUC5AC were detected in normal nasal mucosa in vitro. The protein expressions of p38MAPK. COX-2 and MUC5AC increased in nasal mucosa induced by histamine in a dose-dependent manner. The histamine induced protein expressions of COX-2 and MUC5AC were dose-dependently attenuated by selective inhibitor of COX-2, namely NS-398. No apparent influence of NS-398 on the expression of p38MAPK was observed. The histamine induced protein expressions of p38MAPK, C()X-2 and MUCbAC dose-dependently decreased after nasal mucosa was treated by selective inhibitor of p38MAPK, namely SB203580. And no significant change of MUC5AC protein expression induced by NS-398 or SB203580 was observed.

CONCLUSION

Our findings indicated that the histamine-induced increased expression of MUC5AC by activated p38MAPK/COX-2 may be a possible pathogenesis of mucus hypersecretion in AR.

[Effect of topical steroid on oral and nasal nitric oxide production in patients with allergic rhinitis]

OBJECTIVE

To evaluate the effects of nasal mometasone furoate on oral and nasal nitric oxide (NO) production in patients with allergic rhinitis.

METHOD

Twenty-seven patients with moderate to severe symptoms of persistent allergic rhinitis were treated with mometasone furoate nasal spray (200 microg/d. qd) for 2 weeks. Nasal and oral exhaled nitric oxide concentrations, symptoms of rhinitis and quality of life were investigated before and after the treatment.

RESULT

There was a significant improvement in nasal exhaled nitric oxide concentrations, symptoms of rhinitis and quality of life, but not in oral exhaled nitric oxide concentrations. Subjective improvements in symptoms and quality of life did not correlate significantly with objective measurements.

CONCLUSION

Our study provides subjective and objective evidence on the efficacy of intranasal mometasone furoate in improving nasal symptoms and quality of life, as well as reducing nasal inflammation.

Lack of bone metabolism side effects after 3 years of nasal topical steroids in children with allergic rhinitis

This study evaluated the effects on bone mineral status of long-term treatment with intranasal budesonide (INB) spray, using the recommended dose, in pediatric patients with allergic rhinitis (AR). This retrospective, case-control study of 230 prepubertal children with perennial AR, who had used nasal budesonide at a mean daily dose of 100 μg (range, 89-132 μg) for at least 3 years intermittently, was conducted from May 2007 through May 2010. The bone mineral density (BMD) of the lumbar spine was measured by dual-energy X-ray absorptiometry. Levels of serum calcium, phosphorus, alkaline phosphatase (ALP), parathyroid hormone, and osteocalcin were also assessed. The results were compared to sex- and age-matched controls (n = 140), who were newly diagnosed children with AR without any corticosteroid treatment. The 230 study patients (145 boys) were aged from 7 to 11 years. The average age (± SEM) was 8.7 ± 0.7 years; the mean (± SEM) steroid dosage used was 73.5 ± 7.0 μg daily, with 65.2 ± 5.2 g total steroid use during treatment. The 140 control patients (90 boys) were aged from 6 to 11 years. No significant differences were observed in BMD (P > 0.05) between the study and the control groups. Although mean serum ALP level was higher, and cortisol, phosphorus, and osteocalcin levels were lower, in the treatment group, these differences were not statistically significant. The findings suggest that long-term intermittent treatment for 3 years with INB spray, 50 μg twice daily, for children with perennial rhinitis revealed no negative effect on BMD and associated parameters.

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.

2-Aminoethoxydiphenyl borate administration into the nostril alleviates murine allergic rhinitis

OBJECTIVE

Orai1 is the 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 rhinitis (AR). In this study, we examined whether the intervention of Orai1 pathway was capable of controlling IgE-mediated allergic reactions by using AR mice models.

MATERIALS AND METHODS

We used Western blotting and real-time reverse transcription polymerase chain reaction to evaluate Orai1 expression in nasal mucosa and nasal-associated lymphoid tissue (NALT) of normal, control, and 2-aminoethoxydiphenyl borate (2-APB)-treated mice. In addition, we analyzed concentrations of nasal lavage fluid leukotriene C4 (LTC4), eosinophil cation protein (ECP), ovalbumin-specific IgE, and interleukin-4 (IL-4) through enzyme-linked immunosorbent assay and measured messenger RNA (mRNA) levels of LTC4 synthase and ECP in nasal mucosa, and germline Cɛ transcription and IL-4 mRNA in NALT by using real-time reverse transcription polymerase chain reaction among groups.

