Associations between urine iodine and allergic diseases in the Korean National Health and Nutrition Examination Survey 2013-2015: A STROBE-compliant article.

BACKGROUND: The associations between excessive iodine intake and allergic diseases have not been evaluated. PURPOSE: We aimed to investigate the associations of allergic diseases with urinary iodine concentration (UIC). STUDY DESIGN: A nation-wide population-based survey conducted by the the Korean Centers for Disease Control and Prevention METHODS: In total, 5598 participants older than 19 years who participated in the Korean National Health and Nutrition Examination Survey 2013-2015 were enrolled for analysis. Multiple logistic regression analysis was used to determine the odds ratios for allergic diseases according to UIC. RESULTS: Allergic diseases were associated with the highest UIC quartile. Compared with subjects in lower UIC quartiles, subjects in the highest UIC quartile were at greater risk for atopic dermatitis (OR = 1.471, 95% CI, 1.028-2.107) and allergic rhinitis (OR = 1.362, 95% CI, 1.129-1.644) after adjustment for age and sex. CONCLUSION: This study revealed that the highest UIC quartile is associated with allergic diseases. Further laboratory and clinical studies are needed to evaluate the associations between excessive iodine intake and allergic diseases.

Renal tubular function and urinary N-acetyl-ß-d-glucosaminidase and kidney injury molecule-1 levels in asthmatic children.

BACKGROUND: Asthma is a chronic inflammatory disorder of the airways which results in chronic hypoxia. Chronic hypoxia and inflammation can affect renal tubular function. OBJECTIVES: The aim of this study was to investigate renal tubular function and early kidney injury molecules such as urinary N-acetyl-betaglucosaminidase (NAG) and kidney injury molecule-1 (KIM-1) excretion in children with asthma. METHODS: Enrolled in the study were 73 children diagnosed with asthma and 65 healthy age- and gender-matched control subjects. Urine pH, sodium, phosphorus, potassium, microalbumin, creatinine, NAG, KIM-1, and serum creatinine, sodium, phosphorus were evaluated. The diagnosis of asthma and classification of mild or moderate were done according to the Global Initiative for Asthma guidelines. RESULTS: Serum sodium, phosphorus, creatinine, and urinary microalbumin were within normal levels in the both groups. Urinary pH, sodium, potassium, phosphorus, microalbumin, and KIM-1 excretions were similar between the control and study groups. Tubular phosphorus reabsorption was within normal limits in two groups. Urine NAG was elevated in the study group (P = 0.001). Urinary KIM-1 and NAG levels were positively correlated (r = 0.837; P = 0.001). When children with mild and moderate asthma were compared, all of the parameters were similar (P >0.05). CONCLUSIONS: This study showed that chronic asthma can lead to subtle renal impacts. We suggest that in children with asthma, urinary NAG level is a more valuable parameter to show degree of renal tubular injury than markers such as microalbumin and KIM-1. Chronic hypoxy and inflammation probably contributes to these subclinical renal effects.

Effects of a dietary intervention with conjugated linoleic acid on immunological and metabolic parameters in children and adolescents with allergic asthma--a placebo-controlled pilot trial.

