• Title/Summary/Keyword: Clinical allergic rhinitis

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Characteristics of allergic pollens and the recent increase of sensitization rate to weed pollen in childhood in Korea (알레르기 화분의 특성과 최근 소아에서 잡초류 화분의 감작률 증가)

  • Oh, Jae-Won
    • Clinical and Experimental Pediatrics
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    • v.51 no.4
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    • pp.355-361
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    • 2008
  • Pollen is very important causing factor for allergy such as allergic rhinitis, allergic conjunctivitis, and asthma, and pollen allergy has a remarkable clinical impact all over Korea. The main pollination period covers about half the year, from spring to autumn, and the distribution of airborne pollen taxa of allergological interest is related to pollen season dynamics. Korean academy of pediatric allergy and respiratory diseases (KAPARD) has evaluated the pollen characteristics and nationwide pollen count for over 10 years since 1997. Airborne particles carrying allergens were collected daily from nationwide 8 stations (Seoul, Guri, Cheongju, Daegu, Kwangju, Busan, Kangneung, and Jeju) by using 7 days-Burkard sampler (Burkard Manufacturing Co Ltd, Hertfordshire, UK) in South Korea (July 1, 1997-June 30, 2007). They were counted and recorded along with the meteorological factors daily. Tree pollen is a major airborne allergen in spring, grass is most common in summer, and weed pollen is major pollen in autumn in Korea. There has two peak seasons for pollen allergy, as summer and autumn. There is some evidence suggesting that the prevalence of allergic diseases in Korea has been on the increase in the past decade. However, recent findings of the phase I and II studies of the international Study of Asthma and Allergies in Childhood (ISAAC) study showed the absence of increases or little changes in prevalence of asthma symptoms and diagnosis rates in Korea, whereas the prevalence of allergic rhinitis and atopic dermatitis were increased. We reported the evidence that sensitization rate to weed pollen has been increased yearly since 1997 in childhood. Climate change and air pollution must be the major causing factors for the increase of pollen counts and sensitization rate to pollen. Climate change makes the plants earlier pollination and persisting pollination longer. In conclusion, data on pollen count and structure in the last few years, the pathogenetic role of pollen and the interaction between pollen and air pollutants with climate change gave new insights into the mechanism of respiratory allergic diseases in Korea.

Exhaled Nitric Oxide Concentration in Children with Asthma and Allergic Rhinitis : Association with Atopy and Bronchial Hyperresponsiveness (천식 및 알레르기성 비염 환아에서의 호기 일산화질소 농도 : 아토피 및 기도과민성과의 연관성)

  • Nah, Kyu Min;Park, Yang;Kang, Eun Kyeong;Kang, Hee;Koh, Young Yull;Lee, Sun Wha;Paek, Domyung
    • Clinical and Experimental Pediatrics
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    • v.46 no.3
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    • pp.284-290
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    • 2003
  • Purpose : A new airway inflammatory marker, exhaled nitric oxide(ENO) has been reported to correlate with bronchial hyperresponsiveness(BHR) and atopy. The purpose of this study was to analyze the relationship of ENO with BHR or atopy in patients with asthma and with allergic rhinitis. Methods : The subjects consisted of 55 children with asthma, 17 with allergic rhinitis, and 14 healthy controls. The asthma group was subdivided into the atopic asthma group(n=37) and the nonatopic asthma group(n=18) and the allergic rhinitis group into BHR group(n=7) and non-BHR group(n=10). All were investigated with spirometry and measurements of ENO concentration. The correlations between ENO concentration and both methacholine $PC_{20}$(provocative concentration causing a 20% decrease in forced expiratory volume in one second) and the number of allergen skin test positivity were analyzed. Results : ENO concentrations of both asthma and allergic rhinitis groups were significantly greater than that of control(P<0.01). ENO concentration of atopic asthma was significantly greater than that of nonatopic asthma(P<0.01). In allergic rhinitis, ENO concentration did not differ according to the presence or absence of BHR(P=0.50). ENO concentrations correlated significantly with the number of skin test positivity(r=0.32, P=0.02) or methacholine $PC_{20}$(r=-0.38, P<0.01) in asthma group, but not in the allergic rhinitis group(r=0.42, P=0.09; r=-0.06, P=0.83). Conclusion : In asthma patients, some pathogenetic mechanisms associated with atopy and BHR seem to influence ENO concentration. In allergic rhinitis patients, some factors other than BHR may be important in determining ENO concentration.

