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ABSTRACT: To evaluate the long-term efficacy of subcutaneous immunotherapy with Dermatophagoides pteronyssinu (DerP) in patients with allergic rhinitis.
Ninety-two patients with allergic rhinitis to DerP were randomly allocated to receive either specific immunotherapy (n = 46) or medical treatment (n = 46). Symptom and medication scores and skin response to Derp were assessed to evaluate the clinical efficacy in the baseline and after three years treatment. DerP-specific IgE and IgG4 were measured.
After three years treatment, the immunotherapy group showed sustained reductions in symptom scores (before treatment 9.20 [7.50;11.13], after treatment 3.32 [2.49;5.12], Z = -5.13, P < 0.05), medication scores (before treatment 0.72 [0.47;0.83], after treatment 0.31 [0.28;0.45], Z = -5.78, P < 0.05) and specific skin response to Derp (t = 6.37, P < 0.05) when compared with control group. There were no differences in the level of serum specific IgE before and after three-year treatment (before treatment 16.32 [4.34;38.65] kU/L, after treatment 15.85 [4.93;46.27] kU/L, Z = -0.84, P > 0.05), but the level of serum specific IgG4 increased significantly after one year treatment in immunotherapy group (before treatment 486 [319;1439] AU/L, after treatment 8387 [7732;16 634] AU/L, Z = -2.81, P < 0.05). After three-year treatment, 7.5% (3/40) of patients had asthma in immunotherapy group compared to 27.8% (10/36) in the control group (χ(2) = 5.50, P < 0.05), and 15.0% of the initially DerP monosensitized patients in immunotherapy group had developed new sensitization compared to 47.2% in the control group (χ(2) = 9.32, P < 0.05).
Three years immunotherapy improves allergic rhinitis symptoms, increases the level of serum specific IgG4, reduces the development of asthma and new sensitization.
Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery 10/2012; 47(10):804-8.
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ABSTRACT: To compare the efficacy and safety of a 6-week cluster schedule of specific immunotherapy with that of a 14-week conventional schedule for the treatment of subjects with persistent allergic rhinitis (AR).
The trial was a prospective and randomized study involving 80 patients with persistent AR, who were allergic to Dermatophagoides pteronyssinus. While 40 patients were randomly assigned to the cluster schedule reaching the maintenance dose within 6 weeks, the other 40 patients were randomly assigned to the conventional schedule reaching the maintenance dose within 14 weeks. Symptom scores and medication scores were used to evaluate the clinical efficacy. Serum specific IgG4 level was examined to mark immunologic change, adverse reactions were recorded during the treatment.
Cluster group achieved clinical efficacy (reducing symptom scores and medication score) and increasing serum specific IgG4 sooner (after 6 weeks treatment). During the incremental dose phase, there were 6 systemic adverse reactions (1.12% of all injection) in 3 patients in cluster group and there were 5 systemic adverse reactions (0.85% of all injection) in 3 patients in conventional group. No severe systemic reactions occurred in both group. There was no difference between the 2 groups in frequency or type of systemic reaction (χ(2) = 0.333, P > 0.05).
The cluster schedule is a safe alternative to the conventional schedule with the advantage of achieving clinical efficacy sooner.
Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery 12/2011; 46(12):981-5.
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ABSTRACT: To investigate the main inhaled allergens in patients with allergic rhinitis.
Forty-three standardization allergens were used to perform skin prick test in 54 813 patients with chronic rhinitis. According to different gender and age groups, 10 030 patients with allergic rhinitis were divided into eight groups. The distributions of different allergens in the eight groups were analyzed.