RESULTS

2-Aminoethoxydiphenyl borate administration into the nostril reduced numbers of sneezing and nasal rubbing as well as counts of invasive eosinophils in treated mice compared with those in control ones. Furthermore, the administration suppressed Orai1 expression in nasal mucosa and NALT of treated mice compared with that of control ones. Similarly, 2-APB treatment restrained nasal lavage fluid LTC4, ECP, ovalbumin-specific IgE, and IL-4 and their corresponding mRNAs in the previously mentioned tissues of treated mice in comparison with those of control ones.

CONCLUSION

Our results indicate that 2-APB treatment effectively alleviates murine AR through pleiotropic activities.

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.

[Changes of leukotriene D4 in nasal discharge and plasma of patients with persistent allergic rhinitis and the effects of antihistamine]

OBJECTIVE

To investigate the changes of leukotriene D4 (LTD4) in nasal discharge and plasma of patients with persistent allergic rhinitis (AR) and the effects of antihistamine.

METHOD

The investigation was a prospective, randomized controlled trial. Forty AR patients (group C) were divided randomly into two subgroup. One group received oral antihistamine 10 mg everyday for one week (group CA) and another group received no loratadine tablets 10 mg everyday for one week (group CB). Fifteen age matched healthy (group D) people were enrolled as control. The level of LTD4 and interleukin-5 (IL-5) in both nasal discharge and plasma by using enzyme linked immunosorbent assay (ELISA) and enzyme immunoassay (EIA), cell counts and cell differentials in nasal discharge, were measured before and after three month. The clinical symptom and life quality scores of group C were also investigated.

RESULT

The concentrations of LTD4 in nasal discharge [(794 +/- 305) pg] and plasma [(5219 +/- those in group D [(347 +/- 169) pg, (2283 +/- 489) ng/L, all P 1185) ng/L] in group C were significantly higher than those in group D [(347 +/- 169) pg, (2283 +/- 489) ng/L, all P < 0.05]. The level of LTD4 in nasal discharge was positively correlated with the percentage of neutrophil (r = 0.453, P < 0.05) and IL-5 (r = 0.364, P < 0.05). The pre- and post-therapy concentrations of nasal discharge and plasma in group CA were (812 +/- 1592) pg, (657 +/- 495) pg and (5422 +/- 935) ng/L, (4589 +/- 1057) ng/L respectively; While in group CB the concentrations were (776 +/- 227) pg, (860 +/- 194) pg and (5074 +/- 1850) ng/L, (6063 +/- 450) ng/L, respectively. There were no significant difference either in the level of LTD4 in nasal discharge or in plasma in both groups (all P > 0.05).

CONCLUSION

The results suggested that LTD4 was involved in airway inflammation in AR. Antihistamine was not effective enough in decreasing the levels of LTD4 in both nasal discharge and plasma of AR patients.

[Role and mechanism of the expression of matrix metalloproteinase 9 and tumor necrosis factor α in upper and lower respiratory tract inflammation in rats]

OBJECTIVE

To investigate the role and mechanism of matrix metalloproteinase 9 (MMP-9) and tumor necrosis factor α (TNF-α) in the pathogenesis of allergic rhinitis (AR) and asthma(AS).

METHODS

The rat models of AR and AS were made by injecting ovalbumin. The infiltration of eosinophils and mast cells were detected by hematoxylin-eosin (HE) staining and toluidine blue staining respectively, and the expression of MMP-9 and TNF-α in nasal mucosa and lung tissue were examined by immunohistochemical staining (SP method). The relationship of their expression with upper and lower respiratory tract inflammation was analyzed. SPSS 13.0 software was used to analyze the data.

