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Atopic dermatitis: natural history, diagnosis, and treatment. 特应性皮炎:自然史、诊断和治疗。
Pub Date : 2014-04-02 eCollection Date: 2014-01-01 DOI: 10.1155/2014/354250
Simon Francis Thomsen

Atopic dermatitis is an inflammatory skin disease with early onset and with a lifetime prevalence of approximately 20%. The aetiology of atopic dermatitis is unknown, but the recent discovery of filaggrin mutations holds promise that the progression of atopic dermatitis to asthma in later childhood may be halted. Atopic dermatitis is not always easily manageable and every physician should be familiar with the fundamental aspects of treatment. This paper gives an overview of the natural history, clinical features, and treatment of atopic dermatitis.

特应性皮炎是一种早期发病的炎症性皮肤病,终生患病率约为20%。特应性皮炎的病因尚不清楚,但最近发现的聚丝蛋白突变有希望阻止儿童晚期特应性皮炎向哮喘的进展。特应性皮炎并不总是容易控制,每个医生都应该熟悉治疗的基本方面。本文就特应性皮炎的自然病史、临床特点及治疗方法作一综述。
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引用次数: 252
Female asthma has a negative effect on fertility: what is the connection? 女性哮喘对生育能力有负面影响:这两者之间有什么联系?
Pub Date : 2014-03-27 eCollection Date: 2014-01-01 DOI: 10.1155/2014/131092
Elisabeth Juul Gade, Simon Francis Thomsen, Svend Lindenberg, Vibeke Backer

Reproductive changes such as impaired fertility and adverse pregnancy outcomes have been related to female asthma. We recently found that time to pregnancy is prolonged in asthmatic females especially in women with moderate to severe asthma and in those above 30 years of age. Despite their reproductive difficulties the asthmatics ultimately conceived just as many biological children as healthy throughout their reproductive lives. This knowledge therefore raises questions about how asthma affects fertility pathophysiologically. The purpose of this review is to describe the existing knowledge in this field and suggest hypotheses of causal relationships, which may form the basis for future studies in this field. The aim is, in particular, in the literature to examine whether there is any evidence to suggest that the systemic inflammation that characterizes asthma, can affect fertility. The issue is potentially clinically important for asthmatic, infertile individuals and society because treatment of the general systemic inflammation associated with the asthmatic disease combined with hormone stimulation might be the optimal target for an effective infertility therapy, possibly decreasing the need for in vitro fertilization.

生育能力受损和不良妊娠结局等生殖变化与女性哮喘有关。我们最近发现,患有哮喘的女性,特别是患有中度至重度哮喘的女性和30岁以上的女性,怀孕时间延长。尽管在生育方面存在困难,但哮喘患者在整个生育过程中最终怀上的亲生孩子和健康的孩子一样多。因此,这一知识提出了哮喘如何从病理生理上影响生育能力的问题。本综述的目的是描述该领域的现有知识,并提出因果关系的假设,这可能为该领域的未来研究奠定基础。研究的目的是,在文献中研究是否有证据表明,作为哮喘特征的全身炎症会影响生育能力。这个问题对于哮喘、不孕症患者和社会具有潜在的临床重要性,因为治疗与哮喘相关的全身性炎症并结合激素刺激可能是有效的不孕症治疗的最佳目标,可能会减少体外受精的需求。
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引用次数: 19
Respiratory allergies: a general overview of remedies, delivery systems, and the need to progress. 呼吸道过敏:一般概述的补救措施,输送系统,和需要的进展。
Pub Date : 2014-03-12 eCollection Date: 2014-01-01 DOI: 10.1155/2014/326980
Giuliano Molinari, Giselda Colombo, Cinzia Celenza

The spread of respiratory allergies is increasing in parallel with the alarm of the scientific community. Evidently, our knowledge of the onset mechanisms of these diseases and, as a consequence, of the available remedies is inadequate. This review provides a brief, general description of current therapeutic resources and the state of research with regard to both drugs and medical devices in order to highlight their limits and the urgent need for progress. Increasing the amount of basic biochemical research will improve our knowledge of such onset mechanisms and the potential efficacy of therapeutic preparations.

