Bronchial asthma in hay fever

The author diagnosed cough, emphysema and the symptoms characteristic for the bronchial asthma in 43% of patients with seasonal allergy (rhinitis, conjunctivitis) to pollens. Such symptoms were more frequent (51% of cases) in patients allergic to the grass pollens with coexisting hypersensitivity to Compositae family. Asthmatic symptoms in patients allergic only to grass pollens were seen in 38%. The author suggests that prolonged exposition in the inhalatory allergens (from two to four-five months) plays an important role in asthma onset in such patients. It rather delays than accelerates admittance to allergic clinics.     

Assessing allergenicity of urban parks: a case study from Aydin,Turkey

Aerobiologia - Allergenic pollens produced by some tree species in urban parks, a part of the urban flora, cause pollinosis, allergic rhinitis, allergic rhinoconjunctivitis, and asthma. The...     

支气管扩张合并支气管哮喘患者的病原菌检测及危险因素分析

目的分析支气管扩张合并支气管哮喘患者的病原菌及危险因素。方法选取湖州市中心医院115例支气管扩张合并支气管哮喘患者作为观察组,另选取同期110例健康体检者作为对照组。分析患者病原菌的组成、耐药性及发病危险因素。结果观察组患者送检痰样本经痰培养,阳性检出者68例,阳性率为59.13%(68/115)。全部样本共分离出104株病原菌,其中革兰阴性菌92株(以铜绿假单胞菌最多,占54.81%),革兰阳性菌8株,真菌4株。药敏试验结果表明革兰阴性菌对复方新诺明、头孢曲松、左旋左氧氟沙星和阿莫西林/克拉维酸等药物的耐药性均较高,对妥布霉素、亚胺培南、头孢哌酮/舒巴坦和哌拉西林的耐药性较低。Logistic回归分析显示,吸烟史、药物过敏史、食物过敏史、过敏性鼻炎、哮喘、过敏性肺炎、慢性支气管炎及慢性阻塞性肺疾病均是支气管扩张伴支气管哮喘发生的危险因素。结论支气管扩张合并支气管哮喘患者其病原菌以革兰阴性菌为主,吸烟史、药物过敏史、食物过敏史、过敏性鼻炎等是支气管扩张伴支气管哮喘发生的危险因素。     

Desensitization at the first stage of IGE-mediated response as hay fever prophylaxis

The aim of our work was to assess the prophylactic aspects of desensitization at the first stage of IgE-mediated response to grass pollen antigens (GPA). Forty six patients aged 10-45 (Me = 20.45) years (group I) and 50 patients aged 11-45 (Me = 19.17) years (group II) were included in to the study. All of them: 1) suffered from allergic rhinitis due to house dust (HD), feathers (F), weed (W) or tree (T) pollen, 2) had also some other allergic diseases, 3) had positive family history of allergic disorders, 4) had reproducible, strongly positive skin reaction of type I to GPA, but 5) did not show any clinical symptoms of hypersensitivity to GPA. Specific immunotherapy with HD, F, W, and T aqueous extracts was administered to both groups for at least 3 successive years, while parallel desensitization with GPA aqueous extract was carried out in group I, only. The symptoms of grass pollinosis were searcher for and the effects of immunotherapy were evaluated in all the patients over the period of at least 5 successive years after the complete course of vaccines administration. Clinical signs of hypersensitivity to GPA became evident in 6 patients (13.04%) of group I and in 27 patients (54.00%) of group II (p less than 0.001). Thus the desensitization at the first stage of IgE-mediated response to GPA effectively prevented development of the symptomatic hay fever. However, the disease revealed itself in few cases still much later and its course was much milder than in people who were not subjected to such a preventive desensitization.(ABSTRACT TRUNCATED AT 250 WORDS)     

Association between childhood atopic disease and parental atopic disease in a population with high consanguinity

The aim of the study was to investigate the association between asthma, allergic rhinitis, and eczema in Qatari schoolchildren with allergic conditions in their parents. A cross-sectional study was conducted among 3500 Qatari schoolchildren aged 6-14 years in period: February, 2003-February, 2004. A questionnaire was used to collect the clinical history of asthma and allergic rhinitis in their parents and siblings. It was found that 21.6% of asthmatic children had mothers with asthma and 18.2% fathers with asthma. This contrasted with 6.8% of non-asthmatic children who had fathers with asthma and 9.4% mothers with asthma. As for allergic rhinitis, 26.5% of asthmatic children had mothers with allergic rhinitis and 25.3% fathers with allergic rhinitis. The frequency of either parent of the asthmatic children having allergic rhinitis was 41.8% and for both parents was 10.0%. The frequency of siblings having asthma was 36.6%, allergic rhinitis 16.4%, and eczema 29.1%. The present study revealed a strong association between respiratory allergies and eczema in parents, and their asthmatic children.     

