Aqueous intradermal low-dose house dust mite immunotherapy in tropical settings: a valid cost-effective approach for developing nations?

INTRODUCTION: Aqueous allergen injections, an effective and century-old technique, is considered a second-line approach in daily clinical practice. Inconveniences still surround conventional subcutaneous immunotherapy (SCIT) administration, such as a need for frequent injections, prolonged up-dosing schedules, elevated costs, and the unlikely possibility of a systemic reaction. The intradermal immunotherapy route (IDR) might favorably impact many of the aforementioned issues (Table 1). House dust mite (HDM) allergens are the main perennial sensitizers in the tropics, and as such, are solely employed in immunotherapy treatments. METHODS: We carried out a year-long real-life study in 25 perennial allergic rhinitis children, symptomatic on exposure to house dust, employing an intradermal low-dose allergen mix consisting of 50 ng of Dermatophagoides pteronyssinus/Dermatophagoides farinae and 120 ng of Blomia tropicalis, under a unique cost-wise protocol. Basal symptoms/signs and face Visual Analog Scale (fVAS) scores were recorded for 2 weeks and later compared with those registered throughout the 1-year treatment. Serum-specific IgG4 and IL-10 levels were employed in the assessment of the immune responses. RESULTS: Symptoms/signs and fVAS scores were significantly reduced from days 42 and 49, respectively, and remained so until treatment completion. Increases in specific IgG4's and IL-10 levels reflected significant immune responses. Injections were well tolerated and families reported improved health status (quality of life, QoL). CONCLUSIONS: A unique cost-effective immunotherapy alternative for deprived allergic communities in tropical settings is depicted; further research is needed.

Efficacy of acupuncture at three nasal acupoints plus acupoint application for perennial allergic rhinitis: A multicenter, randomized controlled trial protocol.

BACKGROUND: Many studies have shown the potential therapeutic effect of acupuncture on allergic rhinitis. Most of these studies were limited by low-quality evidence. Preliminary experiments showed that the use of acupuncture at three nasal acupoints plus acupoint application (AAP) achieves a more persistent effect in the treatment of perennial allergic rhinitis than acupuncture alone. In this study, a multicenter, single-blind, randomized controlled trial will be performed, in which acupuncture at nonmeridian acupoints and sham AAP will be used as the control group to evaluate the effect of AAP through long-term observation. METHODS: The trial is designed on the basis of the Consolidated Standards of Reporting Trials 2010 guidelines and Standards for Reporting Interventions in Controlled Trials of Acupuncture. A total of 120 participants with perennial allergic rhinitis will be randomly assigned to a treatment or control group. A specially appointed investigator will be in charge of randomization. The participants in the treatment group will be treated with acupuncture at EX-HN3, LI20, and EX-HN8 thrice per week for a total of 12 sessions. In addition, they will undergo AAP at DU14, BL13, EX-BI, and RN22. The participants in the control group will be treated with sham AAP. The primary outcome will be the change in the Total Nasal Symptom Score from baseline to the completion of 4-week treatment. Secondary outcomes include changes in visual analog scale and total non-nasal symptom scores from baseline to the second and fourth weeks of treatment, as well as 1, 3, and 6 months after the completion of treatment. Peripheral blood IL-4, IL-5, IL-6, IL-8, and IL-10 levels will be measured, and any side effects related to treatment will be observed and recorded. DISCUSSION: It is expected that this randomized clinical trial will provide evidence to determine the effects of AAP compared with acupuncture at nonmeridian acupoints and sham AAP, particularly the long-term effect. These findings will help improve the clinical application of this technique. TRIAL REGISTRATION: Acupuncture-Moxibustion Clinical Trial Registry AMCTR-ICR-18000179. Registered on 12 April 2018.

[Therapeutic effect and mechanism of Phoenix roebelenii pollen vaccine for treatment of mice with allergic rhinitis].