(1) The most common four allergens in male patients with allergic rhinitis were Dermatophagoides farina (Der f), Dermatophagoides pteronyssinus (Der p), Mugwort and Blaterlia Germanica. Der f, Der p, Mugwort and Chenopodium album were the most common in female patients. (2) In all groups, patients with dual positive allergens were the most common, followed by triple positive allergens and single positive allergen. (3) In single positive allergen group, the top four allergen in male 3-17 year group were Der f, Der p, Alternaria tenuis and Mugwort. In other male groups, the most common positive allergen were Der f, Der p, Mugwort and Blaterlia Germanica. Meanwhile, the top four positive allergens in female 3-17 year group were Der f, Der p, Mugwort and Alternaria tenuis, in 18-39 year group were Der f, Der P, Mugwort and Dandelion, in 40-59 year group were Der f, Der p Mugwort and mixed tree 1, in ≥60 year group were Derf, Der P, mixed animal hair and Mugwort. (4) In dual positive allergens group, the most common allergen combination was Der f+Der p, followed by Alternaria tenuis in patient of 3-17 year group. (5) In triple positive allergens group, the most common allergen combination was Der f+Der p+Blaterlia Germanica, followed by Der f+Der p+mixed animal hair.
Dust mites, flowers pollen, herbs, Alternaria tenuis and Blaterlia Germanica were the most common allergens in patients with allergic rhinitis. However, the frequencies of the allergens were different in different age groups.
Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery 11/2011; 46(11):914-20.
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Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery 01/2011; 46(1):12-4.
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Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery 01/2011; 46(1):17-8.
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ABSTRACT: To evaluate the efficacy and immunological changes of children receiving subcutaneous immunotherapy with Dermatophagoides pteronyssinus.
Sixty-four children with allergic rhinitis to Dermatophagoides pteronyssinus (Der p) were randomly allocated to receive either specific immunotherapy (n = 32) or medical treatment (n = 32). Symptom and medication scores were assessed to evaluate the clinical efficacy in the baseline and after one year treatment. Total IgE, Der p-specific IgE, and specific IgG4 were measured.
Immunotherapy reduced the symptom (the scores reduced from 10[9;11] to 4[3;6]) and medication score (the scores reduced from 0.76[0.61;0.90] to 0.35[0.30;0.43]) in children with allergic rhinitis significantly(Z value were -4.80 and -4.74, respectively, each P < 0.01). There was a significant difference in symptom and medication scores between both groups after one year treatment (U value were 155.00 and 139.50, respectively, each P < 0.01). There were no differences in levels of serum total IgE, specific IgE before and after one year treatment, but the level of serum specific IgG4 increased significantly after one year treatment.
Immunotherapy with standardized extract is efficacious to treat children sensitive to Der p, allergen-specific IgG4 is significant as immunological marker to predict efficacy of immunotherapy.
Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery 01/2011; 46(1):36-9.
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ABSTRACT: To investigate the correlation between polymorphisms in the FOXP3 locus and the susceptibility of allergic rhinitis.
Two polymorphisms in FOXP3 locus were genotyped in 193 subjects with allergic rhinitis and 191 healthy controls. The polymorphisms were chosen in terms of the information from Hapmap website as well as Haploview version 4.1 program implemented results. PCR-resequencing methods was performed for genotyping. SPSS program version 13.0 was used for statistical analysis.
Heterozygotes of rs3761547 and rs3761548 appeared significant, while only rs3761548 (P = 0.020, OR = 3.12, 95%CI were 1.21 - 8.04) remained significant following application of the Bonferroni correction for multiple testing. Subgroup analysis for the presence of different allergen allergy also showed significant association for house dust mites (rs3761547, P = 0.013, OR = 2.00).
Heterozygous allele in rs3761548 is associated with allergic rhinitis and rs3761547 is related to house dust mites allergic rhinitis.
Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery 05/2010; 45(5):397-400.
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Luo Zhang,
Geng Xu,
Xiang-dong Wang,
Shi-xi Liu,
Yuan Li,
Shen-qing Wang,
Bei-bei Yang,
Chun-quan Zheng, Cheng-shuo Wang,
Pin Dong,
Zi-ping Lin,
Hua Zhang,
De-min Han
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ABSTRACT: To evaluate the effects of nasal mometasone furoate on moderate to severe allergic rhinitis.