随着科学界的警惕,呼吸道过敏的传播也在增加。显然,我们对这些疾病的发病机制以及由此产生的现有补救措施的认识是不够的。这篇综述简要概述了目前的治疗资源以及药物和医疗器械的研究现状,以突出其局限性和迫切需要取得进展。增加基础生化研究的数量将提高我们对这种发病机制和治疗制剂潜在功效的认识。
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引用次数: 0
Prevalence of Allergies among University Students: A Study from Ajman, United Arab Emirates. 大学生过敏患病率:来自阿拉伯联合酋长国阿治曼的一项研究
Pub Date : 2014-02-19 eCollection Date: 2014-01-01 DOI: 10.1155/2014/502052
Lisha Jenny John, Sharfaa Ahmed, Fiza Anjum, Mohieddin Kebab, Naik Mohammed, Haitham Darwich, Nusaibah Ibraheem, Mohamed Arifulla, Jayadevan Sreedharan

Aim. Urbanization and globalization in the Middle East have resulted in drastic environmental changes and increased allergens present in the environment. This study aimed to assess the prevalence of allergies among undergraduate students from a university. Material and Methods. This cross-sectional survey was carried out among undergraduate students of a University at Ajman, UAE. A self-administered questionnaire was used as research instrument for data collection. The demographic data and the allergy characteristics were collected and analyzed using SPSS version 19. Descriptive and inferential statistics were performed. Results. A total of 255 students (33.3% males; 66.7% females) were included. Commonest allergies among the students were allergic conjunctivitis (104 (40.8%)), allergic dermatitis (89 (34.9%)), and eczema (38 (14.9%)). Family history of allergies was strongly associated with occurrence of allergic conjunctivitis and allergic dermatitis. In about 58 (22%) of the students, dust was the most common triggering factor for allergies. Allergies associated with pollen, food, and drugs were less frequent. The distribution of allergies based on gender revealed female preponderance in all types of allergies. Students with allergies reported interference with their daily activities, and academic, social, and extracurricular activities. Conclusions. Allergic conjunctivitis and allergic dermatitis were the frequent allergies reported. Adequate preventive strategies can crumb the prevalence of allergies.

的目标。中东地区的城市化和全球化导致了剧烈的环境变化和环境中过敏原的增加。本研究旨在评估一所大学本科生的过敏患病率。材料和方法。本横断面调查是在阿联酋阿治曼一所大学的本科生中进行的。采用自填问卷作为数据收集的研究工具。统计统计资料及过敏特征,采用SPSS 19进行统计分析。进行描述性和推断性统计。结果。共255名学生,其中男生占33.3%;66.7%为女性)。学生中最常见的过敏为过敏性结膜炎104例(40.8%)、过敏性皮炎89例(34.9%)、湿疹38例(14.9%)。过敏家族史与过敏性结膜炎和过敏性皮炎的发生密切相关。在大约58名(22%)学生中,灰尘是最常见的过敏触发因素。与花粉、食物和药物相关的过敏较少。过敏症的性别分布显示,所有类型的过敏症均以女性为主。据报告,过敏学生的日常活动、学业、社交和课外活动都受到了干扰。结论。变态反应性结膜炎和变态反应性皮炎是常见的变态反应。适当的预防策略可以抑制过敏的流行。
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引用次数: 26
Complementary therapies in allergic rhinitis. 变应性鼻炎的补充疗法。
Pub Date : 2013-11-13 eCollection Date: 2013-01-01 DOI: 10.1155/2013/938751
Ibrahim Sayin, Cemal Cingi, Fatih Oghan, Bahadir Baykal, Seckin Ulusoy

Objective. To determine the prevalence of herbal treatment of allergic rhinitis. Methods. In this prospective study, patients who were diagnosed with perennial allergic rhinitis were questioned about their use of natural products/herbal therapies for their symptoms. Results. In total, 230 patients were enrolled. Overall, 37.3% of the patients stated that they had used natural products/herbal therapies at least once. Women were more likely than men to use herbal supplements (38.3% versus 32.4%). Ten different types of herbal supplements were identified, with stinging nettle (Urtica dioicath), black elderberry (Sambucus nigra), and Spirulina being the most common (12.6%, 6.1%, and 5.7%, resp.). Conclusion. This study found a high prevalence of herbal treatment usage for the relief of allergic rhinitis symptoms in Turkey. The herbal products identified in this study and in the literature are discussed.