A Clinical study of Allergic Rhinitis (treated with aroma-therapy) (알레르기성 비염 환자에 대한 임상적 고찰 - 외치요법(吹鼻法)을 응용하여 -)

  • 신진욱;김남권
    • The Journal of Korean Medicine
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    • v.21 no.4
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    • pp.174-182
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    • 2000
  • Objectives : In order to apply herbal medicine to aroma-therapy, we observed clinically remedical effect for allergic rhinitis of aroma-therapy using herbal medicine. Methods : Twenty-four allergic rhinitis patients were treated in the Kun-po Oriental Medical Hospital of Wonkwang University from September 2000 to October 2000. They were treated with aroma-therapy and analyzed clinically. Results : 1. 25.0% (6 cases) of all cases involved pre-teenagers; teenagers 29.2% (7 cases); patients in their 20s, 20.8% (5 cases); patients in their 30s, 12.5% (3 cases); patients in their 40s, 8.3% (2 cases); patients in their 50s, 4.2% (1 cases). 2. The ratio of male to female patients was 58.3%(14 cases) to 41.7%(10 cases). 3. Cases involving patients under the age of six months was 0%; under 1 year 12.5% (3 cases); under 2 years 33.3%(8 cases); under 3 years 16.7%(4 cases); over 3 years 37.5%(9 cases). 4. Past history : The cases of sinusitis were 33.3%(8 cases); otitis media 20.8%(5 cases), bronchitis 16.7%(4 cases), atopic dermatitis 12.5%(3 cases), asthma 8.3%(2 cases). 5. The ratio of allergic onset based on seasons were : spring 16.7%(4 cases), summer 0%, fall 29.2%(7 cases), winter 16.7%(4 cases), and not defined 37.5%(9 cases). 6. The cases of nasal obstruction was 91.7%(22 cases); followed by : sneezing 83.3(20 cases), white rhinorrhea 70.8%(17 cases), eye itching 66.7%(16 cases), nasal itching 58.3%(14 cases), rhinalgia 58.3%(14 cases), postnasal drip 50.0%(12 cases), headache 41.7%(10 cases), yellow rhinorrhea 33.3%(8 cases), cough 33.3%(8 cases), fatigue 29.2%(7 cases). 7. The cases of familial factor was 66.7%(16 cases); the non-familial factor 33.3%(8 cases). 8. The remedical effect of the treatment showed an improvement in 58.4% of the total cases studied. 9. The improvement-rate of the 1st group (mahwang group) was 66.7%; of the 2nd group (hwangkum group) 48.5%, and of the 3rd group (pine group) 55.8%. Conclusions : Considering the above results, we have concluded that the remedical effect for allergic rhinitis of aroma-therapy using herbal medicine showed to be intentional in comparison with aroma-therapy using aroma-oil.

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Inter- and Intra-rater Reliability of Pattern Identification Using Nasal Endoscopy for Allergic Rhinitis (비내시경을 활용한 알레르기 비염에 대한 한의학적 변증 지표의 관찰자간, 관찰자내 신뢰도 연구)