OBJECTIVE: To apply Phoenix roebelenii pollen vaccine to murine models of allergic rhinitis and observe the pathological changes of allergic rhinitis in mice, and to study the efficacy and mechanism of the vaccine for the treatment of allergic rhinitis. METHODS: BALB/c mice models of allergic rhinitis were established by intraperitoneal injection, and then treated with immunotherapy of allergen vaccine by subcutaneous injection. The mice were examined for the levels of airway hyperresponsiveness by a noninvasive lung function detector, for the specific antibodies IgE and IgG2a in serum and cytokines by indirect ELISA, and for the pathological changes of ultrastructure of nasal mucosa of the mice by transmission electron microscopy before and after the treatment. RESULTS: After the immunotherapy, nasal symptoms and airway hyperresponsiveness of the mice were relieved. The level of specificity antibody IgG2a in serum was elevated, and IgE dropped significantly. In the culture supernatant of spleen cells, INF-γ and IL-10 levels increased and the production of IL-4 decreased. CONCLUSION: The recombinant profilin of the Phoenix roebelenii pollen as vaccine has a certain therapeutic effect for the pollen allergic rhinitis, and it works maybe through promoting the transition of Th2 to Th1 and regulating the balance of helper T cells.

Characterisation of CD154+ T cells following ex vivo allergen stimulation illustrates distinct T cell responses to seasonal and perennial allergens in allergic and non-allergic individuals.

BACKGROUND: Allergic sensitisation has been ascribed to a dysregulated relationship between allergen-specific Th1, Th2 and regulatory T cells. We sought to utilise our short-term CD154 detection method to further analyse the relationship between these T cell subsets and investigate differences between seasonal and perennial allergens. Using peripheral blood samples from grass-allergic, cat-allergic and healthy non-atopic subjects, we compared the frequencies and phenotype of CD154-positive T helper cells following stimulation with seasonal (grass) and perennial (cat dander) allergens. RESULTS: We identified a higher frequency of CD154+ T cells in grass-allergic individuals compared to healthy controls; this difference was not evident following stimulation with cat allergen. Activated Th1, Th2 and Tr1-like cells, that co-express IFNγ, IL4 and IL10, respectively, were identified in varying proportions in grass-allergic, cat-allergic and non-allergic individuals. We confirmed a close correlation between Th1, Th2 and Tr1-like cell frequency in non-allergic volunteers, such that the three parameters increased together to maintain a low Th2: Th1 ratio. This relationship was dysregulated in grass-allergic individuals with no correlation between the T cell subsets and a higher Th2: Th1 ratio. We confirmed previous reports of a late-differentiated T cell phenotype in response to seasonal allergens compared to early-differentiated T cell responses to perennial allergens. CONCLUSIONS: The findings confirm our existing work illustrating an important balance between Th1, Th2 and Tr1-like responses to allergens in health, where Th2 responses are frequently observed, but balanced by Th1 and regulatory responses. We confirm previous tetramer-based reports of phenotypic differences in T cells responding to seasonal and perennial allergens.

1,25(OH)2D3 and specific IgE levels in children with recurrent tonsillitis, and allergic rhinitis.

OBJECTIVES: We investigated 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] and specific immunoglobulin E (IgE) levels in children with recurrent tonsillitis (RT) plus allergic rhinitis (AR). METHODS: Thirty children with RT+AR were included in the study group, and 30 healthy children comprised the control group. AR-related symptoms were determined using a symptom scale. 1,25(OH)2D3 and specific IgE measurements were made in both groups. RESULTS: The 1,25(OH)2D3 value was significantly lower in the RT+AR group than in the control group. Specific IgE (mixed) panels were in normal limits in both groups; whereas specific IgE (mixed) grass pollen panel value of RT+AT group was significantly higher than that of the control group. Higher nasal itching, nasal obstruction, and concha edema scores were related to significantly higher specific IgE values for the (mixed) grass pollen panel, whereas higher sneeze scores were related to higher specific IgE values for the (mixed) pediatric panel. CONCLUSIONS: Children with grass pollen allergy may not be exposed to sufficient sunlight. With reduced 1,25(OH)2D3, T helper cells may increase, and allergic response also increases. As allergic events increased, these children did not go outside and thus lacked sun exposure. This vicious cycle must be broken, and children with RT+AR should have sunlight exposure to increase 1,25(OH)2D3 levels.

[The correlation of serum specific IgE detection and skin prick test in allergic rhinitis].

