Immunological markers in allergic rhinitis patients treated with date palm immunotherapy.

OBJECTIVE: Allergic rhinitis (AR) is regulated by the local production and release of several cytokines. Allergen specific immunotherapy (IT) has been widely used for many years as a specific treatment of allergic diseases. This study aimed to investigate the changes in clinical and immunological markers before and after Phoenix dactylifera IT in AR patients. MATERIALS AND METHODS: Total symptom score and levels of total immunoglobulin E (IgE), albumin, interferon (IFN)-γ, tumor necrosis factor (TNF)-α, interleukin (IL)-10, IL-4, and IL-13 were measured in the serum and nasal samples of thirty non-atopic healthy controls and thirty patients with allergic rhinitis before and after 15 months of IT. RESULTS: We found significantly higher concentrations of serum TNF-α and nasal TNF-α and IL-13, and significantly lower concentration of nasal IL-10, in allergic patients than in non-allergic. Moreover, serum and nasal IL-10 increased significantly after IT. However, there was neither a significant reduction in total IgE nor a significant increase in IFN-γ at the end of IT. CONCLUSIONS: Our data show a clinical improvement associated with a decline in some inflammation parameters after IT. Moreover, date palm IT induced a significant increase in serum and nasal IL-10 levels.

Relation between asymmetric dimethylarginine (ADMA) and hearing loss in patients with renal impairment.

BACKGROUND: Hearing loss is common in patients with CRF. The exact etiology of this complication is not known, and little can be done to ameliorate the disorder. ADMA is found to be high in CRF patients. We studied the relation between ADMA and hearing loss in patients with CRF under conservative treatment. METHODS: The study was carried out on 40 patients with renal impairment under conservative treatment (group 1) and 30 normal control subjects (group 2). For both groups' medical history and examination, biochemical tests, otological examination, pure tone audiometry, high sensitivity CRP, and asymmetric dimethylarginine (ADMA) were completed. RESULTS: High-frequency hearing impairment was the predominant auditory dysfunction in CRF patients who showed worse high-tone hearing level on pure tone audiometry as compared with the controls (p < .001). Multiple regression analysis for hearing level at high frequency in group 1 shows that significant determinants of hearing level are ADMA (p = 0.002), high sensitivity CRP (p = 0.02), duration of renal disease (p = 0.01), diabetes mellitus (p < 0.001), and serum creatinine (p = 0.008). No correlation was found between hearing loss with age, gender, smoking, hematocrit, or lipid parameters. CONCLUSION: Patients with CRF under conservative treatment often experience a significant frequency hearing loss. Such a hearing disorder is mainly affected by duration and degree of renal disease, presence of DM, and level of hsCRP and ADMA. There is a close correlation between ADMA and hearing loss. Thus, ADMA could be an important factor causing hearing loss in those patients. Modifying this factor can be of value to ameliorate this common complication.