目标。目的了解中药治疗变应性鼻炎的流行情况。方法。在这项前瞻性研究中,被诊断为常年性过敏性鼻炎的患者被问及他们使用天然产品/草药治疗他们的症状。结果。总共有230名患者入组。总体而言,37.3%的患者表示他们至少使用过一次天然产品/草药疗法。女性比男性更有可能使用草药补充剂(38.3%比32.4%)。确定了10种不同类型的草药补充剂,其中荨麻(Urtica dioicath),黑接骨木(Sambucus nigra)和螺旋藻是最常见的(分别为12.6%,6.1%和5.7%)。结论。本研究发现,在土耳其,草药治疗用于缓解过敏性鼻炎症状的患病率很高。本研究和文献中鉴定的草药产品进行了讨论。
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引用次数: 16
Noneczematous contact dermatitis. 非湿疹性接触性皮炎。
Pub Date : 2013-09-15 DOI: 10.1155/2013/361746
Domenico Bonamonte, Caterina Foti, Michelangelo Vestita, Gianni Angelini

Irritant or allergic contact dermatitis usually presents as an eczematous process, clinically characterized by erythematoedematovesicous lesions with intense itching in the acute phase. Such manifestations become erythematous-scaly as the condition progresses to the subacute phase and papular-hyperkeratotic in the chronic phase. Not infrequently, however, contact dermatitis presents with noneczematous features. The reasons underlying this clinical polymorphism lie in the different noxae and contact modalities, as well as in the individual susceptibility and the various targeted cutaneous structures. The most represented forms of non-eczematous contact dermatitis include the erythema multiforme-like, the purpuric, the lichenoid, and the pigmented kinds. These clinical entities must obviously be discerned from the corresponding "pure" dermatitis, which are not associated with contact with exogenous agents.

刺激性或过敏性接触性皮炎通常表现为湿疹过程,临床表现为急性期的红斑、水肿性皮损伴强烈瘙痒。随着病情发展到亚急性期,这些表现变为红斑鳞状,在慢性期变为丘疹性角化过度。然而,接触性皮炎并非罕见地表现为非湿疹性特征。这种临床多态性的原因在于不同的部位和接触方式,以及个体易感性和不同的靶向皮肤结构。最具代表性的非湿疹性接触性皮炎包括多形性红斑、紫癜性红斑、类地衣性红斑和色素性红斑。这些临床实体必须明显与相应的“纯粹”皮炎区分开来,后者与外源性药物接触无关。
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引用次数: 46
Ultrastructural changes of airway in murine models of allergy and diet-induced metabolic syndrome. 过敏和饮食诱发代谢综合征小鼠模型的气道超微结构变化。
Pub Date : 2013-09-10 eCollection Date: 2013-01-01 DOI: 10.1155/2013/261297
Geeta Devi Leishangthem, Ulaganathan Mabalirajan, Vijay Pal Singh, Anurag Agrawal, Balaram Ghosh, Amit Kumar Dinda

Studying ultrastructural changes could reveal novel pathophysiology of obese-asthmatic condition as existing concepts in asthma pathogenesis are based on the histological changes of the diseased airway. While asthma is defined in functional terms, the potential of electron microscopy (EM) in providing cellular and subcellular detail is underutilized. With this view, we have performed transmission EM in the lungs from allergic mice that show key features of asthma and high-fat- or high-fructose-fed mice that mimicked metabolic syndrome to illustrate the ultrastructural changes. The primary focus was epithelial injury and metaplasia, which are cardinal features of asthma and initiate airway remodeling. EM findings of the allergically inflamed mouse lungs correlate with known features of human asthma such as increased mitochondria in airway smooth muscle, platelet activation and subepithelial myofibroblasts. Interestingly, we found a clear and unambiguous evidence to suggest that ciliated cells can become goblet cells using immunoelectron microscopy. Additionally, we show for the first time the stressed mitochondria in the bronchial epithelia of high-fat- or high-fructose-fed mice even without allergen exposure. These results may stimulate interest in using EM in understanding novel pathological mechanisms for different subtypes of asthma including obese asthma.