BACKGROUND: Circumstantial evidence suggests that conjugated linoleic acid (CLA) beneficially modulates immune function in allergic subjects. C9,t11-CLA, naturally occurring in ruminant fats, is suggested to be the effective isomer. In contrast, for the t10,c12-CLA isomer, which is naturally found only in traces but usually constitutes a relevant part in commercial CLA mixtures, adverse effects have been reported. Aim of this study was to assess putative immunomodulatory effects of highly enriched c9,t11-CLA in allergic subjects. To our best knowledge, our study is the first in that a CLA preparation was used for such purpose which was free of t10,c12-CLA. DESIGN: Twenty-nine asthmatic children and adolescents (age 6-18 y) with diagnosed allergic sensitization against grass pollen, house dust mite, or cat hair/epithelia consumed daily a portion of yoghurt containing either 3 g CLA (75 % c9,t11-CLA, 87 % purity) or placebo (safflower oil) over a period of 12 weeks. At study start and end, lung function parameters, specific IgE, in vitro allergen-induced cytokine production in peripheral blood mononuclear cells (PBMC), plasma ECP, urinary 8-oxodG as marker of oxidation, fatty acid profiles of erythrocytes, and routine haematological parameters were determined. Prior to blood samplings, 3-days dietary records were requested. Throughout the study, the participants documented daily their peak expiratory flow and kept protocol about their allergy symptoms and usage of demand medication. RESULTS: In contrast to the CLA group, PBMC-produced IFN-γ and IL-4 increased significantly and by trend, respectively, in the placebo group. Moreover, plasma ECP tended to increase in the placebo group. In the pollen subgroup, FEV1 improved upon both CLA and placebo oil supplementation. In both intervention groups, the n-6/n-3 PUFA ratio in red blood cells decreased, mainly due to an increase in n-3 PUFA. Moreover, 8-oxodG excretion increased in both groups. No changes occurred regarding specific IgE concentrations, allergy symptoms, and volume parameters. CONCLUSION: Our results indicate that CLA modestly dampens the inflammatory response on the cellular level. A clinically relevant amelioration of the symptoms could not be proved in atopic manifest patients. TRIAL REGISTRATION: NCT01026506.

Orinoterapia para el control de las manifestaciones clínicas del asma bronquial en niños: intervención realizada en un centro holístico / Urinotherapy for the control of the clinical manifestations of bronchial asthma in children: intervention conducted in a holistic center

La orinoterapia, parte de la medicina tradicional, se basa en la práctica de estilos de vida saludables y el uso de la propia orina para mejorar el estado de salud. Objetivo: determinar el efecto de la orinoterapia en el control de las manifestaciones clínicas del asma bronquial en niños de 4 a 11 años que asistieron al Centro de Retiro Holístico Anna Margottini (CRHAM) entre octubre de 2008 a enero de 2009. Material y métodos: enfoque cuantitativo, diseño ex post facto, basado en la recolección y descripción de datos obtenidos de 30 niños a los que se les aplicó el Child Asthma Control Test, antes y después de haber recibido orinoterapia. Resultados: antes de recibir orinoterapia, 19 de 30 niños (63,3 por ciento) no controlaban el asma bronquial y once controlaban el asma parcialmente. Contrario a esto, luego de recibir orinoterapia 24 de los 30 niños (80 por ciento) controlan su asma adecuadamente; seis de los niños (20 por ciento) controlan el asma parcialmente no quedando ningún niño en el nivel no controlado. Conclusión: al comparar el grado de control de las manifestaciones clínicas del asma bronquial antes y despues de recibir orinoterapia, se observa que el nivel de control del asma de los niños se ha incrementado con la aplicación del tratamiento. Sin embargo, la orinoterapia no radica en el uso exclusivo de la propia orina, sino también en la practica de estilos de vida saludables como el consumo de fitos, los cuales ya han demostrado su beneficio en el tratamiento del asma.

The urinotherapy part of traditional medicine is based on the practice of the healthy lifestyles and use their own urine to improve health status. Objective: To determine the effect of urinotherapy to control the clinical manifestations of bronchial asthma in children 4 to 11 years who attended the Center for Holistic Retreat Margottini Anna (CRHAM) between October 2008 and January 2009. Material and methods: Experimental design is not ex post facto, of a quantitative approach, since it was based on the collection and description of the data obtained from 30 children who were interviewed with the Child Asthma Control Test before and after receiving urinotherapy. Results: Before receiving urinotherapy 19 of 30 children (63.3 per cent) did not control the asthma and 11 partially controlled asthma. Contrary to this, it was noted that after receiving urinotherapy 24 of the 30 children (80 per cent) adequately control their asthma, 6 of all children (20 per cent) partially controlled asthma is not leaving any child in the uncontrolled level. Conclusion: By comparing the degree of control of the clinical manifestations of bronchial asthma before and after receiving urinotherapy is observed that the level of asthma control of children in this study increased with the treatment. However urinotherapy not only lies in the exclusive use of one's own urine, but also in the practice of healthy lifestyles such as consumption of phytosanitary of which has already demonstrated its benefit in the treatment of asthma.

