The role of the sensitization to storage mites in the diagnosis of allergic respiratory diseases

Summary Numerous studies suggest the capacity of storage mites (S.M.) to induce IgE-mediated reactions but their etiopathogenetic role in allergic respiratory diseases has not yet been established. Therefore we examined 283 patients affected by rhinitis and/or bronchial asthma resident in urban and rural areas who underwent skin tests and a RAST with a group of allergens including S.M. (Acarus s., Lepidoglyphus d., Glycyphagus d., Tyrophagus p.).The incidence of patients showing a positive reaction to S.M. was evaluated according to their place of residence and work. 48 patients were selected who resulted positive to mites; 28 of them resulted positive to S.M. and pyroglyphid and 5 to S.M. only.The relationship between skin tests and RAST for S.M. positive patients resulted high forL.d. (70%),G.d. (75%),T.p. (80%) and low forA.s. (58%). In RAST positive subjects cross-reactivity withD. ptero was evaluated:A.s. (70%),L.d. (80%),T.p. (75.4%),G.d. (78.9%).Dwelling and place of work of skin and RAST positive patients revealed an equal distribution between urban and rural populations for S.M.; however, while in urban areas the association with pyroglyphid mites is constant, the rare single sensitivities are found only in rural areas and in farmers. From our data it emerges that the allergological diagnostics must use S.M. when considering respiratory diseases of professionally exposed subjects and residents of given areas. An interpretation of their etiologic role, given the frequent association with pyroglyphid mites, will demand further diagnostic data and an identification and purification of the clinically relevant allergens.     

Histone deacetylase 3 mediates allergic skin inflammation by regulating expression of MCP1 protein

We have shown the induction of histone deacetylase 3 (HDAC3) in antigen-stimulated rat basophilic leukemia cells via NF-κB. We investigated the role of HDAC3 in allergic skin inflammation. We used a BALB/c mouse model of triphasic cutaneous anaphylaxis (triphasic cutaneous reaction; TpCR) and passive cutaneous anaphylaxis (PCA) to examine the role of HDAC3 in allergic skin inflammation. Triphasic cutaneous reaction involved induction of HDAC3 and was mediated by HDAC3. HDAC3 showed an interaction with FcεRIβ. Trichostatin A (TSA), an inhibitor of HDAC(s), disrupted this interaction. Cytokine array analysis showed that the down-regulation of HDAC3 led to the decreased secretion of monocyte chemoattractant protein 1 (MCP1). FcεRI was necessary for induction of HDAC3 and MCP1. ChIP assays showed that HDAC3, in association with Sp1 and c-Jun, was responsible for induction of MCP1 expression. TSA exerted a negative effect on induction of MCP1. HDAC3 exerted a negative regulation on expression of HDAC2 via interaction with Rac1. The down-regulation of HDAC3 or inactivation of Rac1 induced binding of HDAC2 to MCP1 promoter sequences. TSA exerted a negative effect on HDAC3-mediated TpCR. The BALB/c mouse model of PCA involved induction of HDAC3 and MCP1. HDAC3 and MCP1 were necessary for PCA that involved ear swelling, enhanced vascular permeability, and angiogenesis. Recombinant MCP1 enhanced β-hexosaminidase activity and histamine release and also showed angiogenic potential. TSA exerted a negative effect on PCA. Our data show HDAC3 as a valuable target for the development of allergic skin inflammation therapeutics.     

Trichuris vulpis (Froelich, 1789) infection in a child: a case report

We present a human infection with the canine whipworm, Trichuris vulpis, in a child suffering from rhinitis with a diagnosis of rhinitis. T. vulpis eggs resemble those of T. trichiura but they can be differentiated based on their morphological features and egg size, using micrometry with an ocular micrometer. T. vulpis eggs measured an average of 90 μm by 44 μm (range 86-99 μm by 38-47 μm). Prevalence of hookworms (28.1%), Toxocara canis (11.8%), and Trichuris vulpis (3.5%) was found in 292 fecal samples of dogs collected at the peri-domicile, which showed that the risk of infection was not only fortuitous. The treatment of canine whipworm infections is similar to that of T. trichiura infection. We recommend differentiation of the 2 species for their epidemiological and prevention implications.     

