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Introducción. La rinitis alérgica (RA) es una de las enfermedades crónicas más frecuentes en la población pediátrica, afecta la calidad de vida del niño y la familia, tiene impacto económico y es frecuentemente subdiagnosticada y subtratada. Dada la escasez de datos locales, se describe su prevalencia y las características clínicas de la población en estudio. Población y métodos. Estudio observacional de corte transversal de pacientes menores de 19 años. Resultados. Se incluyeron 250 pacientes al azar, con una media de edad de 9 años (DE 5) Presentaron diagnóstico de RA 14 de ellos; se observó una prevalencia de RA del 6 %. Conclusiones. La prevalencia de RA en nuestro medio es del 6 %. Debemos darle la relevancia que amerita para brindar un diagnóstico y tratamiento adecuado.
Introduction. Allergic rhinitis (AR) is one of the most frequent chronic diseases in the pediatric population; it affects the quality of life of children and their families, has economic impact, and is frequently underdiagnosed and undertreated. Given the scarcity of local data, here we describe the prevalence of AR and the clinical characteristics of the study population. Population and methods. Observational, cross-sectional study in patients younger than 19 years. Results. A total of 250 patients were randomly included; their mean age was 9 years (SD: 5). AR was diagnosed in 14 of them. The prevalence of AR was 6%. Conclusions. The prevalence of AR in our setting was 6%. AR should be given the relevance it deserves so as to provide an adequate diagnosis and treatment.
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Humans , Male , Female , Child, Preschool , Child , Adolescent , Rhinitis, Allergic/diagnosis , Rhinitis, Allergic/epidemiology , Hospitals, General , Pediatrics , Prevalence , Cross-Sectional Studies , Hospital Departments/statistics & numerical dataРеферат
Introducción: La pandemia de COVID-19 ha sido la causa de morbilidad y mortalidad muy elevadas a escala mundial, que también ha afectado al personal de salud debido a la naturaleza propia de su trabajo, muchas veces en condiciones inseguras y con riesgo de contagio. Objetivo: Caracterizar a trabajadores de la salud afectados por la covid-19 según variables clínicas y sociodemográficas. Método: Se realizó un estudio observacional, descriptivo y transversal de 114 trabajadores de la salud con COVID-19, pertenecientes al Policlínico Docente José Martí Pérez de Santiago de Cuba, en el 2021. Para recoger la información se revisó la base de datos del Departamento de Higiene y Epidemiología y se elaboraron encuestas. Resultados: Se encontró un predominio del sexo femenino (78,0 %), en las edades de 30 a 59 años (83,3 %). Los antecedentes personales de hipertensión arterial estuvieron presentes en 46,5 % de los afectados. La pérdida del olfato resultó ser el síntoma más frecuente (53,5 %). La neumonía (14,9 %) y la fatiga (37,7 %) fueron la complicación y la secuela que prevalecieron. Los médicos representaron 50,0 % en el perfil ocupacional y el área de contagio más frecuente fue el policlínico (36,8 %). Conclusiones: Las características clínicas y sociodemográficas encontradas en los trabajadores de la salud con COVID-19 mostraron que este personal es vulnerable, por lo que se debe cumplir estrictamente con las medidas de bioseguridad.
Introduction: The pandemic of COVID-19 has been the very high morbidity and mortality cause worldwide that has also affected the health personnel due to the nature characteristic of its work, many times under insecure conditions and with infection risk. Objective: To characterize health workers affected by covid-19 according to clinical and sociodemographic variables. Method: An observational, descriptive and cross-sectional study of 114 health workers with COVID-19 belonging to José Martí Pérez Teaching Polyclinic was carried out in Santiago de Cuba, in 2021. To pick up the information the database of the Hygiene and Epidemiology Department was revised and surveys were elaborated. Results: There was a prevalence of the female sex (78.0 %), aged 30 to 59 (83.3 %). The personal history of hypertension was present in 46.5% of those affected. The loss of smell was the most frequent symptom (53.5 %). Pneumonia (14.9 %) and fatigue (37.7%) were the complication and sequel that prevailed. Doctors represented 50.0% in the occupational profile and the most frequent infection area was the polyclinic (36.8 %). Conclusions: The clinical and sociodemographic characteristics found in health workers with COVID-19 showed that this personnel is vulnerable, reason why biosafety measures should be strictly followed.
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Allergen specific immunotherapy (AIT) is to identify the patient's allergen, give the patient repeated exposure to the allergen extract, and gradually increase the concentration and dose until the target maintenance dose is reached, so that the patient can develop tolerance to the allergen, which is the only treatment that can regulate the pathogenesis of allergic diseases and change its natural course. In recent years, domestic and foreign scholars have made great progress in the clinical practice and research field of AIT. This article reviewed the relevant progress of the mechanism, efficacy and drug administration of AIT.