OBJECTIVE: To investigate the correlation between serum specific immunoglobin E(sIgE) and skin prick test(SPT) and their differences of the positive rate. METHOD: One hundred and nine patients with allergic rhinitis were detected the serum slgE. The patients had positive symptoms and signs, positive SPT results with at least one allergen. RESULT: Specific IgE and SPT results of Dp,Df and Artemisia showed a positive correlation (r = 0.520, 0.4413, 0.764, P < 0.01). sIgE positive rates were 55.0%, 54.1% and 17.4% for Dp, Df and Artemisia respectively, whereas SPT positive rates were 68.8%,79.8% and 27.5% respectively. The difference between the positive rates of the sIgE and SPT was significant (chi2 = 27.93,18. 20,60. 60, are P< 0.01). CONCLUSION: There was a good correlation between specific IgE and SPT. SPT is more sensitive than sIgE, but SPT can not substitute for slgE,vice versa.

[Analysis of total and specific IgE in serum of carvota mitis pollen-induced allergic rhinitis patients].

OBJECTIVE: Exploring the relationship between total and specific IgE in serum and allergen skin test of carvota mitis pollen-induced allergic rhinitis patients. METHOD: Four hundred and-twenty-nine carvota mitis pollen-induced allergic rhinitis patients and 243 healthy control subjects were recruited. The experimental group carried out skin tests. and pollen-specific IgE were also examined by BSA-ELISA method. Total IgE in serum of all of the subjects were determined by ELISA. RESULT: The positive rate of the total IgE level of the patients were much higher than those of the controls (66.2% vs. 15.6%, P < 0.01). No statistically significance was found between the positivity of skin test and serum specific IgE of the experimental group (chi2 = 0.758 8, P > 0.05). The difference between serum-specific IgE and total IgE was statistically significant (chi2 = 50.639, P<0.01). There was no statistical significance of specific IgE and the total IgE in serum between long term residents in Haikou and Hainan Tourisms (P > 0.05). CONCLUSION: Allergen skin test and carvota mitis pollen-specific IgE are two effective methods for the diagnosis of carvota mitis pollen-induced allergic rhinitis. The detection of total IgE in serum of carvota mitis pollen-induced allergic rhinitis provides a reference value for diagnosis. The relationship between concentration of IgE in serum of the carvota mitis pollen-induced allergic rhinitis and allergen contact duration is waiting for further study.

[The role of sinomenine in treatment of allergic rhinitis mice model and its mechanism].

OBJECTIVE: To explore the role of sinomenine in treatment of allergic rhinitis mice model and its possible mechanism. METHOD: We used ovalbumin (OVA) to make allergic rhinitis model of BALB/c mice. Saline was used in the control group. When we challenged the mice with OVA intranasally, the mice in sinomenine treatment group were feed by the food containing sinomenine. Mice were then killed 24 h after the last OVA challenge. The noses of mice from each group were removed en bloc and fixed, then each section was stained with hematoxylin and eosin. ELISA assay was used to measure the concentration of anti-OVA IgE, IL-4 and IFN-gamma. The proteins expressive level of T-bet and GATA3 were examined. RESULT: Nasal mucosa of the mice in sinomenine treatment group were not hyperplasia and without obvious infiltration of eosinophils. The concentration of anti-OVA IgE, IL-4 and IFN-gamma in the serum and T-bet and GATA3 expression levels of sinomenine treatment group were lower than those of allergic rhinitis group. CONCLUSION: The sinomenine can be used to treat allergic rhinitis mice, and the mechanism may rely on the improvements of the Th1/Th2 imbalance.

Comparison of the efficacy of KOB03, ketotifen, and montelukast in an experimental mouse model of allergic rhinitis.

KOB03 is a polyherbal medicine derived from an oriental prescription traditionally used to treat allergic diseases. In the present study, we compared the efficacy of KOB03 with modern drugs such as ketotifen and montelukast in an experimental mouse model of allergic rhinitis (AR). Ketotifen is a H1 receptor antagonist and montelukast is a leukotriene receptor antagonist. Mice were treated with KOB03, ketotifen or montelukast in an established AR mouse model using ovalbumin (OVA)-sensitized/challenged BALB/c mice. The treatment of KOB03 had inhibitory effects on symptom scores, serum levels of OVA-specific IgE, histamine, leukotriene C4, IL-4, TNF-α, and IL-1ß in AR mice, and the histolopathological changes of nasal mucosa with mucin release and inflammation. AR mice treated with KOB03 had significantly lower serum levels of OVA-specific IgE, LTC4, IL-4, and IL-1ß than mice treated with ketotifen, whereas they only had significantly lower serum levels of OVA-specific IgE and IL-4 than those treated with montelukast. In addition, the histolopathological changes of nasal mucosa with eosinophil infiltration were significantly lower in the KOB03-treated mice than those in the ketotifen and montelukast-treated group. These results suggest that KOB03 has therapeutic potential for treating AR like other modern medicines.