Urinary magnesium excretion in asthmatic children receiving magnesium supplementation: a randomized, placebo-controlled, double-blind study.

The aims of this study were to establish whether a magnesium (Mg) deficit indicated by a decreased urinary excretion exists and to determine whether 12-week oral Mg supplementation affects the Mg status and bronchodilator use in children with stable bronchial asthma. The effects of long-lasting Mg supplementation were investigated in 89 children 4 to 16 years of age with mild or moderate persistent bronchial asthma in a randomized, double-blind, placebo-controlled, prospective study. Each subject received one capsule of Mg citrate per day (= 7 years: 200 mg, > 7 years: 290 mg) or one capsule of placebo containing 260 mg glucose during 12 weeks. Evaluation was performed at 4-week intervals. Venous blood serum total and free Mg and urine Mg levels were determined at the beginning and end of the 12-week period. Parents recorded the number of bronchodilator doses twice daily. A urinary Mg loss (6.81 +/- 3.9 versus 2.79 +/- 1.39 mmol/day, p = 0.01) was observed in the placebo-treated persistent moderate asthmatics. Bronchodilator use was significantly higher after 8 and 12 weeks in the placebo-treated than in the Mg-treated patients with moderate asthma (31.1 +/- 1.8 versus 29.5 +/- 1.2 puffs per patient/4 weeks, p < 0.05, and 31.0 +/- 2.3 versus 29.3 +/- 0.9 puffs per patient/4 weeks, p < 0.05, respectively). Long-lasting Mg supplementation is clearly of benefit in mildly to moderately asthmatic children and is recommended as a concomitant drug in stable asthma.

Selenium serum and urine is associated to mild asthma and atopy. The SUS study.

To examine the associations between selenium (Se) status, asthma, bronchial hyperresponsiveness (BHR), and atopy in 154 male subjects (72 with mild asthma, 41 with BHR and 41 with no respiratory symptoms) aged 18 (range 17-22) years. Each subject underwent a medical interview and FEV1 and FVC were recorded. Histamine bronchial reactivity (Yan method) was measured, skin prick test (inhalant allergens) was performed and Se in urine and serum was analysed (AOAC modified fluometric method). Se in serum 74.04 (10.58) micrograms/L (mean (SD)) was lower in subjects with asthma and the logarithm of the ratio of Se in serum (microgram/L) and urine standardised to creatinine excretion (ng/mg creatinine) 0.748 (0.096) (mean (SD)) was lower in subjects with asthma and atopy compared to subjects with no allergic symptoms 77.79 (10.16) micrograms/L and 0.808 (0.111) respectively (p < 0.05). In subjects with asthma atopy was significantly associated to urine Se 0.24 (0.73) (beta (SE)) (p < 0.05). Subjects with BHR had the same Se status as subjects with no respiratory symptoms and heavy smokers had a lower concentration of Se in serum 73.80 (9.56) micrograms/L than non-smokers 78.16 (10.74) micrograms/L (p < 0.05), Se status was associated to asthma and smoking. Measuring Se in urine might add further information to possible relations between Se status, atopy and asthma.

Pharmacological effects of urinary products obtained after treatment with saiboku-to, a herbal medicine for bronchial asthma, on type IV allergic reaction.

To define the anti-allergic components in Saiboku-To, a herbal medicine for bronchial asthma, we examined the effects of 11 compounds found in post-administrative urine of Saiboku-To on concanavalin A-induced human lymphocyte blastogenesis in vitro and picryl chloride (PC)-induced mouse ear swelling in vivo. The urinary products of Saiboku-To were flavonoids and lignans derived from the constitutional herbs and their hydrogenated metabolites. Medicarpin derived from Glycyrrhiza glabra, magnolol and 8,9-dihydroxydihydromagnolol from Magnolia officinalis, baicalein, wogonin and oroxylin A from Suctellaria baicalensis inhibited lymphocyte blastogenesis in dose-dependent fashion with IC50 values ranging from 3.0 to 7.7 micrograms/mL, which corresponded to 20-100 times that of prednisolone IC50 (0.08 microgram/mL). Davidigenin, dihydrowogonin and dihydrooroxylin A, which are hydrogenated metabolites of liquiritigenin, wogonin and oroxylin A, respectively, had no or little effects on lymphocyte blastogenesis. Oral administration of Saiboku-To, medicarpin, baicalein, magnolol and baicalin (100 mg/kg), inhibited PC-induced ear swelling significantly by 23.5, 40.1, 30.5, 23.6 and 20.9%, respectively, though the effects were weaker than that of 5 mg/kg of prednisolone (52.9%). The results suggested that flavonoids and lignans tested in the present study were implicated in anti-asthmatic effect of Saiboku-To through suppression of type IV allergic reaction.