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Abstract Introduction Despite the high level of patient satisfaction with functional endoscopic sinus surgery (FESS) and the clinical improvement, polyp recurrence is observed in 23% to 87% of patients and requires reoperation. Objective To assess the prognostic value of polypoid changes of the middle turbinate (PCMT) in relapse of paranasal sinus polyps in patients with chronic rhinosinusitis with nasal polyp (CRSwNP) after FESS and the effect of partial middle turbinectomy (PMT) on the outcome of surgery. Methods We conducted a prospective clinical study on 60 patients with CRSwNP with and without PCMT. The patients were allocated into three groups: group I included twenty patients without PCMT; group II, twenty patients with PCMT; and group III included twenty patients with PCMT submitted to PMT. The patients were evaluated endoscopically according to the Lund-Kennedy endoscopic scoring system, radiologically according to the Lund-Mackay scoring system, and symptomatically through the 22-item Sinonasal Outcome Test (SNOT-22). Results The total postoperative Lund-Kennedy score differed significantly among the 3 groups (p < 0.001), with a group II presenting a significantly higher total score compared to groups I and III. The Preoperative SNOT-22 score differed significantly among the three groups (p = 0.013), with group II presenting a significantly higher score compared to group I. There was a significant association involving the 3 groups and relapse at 12 months (p = 0.029); relapse was higher in group II (50.0%) than in groups I (20%) and III (15.0%). Conclusion There was a significant association between PCMT and the relapse of nasal polyps. Also, nasal polyposis recurred at a lower rate in the group submitted to middle turbinate resection compared to the group in whom it was preserved.
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Abstract Objectives Montelukast is a well-known leukotriene receptor antagonist commonly used in treating allergic rhinitis and asthma. Omega-3 fatty acid is also known as an antiallergic and immunomodulator molecule. This study aimed to elucidate the efficacy of systemic montelukast and omega-3 fatty acid treatment in allergic rhinitis models in Wistar Hannover rats. Methods This research was conducted on 28 healthy Wistar Hannover rats weighing 250-350 g. After establishing the allergic rhinitis model, nasal symptoms were observed and scored, and the nasal mucosa of all rats was investigated histologically. Light microscopy was utilized to evaluate the degree of ciliary loss, goblet cell hyperplasia, vascular congestion, vascular proliferation, inflammatory cell infiltration, eosinophil infiltration, and hypertrophy in chondrocytes. Results As a result of the analysis of the data obtained from the study, it was determined that typical allergic rhinitis symptoms such as nasal scratching and sneezing were significantly reduced in the rats in the montelukast and omega-3 treated group, and these symptoms did not increase after repeated intranasal OVA-protease applications. Histological examinations after fish oil treatment did not reveal typical inflammatory changes in allergic rhinitis. None of the rats in the montelukast and omega-3 groups had any increase in goblet cells, whereas 14.3% of the rats in the control group and 28.6% of the rats in the allergic rhinitis group had mild increase. Last but not least, 71.4% of rats in the allergic rhinitis group had a moderate increase. The difference between the groups was statistically significant (p< 0.001). Conclusion Regarding the outcomes of this research, it was observed that w-3 fatty acids had antiallergic effects, both histopathological and clinical, in the allergic rhinitis model. We believe that further randomized controlled trials incorporating larger cohorts are warranted to verify the use of omega-3 fatty acids in treating allergic rhinitis. The level of evidence of this article is Level 2.
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@#Objective To analyze the distribution of common allergens in children with allergic rhinitis(AR)in Hangzhou,and to provide reference for its prevention and treatment.Methods From January 2020 to December 2022,13 521 children who were diagnosed with AR and underwent in vitro serum specific immunoglobulin E(sIgE)detection in Affiliated Hangzhou First People's Hospital,School of Medicine,Westlake University were selected as the research objects.The positive rates of allergens in children with AR of different genders,ages and seasons were compared.Results Among 13 521 children,the positive rate of sIgE was 54.49%(7367/13 521),of which 64.82%were allergic to only one allergen.Among the 19 common allergens,the top three overall positive rates were household dust mite(44.27%),milk(14.62%),and mixed grass(4.82%).The positive rates of allergens of house dust mites,cat hair dander,mulberry,mold combination,tree pollen combination,amaranth,cockroach,milk,shrimp,crab,pineapple,shellfish and mango in male children were significantly higher than those in female children(P<0.05).The positive rates of allergens of house dust mite,mixed grass,cat hair dander,mulberry,mold combination,egg white,shrimp,crab,pineapple,cashew nuts and shellfish in different age groups were statistically significant(P<0.05).July and August were the two months with the highest allergen positive rate.The allergen positive rates of house dust mite,dog and cat hair dander were the highest in summer,and the allergen positive rate of plants was consistent with the flowering season.The sIgE concentration of house dust mite(77.87%)was mainly grade 3 and above.The sIgE concentration of other allergens was mainly grade 1 and 2.Conclusion Dust mites and milk are the most common allergens in children with AR in Hangzhou,and the distribution of allergens varies with gender,age and season.Allergen detection can provide a more accurate plan for the diagnosis,prevention and treatment of AR.