Immune-modulatory effect of probiotic Bifidobacterium lactis NCC2818 in individuals suffering from seasonal allergic rhinitis to grass pollen: an exploratory, randomized, placebo-controlled clinical trial.

BACKGROUND/OBJECTIVES: Probiotics are defined as 'living micro-organisms that when administered in adequate amounts confer a health benefit to the host'. Different probiotic strains have been investigated for beneficial effects on allergic disorders. The purpose of the current study was to evaluate the effect of orally administering the probiotic Nestlé culture collection (NCC)2818 Bifidobacterium lactis strain on immune parameters and nasal symptom scores in subjects suffering from seasonal allergic rhinitis (SAR). SUBJECTS/METHODS: The study was a double-blinded, parallel, randomized placebo-controlled trial conducted during the peak of the pollen season. Adult subjects with clinical history of SAR and positive skin prick test to grass pollen were recruited. The subjects received B. lactis NCC2818 or placebo for 8 weeks and completed symptom questionnaires every week. Whole blood was collected at baseline (V1), 4 weeks (V2) and 8 weeks (V3) to measure immune parameters. RESULTS: Concentrations of Th-2 cytokines, secreted by stimulated blood lymphocytes, were significantly lower in the probiotic group compared with the placebo group at V3 (interleukin (IL)-5, P=0.016; IL-13, P=0.005). Total nasal symptom scores were significantly lower in the second month of the study (weeks 5-8) in the probiotic group compared with the placebo group (P=0.03). Also, percentages of activated CD63 expressing basophils were significantly lower in the probiotic group at V2 (P=0.02). CONCLUSIONS: Oral administration of the probiotic NCC2818 mitigates immune parameters and allergic symptoms during seasonal exposure. These promising results warrant that B. lactis NCC2818 be investigated further in large-scale trials for management of respiratory allergy.

[Acupoint autohemotherapy for allergic rhinitis and its effect on serum IL-12 and IFN-gamma].

OBJECTIVE: To explore the clinical efficacy and the mechanism of acupoint autohemotherapy in the treatment of allergic rhinitis. METHODS: Forty-five cases were randomized into an autohemotherapy group (24 cases) and a western medication group (21 cases). In the autohemotherapy group, the acupoint autohemotherapy was applied to the bilateral Dingchuan (EX-B 1), Fengmen (BL 12), Feishu (BL 13), Quchi (LI 11), Zusanli (ST 36) and the others. In the western medication group, loratadine tablets were prescribed. The patients were treated continuously for 3 months in both groups. The clinical symptom score was taken for the assessment of clinical efficacy. The enzyme-linked immunoadsordent assay (ELISA) was adopted to determine the contents of serum interferon-gamma (IFN-gamma) and interleukin-12 (IL-12). RESULTS: The total effective rate was 83.3% (20/24) in the autohemotherapy group, which was obviously superior to 66.7% (14/21) in the western medication group (P < 0.05). After treatment, the clinical symptom scores of patients in the two groups were all reduced. The improvements in the scores of sneezing and clear nasal discharge in the autohemotherapy group were much more significant than those in the western medication group (both P < 0.05). After treatment, the serum IL-12 content of patients in the two groups was all increased to different extents as compared with that before treatment (both P < 0.05). In the autohemotherapy group, the serum IFN-gamma was increased after treatment (P < 0.05). In the western medication group, the serum IFN-gamma was not increased obviously after treatment (P > 0.05). The increase of the above index contents in the autohemotherapy group were more apparent than those in the western medication group (both P < 0.05). CONCLUSION: The acupoint autohemotherapy relieves significantly the clinical symptoms of allergic rhinitis and the therapeutic effect is better than that with oral administration of loratadine tablets, which is probably relevant with the increase of serum IL-12 content and the promotion of IFN-gamma synthesis.

[Clinical study of curing patients with perennial allergic rhinitis by qumin tongbi nasal spraying agent].