RESULTS

The numbers of MMP-9 positive inflammatory cells in nasal mucosa and lung tissue of AR were (154.8 ± 12.0) and (124.0 ± 8.2), (43.2 ± 7.6) and (34.5 ± 5.0) in the control groups, the difference was significant (t value were 24.260, 29.525 respectively, all P < 0.05). The numbers of MMP-9 positive inflammatory cells in nasal mucosa and lung tissue of AS were (149.9 ± 11.7) and (120.1 ± 7.3), (48.6 ± 7.6) and (39.1 ± 5.2) in control groups, the difference was significant (t value were 22.929 and 28.530 respectively, all P < 0.05). The numbers of TNF-α positive inflammatory cells in nasal mucosa and lung tissue of AR were (188.8 ± 17.0), and (134.8 ± 7.9), (57.6 ± 23.3) and (40.3 ± 8.2) in control groups, the difference was significant (t value were 13.836 and 26.220, all P < 0.05). The numbers of TNF-α positive inflammatory cells in nasal mucosa and lung tissue of AS were (179.2 ± 15.4) and (153.5 ± 10.1), (70.5 ± 33.1) and (33.8 ± 14.0) in control groups, the difference was significant (t value were 9.412 and 21.858, all P < 0.05). There was a correlation between the expression of MMP-9 and TNF-α in nasal mucosa and lung tissue of AR (r values were 0.893 and 0.700 respectively, P values were 0.001 and 0.024, respectively) and AS (r values were 0.692 and 0.644 respectively, P values were 0.027 and 0.044 respectively) groups.

CONCLUSIONS

The inflammation is similar between AR and AS. The MMP-9 and TNF-α may play an important role in the pathogenesis of upper and lower respiratory tract inflammation.

[Change of Th17 and expression of RORγt in a murine model of allergic rhinitis after a stimulation of allergen and corticosteroid]

OBJECTIVE

To study the effects of allergen and corticosteroid on T help 17 (Th17) and orphan nuclear receptor gammat (RORγt) in allergic-rhinitis mice.

METHODS

Experimental allergic rhinitis (AR) was induced by the extract of dermatophagoides pteronyssinus (DP) including 2% ovalbumin (OVA) sensitization in 30 male mice with DP allergen group (n = 10), intranasal corticosteroid (budesonide, BUD) group (n = 10) or without treatment (model group, n = 10). And another 10 were included into the normal control group. The murine levels of Th17 were measured by flow cytometry (FCM). The expression of RORγt mRNA was measured by reverse transcription-polymerase chain reaction (RT-PCR) while that of RORγt protein in nasal mucosa detected by immunohistochemical staining.

RESULTS

The expression of RORγt in nasal mucosa of AR model was higher than that in the control group (25 ± 5 vs 48 ± 10, P < 0.01). But its expression declined significantly after the administration of local corticosteroid (48 ± 10 vs 31 ± 6, P < 0.01). The levels of RORγt mRNA and Th17 in the AR model group were significantly higher than those in the control group (18.4% ± 1.3% vs 27.5% ± 1.6%, 0.43 ± 0.04 vs 0.64 ± 0.05, both P < 0.01). The levels of RORγt mRNA and Th17 in the spleen of AR mice were significantly reduced by allergen dosing (27.5% ± 1.6% vs 20.0% ± 2.1%, 0.64 ± 0.05 vs 0.54 ± 0.03, both P < 0.01) but not by corticosteroid (P > 0.05).

CONCLUSIONS

Allergen may affect the systemic immunity to inhibit the RORγt expression and block the Th17 differentiation in AR model. Local steroid only produces a marked effect through a down-regulated RORγt expression in nasal mucosa.

[Relationship between allergic symptoms and RORC2 and IL-17 in patients with allergic rhinitis]

OBJECTIVE

To evaluate the relationship between allergic symptoms and retinoic acid-related orphan receptor variant 2 (RORC2) and interleukin (IL) 17 in patients with allergic rhinitis (AR).

METHODS

Blood sample, nasal secretion and nasal mucosa were taken from 23 patients with AR and 16 health individuals. The expression of RORC2 and IL-17 were detected by immunohistochemistry and quantitative real-time fluorescence reverse polymerase chain reaction. The allergic symptoms in patients were graded.

RESULTS

The rate of positive cells of RORC2 and IL-17 in AR group were 0.17 ± 0.05 and 0.72 ± 0.13, higher than the 0.05 ± 0.02 and 0.27 ± 0.11 of health controls, the difference was statistically significant (t were 9.51 and 11.92 respectively, all P < 0.05). The expression level of RORC2 mRNA in nasal mucosa and peripheral blood of AR group were 0.063 ± 0.011 and 0.452 ± 0.031, higher than the 0.029 ± 0.009 and 0.239 ± 0.027 of health controls, the difference was statistically significant (t were 6.51 and 3.35 respectively, all P < 0.05). The concentrations of IL-17 in the nasal mucosa, nasal secretions and serum levels of AR group were (70.28 ± 10.69), (45.32 ± 8.55) and (6.76 ± 1.18) pg/ml, compared with (18.43 ± 8.34), (6.83 ± 1.31) and (0.74 ± 0.05) pg/ml of controls, the difference was statistically significant (t were 7.92, 17.66 and 15.43 respectively, all P < 0.05). The allergy symptom scores of AR group were 9.43 ± 1.27. There were correlations between the allergic symptom and the expression of RORC2 mRNA and IL-17 in nasal mucosa and peripheral blood (r value were 0.820, 0.746, 0.629, 0.841 respectively, all P < 0.05).

