ISRN allergy最新文献

Background/Aims. Glucocorticoids may have adverse effects on carbohydrate and lipid metabolism. The present study was conducted to investigate possible effects on carbohydrate and lipid metabolism of inhaled and oral glucocorticoids in children with asthma. Methods. Two randomised controlled trials with blinded crossover designs were performed. Active treatment was 400  μ g inhaled budesonide or 5 mg prednisolone orally daily during one week. The budesonide trial included 17 and the prednisolone trial 20 school children. Serum fructosamine, total cholesterol and high-density lipoprotein were assessed. Results. Serum fructosamine was increased during active treatment (prednisolone 252.3  μ M versus placebo 247.3  μ M; P = 0.03 and budesonide 228.1  μ M versus no treatment 223.1  μ M; P = 0.02). Total cholesterol and high-density lipoprotein were not statistically significantly increased. Conclusion. Short-term treatment with oral prednisolone and inhaled budesonide may adversely affect mean blood glucose concentration. Possible long-term consequences require further investigations.

Background. In recurrent wheezing infants, it is important to identify those likely to remain asthmatic in order to propose appropriate long-term management. Objective. To establish predictive factors for persistent asthma at adolescence in a population of recurrent wheezing infants. Methods. Retrospective study of 227 infants. Inclusion criteria were age under 36 months, a history of at least three wheezing episodes assessed via a doctor-led ISAAC questionnaire and a standardized allergy testing programme. At 13 years, active asthma was assessed by questionnaire. Results. Risk factors for asthma persisting into adolescence were allergic sensitization to multiple airborne allergens (OR 4.6, CI-95% (1.9-11.2) P = 0.001), initial atopic dermatitis (OR 3.4, CI-95% (1.9-6.3) P < 0.001), severe recurrent wheezing (OR 2.3, CI-95% (1.3-4.2) P = 0.007), and hypereosinophilia ≥470/mm(3) (OR 2.2, CI-95% (1.07-4.7) P = 0.033). Conclusion. While it is still difficult to predict the long-term course of asthma, atopy remains the major risk factor for persistent asthma.

Unlabelled: Background. Clinical experiences in vitro and clinical studies have demonstrated the curative potency and safety of Citrus/Cydonia compositum in seasonal allergic rhinitis treatment. Objectives. To compare the efficacy and safety of two routes of administration (nasal spray versus subcutaneous injections).

Methodology: Design. a national, randomised, comparative clinical trial with two parallel groups. Participants. 23 patients fulfilled the study requirements. Intervention. after a one- or two-week wash-out period, 23 patients were randomized, to a 6-week treatment period. Outcomes. immunological and symptom severity changes and safety. Immunologic outcome assessments were blinded to group assignment. 23 patients were randomized and from 22/23 patients (11 in each group) blood samples were analyzed before and after treatment. Conclusion. Both routes of administration demonstrate immunological and clinical effects, with larger inflammatory and innate immunological effects of the nasal spray route and larger allergen-specific clinical effects of the subcutaneous route, and are safe.

Background. Various sources of mammalian milk have been tried in CMA. Objectives. To determine whether camel milk is safer than goat milk in CMA. Methods. Prospective study conducted at Hamad Medical Corporation between April 2007 and April 2010, on children with CMA. Each child had medical examination, CBC, total IgE, cow milk-specific IgE and SPT. CMA children were tested against fresh camel and goat milks. Results. Of 38 children (median age 21.5 months), 21 (55.3%) presented with urticaria, 17 (39.5%) atopic dermatitis, 10 (26.3%) anaphylaxis. WBC was 10, 039 ± 4, 735 cells/μL, eosinophil 1, 143 ± 2, 213 cells/μL, IgE 694 ± 921 IU/mL, cow's milk-specific-IgE 23.5 ± 35.6 KU/L. Only 7 children (18.4%) tested positive to camel milk and 24 (63.2%) to goat milk. 6 (15.8%) were positive to camel, goat, and cow milks. Patients with negative SPT tolerated well camel and goat milks. Conclusions. In CMA, SPT indicates low cross-reactivity between camel milk and cow milk, and camel milk is a safer alternative than goat milk.

Aim. To study the relationship between atopy-related traits in a random sample of children. Methods. A total of 1007 randomly selected children, 7-17 years of age, from Copenhagen, Denmark were studied. The children were interviewed about symptoms of atopic diseases, and skin test reactivity, serum total IgE, lung function, and airway responsiveness were measured. Principal components analysis was performed in order to examine the relationship between the different traits. Results. Most of the studied traits were significantly correlated. A three-component solution explained about 55% of the variation in the observed traits. The first component loaded most strongly on hay fever, serum total IgE, skin test reactivity and sensitisation to grass, cat and house dust mite allergen; the second factor was most associated with asthma, airway obstruction, and airway hyperresponsiveness, whereas the third factor corresponded most strongly to atopic dermatitis. There was some indication of cross-relations between the three components with respect to serum total IgE. Conclusion. Asthma, hay fever, and atopic dermatitis are characterised by different sets of biomarkers suggestive of a high degree of heterogeneity within the atopic syndrome.