OBJECTIVE: To study the mechanism of action and the therapeutic efficacy of treating patients with perennial allergic rhinitis by Qumin Tongbi Nasal Spraying Agent (QTNSA). METHODS: One hundred and three patients with perennial allergic rhinitis were randomly assigned to two groups. Of them, 57 patients in the treatment group were treated with QTNSA and 46 patients in the control group were treated with Veconase. Seven days were taken as one therapeutic course, two courses in total. The therapeutic efficacy and the serum levels of interleukin-4 (IL-4), IL-8, immunoglobulin E (IgE) and nasal airway resistance (NAR), symptoms and signs integrals before and after treatment were observed in the two groups. RESULTS: There was no statistical significance between the treatment group and the control group in the markedly effective rate (61.40% vs. 63. 04%) and the total effective rate (87.72% vs. 89.13%). After treatment symptoms and signs integrals of the two groups were significantly improved when compared with before treatment (P < 0.01). There was no significant difference between the two groups after treatment (P > 0.05). The serum levels of IL-4, IL-8, IgE, and NAR were significantly higher in the two groups than those of the normal group. They significantly decreased after treatment in the two groups, showing statistical difference (P < 0.01). There was no statistical difference between the treatment group and the control group (P > 0.05). CONCLUSIONS: QTNSA could effectively treat perennial allergic rhinitis. It could obviously lower serum levels of IL-4, IL-8, IgE, and NAR in patients with perennial allergic rhinitis.

Soluble HLA-G and HLA-A,-B,-C serum levels in patients with allergic rhinitis.

BACKGROUND: Allergic rhinitis (AR) is characterized by Th2-polarized immune response. Soluble HLA (sHLA) molecules play an immunomodulatory activity. So far, however, no study investigated them in AR. OBJECTIVE: The aim of this study was to evaluate sHLA-G and sHLA-A,-B,-C serum levels in AR patients with pollen allergy and in a group of healthy controls. METHODS: Forty-nine AR patients were enrolled. A group of healthy nonallergic subjects was considered as control. sHLA-G and sHLA-A,-B,-C serum levels were determined by immunoenzymatic method. The study was conducted during the winter, such as outside the pollen season. RESULTS: Allergic patients had significantly higher levels of both sHLA-G (P < 0.0001) and sHLA-A,-B,-C (P = 0.011) molecules than normal controls. Moreover, there was a significant relationship between these two soluble molecules (r = 0.69) in allergic patients. CONCLUSION: The present study provides the first evidence that both sHLA-G and sHLA-A,-B,-C serum levels are significantly increased in AR patients with pollen allergy.

[Effects of electroacupuncture on plasma vasoactive intestinal peptide and substance P in perennial allergic rhinitis patients].

OBJECTIVE: To explore the underlying neuroimmunological mechanism of electroacupuncture (EA) in the treatment of perennial allergic rhinitis (PAR). METHODS: One hundred PAR outpatients were evenly randomized into EA group and medication group. Patients in EA group were treated with EA (5-10 mA, 80-100 Hz, and 30 min of stimulation) of Sphenopalatine ganglion area, Yingxiang (LI 20), Shangyingxiang (EX-HN 8), Yintang (EX-HN 3), supplemented with other acupoints according to syndrome-differentiation (once daily, 10 days being a therapeutic course). Patients of medication group were treated by Cetirizine (10 mg/times, t. i.d, peros). Before and after the treatment, blood samples of the ulnar vein were collected for detecting plasma vasoactive intestinal peptide (VIP) and substance P (SP) contents with radioimmunoassay. RESULTS: After the treatment, of the two 50 cases in EA and medication groups, 20 (40%) and 16 (32%) had an obvious improvement, 28 (56%) and 24 (48%) had an improvement, 2 (4%) and 10 (20%) failed, with the total effective rates being 96% and 80% separately. The therapeutic effect of EA group was significantly superior to that of medication group (P < 0.05). Self-comparison of each group showed that after the treatment, both plasma VIP and SP levels of two groups lowered apparently (P < 0.05, 0.01). Comparison between two groups showed that after the treatment, the content of VIP in EA group was markedly lower than that of medication group, while no significant difference was found between two groups in plasma SP levels (P > 0.05). CONCLUSION: EA can effectively relieve perennial allergic rhinitis patients' clinical symptoms, which is closely related to its functions in lowering plasma VIP and SP levels.

Plasma levels of polyunsaturated fatty acids in children with atopic dermatitis and in atopic and nonatopic controls.