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Allergen immunotherapy（AIT）is currently the etiological treatment for respiratory allergic diseases，which can change the natural course of the disease.However，due to the complexity of patients' autoimmune status，allergy triggers and their complicated relationship with AIT vaccines，there are still about 40% of allergic rhinitis and 10%-20% of asthma patients who respond nonoptimally or even don't show any response to AIT. Thus，searching biomarkers that can evaluate and predict the efficacy of AIT and optimize the AIT strategy has been a major focus and challenge in allergy field.Currently，several serologic biomarkers have been found to be associated with AIT efficacy in vitro，but their value as predictive biomarkers of AIT efficacy needs to be further verified. This article reviews the research progress of serologic candidate biomarkers for AIT efficacy.
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Objective To investigate the levels of serum CXC-chemokine ligand 16(CXCL16)and anti-neu-trophil cytoplasmic antibody(ANCA)in patients with allergic rhinitis and their clinical diagnostic value.Meth-ods A total of 84 patients with allergic rhinitis(allergic rhinitis group)treated in the hospital from January to December 2022 were selected as the study objects,and were divided into mild group(44 cases)and moderate and severe group(40 cases)according to the severity of their disease.Another 80 healthy subjects who had physical examination in the same period were selected as the control group.The levels of CXCL16 and ANCA in serum were determined by enzyme-linked immunosorbent assay.The correlation between serum CXCL16 and ANCA levels and inflammatory factors[interleukin(IL)-4,IL-9,IL-13]and immunoglobulin E(IgE)was analyzed by Pearson.The value of serum CXCL16 and ANCA levels in the diagnosis of moderate and severe allergic rhinitis was evaluated by receiver operating characteristic(ROC)curve.Results Compared with con-trol group,the levels of IL-4,IL-9,IL-13 and IgE in allergic rhinitis group were significantly increased,and the difference was statistically significant(P＜0.05).Compared with control group,serum CXCL16 and ANCA levels in allergic rhinitis group were significantly increased,and the differences were statistically significant(P＜0.05).The area under the curve(AUC)of serum CXCL16 and ANCA in patients with allergic rhinitis was 0.897 and 0.844,respectively.The AUC of combined diagnosis was 0.959,both of which were better than that of individual diagnosis(Z=2.164,3.474,P＜0.05),and the specificity was 93.75％.The sensitivity was 89.29％.The levels of serum CXCL16 and ANCA in patients with allergic rhinitis increased with the se-verity of the disease(P＜0.05).Pearson correlation analysis showed that serum CXCL16 and ANCA levels were positively correlated with IL-4,IL-9,IL-13 and IgE in patients with allergic rhinitis(P＜0.05).ROC curve analysis results showed that the AUC of the patients diagnosed with moderate and severe allergic rhini-tis by serum CXCL16 and ANCA was 0.862 and 0.832,respectively,and the AUC of the combined diagnosis of CXCL16 and ANCA was 0.949,both of which were better than those diagnosed separately(Z=1.981,2.378,P＜0.05),and the specificity was 90.91％.The sensitivity was 90.00％.Conclusion The levels of se-rum CXCL16 and ANCA in patients with allergic rhinitis increased significantly,and increased with the severi-ty of the patients'disease,both of which have certain value in the clinical diagnosis of allergic rhinitis.
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Objective To observe the clinical efficacy of acupuncture at Neiyingxiang(EX-HN09)points combined with western medicine in the treatment of allergic rhinitis of deficiency-cold of lung qi type.Methods Sixty patients with deficiency-cold of lung qi type of allergic rhinitis were randomly divided into observation group and control group,with 30 patients in each group.The control group was treated with Desloratadine Tablets combined with Mometasone Furoate Aqueous Nasal Spray,and the observation group was treated with acupuncture at Neiyingxiang points combined with the self-made rhinitis recipe on the basis of the control group,and the clinical efficacy of the two groups was evaluated after 14 days.The changes of nasal symptom scores,Visual Analogue Scale(VAS)and rhinoconjunctivitis quality of life scores of the patients of the two groups were observed before and after the treatment.After 14 days of treatment,the clinical efficacy of the two groups was evaluated.The changes in nasal symptom scores,as well as VAS and rhinoconjunctivitis quality of life questionnaire(RQLQ)scores were observed before and after treatment.The changes in traditional Chinese medicine(TCM)sydnrome scores and serum immunoglobulin E(IgE)were compared before and after treatment in the two groups,and the safety of the two groups was evaluated.Results(1)The total effective rate of the observation group was 93.33%(28/30),and the control group was 73.33%(22/30).The efficacy of the observation group was superior to that of the control group,and the difference was statistically significant(P＜0.05).(2)After treatment,the symptoms of nasal congestion,sneezing,runny nose and nasal itching were significantly improved in the two groups(P＜0.01),and the observation group was significantly superior to the control group in improving nasal symptoms,and the differences were statistically significant(P＜0.05).(3)After treatment,the VAS scores of patients in the two groups were significantly improved(P＜0.01),and the observation group was superior to the control group in improving VAS scores,with statistically significant differences(P＜0.05).(4)After treatment,the PQLQ scores of patients in the two groups improved significantly(P＜0.01),and the observation group was significantly superior to the control group in improving the PQLQ scores,and the difference was statistically significant(P＜0.05).(5)After treatment,the TCM syndrome scores of the patients in the two groups were significantly improved(P＜0.01),and the observation group was significantly superior to the control group in improving TCM syndrome scores,with statistically significant differences(P＜0.05).(6)After treatment,the serum IgE levels of patients in the two groups were significantly improved(P＜0.01),and the observation group was significantly superior to the control group in improving serum IgE levels(P＜0.05),with a statistically significant difference.(7)There was no significant difference in the incidence of adverse reactions between the observation group and the control group(P＞0.05).Conclusion Acupuncture at Neiyingxiang points plus self-made rhinitis recipe combined with western medicine in the treatment of deficiency-cold of lung qi type of allergic rhinitis can significantly improve the clinical symptoms of the patients,thus improving the quality of life of the patients,and the therapeutic efficacy is remarkable.