Th17 Immunity in Children with Allergic Asthma and Rhinitis: A Pharmacological Approach

Th17 cells and IL-17A play a role in the development and progression of allergic diseases. We analyzed the IL-17A levels in sputum supernatants (Ss), nasal wash (NW) and plasma (P) from Healthy Controls (HC) and children with Asthma/Rhinitis. We tested the expression of IL-17A, RORγ(t) and FOXP3 in peripheral blood T-lymphocytes from intermittent and mild-moderate asthma. The effect of Budesonide and Formoterol was tested “in vitro” on IL-17A, RORγ(t) and FOXP3 expression in cultured T-lymphocytes from mild-moderate asthma/persistent rhinitis patients, and on nasal and bronchial epithelial cells stimulated with NW and Ss from mild-moderate asthma/persistent rhinitis. Further, the effect of 12 weeks of treatment with Budesonide and Formoterol was tested “in vivo” in T-lymphocytes from mild-moderate asthma/persistent rhinitis patients. IL-17A was increased in Ss, NW and P from children with mild-moderate asthma compared with intermittent and HC. In cultured T-lymphocytes IL-17A and RORγ(t) expression were higher in mild-moderate asthma/persistent rhinitis than in mild-moderate asthma/intermittent rhinitis, while FOXP3 was reduced. Budesonide with Formoterol reduced IL-17A and RORγ(t), while increased FOXP3 in cultured T-lymphocytes from mild-moderate asthma/persistent rhinitis, and reduced the IL-8 release mediated by IL-17A present in NW and Ss from mild-moderate asthma/persistent rhinitis in nasal and bronchial epithelial cells. Finally, Budesonide with Formoterol reduced IL-17A levels in P and Ss, CD4⁺IL-17A⁺T-cells, in naïve children with mild-moderate asthma/persistent rhinitis after 12 weeks of treatment. Th17 mediated immunity may be involved in the airway disease of children with allergic asthma and allergic rhinitis. Budesonide with Formoterol might be a useful tool for its therapeutic control.     

Pet ownership and associated respiratory diseases

Background Studies have shown that pets are very important sensitizing agents in patients with asthma. Respiratory disorders and allergic diseases are common in the State of Qatar. Objective The aim of the present study was to determine whether exposure to pets and domestic animals plays a significant role in the development of asthma and allergic rhinitis among Qatari school children aged 6–14 years. Design A cross-sectional prospective study. Setting Public schools for boys and girls in urban and semi-urban areas. Subjects A total of 3,500 Qatari school boys and girls aged 6–14 years were approached. After exclusion of those who did not give consent for the study and incomplete questionnaires, 3,283 (98.3%) participants were included in the data analysis. Methods A multistage sampling technique was used and different schools from urban and semi-urban areas were selected. A standard questionnaire was distributed to parents of randomly selected school children aged 6–14 years between February 2003 and February 2004. Results The overall prevalence of asthma was 19.8% and the mean age of the children was 9.0 ± 2.0 years. The male and female percentages were 52.3% and 47.7% respectively. Nine hundred and ninety-six families out of 3,283 (30.3%) owned pets. It was found that among children with no family history of asthma, the relative risk (RR) of asthma with pets at home was 1.19 and the 95% confidence interval (CI) was 1.0–1.4 (P = 0.025). The RR of having allergic rhinitis was 1.60 (95% CI = 1.4–1.8; P < 0.001) and risk of having eczema was also significantly higher in participants with pets at home (RR = 1.28; 95% CI = 1.1–1.5; P < 0.001). Conclusion In the present study, the prevalence of asthma, allergic rhinitis, and eczema was significantly more common in families with domestic animals than in those without.     