CONCLUSION

RORC2 and IL-17 involved in the inflammatory response of AR and can be used as an indicator to judge the severity.

Adrenomedullin level in the nasal discharge from allergic rhinitis cohort

Adrenomedullin (AM) is a potent hypotensive and vasodilatory peptide. AM may exert protective actions against the development of many diseases by modulating the blood circulation and body fluid balance. In addition to these functions, it has recently been reported to play important roles in the development of allergy and infections. The purpose of the present study was to demonstrate the existence of AM in the human nasal mucosa and to discuss whether AM might contribute to the pathogenesis of nasal congestion. We measured the total AM concentrations in the nasal discharge. The total AM concentration in the nasal discharge was significantly higher in the non-allergy group (72.1 ± 55.5 fmol/ml) than in the allergy group (37.1 ± 44.2 fmol/ml). By immunohistochemical examination, we identified AM-containing cells in the nasal mucosa from both subjects with and without nasal allergy, and also in nasal polyps. Moreover, those cells were positive for anti-tryptase antibody which recognizes mast cells. In nasal allergy, vasodilatation and increase in vascular permeability are characteristic features of the immediate phase response. Reduced AM levels in the nasal discharge may be associated with attenuation of both of these factors. On the other hand, immunohistochemical analysis demonstrated AM-immunoreactive cells in the chronic phase of rhinosinusitis. In the late and inflammatory phase, mast cells produce AM, which possibly acts as an inhibitor of inflammatory cell migration. In conclusion, AM may be actively secreted into the nasal discharge. AM in the nasal discharge may have protective and anti-inflammatory effects in the nasal mucosa.

[Effects of intranasal interferon gamma on transforming growth factor-β1/Smad in rats with allergic rhinitis]

OBJECTIVE

To investigate the effects of intranasal interferon gamma (IFN-γ) on nasal mucosa remodeling and expression of transforming growth factor-β1 (TGF-β1), Smad2, Smad3, Smad7 in allergic rhinitis (AR) rat model.

METHODS

Ovalbumin (OVA) and aluminum hydroxide were used to construct the AR model. Thirty AR rats were randomly divided into positive control group (group B, n = 10), IFN-γ treatment group (group C, n = 10) and negative control group (normal rats, n = 10). After the AR models were built, 50 µl PBS, 1 µg IFN-γ was dropped into the nasal cavity of each rat in group B and group C, from the fouth week to tenth week, twice a week. The nasal mucosa was collected on day 71 in order to observe the pathologic changes, and the expression of TGF-β1, TGF-β1 mRNA, Smad2 mRNA, Smad3 mRNA and Smad7 mRNA by immunohistochemistry and reverse transcriptase-polymerase chain reaction.

RESULTS

Decreases of TGF-β1, Smad2 and Smad3 mRNA were seen in nasal tissue of group C (0.59 ± 0.04, 0.39 ± 0.08, 0.46 ± 0.15) as compared with group B (0.82 ± 0.12, 0.70 ± 0.18, 0.95 ± 0.26), the differences were significant (q value were 3.15, 4.47, 3.03, all P < 0.05). The levels of Smad7 mRNA expression increased significantly (q = 2.98, P < 0.05) in group C (0.31 ± 0.05) as compared with group B (0.25 ± 0.06). Immunohistochemistry showed significant decrease of TGF-β1 expression in the nasal tissue of group C much lesser than that in group B.

CONCLUSIONS

Intranasal IFN-γ could decrease the expression of TGF-β1, TGF-β1 mRNA, Smad2 mRNA, Smad3 mRNA, increase the expression of Smad7 mRNA in AR rats model and inhibit the nasal mucosa remodeling.