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Objective To investigate the distribution characteristics of inhalant and ingestive allergens in patients with allergic rhinitis(AR)in Lishui area,and then provide evidences for the clinical diagnosis,treatment and prevention of AR.Methods The detection data of serum sIgE antibodies to allergens from 1 610 patients with suspected AR visited the Department of Otolaryngology of Lishui Central Hospital during January 2020 and December 2022 were collected,and the distribution characteristics of various allergen spectra in AR patients were further analyzed.Results A total of 1 020 patients were diagnosed with AR and the positive rate of serum sIgE an-tibodies to allergens was 63.35%.The positive rate(66.59%)in male AR patients was significantly higher than that in females(59.48%,P＜0.01).The main allergen among AR patients in Lishui area was house dust mite.The top five inhalant allergens were house dust mite(77.94%),mixed mold(10.20%),cat dander(9.22%),tree pollen(5.88%),and dog dander(3.43%).The top five ingestive allergens were milk(23.33%),crab(7.75%),cashew nut(6.67%),shrimp(4.41%),and egg protein(3.33%).The positive rates of serum sIgE antibodies to milk,crab,and shrimp in males were significantly higher than that in females(P＜0.05).There were significant differences in the positive rates of serum sIgE antibodies to house dust mite,mulberry tree,cockroach,tree pol-len,and grass pollen among different age groups(P＜0.05).The positive rates of serum sIgE antibodies to egg protein,milk,crab,and amaranth were significantly different(P＜0.05).There were seasonal differences in the positive rates of serum sIgE antibodies to house dust mite,mulberry,mixed mold,tree pollen,and grass pollen(P＜0.05).Conclusion The allergens of AR patients in Lishui area are diverse and complex,and are affected by factors such as gender,age and season.
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Allergic rhinitis(AR)is a type Ⅰ allergic reaction,which mediated by immunoglobulin E immediately when an individual with a special constitution is exposed to a same allergen for second time,whose pathogenesis has not been clarified yet,and closely related to genes,immune cells and cytokines.Pathogenesis of AR become more deeper and more accurate due to rapid develop-ment of molecular biology and second-generation gene sequencing technology.Current studies have found that miR-155 and transcrip-tion factor GATA3 have important regulatory effects on occurrence and development of AR,then affect dominant differentiation of CD4+T lymphocytes and proliferation of ILC2.This article discusses and reviews pathogenesis of AR,which mainly focuses on miR-155/GATA3 pathway and effects of related upstream genes and downstream regulatory substances.
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Objective:To investigate the expression of IL-18, IL-18-binding protein a(IL-18BPa) and IL-18 receptor α(IL-18Rα) by peripheral blood CD4 + Th17 cells of patients with allergic rhinitis (AR) and the effects of allergens on their expression. Methods:This study enrolled 45 outpatients with AR and 23 healthy control subjects receiving physical examination in the First Affiliated Hospital of Jinzhou Medical University from October 2019 to September 2020. According to the results of skin prick test, the 45 patients were divided into two groups: AR group with positive results (24 cases) and nAR group with negative results (21 cases). Blood samples of them were collected. Flow cytometry was used to analyze the effects of allergens on the expression of IL-18, IL-18BPa and IL-18Rα at protein level by peripheral blood CD4 + Th17 cells. The level of IL-17A in plasma was measured by Bioplex system, and its correlation with the percentage of IL-18 + Th17 cells was analyzed. Results:Compared with the healthy control group, the AR group showed increased ratios of CD4 + Th17 and IL-18 + Th17 cells ( P<0.01), decreased ratio of IL-18BPa + Th17 cells ( P<0.01), enhanced mean fluorescence intensity (MFI) of IL-18BPa ( P<0.01) and reduced MFI of IL-18Rα ( P<0.01); the nAR group showed enhanced MFI of IL-18BPa ( P<0.000 1) and reduced MFI of IL-18Rα ( P<0.000 1). The ratio of IL-18 + Th17 cells and the MFI of IL-18Rα in the AR group were higher than those in the nAR group ( P<0.05, P<0.01). House dust mite extract and Platanus pollen extract induced the expression of IL-18 and IL-18BPa by CD4 + Th17 cells of AR patients ( P<0.05). Moreover, house dust mite extract directly induced the CD4 + Th17 cells isolated from the healthy control subjects to express IL-18 and IL-18R ( P<0.05). Compared with healthy control subjects, AR patients had higher level of IL-17A in plasma and it was moderately correlated with the ratio of IL-18 + Th17 cells ( P<0.05). Conclusions:Allergens may be involved in the pathogenesis of AR by inducing blood CD4 + Th17 cells to express IL-18 and IL-18Rα.