  • Kim, Kyu-Seok;Yun, Young-Hee;Park, Jeong-Su;Kim, Nam-Kwen;Kim, Kyung-Jun;Kim, Hee-Taek;Hong, Seung-Ug;Jang, Bo-Hyeong;Yoon, Hwa-Jung;Choi, In-Hwa;Ko, Seong-Gyu
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.26 no.2
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    • pp.10-18
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    • 2013
  • Objectives : We performed a pilot study to investigate inter- and intra-rater reliability of pattern identification using nasal endoscopy for allergic rhinitis(AR). Methods : Eight experts of ophthalmology, otolaryngology and dermatology of Korean medicine evaluated 20 nasal endoscopy photograph cases of AR patients with pattern identification index using nasal endoscopy for AR including the nasal membrane color(pale / hyperemia), nasal membrane humidity(dryness / dampness), rhinorrhea(watery / yellow), and membrane edema (atrophic / edematous) on nasal endoscopy. Results : Intra-rater agreement(%) and Kappa coefficient was generally from 'moderate' to 'good'(% agreement: 73.13-90% / Kappa coefficient: 0.547-0.748). Inter-rater agreement(%) and Kappa coefficient was also from 'moderate' to 'good' (% agreement: 65-85% / Kappa: 0.475-0.778) except 'humidity(dryness / dampness)' item (% agreement: 55.98% / Kappa: 0.340). In findings of subgroup analysis according to affiliation of raters, Inter-rater agreement(%) and Kappa coefficient of raters in same affiliation was higher than inter-rater agreement(%) and Kappa coefficient of raters in different affiliation except 'dryness / dampness' item. Conclusions : It is necessary to improve objectivity and reproducibility of pattern identification using nasal endoscopy for allergic rhinitis(AR) through the development of detail-oriented criteria and enhanced training of clinicians with development of standard operating procedures(SOPs).

A Study on the Development of Guideline for Assessing Anterior Nasal Cavity Using Nasal Endoscopy on Allergic Rhinitis Patients (비내시경을 활용한 알레르기 비염 환자의 전비경 소견 평가 척도 개발)

  • Yun, Young-Hee;Park, Jeong-Su;Kim, Kyu-Seok;Kim, Nam-Kwen;Kim, Kyung-Jun;Kim, Hee-Taek;Hong, Seung-Ug;Choi, In-Hwa;Ko, Seong-Gyu
    • Journal of Society of Preventive Korean Medicine
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    • v.17 no.1
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    • pp.199-207
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    • 2013
  • Objectives : The prevalence of Allergic Rhinitis (AR) has increased during the last decade. However, a lot of decisions on the assessment and treatment of AR are made depending on the personal experiences and choices of physicians. To suggest preferable approaches and to minimize the variations according to physicians, guidelines for assessing anterior nasal cavity using nasal endoscopy on AR is needed. Methods : The Korean Oriental Medical Ophthalmology, Otolaryngology and Dermatology Society and the Korean Oriental Preventive Medical Society has set out to develop the guidelines for the assessing anterior nasal cavity using nasal endoscopy on AR. Results & Conclusions : This is the first Korean guideline for the assessment of AR and should be revised and supplemented in the future as new evidence becomes available.

Decreased CRTH2 Expression and Response to Allergen Re-stimulation on Innate Lymphoid Cells in Patients With Allergen-Specific Immunotherapy

  • Mitthamsiri, Wat;Pradubpongsa, Panitan;Sangasapaviliya, Atik;Boonpiyathad, Tadech
    • Allergy, Asthma & Immunology Research
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    • v.10 no.6
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    • pp.662-674
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    • 2018
  • Purpose: Group 2 innate lymphoid cells (ILC2s) have been implicated in the pathogenesis of allergic disease. However, the effect of allergen-specific immunotherapy (AIT) on ILCs remains to be clarified. The aim of this study was to evaluate the levels of ILC subsets in allergic rhinitis (AR) patients in response to house dust mite (HDM)-specific immunotherapy. Methods: We enrolled 37 AR patients undergoing AIT (16 responders and 11 non-responders) for 2 years, 35 HDM AR patients and 28 healthy subjects. Peripheral blood mononuclear cells (PBMCs) were analyzed by flow cytometry to identify ILC subsets. Stimulation of ILC2s with recombinant allergen-specific protein was used to determine ILC2's activation (CD69 expression). Results: Responder AIT patients and healthy subjects had a decreased frequency of circulating ILC2s compared to non-responder AIT and AR patients. Conversely, ILC1s from responder AIT patients and healthy subjects showed increased frequency compared to non-responder AIT and AR patients. The frequency of ILC3s natural cytotoxicity receptor $(NCR)^+$ and $NCR^-$ in responder AIT patients was significantly lower compared to AR patients and healthy subjects. The ILC1: ILC2 proportion in responder AIT patients was similar to that of healthy subjects. PBMCs from patients who were responders to AIT had a significantly lower expression of the activation marker CD69 on ILC2s in response to allergen re-stimulation compared to AR patients, but no difference compared to non-responder AIT patients and healthy subjects. Conclusions: We propose that AIT might affect ILC responses. The activation of ILC2s was reduced in AR patients treated with AIT. Our results indicate that a relative ILC1/ILC2 skewed response is a possible key to successful AIT.