[The role of disturbances of lipid metabolism in pathogenesis of allergic rhinitis]

Physiological normal levels of total cholesterol, total lipids, total protein, superoxide dismutase, catalase, malonic dialdehyde, and total antioxidant activity were determined for the first time in nasal secretion of volunteer donors (n = 24). Excessive lipid peroxidation and suppression of antioxidant protection system were documented in 70 patients with round-the-year allergic rhinitis of whom 26 and 44 presented with the mild and moderately forms of the disease, respectively. The clinical efficiency of polyoxidonium (Russia) in the treatment of allergic rhinitis has been demonstrated. This preparation reduces the intensity of lipid peroxidation and strengthens the antioxidant protection of the organism. The results of the study confirm the high efficacy of combined therapy of allergic rhinitis with aerius and polyoxidonium.

Reduced basal salivary cortisol in children with asthma and allergic rhinitis

AIM

Reduced basal cortisol is reported in allergic disease. We investigated if basal salivary cortisol levels were reduced in children with asthma or allergic rhinitis, controlling for inhaled corticosteroids (ICS) use.

METHODS

Morning and evening saliva of asthmatic children aged 7-12 years (n = 50) and that of controls (n = 52) were sampled. A total of 19 asthmatics and four controls had allergic rhinitis. Healthy children were controls without rhinitis. Of all, 14 asthmatic children used low, and 12 used moderate or high doses of ICS. Cortisol was analysed by radioimmunoassay.

RESULTS

Morning salivary cortisol median (95% CI) was lower in asthmatics (8.7 (7.1, 9.7)) compared with that in controls (10.4 (9.6, 11.8); p = 0.006), which was similar for evening cortisol levels. Regression analyses demonstrated that asthmatics using moderate or high doses of ICS had reduced morning salivary cortisol adjusted (for age and gender) odds ratio (aOR) (95% CI) (0.54 (0.37, 0.80); p = 0.002) and reduced evening cortisol aOR (0.09 (0.01, 0.6); p = 0.02) compared with that in healthy children. Asthmatics with rhinitis on no or low doses of ICS had reduced morning cortisol aOR (0.73 (0.56, 0.96); p = 0.02) compared with that in healthy children.

CONCLUSION

Asthmatic children on moderate or high doses of inhaled corticosteroids had reduced salivary cortisol, but co-morbidity of asthma and rhinitis was also associated with reduced cortisol levels.

[Different expression of histamine H4 receptor in nasal mucosa in allergic rhinitis patients]

OBJECTIVE

To observe expression and distribution of histamine H4 receptor in nasal mucosa in normal people and allergic rhinitis patients,and understand role of histamine H4 receptor in allergic rhinitis.

METHOD

Select normal people and allergic rhinitis patients each 10, take the nasal mucosa, detect expression and distribution of histamine H4 receptor at proteins and transcription level respectively by immunohistochemical method and RT-PCR, and compared.

RESULT

Histamine H4 receptor at proteins and transcription level were found in normal nasal mucosa (25 509 +/- 6 441, 0.42 +/- 0.08), increased significantly in nasal mucosa of allergic rhinitis patients (49 676 +/- 8 541, 0.69 +/- 0.11, P < 0.05), which in structural cells and immune cells.

CONCLUSION

Histamine H4 receptors exist in normal nasal mucosa, its express significantly enhance, flew histamine H4 receptor may be mediated histamine in pathogenesis of allergic rhinitis ,who is one of the ligands of histamine.

TGF-beta signaling may play a role in the development of goblet cell hyperplasia in a mouse model of allergic rhinitis

BACKGROUND

Transforming growth factor-beta (TGF-beta) levels are elevated in the nasal mucosa in allergic rhinitis. However, because TGF-beta is secreted extracellulary in latent complexes, it remains unclear whether the local TGF-beta expression actually drives active signaling and affects the pathophysiology of allergic rhinitis. The objective of this study is to investigate whether TGF-beta signaling is activated in allergic rhinitis and plays a role in the pathophysiology of allergic rhinitis.

METHODS

An ovabumin (OVA)-sensitized and -nasally challenged mouse model of allergic rhinitis was established and phosphorylation of Smad2 in the nasal mucosa was examined by immunohistochemistry. In addition, the effects of the pharmacological inhibition of endogenous TGF-beta signaling on the allergic rhinitis model were histologically examined. Furthermore, phosphorylation of Smad2 in the nasal mucosa samples obtained from patients with allergic rhinitis was also evaluated.