BACKGROUND: Atopic dermatitis has been thought to be associated with a disturbance in n-6 polyunsaturated fatty acid (PUFA) metabolism, but randomized trials investigating the clinical efficacy of oral supplementation with gammalinolenic acid have revealed conflicting results. AIM OF THE STUDY: To re-investigate the proposed linkage between PUFA dysregulation and atopic dermatitis. MATERIALS AND METHODS: Plasma levels of linoleic acid (LA), gammalinolenic acid (GLA), dihomogammalinolenic acid (DGLA) and arachidonic acid (AA) were measured using HPLC in 22 children with atopic dermatitis. Patients were subdivided into those with elevated total serum IgE (group A, n = 15, IgE > +1 SD of age-specific normal values) and those with normal IgE (group B, n = 7) and compared with children suffering from allergic rhinitis/asthma (group C, n = 8) and with non-atopic controls (group D, n = 6). RESULTS: GLA levels were significantly lower (p < 0.05) in eczema patients with elevated IgE (A, 0.19 +/- 0.06%) and in atopic controls (C, 0.23 +/- 0.06%) than in eczema patients with low IgE (B, 0.42 +/- 0.19%) and non-atopic controls (D, 0.43 +/- 0.16%). There were no significant differences between groups for LIN, DGLA and AA, except for lower LIN levels in atopic controls. Correlation of individual LA and GLA values showed significantly steeper regression lines in low-IgE responders (B and D, k(x) = 0.058) than in high-IgE responders (A and C, k(x) = 0.012; p < 0.02), suggesting impaired delta-6-desaturase function in the latter. For the study population as a whole, there was a clear negative correlation between total levels of IgE and GLA (r(s) = -0.64) and a moderate negative correlation between total IgE and AA (r(s) = -0.38). CONCLUSIONS: Dysregulation of n-6 PUFA metabolism is neither consistently found in nor specifically associated with atopic dermatitis but rather appears to be associated with IgE production and atopy in general. The finding of decreased GLA levels in eczema patients with elevated total IgE and in children with allergic rhinitis and asthma but not in eczema patients with normal total IgE questions the proposed pathophysiologic role of fatty acid dysregulation in atopic dermatitis.

Allergic sensitisation and allergic rhinitis are associated with n-3 polyunsaturated fatty acids in the diet and in red blood cell membranes.

OBJECTIVE: Due to inconsistent results based on dietary intake data, unsaturated fatty acids in red blood cell (RBC) membranes and diet were used to investigate their association with allergic sensitisation and allergic rhinitis. DESIGN: Cross-sectional, population-based study. SETTING: Bavarian Nutrition Survey II (2002-03), Germany. SUBJECTS: A total of 568 adult participants, 325 women and 243 men. METHODS: By means of logistic regression models, the relation of fatty acids to (i) allergic sensitisation as defined by means of specific serum immunoglobulin E analysis (CAPSX1 class > or = 2), and (ii) self-reported allergic rhinitis was examined. RESULTS: A high cell membrane level of eicosapentaenoic acid (EPA, 20:5 n-3) was inversely associated with allergic sensitisation, the adjusted odds ratio (OR) and 95% confidence interval (95% CI) were 0.52 (0.30-0.90) for the highest (vs lowest) quartile. A similar effect was observed for allergic rhinitis with an OR (95% CI) of 0.50 (0.24-1.03; P = 0.027 for trend). A higher dietary intake of alpha-linolenic acid (ALA, 18:3 n-3) was associated with a decreased risk of allergic sensitisation and allergic rhinitis with ORs (95% CIs) of 0.51 (0.28-0.93) and 0.43 (0.20-0.93), respectively, in the highest quartiles. No other dietary or cell membrane unsaturated fatty acid was significantly associated with the outcome variables, nor was the n-6/n-3 ratio. The strongest effects were observed among subjects under the age of 40 y. CONCLUSIONS: In this cross-sectional study among adults, a high content of n-3 fatty acids in RBC membranes (EPA) or in the diet (ALA) is associated with a decreased risk of allergic sensitisation and allergic rhinitis.

Sublingual specific immunotherapy reduces PBMC proliferations.