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ObjectiveTo explore the possible mechanism of Bimin Formula （鼻敏方） in treating lung-spleen qi deficiency syndrome of allergic rhinitis （AR） with high mucin secretion. MethodsThirty-four SD rats were randomly divided into a blank group （8 rats）， a model group （8 rats）， a low-dose Bimin Formula group （8 rats）， and a high-dose Bimin Formula group （10 rats）. Except for the blank group， the other groups were subjected to AR lung-spleen qi deficiency rat models induced by smoking， gavage of Ginkgo biloba leaf extract， and ovalbumin. After modeling， rats in the low- and high-dose Bimin Formula groups were given Bimin Formula concentrate （concentration of 2.16 g/ml） by gavage at doses of 1.08 g/100 g and 2.16 g/100 g， respectively， while rats in the model group were given 0.5 ml/100 g of normal saline by gavage， once daily for 28 days； the blank group was not intervened. Behavioral assessments were performed after intervention. ELISA was used to detect the levels of peripheral blood total immunoglobulin E （IgE）. HE staining was used to observe the pathological changes of nasal mucosa epithelium in rats， while immunohistochemistry was used to detect the expression of transmembrane protein 16A （TMEM16A） and mucin 5AC （MUC5AC） protein in nasal mucosa. Western Blot was used to detect the expression of nuclear factor kappa B （NF-κB） protein， and RT-PCR was used to detect the expression of TMEM16A， MUC5AC， and NF-κB mRNA in nasal mucosa. ResultsHE staining showed that the nasal mucosa epithelial cell structure in the blank group was intact without shedding， swelling， or necrosis； the nasal mucosa epithelial tissue of rats in the model group was thickened and partially shed， with infiltration of eosinophils and lymphocytes visible； the pathological changes in nasal mucosa tissue of rats in the high- and low-dose Bimin Formulagroups were improved， and more improvement was showen in the high-dose group. Compared with those in the blank group， the behavioral scores and peripheral blood total IgE levels of rats in the model group significantly increased， as well as the expression of TMEM16A， MUC5AC， and NF-κB proteins and mRNA in nasal mucosa （P＜0.05 or P＜0.01）. Compared with those in the model group， the behavioral scores and peripheral blood total IgE levels of rats in the high-dose Bimin Formula group decreased， and the expression of TMEM16A， MUC5AC， and NF-κB proteins and mRNA in nasal mucosaalso decreased （P＜0.05 or P＜0.01）； the behavioral scores and peripheral blood total IgE levels of rats in the low-dose Bimin Formula group were reduced， and the expression of TMEM16A and MUC5AC proteins and mRNA in nasal mucosa， as well as the expression of NF-κB protein decreased （P＜0.05 or P＜0.01）， but the difference in NF-κB mRNA expression was not statistically significant （P＞0.05）. Compared with the low-dose Bimin Formula group， the expression of NF-κB protein in the high-dose group decreased （P＜0.01）. ConclusionBimin Formula may improve the symptoms and high mucus secretion of AR lung-spleen qi deficiency by regulating the TMEM16A/NF-κB/MUC5AC signaling pathway in nasalmucosa.
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ObjectiveTo explore the feasibility and rationality of applying relevant diagnostic and treatment programmes from textbooks as evidence in traditional Chinese medicine （TCM） diagnosis and treatment guidelines， using allergic rhinitis as an example. MethodsTextbooks published from October 1949 to December 2022， as well as TCM diagnosis and treatment guidelines published until December 2022 on allergic rhinitis were searched， and the contents of diagnosis and treatment related to allergic rhinitis were extracted. The similarities and differences between textbooks in different periods， between textbooks in different versions， and between textbooks and guidelines were compared and analyzed. ResultsA total of 12 national planning textbooks on TCM otolaryngology and 4 Chinese medicine diagnosis and treatment guidelines on allergic rhinitis from 1975 to 2021 were included. The evolution of diagnostic and treatment programmes was shown by the textbooks in different periods. Since 2003， syndrome of latent heat in lung channel has been added in the published textbook， and TCM featured therapies， such as nasal packing， intranasal spray were enriched， as well as the contents related to prevention and prognosis. The main syndromes included lung qi deficiency and cold， spleen qi deficiency， kidney yang deficiency， and latent heat in lung meridian. The most common recommended prescriptions were Wenfei Zhiliu Pill （温肺止流丹）， Yupingfeng Powder （玉屏风散） and Cangerzi Powder （苍耳子散）； Buzhong Yiqi Decoction （补中益气汤）， Shenling Baizhu Powder （参苓白术散）； Shenqi Pill （肾气丸） or Zhenwu Decoction （真武汤）； Xinyi Qingfei Decoction （辛夷清肺饮）. A comparison of different versions of textbooks showed that the classification of syndromes was consistent， while the formulas were slightly different. The comparison between different versions of the current textbooks and the guidelines showed that the recommended prescriptions of the textbooks had more Cangerzi Powder， Xiaoqinglong Decoction （小青龙汤）， Zhenwu Decoction， etc.， while TCM featured therapies such as nose blowing， smelling， nasal plugging， nasal washing were enriched， and information on formula modification， prevention and adjustment， prognosis were also added， which can supplement the corresponding evidence for the guidelines. ConclusionTextbooks could serve as a strong supplement for the evidence-based development of TCM clinical guidelines. However， there is still a need for further research on the quality assessment system of textbook evidence to improve the credibility of its applicability of the guidelines evidence.