非索非那定治疗变应性鼻炎的随机对照试验的Meta分析

目的：评价非索非那定治疗变应性鼻炎的疗效及其安全性。方法：计算机检索SCI,Pubmed,Elsevier,Cochrane图书馆,知网,万方数据库,维普数据库中关于非索非那定治疗变应性鼻炎的随机对照试验,同时追索纳入文献的参考文献。检索年限均从建库检索到2013年12月。由两名评价员独立筛查文献,对纳入的文献进行质量评价并提取文献,对符合质量标准的随机对照试验（RCT）进行Meta分析,比较非索非那定组和安慰剂组鼻部症状评分、血清中白三烯浓度、生活质量评价、症状改善率和安全性评估。统计学分析采用RevMan5．2软件。结果：共纳入9个RCT。患者口服非索非那定片30mg／d,120mg／d,180mg／d后可有效改善变应性鼻炎患者的症状,可降低患者鼻部症状评分、血清中白三烯浓度;有效提高生活质量,降低患者总的生活质量评分（P均〈0．05）。非索非那定不良反应的发生率与安慰剂组相似,不良反应发生率差异无统计学意义（P〉0．05）。结论：患者口服非索非那定片30mg／d,120mg／d,180mg／d后可以有效缓解患者的症状,改善患者的生活质量,且不良反应发生率与对照组相近。基于非索非那定较好的有效性和安全性,故可以广泛应用于临床,更加有效的缓解变应性鼻炎患者的症状。     

穴位敷贴治疗变应性鼻炎疗效的Meta分析

目的:对比分析穴位敷贴与传统药物在变应性鼻炎治疗中的临床效果及实验室指标改善情况,系统评价穴位敷贴治疗变应性鼻炎的临床可行性,为临床实践与更深入的研究提供循证依据。方法:全面检索检索PubMed、Embase、Cochrane Library、CNKI、万方数据库,同时手工检索纳入文献的参考文献,由两名独立的评价员对符合纳入标准的研究进行资料提取,并采用偏倚风险表进行质量评价,对符合质量标准的RCTs应用Reman 5.2软件进行Meta分析。结果:12个RCTs共1736名患者纳入研究,其中治疗组(穴位敷贴治疗)970例,对照组(常规药物治疗)766例。Meta分析结果表明穴位敷贴治疗对比常规药物治疗变应性鼻炎治疗总有效率优势显著,差异具有统计学意义[OR=3.13,95%CI(2.40,4.07)];对文献的定性研究表明穴位敷贴治疗变应性鼻炎后鼻分泌物嗜酸性粒细胞、血清特异性IgE对比药物组有改善,差异有统计学意义(P0.05)。结论:穴位敷贴治疗变应性鼻炎患者总有效率高于传统药物治疗,但对于疾病的实验室指标的改善还需进一步验证。穴位敷贴可能是治疗变应性鼻炎的一种安全有效的方法,但受纳入研究的质量和数量限制,本研究结论尚需更多大样本、高质量的相关随机对照试验进行证实。今后还需进一步规范临床实施标准,深入机制研究,以期为敷贴治疗过敏性鼻炎提供科学理论依据,从而在世界范围内推广应用。     

变应性鼻炎模型小鼠鼻黏膜的形态学观察

目的:建立小鼠变应性鼻炎模型,观察小鼠鼻腔黏膜组织的重塑情况。方法:20只BALB/c小鼠被随机分为致敏组和对照组,使用卵清蛋白(OVA)诱导建立小鼠变应性鼻炎模型。通过HE染色观察小鼠鼻黏膜的大体重塑情况,吉姆萨染色观察嗜酸性粒细胞,阿辛蓝-过碘酸-希夫染色观察杯状细胞;酶联免疫吸附(ELISA)法检测小鼠血清中白细胞介素-4(IL-4)的水平。结果:小鼠变应性鼻炎模型的生物学行为评分为6.5±1.3,提示造模成功。与对照组相比,致敏组鼻腔黏膜出现上皮细胞脱落、坏死,杯状细胞增生,鳞状上皮化生,固有层和黏膜下层腺体增生、血管扩张,组织水肿,固有层内可见特征性的嗜酸性粒细胞浸润,造模后鼻腔黏膜结构存在重塑。致敏组小鼠鼻黏膜嗜酸性粒细胞计数及杯状细胞计数分别为(26.4±5.72)和(24.14±3.12),而对照组分别是(8.31±2.42)和(9.41±1.22),两组比较均具有统计学差异(P0.05);致敏组血清中白细胞介素4(IL-4)水平为(18.9±3.1)pg/ml,对照组为(8.3±1.4)pg/ml,致敏组显著高于对照组,差异有统计学意义(P0.05)。结论:通过卵清蛋白诱导建立的小鼠变应性鼻炎模型鼻腔黏膜存在组织重塑。     