研究超微结构的变化可以揭示肥胖-哮喘的新病理生理学,因为现有的哮喘发病机理概念是基于病变气道的组织学变化。虽然哮喘是从功能角度定义的,但电子显微镜(EM)在提供细胞和亚细胞细节方面的潜力却未得到充分利用。有鉴于此,我们对表现出哮喘主要特征的过敏性小鼠肺部和模拟代谢综合征的高脂或高果糖喂养小鼠肺部进行了透射电镜观察,以说明超微结构的变化。研究的主要重点是上皮损伤和增生,这是哮喘的主要特征,也是气道重塑的起始因素。过敏性发炎小鼠肺部的电磁学发现与人类哮喘的已知特征相关,如气道平滑肌线粒体增加、血小板活化和上皮下肌成纤维细胞。有趣的是,我们利用免疫电镜发现了一个明确无误的证据,表明纤毛细胞可以变成鹅口疮细胞。此外,我们还首次在高脂或高果糖喂养的小鼠支气管上皮中发现了受压线粒体,即使没有接触过敏原也是如此。这些结果可能会激发人们的兴趣,利用免疫显微镜了解不同亚型哮喘(包括肥胖性哮喘)的新病理机制。
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引用次数: 0
Sustained elevation of systemic oxidative stress and inflammation in exacerbation and remission of asthma. 持续升高的系统性氧化应激和炎症在哮喘的恶化和缓解。
Pub Date : 2013-08-29 eCollection Date: 2013-01-01 DOI: 10.1155/2013/561831
Judith C W Mak, Siu P Ho, Alice S S Ho, Barbara K W Law, Amy H K Cheung, James C M Ho, Mary S M Ip, Moira M W Chan-Yeung

Oxidative stress has been implicated in the pathogenesis of asthma. We aimed at investigating the biomarkers of oxidative stress, inflammation, and tissue damage in patients with asthma in acute exacerbation and remission. We recruited 18 asthmatics admitted to hospital with acute exacerbation and 18 healthy nonsmoking controls matched for age. We evaluated plasma levels of 8-isoprostane, C-reactive protein (CRP) and total matrix metalloproteinase- (MMP-) 9 by ELISA, and MMP-9 activity by zymographic analysis. Plasma levels of 8-isoprostane and CRP were significantly elevated in acute exacerbation and decreased in remission but remained significantly higher compared to healthy controls. The activities of pro-MMP-9 were also significantly higher in acute exacerbation and decreased in remission but remained significantly higher compared to healthy controls in parallel to plasma levels of total MMP-9. These data suggest that overproduction of MMP-9 along with highly elevated levels of oxidative stress and inflammation is implicated in asthma exacerbation and that measurements of these biomarkers can be a valid index in its management.

氧化应激与哮喘的发病机制有关。我们的目的是研究急性发作和缓解期哮喘患者的氧化应激、炎症和组织损伤的生物标志物。我们招募了18名因急性发作入院的哮喘患者和18名年龄相匹配的健康非吸烟对照者。采用ELISA法测定血浆8-异前列腺素、c反应蛋白(CRP)和总基质金属蛋白酶- (MMP-) 9的水平,并采用酶谱法测定MMP-9的活性。血浆8-异前列腺素和CRP水平在急性加重期显著升高,缓解期显著降低,但与健康对照组相比仍显著升高。血浆中总MMP-9水平与健康对照相比,急性加重期MMP-9的活性显著升高,缓解期降低,但仍显著升高。这些数据表明,MMP-9的过量产生以及氧化应激和炎症水平的高度升高与哮喘加重有关,这些生物标志物的测量可以作为哮喘管理的有效指标。
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引用次数: 27
The challenge of delivering therapeutic aerosols to asthma patients. 向哮喘患者输送治疗性气雾剂的挑战。
Pub Date : 2013-08-05 eCollection Date: 2013-01-01 DOI: 10.1155/2013/102418
Federico Lavorini

The number of people with asthma continues to grow around the world, and asthma remains a poorly controlled disease despite the availability of management guidelines and highly effective medication. Patient noncompliance with therapy is a major reason for poor asthma control. Patients fail to comply with their asthma regimen for a wide variety of reasons, but incorrect use of inhaler devices is amongst the most common. The pressurised metered-dose inhaler (pMDI) is still the most frequently used device worldwide, but many patients fail to use it correctly, even after repeated tuition. Breath-actuated inhalers are easier to use than pMDIs. The rationale behind inhaler choice should be evidence based rather than empirical. When choosing an inhaler device, it is essential that it is easy to use correctly, dosing is consistent, adequate drug is deposited in both central and peripheral airways, and that drug deposition is independent of airflow. Regular checking of inhalation technique is crucial, as correct inhalation is one of the cornerstones of successful asthma management.