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【Objective】 To investigate the expression of Toll-like receptor 9 (TLR9) in B cells in the peripheral blood of patients with allergic rhinitis (AR), allergic asthma (AA), AR combined with AA (ARA) and the blood or lung tissue of sensitized mice, as well as the effect of allergens on its expression. 【Methods】 A total of 100 volunteers from The First Affiliated Hospital of Jinzhou Medical University were recruited for outpatient and acute inpatient attacks, consisting of 19 healthy people (HC) with negative prick test result, 40 AR patients, 26 AA patients, and 15 ARA patients with positive prick test result. The expression of TLR9 in the peripheral blood B cells of the patients before and after stimulation by house dust mite allergen extract (HDME), Artemisia sieversiana wild allergen extract (ASWE), and Platanus pollen allergen extract (PPE) was detected by flow cytometry. AR and AA sensitization models were established in WT mice and FcεRI-KO mice to detect the effects of allergens and FcεRI on the expression of TLR9 in B cells. 【Results】 The expression and mean fluorescence intensity (MFI) of TLR9 in peripheral blood B cells of unstimulated AR, AA and ARA patients were higher than those of HC. After allergen stimulation, the expression of TLR9 and its MFI in blood B cells of AR and AA patients increased (P<0.05). In WT mice and FcεRI-KO mice, compared with NS control mice, MFI was increased in almost each group. Compared with the NS control group, there was no significant difference in the expression of TLR9+ in B cells in the lung tissues of AA mice with FcεRI-KO after allergen challenge, but their MFI increased. FcεRI-KO mice had lower TLR9+ MFI in B cells after allergen challenge compared with WT mice. 【Conclusion】 TLR9 in B cells may be involved in the occurrence of AR and AA, and detecting the expression of TLR9 in B cells may be a new direction for the diagnosis of AR and AA.
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Introducción: Las enfermedades alérgicas son muy comunes en la población pediátrica. Entre las causas frecuentes se encuentran los aeroalérgenos del ambiente, y la identificación de estos es de gran ayuda tanto para el diagnóstico como para el tratamiento. Objetivos: Determinar la frecuencia de aeroalérgenos, por medio de la determinación de Inmunoglobulina E (IgE) específica a alérgenos comunes por la prueba de sensibilidad cutánea en pacientes pediátricos con síntomas de asma y rinitis alérgica. Materiales y Métodos: Diseño observacional, descriptivo, prospectivo, transversal, población de pacientes de 4 a 17 años con síntomas compatibles con asma y rinitis alérgica que acudieron a un centro asistencial pediátrico en el periodo de estudio. Se realizó por medio de las Pruebas de punción cutánea (PCP). Resultados: La edad media de los pacientes fue de 8 años, 57% pacientes de sexo masculino y 43% de sexo femenino. El 53% de los pacientes presenta rinitis y asma, 45% solo rinitis y el 2% solo asma. El 79% de los pacientes presentó reacción positiva de sensibilización alérgica por medio de la PCP. Teniendo en cuenta la sensibilización por tipo de aeroalérgenos se tuvo que el 64% de los pacientes tuvo reacción positiva a ácaros, 19% a animales 18% a cucarachas, 8% a pólenes y 6% a hongos. Conclusión: La gran mayoría de pacientes con asma padecía rinitis alérgica concomitante y los ácaros del polvo fueron los aeroalérgenos más frecuentemente determinados en las pruebas cutáneas de alergia en niños con asma y rinitis de nuestra población.
Introduction: Allergic diseases are very common in the pediatric population. Among the frequent causes are aeroallergens from the environment and the identification of these is a great help for diagnosis and treatment. Objectives: To determine the frequency of aeroallergens, through the determination of Immunoglobulin E (IgE) specific to common allergens by the skin sensitivity test in pediatric patients with symptoms of asthma and allergic rhinitis. Materials and Methods: Observational, descriptive, prospective, cross-sectional design, population of patients from 4 to 17 years old with symptoms compatible with asthma and allergic rhinitis who attended a pediatric care center during the study period. It was carried out by means of Skin Puncture Tests (PCP). Results: The mean age of the patients was 8 years, 57% male patients and 43% female. 53% of the patients presented Rhinitis and Asthma, 45% only Rhinitis and 2% only Asthma. 79% of the patients presented a positive allergic sensitization reaction through PCP. Taking into account the sensitization by type of aeroallergens, 64% of the patients had a positive reaction to mites, 19 % to animals 18% to cockroaches, 8% to pollens and 6% to fungi. Conclusion: The vast majority of patients with asthma suffered from concomitant allergic rhinitis and dust mites were the most frequently determined aeroallergens in allergic skin tests in children with asthma and rhinitis in our population.