Sublingual immunotherapy and influence on urinary leukotrienes in seasonal pediatric allergy.

Sublingual immunotherapy has been suggested for the treatment of respiratory allergies. Many controversial studies have been reported on the efficacy of sublingual immunotherapy. The aim of this prospective study was to evaluate whether sublingual immunotherapy was effective according to clinical and laboratory results in pediatric allergies. Thirty-nine allergic, grass pollen sensitive children were admitted into the study. Sublingual immunotherapy was given over a 12-month period to 21 children (mean age 10.5 +/- 3.3 years), 10 of whom had seasonal allergic rhinitis and 11 seasonal allergic asthma. During the same period, 18 children (mean age 11.1 +/- 2.5 years), 10 with seasonal allergic rhinitis and eight with seasonal allergic asthma, received placebo. Symptom scores and drug requirements were recorded and urine samples were collected to detect urinary levels of leukotrienes (Uc-LTB4 and Uc-LTE4). In patients who received sublingual immunotherapy, the symptom scores of seasonal allergic rhinitis significantly decreased, but no statistically significant changes were observed in terms of symptoms of seasonal allergic asthma. Uc-LTE4 and Uc-LTB4 levels of seasonal allergic rhinitis, with a geometric mean and 95% confidence interval (CI), were significantly decreased from 216 (103-464) and 61 (22-198) pmol/mmol creatinine to 78 (29-159) and 35 (12-118) pmol/mmol creatinine, respectively (p < 0.05 and p < 0.05). On the other hand, Uc-LTE4 and Uc-LTB4 levels for seasonal allergic asthma were 180 (92-355) and 78 (44-258) pmol/mmol creatinine and decreased to 156 (72-402) and 69 (32-254) pmol/mmol creatinine, respectively. These changes were not statistically significant (p > 0.05). According to our clinical results and urinary levels of leukotrienes, which are mediators showing the severity of allergic inflammation, it can be suggested that sublingual immunotherapy may be useful in the treatment of seasonal allergic rhinitis but not of seasonal allergic asthma.

[Melatonin effects on functional activity of platelets in patients with bronchial asthma]. / Vliianie melatonina na funktsional'nuiu aktivnost' trombotsitov u bol'nykh bronkhial'noi astmoi.

AIM: To assess effects of epiphysial hormone melatonin in various dose regimens on ADP-induced aggregation of platelets in patients with bronchial asthma (BA). Correlations with urine levels of 6-sulphatoxymelatonin (6-SOMT), basic melatonin metabolite, were made. MATERIALS AND METHODS: Melatonin was given to 17 patients with mild or moderate BA and 16 healthy controls. RESULTS: BA patients were found to have disorders in circadian rhythm of urine 6-SOMT excretion, lack of correlation between platelet functional activity and elevated nocturnal excretion of 6-SOMT, in vitro platelet activation in response to low-dose melatonin and absence of this reaction to high-dose melatonin. CONCLUSION: It is suggested that melatonin may be involved in genesis of bronchoobstructive syndrome in BA.

[Relationship between Syndrome-Type in TCM and four trace urinary proteins in patients with bronchial asthma].