RESULTS

In the mouse model of allergic rhinitis, OVA challenge induced phosphorylation of Smad2 predominantly in epithelial cells in the nasal mucosa. In addition, the administration of an inhibitor of TGF-beta type I receptor kinase activity during OVA challenge suppressed goblet cell hyperplasia in the nasal mucosa. Furthermore, phosphorylated Smad2 expression increased in nasal epithelial cells in patients with allergic rhinitis.

CONCLUSIONS

These results suggest that TGF-beta signaling is activated in epithelial cells in the nasal mucosa in allergic rhinitis and may contribute to the development of goblet cell hyperplasia.

Proinflammatory mediators in nasal lavage of subjects with occupational rhinitis

We sought to investigate the type and kinetics of late-phase nasal inflammatory response after nasal challenge with occupational allergens. Participants were 10 subjects experiencing work-related rhinitis symptoms who underwent specific inhalation challenge and tested positive for occupational rhinitis. During challenge, we monitored changes in inflammatory cells, eosinophil cationic protein, myeloperoxidase, and interleukin-8 in nasal lavage samples. The challenge with the active agent induced a significant increase in the percentage of eosinophils at 30 minutes as compared with prechallenge values (P = 0.04). A significant increase in eosinophil cationic protein levels after challenge with the control (P = 0.01) and active agent (P = 0.02) was observed in the late phase after challenge. No significant changes in nasal levels of neutrophils, myeloperoxidase, and interleukin-8 were observed on both control and active challenge days. Our results suggest a predominant nasal eosinophilic inflammatory response after occupational allergen challenge.

[The dynamic expression of the TGF-beta1 and FGF-2 in the nasal mucosa in the allergic rhinitis rat models]

OBJECTIVE

To investigate the dynamic expression of the TGF-beta1 and FGF-2 in the nasal mucosa of rat models of allergic rhinitis, at different stages of the process during pathogenesis.

METHOD

One hundred and eighty Sprague-Dawley (SD) rats were randomly divided into three groups, the normal Group A used for contrast and experimental groups: Group B and C, each group were 60 rats. Then, observed the expression of the TGF-beta1 and FGF-2 in the nasal mucosa at different stages of the process by immunohistochemical staining.

RESULT

The expression of the TGF-beta1 and FGF-2 in the nasal mucosa of the normal Group A was negative, while the Group B and Group C were varying degrees of positive both, and Group B, the level of the TGF-beta1 and FGF-2 were both decline after allergen avoidance, but still more not ability than the expression of the Group B (P < 0.05).

CONCLUSION

The expression of the TGF-beta1 and FGF-2 in the nasal mucosa of rats models were varying degrees of positive , and it is decline while the allergen avoidance.

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.

[Effect of histamine H4 receptor and its antagonist on allergic rhinitis in rats]

OBJECTIVE

To clarify the effect of histamine H4 receptor antagonist, JNJ 7777120, and histamine H1 receptor antagonist, Loratadine, on allergic rhinitis (AR) in rats and to study the role of histamine H4 receptor antagonist and histamine H1 receptor antagonist in the pathogenesis of allergic rhinitis and therapeutic value of their antagonist.

METHODS

AR animal model were induced by ovalbumin (OVA) in the Wistar rats, which treated with histamine H4 receptor antagonist and (or) histamine H1 receptor antagonist. The allergic symptoms (sneezing and nasal rubbing), serum total IgE and the levels of cytokines in serum or nasal lavage fluid were measured, the diversity between two groups were observed. Statistical analysis was performed using a SPSS 13.0 software.

RESULTS

Compared with AR group with no treatment, the inhibition of nasal symptoms (P < 0.01), a significant decrease in the levels of IgE, IL-4 in serum and Eotaxin in nasal lavage fluid (P < 0.01), a significant increase in the levels of IFN-γ in serum (P < 0.01) after treatment was found. Compared with group treated with Loratadine, inhibition of nasal symptoms (q value were 3.72, 4.16, P < 0.01), a significant increase in the levels of IgE and IL-4 in serum (q value were 8.01, 4.96, P < 0.05), a significant decrease in the levels of IFN-γ in serum (q = 3.18, P < 0.05) in group treated with JNJ 7777120 also, but no significant differences in the levels of Eotaxin in nasal lavage fluid (P > 0.05). Administration of JNJ 7777120 and Loratadine jointly, neither additive effect nor synergistic action were found (P > 0.05).