Тема - темы
ChildРеферат
Abstract Objectives: Observational studies suggested that obesity may promote the development of allergic rhinitis. The aim of this study was to explore the association of obesity, lipids and adipokines with this allergic disease at the genetic level using Mendelian randomization strategies. Methods: Summary data for three obesity indicators (such as body mass index), eight lipid indicators (such as triglycerides) and six adipokines (such as interleukin-6 and adipocyte fatty acid-binding protein) were collected, and suitable instrumental variables were extracted from these summary data according to the three main assumptions of Mendelian randomization. Three Mendelian randomization methods (such as inverse variance weighted) were used to detect the casual effect of the above indicators on allergic rhinitis risk. Sensitivity analyses were performed to assess heterogeneity and horizontal pleiotropy. Results: After Bonferroni correction, the inverse variance weighted reported that elevated levels of interleukin-6 and adipocyte fatty acid-binding protein were nominally associated with the decreased risk of allergic rhinitis (OR = 0.870, 95% CI 0.765-0.990, p = 0.035; OR = 0.732, 95% CI 0.551-0.973, p = 0.032). The other Mendelian randomization methods supported these results. Obesity, lipids and other adipokines were not related to this allergic disease. Sensitivity analyses found no heterogeneity and horizontal pleiotropy in the study. Conclusion: The study provided some interesting, but not sufficient, evidence to suggest that interleukin-6 and adipocyte fatty acid-binding protein might play a protective role in the development of allergic rhinitis at the genetic level. These findings should be validated by more research. Level of evidence: This was a Mendelian randomized study with a level of evidence second only to clinical randomized trials, and higher than cohort and case-control studies.
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Introdução e objetivo: Devido à pandemia do novo coronavírus, as crianças passaram a ficar mais tempo em casa, e essa mudança implicou diretamente nas manifestações de diversas doenças, inclusive da rinite. A rinite é a inflamação da mucosa causada, principalmente, por alérgenos, ocasionando sintomas como rinorreia, espirros, obstrução nasal, hiperemia conjuntival, prurido nasal e ocular. O objetivo deste estudo é avaliar as consequências do isolamento social nas crianças com rinite, a fim de compreender a modificação da doença nesse período. Métodos: O estudo é observacional transversal, com dados obtidos através de um questionário eletrônico, para pais e/ou responsáveis de crianças entre 5 e 12 anos. Resultados: No total de 116 respostas, 51,7% das crianças eram do sexo masculino, e a mediana de idade foi de 8,5 anos. Em relação à rinite, em 81% dos casos foi relatado melhora ou manutenção do quadro durante o período de isolamento social. Em um quarto da amostra houve piora na qualidade de vida dos pacientes. Os sintomas com maior piora foram espirros e prurido nasal, e o sintoma com maior melhora foi a rinorreia. Os desencadeantes de sintomas mais frequentes foram animais domésticos, tapetes e perfumes. O uso de medicamentos foi relatado em 59,4% dos casos, sendo que em 32,7% não houve prescrição médica. Conclusão: Os resultados encontrados evidenciaram que o isolamento social teve um impacto positivo em relação às manifestações clínicas da rinite na população estudada.
Introduction and objective: The COVID-19 pandemic required children to spend more time at home, and this change had a direct impact on the manifestations of various diseases, including rhinitis. Rhinitis is inflammation of the nasal mucosa caused mainly by exposure to allergens, resulting in symptoms such as rhinorrhea, sneezing, nasal obstruction, conjunctival hyperemia, and itchy eyes and nose. This study aimed to evaluate the consequences of social distancing in children with rhinitis in order to understand the changes in the disease pattern during the pandemic. Methods: We conducted a cross-sectional observational study with data obtained through an electronic questionnaire answered by parents and/or guardians of children aged 5 to 12 years. Results: From a total of 116 responses, 51.7% of children were male with a median age of 8.5 years. In 81% of cases, rhinitis symptoms improved or remained unchanged during the period of social distancing. In a quarter of the sample, there was a worsening of patients' quality of life. The symptoms with the greatest worsening were sneezing and nasal itching, and the symptom with the greatest improvement was rhinorrhea. The most frequent symptom triggers were pets, carpets, and perfumes. Medication use was reported in 59.4% of cases, with the use of over-the-counter medications in 32.7% of them. Conclusion: The results showed that social distancing had a positive impact on the clinical manifestations of rhinitis in the study population.
Тема - темы
Humans , Male , Female , Child, Preschool , ChildРеферат
Introduction: Monitoring changes in the levels of immune markers is of great significance in evaluating the effectiveness of treatment in patients with allergic rhinitis. Objectives: Determine the change in the concentration of immune markers after treatment in patients with allergic rhinitis caused by cotton dust. Methods: A descriptive, single-group, comparative before and after intervention study on 52 patients with allergic rhinitis caused by cotton dust. Comparison of immunological markers results before and after 36 months of treatment. Results: Total IgE concentration after treatment decreased, the median decreased from 1227.756 U/mL to 676.805 UI/mL. Serum levels of IgG, IgG4, and IgG1 in patients after treatment increased compared to before (p< 0.001). The cytokines also changed in the direction of no longer responding toward allergy. Median IL-17 decreased from 1.752 mg/dL to 0.417 mg/dL. Conclusion: In patients with allergic rhinitis after specific sublingual desensitization treatment, IgE levels and cytokines such as IL-6 and IL-17 are significantly reduced and IgG, IgG4 and IgG1 levels are increased after treatment.