Clinical efficacy and mechanism of probiotics in allergic diseases

  • Kim, Ha-Jung;Kim, Hyung Young;Lee, So-Yeon;Seo, Ju-Hee;Lee, Eun;Hong, Soo-Jong
    • Clinical and Experimental Pediatrics
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    • v.56 no.9
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    • pp.369-376
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    • 2013
  • A complex interplay between genetic and environmental factors partially contributes to the development of allergic diseases by affecting development during prenatal and early life. To explain the dramatic increase in the prevalence of allergic diseases, the hygiene hypothesis proposed that early exposure to infection prevented allergic diseases. The hygiene hypothesis has changed to the microbial hypothesis, in which exposure to microbes is closely linked to the development of the early immune system and allergic diseases. The intestinal flora may contribute to allergic disease through its substantial effect on mucosal immunity. Based on findings that exposure to microbial flora early in life can change the Th1/Th2 balance, thus favoring a Th1 cell response, probiotics may be beneficial in preventing allergic diseases. However, evidence from clinical and basic research to prove the efficacy of probiotics in preventing allergy is lacking. To date, studies have yielded inconsistent findings on the usefulness of probiotics in allergic diseases. It is difficult to demonstrate an exact effect of probiotics on asthma, allergic rhinitis, and food allergy because of study limitations, such as different first supplementation period, duration, different strains, short follow-up period, and host factors. However, many studies have demonstrated a significant clinical improvement in atopic dermatitis with the use of probiotics. An accurate understanding of the development of human immunity, intestinal barrier function, intestinal microbiota, and systemic immunity is required to comprehend the effects of probiotics on allergic diseases.

The relationships among birth season, sunlight exposure during infancy, and allergic disease

  • Hwang, Jung Min;Oh, Se Hyun;Shin, Mee Yong
    • Clinical and Experimental Pediatrics
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    • v.59 no.5
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    • pp.218-225
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    • 2016
  • Purpose: The recent increase in the prevalence of allergic diseases is hypothetically attributed to immune dysregulation in turn caused by a reduction in exposure to sunlight. We explored relationships between birth season, sunlight exposure, exercise duration, and an allergic disease. Methods: We performed a questionnaire-based survey on allergic diseases among elementary school students. Birth time was categorized according to the season (summer and winter). Results: The prevalence of atopic dermatitis (AD) "symptoms ever" was higher in the children born in winter than in those born in summer (adjusted odds ratio [aOR], 1.24; 95% confidence interval [CI], 1.03-1.49; P=0.024). Birth in winter was associated with an increase in the "symptoms in the past 12 months" prevalence of food allergy (FA) (aOR, 1.56; 95% CI, 1.09-2.24; P=0.015). The lifetime prevalence of allergic diseases except FA was higher in the children whose parents considered their sunlight exposure prior to 24 months of ageas inadequate than those who considered their exposure as adequate ("diagnosis ever" asthma: aOR, 1.4; 95% CI, 1.17-1.67; P<0.001; allergic rhinitis [AR]: aOR, 1.4; 95% CI, 1.17-1.67; P<0.001; AD: aOR, 1.26; 95% CI, 1.06-1.51; P=0.01). Neither recent sunlight exposure nor exercise duration was associated with the prevalence of an allergic disease. Conclusion: Birth in winter may be associated with development of AD and FA. Inadequate sunlight exposure before the age of 24 months might possibly increase the risks of development of asthma, AR, and AD.