Patients with moderate to severe allergic rhinitis were enrolled and received mometasone furoate nasal spray 200 microg once daily for four weeks. Four hundreds and sixty-three patients completed the study. We weekly interviewed the patients to evaluate the symptoms, and the affection of disease on night sleep and daily life. Mini Rhinoconjunctivitis Quality of Life Questionnaire (Mini-RQLQ) and Nocturnal Rhinoconjunctivitis Quality of Life Questionnaire (NRQLQ) were used to evaluate the quality of life.
The individual and total symptomatic scores of week 1, week 2 and week 4 decreased compared with baseline. The scores of Mini-RQLQ and NRQLQ of week 1, week 2 and week 4 decreased compared with baseline too. The scores of the next visit were significantly lower than those of the previous visit (P < 0.01).
A four-week administration of mometasone furoate nasal spray can effectively treat allergic rhinitis.
Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery 06/2009; 44(6):455-9.
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ABSTRACT: To evaluate the efficacy and safety of cluster immunotherapy with Dermatophagoides pteronyssinus for allergic rhinitis.
One hundred and fifty-four patients with allergic rhinitis to Dermatophagoides pteronyssinus were allocated to receive specific immunotherapy in a 6-week cluster schedule during the incremental-dose phase. Thereafter, these patients received maintenance-dose injection at 6-week intervals until the end of 1 year of treatment. Symptom scores and medication scores were used to evaluate the clinical efficacy and adverse reactions were recorded. A rhinoconjunctivitis quality of life questionnaire (RQLQ) was completed in the baseline and after one year treatment.
Cluster immunotherapy significantly reduced the symptom scores and total medication score of patients enrolled (P < 0.01). The immunotherapy group also had a significant improvement in the Rhinoconjunctivitis Quality of Life Questionnaire. During the one-year of treatment, there were 26 systemic adverse reactions (0.75% of all injection) in 9 patients (5.9%) and no fatal systemic reactions occurred.
The cluster immunotherapy is efficacious and safe to treat allergic rhinitis.
Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery 03/2008; 43(3):187-91.
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ABSTRACT: The endoscopic management of inverted papilloma has gained increasing popularity over the last 15 years. However, the appropriate management of lesions involving the frontal sinus and its drainage pathway still has to be determined.
We performed a retrospective review of the results of the patients with inverted papilloma in the Otolaryngology Head and Neck Surgery department, Beijing Tongren Hospital from 2004 to 2007 to identify the patients with lesions involving frontal sinus and its drainage pathway. By its appearance on nasal endoscopic examination and CT scanning, the tumors were defined using Krouse staging system. Sinus endoscopy was used to screen for disease after endoscopic resection. And their clinical outcomes were analyzed.
A total of nine patients (8 males and one female) with inverted papilloma who had frontal sinus and its drainage pathway involvement were identified. All tumors were defined as T3 lesions. Preoperative and postoperative pathologic examinations revealed inverted papilloma as the diagnosis. Four cases with lateral wall of frontal recess attachment underwent endoscopic Draf II A frontal sinusotomy. Three cases with either lateral and posterior walls of frontal recess and frontal infundibulum attachment or medial and posterior walls of frontal recess and frontal infundibulum attachment underwent Draf II B procedure. Two cases with either posterior wall of frontal recess and frontal infundibulum attachment or medial, lateral and posterior walls of frontal recess and frontal infundibulum attachment underwent Draf III procedure. All patients remain disease free with an average follow-up of 13 months.
Extensive inverted papilloma (Krouse T3 lesions) can be treated successfully with an endoscopic approach.
Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery 02/2008; 43(1):22-6.
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ABSTRACT: To evaluate the efficacy of topical steroid treatment of nonpolypoid chronic sinusitis.