CONCLUSIONS

Histamine H4 receptor is closely related with allergic rhinitis and is important in the pathogenesis of allergic rhinitis, the same as histamine H1 receptor. Histamine H4 receptor antagonist, JNJ 7777120, could relieve symptoms and inflammatory conditions in allergic rhinitis, the effect was weak compared with Loratadine. Neither additive effect nor synergistic action were found between them.

[Substance P and its receptors are involved in the effect of histamine H3 receptor agonist, IMETIT on nasal allergic symptoms in guinea pigs]

OBJECTIVE

To explore the influence of histamine H3 receptor agonist, IMETIT and simultaneous use of IMETIT and H1-receptor antagonist, Loratadine, on the symptoms of allergic rhinitis (AR) and substance P(SP) secretion and expression of SP receptor (SP-R) mRNA in AR model in guinea pigs.

METHODS

Guinea pigs were divided randomly into 4 groups: AR group (group A), IMETIT group (group B), Loratadine group (group C) and IMETIT+Loratadine group (group D). The severity of AR was assessed by determining the extent of three markers of allergic symptoms (sneezing, nasal rubbing and nose blocking). The changes in the nasal mucosa were studied by pathological methods. The expression of positive cell of SP was detected by immunohistochemistry. SP-R mRNA expression in nasal mucosa was used to do reverse transcriptive-polymerase chain reaction (RT-PCR). Statistical analysis was performed using a SPSS 13.0 software.

RESULTS

In Group B, the mean (x ± s) number of sneeze [(15.0 ± 1.3) times], scratching nose [(16.5 ± 2.3) times] and respiratory frequency [(76.3 ± 4.1) times/min] were significantly improved than those in group A [(23.5 ± 2.6) times, (26.1 ± 4.1) times and (66.5 ± 5.8) times/min, respectively), P value were 0.000, 0.000 and 0.001, respectively]. The numbers of SP-positive cells [(11.6 ± 3.6)/HP] and SP-R mRNA expression (0.64 ± 0.04) in group B were reduced significantly compared to group A [(27.1 ± 9.7)/HP, (0.83 ± 0.03), P value were 0.000, 0.000, respectively]. Sneeze [(10.0 ± 2.3) times], scratching nose [(11.8 ± 1.7) times] and respiration [(90.0 ± 5.0) times/min] in Group D were improved significantly than those in group B (P value were 0.000, 0.002 and 0.000, respectively). SP-positive cells [(2.0 ± 1.7)/HP] and SP-R mRNA expression (0.52 ± 0.06) in Group D compared with group B were also significantly reduced (P value were 0.012 and 0.000, respectively). Pathological changes in guinea pig nasal mucosa in group B, group D were alleviated than those in group A. The combination of IMETIT and Loratadine had a synergistic effect on these effects (F value were 11.59, 8.28, 5.61, 5.48, 6.50, respectively, P value were 0.002, 0.008, 0.025, 0.027, 0.017).

CONCLUSIONS

IMETIT and the combination of IMETIT with Loratadine can effectively relieve the symptoms of AR in guinea pigs, its mechanism may be relevant to reduce SP secretion and the expression of SP-R mRNA, and the two has a synergistic effect. It may be useful as a novel therapeutic approach in nasal allergy.

[Effect of H3R agonist, IMETIT on allergic rhinitis in guinea pigs]

OBJECTIVE

To discuss the treatment of H3R agonist, IMETIT, on the allergic rhinitis(AR) ,and the influence to mRNA of Substance P(SP) and Substance P Receptor (SP-R) in AR model of guinea pigs.

METHOD

The severity of AR was assessed by allergic symptoms (sneezing, nasal rubbing and nose blocking). The changes in the nasal mucosa were studied by pathological methods. The expression of SP positive cell was detected by immunohistochemistry, and the expression of SP-R mRNA was detected by reverse transcriptive polymerase chain reaction (RT-PCR).

RESULT

Histamine H3R agonists, IMETIT can effectively improve the AR symptoms, sneezing, nasal itching, nasal congestion, reduce the pathological changes in the nasal mucosa, cut down the SP secretion and SP-R mRNA expression.

CONCLUSION

Histamine H3R agonist, IMETIT can effectively relieve the symptoms of AR in guinea pigs, which is related to reducing SP secretion and SP-R mRNA expression.