BACKGROUND: Subcutaneous specific immunotherapy has been demonstrated capable of inducing T regulatory response. There is few evidence concerning immunological changes induced by sublingual immunotherapy. OBJECTIVE: The aim of this study was to evaluate T cell proliferation in subjects successfully treated with SLIT for HDM. METHODS: PBMCs were isolated from patients after at least 3 years of successful HDM SLIT and from matched untreated allergic and healthy control subjects. After 3 and 6 days of in vitro stimulation with PHA, Candida albicans, Dermatophagoides farinae, grasses, Parietaria judaica, and cat, proliferation. RESULTS: Subjects treated with SLIT showed significant reduction of proliferation induced by Candida albicans, Parietaria, and grasses in comparison with untreated atopics (p=0.0002, 0.0033, and 0.009 respectively). CONCLUSION: This pilot study confirms reduced T cell proliferation in allergic subjects treated with SLIT.

[Effect of kebimin decoction in treating allergic rhinitis and on blood levels of nitric oxide and superoxide dismutase].

OBJECTIVE: To observe the therapeutic effect of Kebimin decoction (KD) on allergic rhinitis (AR) and its effect on blood levels of nitric oxide (NO) and superoxide dismutase (SOD) activity. METHODS: Eighty-two AR patients were randomly divided into two groups, the treated group and the control group, 41 in each group. To the treated group, KD was given one dose per day for 10 days as one therapeutic course and 1-3 courses were given successively. The control group was treated with Xinfang Rhinitis capsule for 30 days. Blood levels were determined and compared before and after treatment. RESULTS: The total effective rate in the treated group was 93%, which was better than that in the control group (51%), the difference was significant (chi 2 = 17.704, P < 0.01). Serum level of NO was higher and that of SOD activity was lower in the AR patients than that in healthy persons (P < 0.01), KD could significantly lower the former and increase the latter (P < 0.01). CONCLUSION: The therapeutic effect of KD in treating AR was significant, its mechanism might be related with the lowering of NO and increasing of SOD activity in serum, as well as the scavenging of oxygen free radical.

Study on cytokines IL-2, IL-6, IL-10 in patients of chronic allergic rhinitis treated with acupuncture.

OBJECTIVES: To observe the plasmatic concentration of IL-6, IL-10 and IL-2 in the patient of chronic allergic rhinitis before and after acupuncture therapy. METHODS: Cytokine levels were determined before and after treatment in 30 healthy volunteers (Group A) and 90 patients of chronic allergic rhinitis (Group B) with an increased plasma IL-10 level. Group B was then divided into 3 subgroups: 30 patients treated with real acupuncture (Group B1); 30 patients treated with sham acupuncture (Group B2); 30 non-treated patients (Group B3). RESULTS: The allergic subjects of group B1, compared with controls, showed a significant reduction of IL-10 after a specific treatment with acupuncture (P < 0.05). On the other hand, in those patients treated with sham acupuncture (B2) as well as in non-treated patients (B3), the IL-10 values remained high and unchanged. There was a statistically significant change in IL-2 values at 24 hours (P < 0.05) after real acupuncture (Groups A, B1), however the values remained within normal ranges. The IL-6 do not change after therapy. CONCLUSION: The acupuncture treatment can reduce plasmatic level of IL-10 in chronic allergic rhinitis.

The Chinese herbal formulation biminne in management of perennial allergic rhinitis: a randomized, double-blind, placebo-controlled, 12-week clinical trial.

BACKGROUND: Herbal therapies have been widely used in allergic rhinitis (AR), but none have been shown to be effective in controlled scientific clinical trials. OBJECTIVE: The aim of this study was to test the effects of the Chinese herbal formulation Biminne in patients with moderate to severe perennial AR. METHODS: In a randomized, double-blind, placebo-controlled clinical trial, 58 patients were randomized to receive either Biminne capsules (n = 26) or placebo (n = 32) in doses of five capsules twice a day for 12 weeks. Main outcomes were measured by changes in symptom diaries, quality of life scores, patients' evaluations of improvement on visual analog scores, and physicians' overall evaluation. Total serum immunoglobulin E was measured in all patients without knowledge of which group they were in. After 1 year we performed a randomized, double-blind, dose-response study in 22 patients who had previously received placebo. RESULTS: The trial outcomes evaluated by four instruments showed a statistically significant improvement in some of the symptoms of AR, whereas others exhibited a positive trend that did not reach statistical significance. Followup 1 year after completion of the trial suggested that benefit of the treatment persisted. A pilot dose-response study showed both half and full strengths were effective. Total serum immunoglobulin E was reduced after the herbal treatment. CONCLUSIONS: Our results suggest the Biminne formulation is effective in treatment of perennial AR. Its mode of action is unknown.