Two cohorts of adult and children with nonpolypoid chronic sinusitis were investigated. The first cohort consisted of 11 pediatric patients [mean age, (11.8 +/- 3.2) years] with a mean Lund score of 10.3 +/- 5.7 (x +/- s). The second cohort consisted of 13 adult patients [mean age, (36.7 +/- 11.0) years] with a mean Lund score of 12.2 +/- 5.7. The mean duration of the nasal budesonide (Rhinocort) treatment was (7.5 +/- 3.2) weeks for adult patients (256 microg/d) and (7.0 +/- 3.4) weeks for pediatric patients (128 microg/d). Each Lund score and the patient's assessment of nasal symptoms were evaluated after treatment.
The average Lund score was significantly decreased to 6.5 -/+ 7.5 (t = 3.82, P < 0.01) in adult patients and to 2.6 +/- 3.7 (t = 5.08, P < 0.01) in pediatric patients after treatment. Thirty-eight percent of the adult patients and 73% of the pediatric patients were cured on CT images. The patient's self-assessment of efficacy was positively correlated with pretreatment Lund score in adult patients (r = 0.676, P < 0.05), but not so in pediatric patients.
These findings demonstrate that most of patients with nonpolypoid chronic sinus did well with topical steroid treatment. Therefore, surgery was required in few patients.
Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery 09/2007; 42(9):673-8.
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ABSTRACT: Recent findings suggest that environmental factors play important roles in the etiology of allergic rhinitis, however, data on the impacts of socioeconomic and environmental factors on self-reported prevalence of allergic rhinitis in China is sparse, which is the aim of this study.
Telephone interviews were performed in 11 cities throughout the mainland of China, and the association between environmental factors and self-reported prevalence of allergic rhinitis were evaluated by multiple linear correlation tests.
In total, there was no association between the adjusted self-reported prevalence of allergic rhinitis and socioeconomic factors such as GDP, GDP per capita, gross output value of industry and gross output value of industry per capita, while the adjusted self-reported prevalence of allergic rhinitis was positively correlated with the concentration of SO2, and no association was found between adjusted self-reported rate of allergic rhinitis and either meteorological factors including annual average temperature, annual average relative humidity, annual hours of sunshine and annual precipitation or other air pollution factors including NO2 and PMl0.
The study demonstrates that the self-reported prevalence of allergic rhinitis in 11 cities in China was positively correlated with the concentration of SO2, and the strategy of prevention for allergic rhinitis could be conducted according to the results. Prevalence;
Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery 07/2007; 42(6):452-6.
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ABSTRACT: To understand the anatomy of the supraorbital ethmoid cell and its relationship with the frontal sinus drainage pathway.
Five patients (5 sides) who had supraorbital ethmoid cell underwent endoscopic frontal sinus surgery. Computed tomographic (CT) scans of the sinuses were obtained in coronal and axial views. The frontal sinus ostium and the supraorbital ethmoid cell were endoscopically identified respectively.
On coronal CT scans, the supraorbital ethmoid cell was a separate cell lateral to the frontal sinus. And on axial CT scans, it was lateral and posterior to the frontal sinus drainage pathway. Under endoscope, its opening was lateral and posterior to the frontal sinus ostium.
The supraorbital ethmoid cell extended superolateral the boundaries of the lamina papyracea and the roof of the ethmoid to pneumatize the orbital plate of the frontal bone.
Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery 10/2006; 41(9):673-6.
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Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery 08/2005; 40(7):503-4.
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ABSTRACT: To understand the expression of Toll-like receptor-2 (TLR-2) and Toll-like receptor-4 (TLR-4) in epithelial cell of nasal mucosa, and to investigate the role of Toll-like receptors in the innate immunity of nasal mucosa.
Specimens from 30 patients with chronic sinusitis and 21 healthy adults were examined by in situ hybridization for TLR-2 and TLR-4 mRNA.
All 30, samples of chronic sinusitis showed a stranger expression of TLR-2 and TLR-4 than in controls (t = 8.605, P < 0.0005, t = 9.050, P < 0.0005).
It is suggested that epithelial in nasal mucosa were not just a physical barrier, which could represent a novel defense mechanism of the host during bacterial infections through Toll-like receptors.
Zhonghua er bi yan hou ke za zhi 08/2003; 38(4):243-6.