儿童过敏性结膜炎与变应性鼻炎的相关性及鼻眼联合防治效果分析

目的：探讨儿童过敏性结膜炎与变应性鼻炎的相关性研究及鼻眼联合防治的临床效果。方法：回顾性分析300 例儿童过敏性 结膜炎与310 例儿童变应性鼻炎患者的临床资料,对儿童过敏性结膜炎与变应性鼻炎的相关性进行分析后将所有患儿随机均分 为对照组与观察组,对照组采用常规点眼的方法进行治疗,观察组则采用鼻朗喷鼻联合人工泪液点眼进行治疗。比较两组临床疗 效及不良反应情况。结果：（1）300 例过敏性结膜炎患儿中,50 例（16.67%）并发变应性鼻炎;310 例变应性鼻炎患儿中,59 例 （19.03%）并发过敏性结膜炎（P＞0.05）;（2）109 例同时并发两种疾病患儿中,均进行眼结膜与鼻粘膜的刮片检查嗜酸性粒细胞, 其中60 例（55.05%）结膜刮片与67 例（61.47%）鼻粘膜刮片检测到嗜酸性粒细胞（P＞0.05）;（3）两组治疗前后BUT 及角膜荧光素 染色评分、症状评分、临床总有效率比较差异明显（P＜0.05）。结论：儿童过敏性结膜炎与变应性鼻炎具有一定的相关性;鼻朗喷鼻 联合人工泪液点眼治疗儿童合并变应性鼻炎的临床疗效显著。     

The Impact of Allergic Rhinitis and Asthma on Human Nasal and Bronchial Epithelial Gene Expression

Background

The link between upper and lower airways in patients with both asthma and allergic rhinitis is still poorly understood. As the biological complexity of these disorders can be captured by gene expression profiling we hypothesized that the clinical expression of rhinitis and/or asthma is related to differential gene expression between upper and lower airways epithelium.

Objective

Defining gene expression profiles of primary nasal and bronchial epithelial cells from the same individuals and examining the impact of allergic rhinitis with and without concomitant allergic asthma on expression profiles.

Methods

This cross-sectional study included 18 subjects (6 allergic asthma and allergic rhinitis; 6 allergic rhinitis; 6 healthy controls). The estimated false discovery rate comparing 6 subjects per group was approximately 5%. RNA was extracted from isolated and cultured epithelial cells from bronchial brushings and nasal biopsies, and analyzed by microarray (Affymetrix U133+ PM Genechip Array). Data were analysed using R and Bioconductor Limma package. For gene ontology GeneSpring GX12 was used.

Results

The study was successfully completed by 17 subjects (6 allergic asthma and allergic rhinitis; 5 allergic rhinitis; 6 healthy controls). Using correction for multiple testing, 1988 genes were differentially expressed between healthy lower and upper airway epithelium, whereas in allergic rhinitis with or without asthma this was only 40 and 301 genes, respectively. Genes influenced by allergic rhinitis with or without asthma were linked to lung development, remodeling, regulation of peptidases and normal epithelial barrier functions.

Conclusions

Differences in epithelial gene expression between the upper and lower airway epithelium, as observed in healthy subjects, largely disappear in patients with allergic rhinitis with or without asthma, whilst new differences emerge. The present data identify several pathways and genes that might be potential targets for future drug development.     

Sensitivity to mugwort pollen allergens (Artemisia vulgaris)

The author has found that 42% of patients with pollinosis had positive skin reactions with mugwort (Artemisia vulgaris) pollen allergens. The majority of tested patients (139 out of 187) were also allergic to grass pollens. However, hypersensitivity to mugwort pollen allergens was isolated and did not accompany grass pollen allergy. The symptoms of pollinosis appeared in this group later than in patients sensitive to grass pollen allergens only (over 21 years of age in 71%). Bronchial asthma was diagnosed in 40% of these patients and allergic skin reactions in 25%. Sensitivity to mugwort pollen allergens was accompanied by the sensitivity to pollen allergens of Graminae family of plants in 80% of cases. The author suggests that sensitivity to mugwort pollen allergens is the second most frequent cause of the pollinosis and is diagnosed too rarely. Failures of desensitization in patients sensitive to pollen allergens of Graminae family of plants may often result from coexisting sensitivity to mugwort pollen allergens as this sensitivity produces not only season but perennial clinical symptoms in nearly 50% of patients. The author discusses also botanical relations and cross-reactions in allergy to mugwort and ragweed pollen allergens.     