Our DIGMA program was established to allow patients time to interact with an allergist, a behaviorist and an asthma educator in a group setting. Weekly meetings targeted patients with chronic asthma. DIGMAs typically last for 90 minute s and include 10 patients per session. Outcome parameters were established to assess the effectiveness of the program over a 4 year time period. Sixty four adult asthmatic patients were enrolled and followed for 4 years. Patients were seen in a group setting in groups of ten. The AQLQ test was administered each year. Spirometry, an analog self assessment scale and the ACT were administered at each visit. Forty two of the 64 patients were followed for a minimum of 3 visits to DIGMA during four years. The average baseline FVC was 85% predicted and remained unchanged. FEV1 was 78% baseline and was 77% at the last determination. Baseline rescue inhaler use was 4 per week compared to 1.5 per week at last visit. ACT scores are 18 at baseline and 19 at last visit. ER claims are 5 at one year prior to enrollment and 2 at the last year of DIGMA. Patient satisfaction improved from 30 to 34 at the last visit. This was an effective, multidisciplinary asthma intervention that focused on behavior. It fulfilled the goals of asthma care as described by the 2007 NAEPP guidelines.

Background. In the present study, quality and quantity of indoor dust mites was evaluated at the residence of 150 atopic allergic patients from four different districts of South Assam. Methods. Suspected patients with case history of allergic disease were selected for indoor survey. Dust samples (500 mg) were collected from the selected patient's house and were analyzed using standard methods. Results. About 60% of the selected patients were found suffering from respiratory disorders and rest 40% from skin allergy. The dominant mites recorded from indoor dust samples were Dermatophagoides followed by Blomia, Acarus, and Cheyletus while Caloglyphus was recorded in least number. The distribution of mites on the basis of housing pattern indicates that RCC type of buildings supports maximum dust mite's population followed by Assam type (semi-RCC) buildings, and the lowest count was observed in wooden houses. Environmental factors like temperature, rainfall, and relative humidity are found to determine the indoor mite's population. Severity of allergic attack in some of the typical cases was found to be proportional to the allergen load of mites in the dust samples. Conclusions. The economic status, housing pattern, and local environmental factors determine the diversity and abundance of dust mites in indoor environment.

Background. There is little knowledge of the causes for raised serum total immunoglobulin E (IgE) in children. We investigated the association between perinatal, socioeconomic, demographic, clinical, paraclinical, and early life factors, and total serum IgE. Methods. In a random sample of 7-17 year old children, data on possible risk factors were collected using a questionnaire and total serum IgE was measured in venous blood. Airway responsiveness to inhaled histamine was measured and skin prick tests were performed using common aeroallergens. Data was analysed using linear regression. Results. Positive skin prick test (P < .001), airway hyperresponsiveness (P = .003), atopic dermatitis (P = .046), and parental predisposition to allergy (P = .047) showed a significant relation to serum total IgE levels. There was no association of smoking to serum total IgE. Conclusions. This study showed a strong positive relationship between markers of the atopic syndrome and serum total IgE levels in children. In contrast to some earlier studies, we did not find a significant relation between smoking status and IgE.

The impact of pollen exposure on population allergic illness is poorly characterized. We explore the association of tree pollen and over-the-counter daily allergy medication sales in the New York City metropolitan area. Dates of peak tree pollen (maple, oak, and birch) concentrations were identified from 2003 to 2008. Daily allergy medication sales reported to the city health department were analyzed as a function of the same-day and lagged tree pollen peak indicators, adjusting for season, year, temperature, and day of week. Significant associations were found between tree pollen peaks and allergy medication sales, with the strongest association at 2-day lag (excess sales of 28.7% (95% CI: 17.4-41.2) over the average sales during the study period). The cumulative effect over the 7-day period on and after the tree pollen peak dates was estimated to be 141.1% (95% CI: 79.4-224.1). In conclusion, tree pollen concentration peaks were followed by large increases in over-the-counter allergy medication sales.

Asthma is a chronic inflammatory airway disease characterized by allergen-induced airway hyperresponsiveness, airway inflammation, and remodeling. Nitric oxide (NO) derived from constitutive and inducible enzymes affects many aspects of asthma physiopathology. Animal in vivo studies have indicated that inhibition of iNOS may play a central role in the modulation of these features, particularly extracellular matrix remodeling. Additionally, increases in iNOS-derived NO, observed in asthmatic patients, may lead to an increase in peroxynitrite and an imbalance of oxidant and antioxidant pathways. In addition, endogenous nitric oxide produced by constitutive enzymes may protect against the remodeling of the lung. Therefore, nitric oxide donors and/or iNOS inhibitors may have therapeutic potential in asthma treatment and can also be used with corticosteroids to counteract airway remodeling. This paper focuses on the pathophysiological role of nitric oxide, mainly derived from inducible isoforms, in the various pathologic mechanisms of allergic asthma and the importance of nitric oxide and/or arginase inhibitors in asthma treatment.