Effects of Schizonepeta Spica water extrect on the OVA-induced BALB/c mice model of allergic rhinitis (난알부민으로 알레르기 비염이 유발된 마우스에서 형개의 개선효과)

  • Song, Dea-Uk;Heo, Jun;Lee, SungYub;Kim, Jae-Hyun;Lee, Bina;Min, Ju-Hee;Kim, Eun-Young;Sohn, Youngjoo;Jung, Hyuk-Sang
    • The Korea Journal of Herbology
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    • v.30 no.6
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    • pp.39-46
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    • 2015
  • Objectives : The aim of this study was to evaluate the effect of Schizonepeta Spica water extract (SS) on the OVA-induced BLAB/c mice allergic rhinitis model.Methods : Thirty two BALB/c mice were equally assigned to 4 groups; the sham group, the control group, the cetirizine hydrochloride (Cet) treatment group, and the SS treatment group. Sham group was sensitized and challenged with saline, and the other groups were sensitized and challenged with OVA. The dosage of SS was 7.6 mg /kg·day, and Cet was 10 mg/kg·day. Nasal rubbing and sneezing were measured by the behavior observation. The concentrations of IL-1β, IL-10, TNF-α and MIP-2 in the sera of allergic rhinitis model were measured by mouse cytokine/chemokine magnetic bead panel kits. Total IgE and OVA-specific IgE were measured by ELISA method. Epithelial thickness and eosinophil infiltration of nasal septum was investigated by histological examination.Results : The clinical symptoms that increased in control group were significantly reduced in SS-treated group. Serum total IgE and OVA-specific IgE in the SS-treated group were significantly reduced compared to the control group. The concentration of IL-1β, IL-10, TNF-α and MIP-2 in SS-treated group showed a significant reduction compared to the control group. The infiltration of eosinophil into nasal tissues of SS-treated group decreased markedly compared to control group, and thickness of nasal septum in nasal mucosa showed a significant reduction compared to control group.Conclusions : According to the above result, it is suggested that SS may inhibit the early and late phase of allergic rhinitis reaction.

Effect of Acupuncture on Nasal Obstruction in Patients with Persistent Allergic Rhinitis: A Randomized Controlled Trial (지속성 알레르기비염의 비폐색에 대한 침치료의 효과: 무작위배정 대조군 연구)

  • Jo, Jeong-Hyo;Hong, Kweon-Eey;Kang, Wee-Chang;Choi, Sun-Mi;Park, Yang-Chun
    • Journal of Acupuncture Research
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    • v.22 no.6
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    • pp.229-239
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    • 2005
  • Objectives : Allergic rhinitis is a prevalent disease. Nasal obstruction is one of the main symptom in allergic rhinitis. It induces sleep disturbances, depression, attention deficit, memory impairments. Acupuncture treatment for rhinitis was mentioned in literature, but there is not enough report that provide evidence by well designed clinical study. The purpose of this research is to examine the effect of acupuncture treatment for nasal obstruction of allergic rhinitis. Methods : In this randomized, single blind, placebo-controlled study, we compared active acupuncture with minimal acupuncture for the treatment of nasal obstruction owing to persistent allergic rhinitis. Acupoints used in active acupuncture group were I120($Y{\hat{o}}nghyang$), GV23($Sangs{\hat{o}}ng$), IL4(Hapkok). Volunteers who satisfied the requirements were enrolled in study. Total nasal volume(NV) and total nasal minimum cross-sectional area(MCA) were measured by acoustic rhinometry before and after treatments(0min, 7.5min, 15min). Results : 101 subjects finished study. There were not difference between two groups on age, sex, weight, height, blood pressure, pulse, respiratory rate, severity of persistent allergic rhinitis, number of positive antigen. After treatment(0min) total NV were significantly increased compared with before treatment in active acupuncture group(p=0.0007) and minimal acupuncture group(p=0.0175). After treatment(15min) total NV of minimal acupuncture group was decreased compared with before treatment(p=0.2560), but total NV of active acupuncture group was maintained increasing in degree of borderline significance(p=0.0871). After treatment(0min) total NV were significantly increased compared with before treatment in active acupuncture group(0.0007) and minimal acupuncture group(p=0.0175). After treatment(Omin) total MCA were significantly increased compared with before treatment in active acupuncture group(p<0.000l) and minimal acupuncture group(p=0.0005). After treatment(15min) total MCA of minimal acupuncture group was decreased compared with before treatment(p=0.6082), but total NV of active acupuncture group was maintained increasing in degree of borderline significance(p=0.0929). Conclusion : Acupuncture treatment reduced nasal obstruction in persistent allergic rhinitis. Further study in the form of long term is needed.

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