Introducción: El monitoreo de los cambios en los niveles de marcadores inmunes es de gran importancia para evaluar la efectividad del tratamiento en pacientes con rinitis alérgica. Objetivos: Determinar el cambio en la concentración de marcadores inmunes después del tratamiento, en pacientes con rinitis alérgica causada por polvo de algodón. Métodos: Estudio descriptivo, monogrupo, comparativo antes y después de la intervención, en 52 pacientes con rinitis alérgica por polvo de algodón. Se compararon resultados de marcadores inmunológicos antes y después de 36 meses de tratamiento. Resultados: La concentración de IgE total después del tratamiento disminuyó, la mediana disminuyó de 1227,756 U/mL a 676,805 UI/mL. Los niveles séricos de IgG, IgG4 e IgG1 en pacientes, después del tratamiento, aumentaron (p< 0,001). Las citocinas también cambiaron en dirección a ausencia de respuesta a la alergia. La mediana de IL-17 disminuyó de 1,752 mg/dL a 0,417 mg/dL. Conclusión: En pacientes con rinitis alérgica, después del tratamiento específico de desensibilización sublingual, los niveles de IgE y citocinas como IL-6 e IL-17 se reducen significativamente y los niveles de IgG, IgG4 e IgG1 aumentan.
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Introdução: A rinite alérgica (RA) é uma doença com sintomas nasais, como rinorreia, espirros e congestão nasal, causada pela inflamação da mucosa após a exposição do indivíduo a um agente alérgeno. A sintomatologia da doença causa consequências na qualidade de vida do paciente, que frequentemente possui problemas de sono, irritabilidade e fadiga. Estudantes podem ter seu desempenho acadêmico afetado de modo negativo pela doença. Objetivo: Tendo em vista a problemática que a doença causa na performance de estudantes, esse estudo pretende analisar a prevalência da RA nos discentes da Universidade do Vale do Itajaí (UNIVALI), com a finalidade de identificar o grau de comprometimento na qualidade de vida dos estudantes com a doença e relacionar com o seu grau de controle dos sintomas da rinite alérgica. Métodos: Trata-se de um estudo descritivo observacional, a partir de dados coletados de estudantes de Medicina, através de questionários específicos para avaliação do controle dos sintomas e impacto na qualidade de vida, sendo eles: o Rhinitis Control Assessment Test e o Sino-Nasal Outcome Test. Resultados: 88 estudantes de Medicina foram avaliados neste estudo, a prevalência da RA foi de 69%. A maioria dos estudantes possui a doença controlada, o que caracteriza menor impacto da doença na qualidade de vida desses pacientes. Entre eles, os sintomas de maior impacto são: espirros, obstrução nasal e lacrimejamento ocular. Houve correlação estatística entre o controle dos sintomas e o impacto dos mesmos na qualidade de vida, avaliado pelos questionários RCAT e SNOT-22 (r = -0,4277; p < 0,001). Conclusão: O conhecimento disseminado entre estudantes de Medicina sobre rinite alérgica, diferentemente do resto da população, permite que os mesmos tenham maior conscientização, aderência aos tratamentos e percepção do quadro. Por isso, a educação da população se faz essencial e útil para controle dos sintomas e garantia da qualidade de vida coletiva.
Introduction: Allergic rhinitis is a disease involving nasal symptoms, such as rhinorrhea, sneezing and nasal congestion, which are caused by mucosal inflammation due to allergen exposure. The symptoms, which affect patient quality of life, frequently include sleep problems, irritability, and fatigue. The disease can have a negative impact on academic performance in affected students. Objective: In view of the disease's effects on academic performance, this study determined the prevalence of allergic rhinitis among medical students at the Universidade do Vale do Itajaí (Santa Catarina, Brazil), identifying the degree to which it impairs quality of life and relating this to symptom control. Methods: This descriptive observational study was based on data collected from medical students through 2 specific questionnaires to assess symptom control and quality of life: the Rhinitis Control Assessment Test (RCAT) and Sino-Nasal Outcome Test (SNOT- 22). Results: Among the 88 medical students evaluated in this study, the prevalence of allergic rhinitis was 69%. The disease controlled in most affected students, indicating a lower impact on quality of life. The most prominent symptoms were sneezing, nasal obstruction, and tearing. According to the RCAT and SNOT-22 results, symptom control was significantly correlated with quality of life (r = -0.4277; p < 0.001). Conclusion: Unlike the rest of the population, the students' knowledge of allergic rhinitis led to greater awareness of the condition and better treatment adherence. Therefore, educating the population is essential for symptom control and guaranteeing collective quality of life.