Prevalence of Asthma and Allergic Rhinitis among Adults in Yaounde,Cameroon

Background

Population-based estimates of asthma and allergic rhinitis in sub-Saharan African adults are lacking. We assessed the prevalence and determinants of asthma and allergic rhinitis in urban adult Cameroonians.

Methods

A community-based survey was conducted from December 2013 to April 2014 among adults aged 19 years and above (N = 2,304, 57.3% women), selected through multilevel stratified random sampling across all districts of Yaounde (Capital city). Internationally validated questionnaires were used to investigate the presence of allergic diseases. Logistic regressions were employed to investigate the determinants of allergic conditions.

Results

Prevalence rates were 2.7% (95% CI: 2.1-3.4) for asthma-ever, 6.9% (5.9-7.9) for lifetime wheezing, 2.9% (92.2-3.6) for current wheezing and 11.4% (10.1-12.7) for self-reported lifetime allergic rhinitis; while 240 (10.4%) participants reported current symptoms of allergic rhinitis, and 125 (5.4%) had allergic rhino-conjunctivitis. The prevalence of current asthma medication use and self-reported asthma attack was 0.8 (0.4-1.2) and 1 (0.6-1.4) respectively. Multivariable adjusted determinants of current wheezing were signs of atopic eczema [2.91 (1.09-7.74)] and signs of allergic rhinitis [3.24 (1.83-5.71)]. Age group 31-40 years [0.27(0.09-0.78), p = 0.016] was an independent protective factor for wheezing. Determinants of current rhinitis symptoms were active smoking [2.20 (1.37-3.54), p<0.001], signs of atopic eczema [2.84 (1.48-5.46)] and current wheezing [3.02 (1.70-5.39)].

Conclusion

Prevalence rates for asthma and allergic rhinitis among adults in this population were at the lower tails of those reported in other regions of the world. Beside the classical interrelation between allergic diseases found in this study, active smoking was an independent determinant of allergic rhinitis symptoms. Nationwide surveys are needed to investigate regional variations.     

Predicting days of high allergenic risk during Betula pollination using weather types

The aim of this study was to build up a picture of the influence of meteorological conditions on pollen and pollinosis, taking account of weather types, pollen concentrations in the air and pollinosis symptoms, with the aim of preventing allergic responses. The study took place in Burgundy from 1996 to 1998, during the pollination of the birch (Betula), which is the most important arborean allergen in this region. We used daily pollen data from four Hirst volumetric traps, identified weather types by Bénichou’s classification, and obtained data on the occurrence of rhinitis, conjunctivitis, asthma and coughing from a sample of 100 patients. These data were analysed by multiple-component analysis. The results show that pollen dispersal is favoured by windy conditions, low relative humidity, precipitation below 2 mm and temperatures above 6°C. Such weather also favours pollinosis, but other particular meteorological situations, even if they do not assist pollen dispersal, can act directly on the development of symptoms: a decrease of temperature (3°C) led to the development of rhinitis and conjunctivitis, while strong winds were associated with many cases of conjunctivitis and asthma, owing to the irritant effect of cold or wind; asthma was favoured by temperature inversions with fog, probably because such weather corresponds to high levels of pollution, which act on bronchial hyperreactivity. Because the weather types favouring pollination and pollinosis are predicted by the meteorological office, this can constitute a tool for reducing the effect of high-risk allergenic days. Received: 12 December 2000 / Revised: 24 April 2001 / Accepted: 9 May 2001     