NAR患者鼻灌洗EOS与诱导痰EOS的相关性研究

目的:评估非变应性鼻炎(nonallergic rhinitis,NAR)患者全身、鼻腔及下气道嗜酸性粒细胞(Eosinophils,EOS)浸润水平及相关性。探讨EOS在NAR患者鼻腔及下气道的特征及意义。方法:2011年6月~2012年6月在我院就诊的NAR患者241例,同期征集健康对照组222例,所有受试者均进行病史采集、皮肤点刺实验(SPT)、血清嗜酸性粒细胞、鼻灌洗、诱导痰检查。结果:1NAR组和对照组相比鼻灌洗EOS计数、诱导痰EOS比例、血EOS比例均显著高于健康对照组(P均0.01)。2有鼻腔EOS炎症和无鼻腔EOS炎症层的诱导痰EOS百分比阳性率分别为34.7%vs 9.6%(P0.01)。3NAR组鼻灌洗EOS计数和诱导痰EOS比例存在明显相关性(r=0.262,P=0.000),鼻灌洗EOS计数和血EOS比例存在明显相关性(r=0.228,P=0.000),诱导痰EOS比例和血EOS比例存在明显相关性(r=0.291,P=0.000)。结论:NAR患者血液、鼻腔及下气道EOS浸润程度较正常对照组均明显升高,EOS在NAR患者血液、鼻腔及下气道炎症中存在明显一致性,提示NAR是一种全身系统性炎症性疾病;无下气道症状的NAR患者部分存在下气道EOS炎症,鼻腔及血液EOS炎症是导致下气道EOS炎症的主要高危因素。鼻灌洗EOS可能是观测NAR患者下气道炎症及对下气道炎症进行评估和追踪的有效指标。EOS可能是鼻炎、哮喘及血液炎症相关的效应细胞,是上下气道炎症有效生物标记物。     

变应性鼻炎患者外周血中Tr1/Th3细胞的检测和分析

目的:检测变应性鼻炎(Allergic rhinitis,AR)患者和健康对照者外周血中IL-10+CD4+T细胞、TGF-β+CD4+T细胞(分别代表Tr1细胞和Th3细胞的特性)的比例,并探讨其在AR发病中的意义,为AR的治疗提供临床参考。方法:分离19例对粉尘螨过敏的AR患者和19例健康对照者外周血单个核细胞(PBMCs),采用流式细胞术分别检测外周血中IL-10+CD4+T细胞、TGF-β+CD4+T细胞的比例。结果:同健康对照者相比,AR患者外周血中IL-10+CD4+T细胞的比例显著降低[(1.66±0.48)%vs.(3.80.92)%,t=-9.08,P0.01)],AR患者外周血中TGF-β+CD4+T细胞的比例降低[(1.92±0.54)%vs.(4.76±1.12)%,t=-9.94,P0.01)]。结论:外周血中IL-10+CD4+T(Tr1)细胞比例的降低可能是AR发病的一个重要因素,提高AR患者外周血中分泌IL-10的Tr1细胞的比例可能在AR的治疗中具有重要意义。外周血中TGF-β1+CD4+T(Th3)细胞的比例显著降低,可能是AR发病的一个重要因素。但TGF-β1与AR关系的研究较少,特别是外周血中TGF-β1水平与AR的关系研究较少,需进一步研究。     

Nebulized perflubron and carbon dioxide rapidly dilate constricted airways in an ovine model of allergic asthma

Background

The low toxicity of perfluorocarbons (PFCs), their high affinity for respiratory gases and their compatibility with lung surfactant have made them useful candidates for treating respiratory diseases such as adult respiratory distress syndrome. We report results for treating acute allergic and non-allergic bronchoconstriction in sheep using S-1226 (a gas mixture containing carbon dioxide and small volumes of nebulized perflubron). The carbon dioxide, which is highly soluble in perflubron, was used to relax airway smooth muscle.

Methods

Sheep previously sensitized to house dust mite (HDM) were challenged with HDM aerosols to induce early asthmatic responses. At the maximal responses (characterised by an increase in lung resistance), the sheep were either not treated or treated with one of the following; nebulized S-1226 (perflubron + 12% CO₂), nebulized perflubron + medical air, 12% CO₂, salbutamol or medical air. Lung resistance was monitored for up to 20 minutes after cessation of treatment.In additional naïve sheep, a segmental bronchus was pre-contracted with methacholine (MCh) and treated with nebulized S-1226 administered via a bronchoscope catheter. Subsequent bronchodilatation was monitored by real time digital video recording.

Results

Treatment with S-1226 for 2 minutes following HDM challenge resulted in a more rapid, more profound and more prolonged decline in lung resistance compared with the other treatment interventions. Video bronchoscopy showed an immediate and complete (within 5 seconds) re-opening of MCh-constricted airways following treatment with S-1226.

Conclusions

S-1226 is a potent and rapid formulation for re-opening constricted airways. Its mechanism(s) of action are unknown. The formulation has potential as a rescue treatment for acute severe asthma.

Electronic supplementary material

The online version of this article (doi:10.1186/s12931-014-0098-x) contains supplementary material, which is available to authorized users.