OBJECTIVE: To explore the possible relationship between Syndrome-Type in TCM and the 4 trace urinary proteins in patients with bronchial asthma. METHODS: The 4 kinds of trace urinary proteins in 217 patients with asthma were measured by radioimmunoassay, and that in 66 normal subjects were compared. RESULTS: The results showed that there were increments of urinary albumin, urinary IgG, urinary beta 2-microglobulin and urinary Tamm-Horsfall protein in patients with asthma; and the gradual increase tended to be accompanied by the continuous aggravation of patient's condition on TCM Syndrome-Type. Furthermore, these datas proved that the 4 trace urinary proteins might be the most sensitive indicators for detecting impaired renal functions than serum blood urea nitrogen and creatinine. CONCLUSIONS: There were the objective material foundations on TCM Syndrome-Type in asthmatics, which consisted of renal glomerular dysfunctions to filter out albumin and IgG, renal tubular dysfunction to reabsorb beta 2-microglobulin, and to synthesize and excrete Tamm-Horsfall protein.

Inhaled beclomethasone dipropionate suppresses the hypothalamo-pituitary-adrenal axis in a dose dependent manner.

OBJECTIVE: Little is known about the dose-response relationship of potential, unwanted, effects of inhaled beclomethasone (BDP) on the hypothalamo-pituitary-adrenal (HPA) axis, particularly in nonspecialist clinic settings. The purpose of our study was to investigate the dose-response relationship of inhaled BDP on the HPA axis in a general practice patient population. We also explored the optimal testing strategy in this population and correlated effects of inhaled BDP on the HPA axis with other systemic corticosteroid side effects. PATIENTS AND DESIGN: Controlled observational study employing 21 patients on inhaled BDP recruited from general practice, with minimal past and no present exposure to other corticosteroids, and 21 age and gender-matched controls. MEASUREMENTS: Twenty-four-hour urinary free cortisol excretion (UFC), serum cortisol before and 30 minutes after injection of 1 microgram and 250 micrograms of tetracosactrin, serum IGF-I and serum osteocalcin were measured. BDP use was estimated by inhaler weighing and prescription count. RESULTS: In subjects on inhaled BDP, 24-hour UFC (P < 0.008), serum cortisol 30 minutes after 250 micrograms tetracosactrin (P < 0.05) and the serum cortisol rise after 250 micrograms tetracosactrin (P < 0.04) were significantly lower when compared with controls. Measurements of HPA function correlated inversely with BDP dose estimated by inhaler weighing (all P < 0.03). Serum IGF-I and osteocalcin levels did not differ. CONCLUSIONS: We have demonstrated hypothalamo-pituitary-adrenal axis suppression in nonspecialist-clinic asthma patients on moderate to large doses of inhaled beclomethasone dipropionate. When accurate measurements of inhaled steroid dose are used, there is an exponential relationship between dose and hypothalamo-pituitary-adrenal axis suppression. There appears to be no 'safe' threshold, and around 15% of patients may have clinically significant suppression. However, the significance of hypothalamo-pituitary-adrenal axis suppression as a marker for concomitant corticosteroid effects on other organ systems remains uncertain.

Chronotherapy of asthma with inhaled steroids: the effect of dosage timing on drug efficacy.

BACKGROUND: Studies in asthma with systemic corticosteroids given at 3:00 PM have shown a superior therapeutic benefit compared with dosing at other time points. OBJECTIVE: The study was designed to compare beneficial and systemic effects of 800 micrograms of inhaled triamcinolone once daily at 3:00 PM (QD group) versus 200 micrograms conventional four times a day dosing (QID group). METHODS: Efficacy outcome measures included forced expiratory volume in 1 second (FEV1), peak expiratory flow rates, bronchial responsiveness, and use of beta-agonist. Systemic effects were blood eosinophil and cortisol levels, 24-hour urinary cortisol, and evaluation for oral candidiasis and dysphonia. RESULTS: The baseline FEV1 was comparable in the two groups: QD = 67% +/- 2% and QID = 66% +/- 2% of predicted value. After 4 weeks of treatment, FEV1 increased similarly in the QD group to 77% +/- 4% and in the QID group to 74% +/- 4% of predicted value. Likewise, the improvement in morning and evening peak expiratory flow rates was not significantly different between the groups. Both QD and QID groups experienced comparable daily decrements in beta-agonist use. The systemic responses to the two regimens as assessed by eosinophil count, morning serum cortisol, and 24-hour urinary cortisol were also comparable. CONCLUSIONS: The single daily administration of inhaled triamcinolone at 3:00 PM has no increased systemic effects and produces similar improvement in efficacy variables. A dosing strategy based on once daily dosing should increase compliance of inhaled steroid use in the clinical setting.