顺尔宁对变应性鼻炎患者血清肺表面活性蛋白A、D动态水平影响及近 期疗效观察

目的:探讨顺尔宁对变应性鼻炎患者体内肺表面活性蛋白A、D水平的影响及近期疗效观察。方法:纳入的变应性鼻炎患者分成单纯变应性鼻炎患者组不伴哮喘组106例,变应性鼻炎伴哮喘患者组75例,健康成人组20例作为实验对照组。连续应用顺尔宁8周后,统计患者鼻部总体症状评分,以及血清SP-A、SP-D水平的动态变化情况。结果:单纯变应性鼻炎组、变应性鼻炎伴哮喘组患者治疗4周后、8周后与治疗前比较,鼻部总体症状评分均明显降低,差异均有统计学意义(均P0.05)。治疗4周后,单纯变应性鼻炎组、变应性鼻炎伴哮喘组患者血清SP-A、D水平较治疗前,差异无统计学意义(均P0.05);治疗8周后,单纯变应性鼻炎组、变应性鼻炎伴哮喘组患者血清SP-A、D水平较治疗前明显下降(均P0.05)。结论:顺尔宁可影响变应性鼻炎患者体内SP-A、SP-D水平,改善鼻部不适的症状。     

Prevalence of asthma and allergic disorders among children in united Germany: a descriptive comparison.

OBJECTIVES--To compare the prevalence of asthma and allergic disorders among children in Munich, western Germany, and Leipzig, eastern Germany, where environmental exposure, particularly air concentrations of sulphur dioxide and particulate matter, and living conditions have differed over the past 45 years. DESIGN--Prevalence surveys among school-children aged 9-11 years in Leipzig and Munich. Self completion of written questionnaire by the children''s parents and lung function measurements. SUBJECTS--1051 children in Leipzig and 5030 in Munich. SETTING--Primary schools. MAIN OUTCOME MEASURES--Reported lifetime prevalence of asthma and allergic disorders, and bronchial hyperresponsiveness assessed by cold air inhalation challenge. RESULTS--The lifetime prevalence of asthma diagnosed by a doctor was 7.3% (72) in Leipzig and 9.3% (435) in Munich; prevalence of wheezing were 20% (191) and 17% (786) respectively. The prevalence of diagnosed bronchitis was higher in Leipzig than Munich (30.9% (303) v 15.9% (739); p < 0.01). A significant drop in forced expiratory volume (> 9%) after cold air challenge was measured in 6.4% (57) of children in Leipzig and in 7.7% (345) of those in Munich. Hay fever (2.4% (24) v 8.6% (410); p < 0.01) and typical symptoms of rhinitis (16.6% (171) v 19.7% (961); p < 0.05) were reported less often in Leipzig than in Munich. CONCLUSIONS--No significant differences were seen in the lifetime prevalence of asthma, wheezing, and bronchial hyperresponsiveness between children in Leipzig and Munich. The lifetime prevalence of bronchitis was higher in Leipzig than in Munich. The lower prevalence rates of allergic disorders in Leipzig could point toward aetiological factors that are associated with Western lifestyle and living conditions.     

Effect of additional disease (Comorbidity) on association of allergic rhinitis with KCNE4 gene rs12621643 variant

Analysis of association of allergic rhinitis with the KCNE4 gene rs12621643 variant was conducted in Russian residents of West Siberia (taking into account comorbidity with bronchial asthma). It was found that, among individuals without bronchial asthma, the frequencies of the KCNE4*G allele and KCNE4*G/G genotype are significantly higher in patients with rhinitis compared to individuals without it. At the same time, no association of rs12621643 with rhinitis was detected in the group of individuals with bronchial asthma. The data obtained indicate the association of the KCNE4 gene variability with allergic rhinitis, although the effect of this gene relative to the development of the disease can be leveled against a background of the manifestation of another atopic disease.     

Biological pollution and its relationship with respiratory symptoms indicative of asthma, Bucaramanga, Colombia

Introduction. Indoorair pollution may play an important role in development and exacerbation of asthma in children. Objective. The association between the presence of indoor biological contaminants and respiratory symptoms related to asthma was assessed in preschool children. Materials and methods. This cross-sectional study was undertaken in Bucaramanga, Colombia, and included children <7 years of age living in two urban areas of with different levels of outdoor air pollution. The 678 children were an average of 3.5 years of age. Respiratory symptoms indicative of asthma and indoor air pollutants were assessed by previously validated questionnaires.. Biological samples potentially containing mites and fungi were collected by standardized laboratory methods. The log binomial regression model was used for multivariate analysis, using adjusted prevalence ratios (PR). Results. The prevalence of asthmatic respiratory symptoms was 8.0%; (95% C.I: 5.6-9.6), without significant differences between the two areas. Binomial model analysis showed that asthma symptoms were associated with mites (PR 1.78; 95% C.I. 1.0-3.0), Acremonium sp (PR 6.24; 95 C.I.: 3.8-10.0) and a history of child pneumonia (PR 4.0; 95% C.I. 2.5-6.4), allergic rhinitis (PR 1.9; 95% C.I.: 1.2-3.1), prematurity (PR 3.4; 95% C.I. 1.8-6.5), parents with asthma (PR 2.6; 95% C.I. 1.4-5.0) and pet ownership (PR 0.4; 95% C.I. 0.2-0.9). Conclusions. The indoor exposure to biological contaminants (dust mites and fungi), history of prematurity, pneumonia, rhinitis and family history of asthma increased the occurence of symptoms suggestive of asthma in young children.     