全世界哮喘患者人数持续增长,尽管有管理指南和高效药物,但哮喘仍然是一种控制不佳的疾病。患者对治疗的不依从性是哮喘控制不良的主要原因。由于各种各样的原因,患者未能遵守他们的哮喘治疗方案,但不正确使用吸入器装置是最常见的原因之一。加压计量吸入器(pMDI)仍然是世界范围内使用最频繁的设备,但许多患者即使经过反复指导也不能正确使用。呼吸驱动吸入器比pmdi更容易使用。选择吸入器的理由应该基于证据而不是经验。在选择吸入器装置时,重要的是它易于正确使用,剂量一致,在中央和外周气道中沉积足够的药物,并且药物沉积与气流无关。定期检查吸入技术是至关重要的,因为正确的吸入是成功的哮喘管理的基石之一。
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引用次数: 101
Reciprocal interference of experimental dyslipidemia and food allergy in the evolution of both diseases. 实验性血脂异常和食物过敏在两种疾病演变中的相互干扰。
Pub Date : 2013-06-06 Print Date: 2013-01-01 DOI: 10.1155/2013/545184
A C Gomes-Santos, J L Gonçalves, T R Fonseca, A R Marques, L P A Dourado, D C Cara, J I Alvarez-Leite

Background. Food allergies have been shown to reduce serum triacylglycerol, glucose, cholesterol, and free fatty acid levels in mice. In turn, dyslipidemias, especially dyslipidemias presenting with low levels of HDL cholesterol, are important risk factors for the development of atherosclerosis. However, the consequences of food allergies on dyslipidemia and atherosclerosis have not been fully investigated. Methods. Food allergy was induced using an egg white solution (EWS) in ovalbumin- (OVA-) sensitized C57BL/6 and low-density lipoprotein receptor knockout mice (LDLr(-/-)) for 5 weeks and was confirmed by the high production of anti-OVA IgE and IgG1 antibodies in both mouse strains. Results. The allergic C57BL/6 mice exhibited EWS aversion that was associated with less visceral fat and high levels of anti-Ova IgE antibodies after 5 weeks of EWS intake compared to controls. However, LDLr(-/-) allergic mice showed reduced anti-Ova IgE levels that were similar to the nonsensitized group. The LDLr(-/-) allergic mice also demonstrated a reversal of food aversion and sustained visceral fat after 5 weeks of allergy. Although HDL cholesterol levels were reduced in both sensitized mouse strains, lipid deposition in thoracic and abdominal aorta as well as area and composition of atherosclerotic plaques as unaffected by chronic ingestion of EWS. Conclusion. LDLr(-/-) mice develop an attenuated food allergy, as they showed a reversal of food aversion and lower IgE production after 5 weeks of induced allergy. The development of atherosclerosis, in turn, was not accelerated in the allergic LDLr(-/-) group despite the more atherogenic lipid profile.

背景。食物过敏已被证明能降低小鼠血清中甘油、葡萄糖、胆固醇和游离脂肪酸的水平。反过来,血脂异常,特别是表现为低水平HDL胆固醇的血脂异常,是动脉粥样硬化发展的重要危险因素。然而,食物过敏对血脂异常和动脉粥样硬化的影响尚未得到充分研究。方法。用蛋清溶液(EWS)诱导卵白蛋白- (OVA-)致敏C57BL/6和低密度脂蛋白受体敲除小鼠(LDLr(-/-)) 5周的食物过敏,两种小鼠品系均产生高水平的抗OVA IgE和IgG1抗体。结果。与对照组相比,过敏的C57BL/6小鼠在摄入EWS 5周后表现出对EWS的厌恶,与内脏脂肪减少和抗卵细胞IgE抗体水平升高有关。然而,LDLr(-/-)过敏小鼠显示抗卵IgE水平降低,与未致敏组相似。LDLr(-/-)过敏小鼠在过敏5周后也表现出食物厌恶和持续内脏脂肪的逆转。尽管两种致敏小鼠品系的HDL胆固醇水平均有所降低,但胸腹主动脉的脂质沉积以及动脉粥样硬化斑块的面积和组成不受慢性摄入EWS的影响。结论。LDLr(-/-)小鼠在诱导过敏5周后表现出对食物厌恶的逆转和较低的IgE产生,从而产生减轻的食物过敏。反过来,在过敏的LDLr(-/-)组中,动脉粥样硬化的发展并没有加速,尽管有更多的致动脉粥样硬化的脂质谱。
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引用次数: 0
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