Liquid chromatographic determination of magnolol in urine collected from volunteers after a single dose of saiboku-to, an oriental herbal medicine for bronchial asthma.

Saiboku-To is an anti-asthmatic herbal remedy which consists of ten herbal extracts. To investigate the clinical relationship between the effects and chemical components of Saiboku-To, a simple and sensitive high-performance liquid chromatographic method (HPLC) for determination of magnolol, one of the major urinary products, was developed. Organic solvent extraction of urinary magnolol was conducted by diatomaceous earth column rapid-flow fractionation using ethanol/dichloromethane (8/92, v/v). Recovery rates of magnolol were more than 99% with coefficient of variations less than 6% in the concentration range 9.7-970 ng mL-1. Subsequent HPLC determination of magnolol was achieved using a conventional silica-gel column, a mobile phase mixture of acetic acid/diethyl ether/n-hexane (0.2/17.0/82.8, v/v), and a UV-absorption detector set at 290 nm. Calibration was on the basis of peak height ratio between magnolol and flavone as an internal standard. The method was used to demonstrate excretion profiles of magnolol in healthy and asthmatic subjects following single administration of Saiboku-To.

Impact of free magnolol excretions in asthmatic patients who responded well to saiboku-to, a Chinese herbal medicine.

Saiboku-To, a mixture of ten different herbal extracts, has been used in Japan and Czechoslovakia for corticosteroid-dependent severe asthma to reduce the maintenance doses of corticosteroid. Magnolol has been considered to be an active component of Saiboku-To as an inhibitor of 11 beta-hydroxysteroid dehydrogenase and T-lymphocyte proliferation resulting in corticosteroid-sparing. To investigate the relationship between magnolol and the clinical effects of Saiboku-To, urinary magnolol excretion was compared in responders and non-responders under long-term Saiboku-To treatment. The clinical outcome of the Saiboku-To treatment was evaluated in nine asthmatic patients at 52 weeks after the onset of the treatment, using individual fluctuation of asthmatic points obtained from the patients' diary cards. Three patients whose clinical conditions were improved by the treatment were termed responders and six others were termed non-responders. The difference in the amounts of the total magnolol excreted were not significant; however, free (or non-conjugated) amounts of magnolol excreted in the responders were 7 times those in the non-responders (P < 0.05). These results suggest that the magnolol might be responsible for the therapeutic effect of Saiboku-To, indicating practical bioavailability in the responders.

Urinary leukotriene E4 after antigen challenge and in acute asthma and allergic rhinitis.

The leukotrienes LTC4, D4, and E4 are potent bronchoconstrictor agents and are thought to have an important role in asthma. Urinary LTE4, a stable urinary end-product of LTC4 and LTD4, was measured, by means of high-performance liquid chromatography and radioimmunoassay. LTE4 excretion followed a log-normal distribution in twenty-nine healthy controls, with a geometric mean of 23.8 (95% confidence interval 19.9-28.2) ng/mmol creatinine. Urine was collected from eight atopic subjects for 3 h after antigen inhalation and a control urine collection was made a week later at the same time of day. Urinary LTE4 was significantly higher after antigen challenge than in the control sample (153.7 [87.1-271.3] vs 23.5 [13.7-69.5] ng/mmol creatinine; p less than 0.01). Urinary LTE4 was also measured in twenty patients with severe acute asthma and nine patients with seasonal allergic rhinitis. Mean urinary LTE4 was higher in the asthmatic patients (78.3 [46.5-131.8] ng/mmol creatinine) than in normal subjects (p less than 0.01), although there was substantial overlap into the normal range. The urinary LTE4 values of the rhinitis patients were within the normal range whether or not they had symptoms. LTC4 and LTD4 were also found in bronchoalveolar lavage fluid from one of the three atopic subjects challenged with antigen before lavage, and in a single patient who underwent lavage after admission with severe acute asthma. These studies provide evidence that leukotrienes are released in vivo in man after antigen challenge and in acute asthma.