Allergic bronchial asthma and rhinitis; the importance of studies for sensitivity to foods

The authors consider sensitivity to foods and sensitivity to inhalants about equal in importance in bronchial asthma, allergic rhinitis and allergic bronchitis. Food allergens are the sole cause of bronchial and nasal allergic disease in 20 to 40 per cent of cases throughout life, including old age; inhalants are the sole cause in approximately an equal number; and sensitivity to foods and to inhalants are often associated. THEIR FREQUENT RECOGNITION OF SENSITIVITY TO FOODS AS A CAUSE OF DISEASE, THE AUTHORS BELIEVE, DEPENDS ON: (1) The recognition of the fallibility of skin testing and the usual negative skin reactions to allergenic foods in chronic and recurrent bronchial asthma and allergic rhinitis. (2) The adequate use of trial diets, especially cereal-free elimination diet. (3) The realization that ingested foods remain in the body usually for two to four weeks and that the diet must be continued until symptoms have been relieved for two to three times as long as preceding relief between attacks.     

Smoking particles enhance endothelin A and endothelin B receptor-mediated contractions by enhancing translation in rat bronchi

Background

The prevalence of asthma and allergic diseases has increased in industrialised countries, and it is known that rates vary according whether the area is urban or rural and to socio-economic status. Surveys conducted in some urban settings in Latin America found high prevalence rates, only exceeded by the rates observed in industrialised English-speaking countries. It is likely that the marked changes in the environment, life style and living conditions in Latin America are responsible for these observations. The understanding of the epidemiological and immunological changes that underlie the increase in asthma and allergic diseases in Latin America aimed by SCAALA studies in Brazil and Ecuador will be crucial for the identification of novel preventive interventions.

Methods/Design

The Salvador-SCAALA project described here is a longitudinal study involving children aged 4–11 years living in the city of Salvador, Northeastern Brazil. Data on asthma and allergic diseases (rhinitis and eczema) and potential risk factors will be collected in successive surveys using standardised questionnaire. This will be completed with data on dust collection (to dust mite and endotoxin), skin test to most common allergens, stool examinations to helminth and parasites, blood samples (to infection, total and specific IgE, and immunological makers), formaldehyde, physical inspection to diagnoses of eczema, and anthropometric measures. Data on earlier exposures when these children were 0–3 years old are available from a different project.

Discussion

It is expected that knowledge generated may help identify public health interventions that may enable countries in LA to enjoy the benefits of a "modern" lifestyle while avoiding – or minimising – increases in morbidity caused by asthma and allergies.     

ALLERGIC BRONCHIAL ASTHMA AND RHINITIS—The Importance of Studies for Sensitivity to Foods

The authors consider sensitivity to foods and sensitivity to inhalants about equal in importance in bronchial asthma, allergic rhinitis and allergic bronchitis. Food allergens are the sole cause of bronchial and nasal allergic disease in 20 to 40 per cent of cases throughout life, including old age; inhalants are the sole cause in approximately an equal number; and sensitivity to foods and to inhalants are often associated.Their frequent recognition of sensitivity to foods as a cause of disease, the authors believe, depends on: (1) The recognition of the fallibility of skin testing and the usual negative skin reactions to allergenic foods in chronic and recurrent bronchial asthma and allergic rhinitis. (2) The adequate use of trial diets, especially cereal-free elimination diet. (3) The realization that ingested foods remain in the body usually for two to four weeks and that the diet must be continued until symptoms have been relieved for two to three times as long as preceding relief between attacks.