筛前神经及下鼻甲激光切割术治疗过敏性鼻炎29例临床观察

本文介绍了用筛前神经和下鼻甲激光切割术治疗２９例过敏性鼻炎病人，有效率为９７％。随访６个月至２年，除２例于术后６个月复发外，余者均未复发。实践表明这一手术优于翼管神经手术，优点是：１、解剖标志清楚；２、手术操作简便且易于掌握；３、并发症少而不严重。本文对这一手术的方法，术后处置和疗效进行了讨论。     

Adenosine Signaling in Mast Cells and Allergic Diseases

Adenosine is a nucleoside involved in the pathogenesis of allergic diseases. Its effects are mediated through its binding to G protein-coupled receptors: A1, A2a, A2b and A3. The receptors differ in the type of G protein they recruit, in the effect on adenylyl cyclase (AC) activity and the downstream signaling pathway triggered. Adenosine can produce both an enhancement and an inhibition of mast cell degranulation, indicating that adenosine effects on these receptors is controversial and remains to be clarified. Depending on the study model, A1, A2b, and A3 receptors have shown anti- or pro-inflammatory activity. However, most studies reported an anti-inflammatory activity of A2a receptor. The precise knowledge of the adenosine mechanism of action may allow to develop more efficient therapies for allergic diseases by using selective agonist and antagonist against specific receptor subtypes.     

5 nm Silver Nanoparticles Amplify Clinical Features of Atopic Dermatitis in Mice by Activating Mast Cells

The triggering effect of silver nanoparticles (NPs) on the induction of allergic reactions is evaluated, by studying the activation of mast cells and the clinical features of atopic dermatitis in a mouse model. Granule release is induced in RBL‐2H3 mast cells by 5 nm, but not 100 nm silver NPs. Increases in the levels of reactive oxygen species (hydrogen peroxide and mitochondrial superoxide) and intracellular Ca⁺⁺ in mast cells are induced by 5 nm silver NPs. In a mouse model of atopic dermatitis induced by a mite allergen, the skin lesions are more severe and appear earlier in mice treated simultaneously with 5 nm silver NPs and allergen compared with mice treated with allergen alone or 100 nm silver NPs and allergen. The histological findings reveal that number of tryptase‐positive mast cells and total IgE levels in the serum increase in mice treated with 5 nm silver NPs and allergen. The results in this study indicate that cotreatment with 5 nm silver NPs stimulates mast cell degranulation and induces earlier and more severe clinical alterations in allergy‐prone individuals.     

The Utility of Nasal Challenges to Phenotype Asthma Patients

Asthma is a heterogeneous disease in terms of both phenotype and response to therapy. Therefore, there is a great need for clinically applicable tools allowing for improved patient classification, and selection for specific management approaches. Some interventions are highly helpful in selected patients (e.g., allergen immunotherapy or aspirin desensitization), but they are costly and/or difficult to implement. Currently available biomarkers measurable in peripheral blood or exhaled air display many limitations for asthma phenotyping and cannot identify properly the specific triggers of the disease (e.g., aeroallergens or NSAID). The united airway concept illustrates the relevant epidemiological and pathophysiological links between the upper and lower airways. This concept has been largely applied to patient management and treatment, but its diagnostic implications have been less often explored. Of note, a recent document by the European Academy of Allergy and Clinical Immunology proposes the use of nasal allergen challenge to confirm the diagnosis of allergic asthma. Similarly, the nasal challenge with lysine acetylsalicylate (L-ASA) can be used to identify aspirin-sensitive asthma patients. In this review, we will summarize the main features of allergic asthma and aspirin-exacerbated respiratory disease and will discuss the methodology of nasal allergen and L-ASA challenges with a focus on their capacity to phenotype the inflammatory disease affecting both the upper and lower airways.     

A comparative study on the antioxidative and anti‐allergic activities of fresh and aged black garlic extracts

The antioxidative and anti‐allergic activities of fresh and aged black garlic extracts were investigated. The garlic samples were extracted with 70% ethanol (v/v) and the total phenolic content was measured. The antioxidant capacity of extracts was assessed by determining the scavenging activities on 1,1‐diphenyl‐2‐picrylhydrazyl and hydroxyl radicals, ferricyanide reducing power, ferrous ion‐chelating ability and inhibitory effect on linoleic acid peroxidation. The anti‐allergic activity of extracts was analysed by measuring their inhibitory effects against β‐hexosaminidase release. The aged black garlic exhibited significantly higher phenolic content and greater antioxidative activity than fresh garlic. Both garlic extracts showed strong antioxidant capacity in a dose‐dependent manner. On the other hand, a considerably higher suppression of β‐hexosaminidase release was found in fresh garlic extract at lower concentration compared with that of the black garlic. Results of this study illustrate that ageing of garlic could enhance its antioxidant capacity, but could decrease its anti‐allergic activity.     

MicroRNA in United Airway Diseases

The concept of united airway diseases (UAD) has received increasing attention in recent years. Sustained and increased inflammation is a common feature of UAD, which is inevitably accompanied with marked gene modification and tight gene regulation. However, gene regulation in the common inflammatory processes in UAD remains unclear. MicroRNA (miRNA), a novel regulator of gene expression, has been considered to be involved in many inflammatory diseases. Although there are an increasing number of studies of miRNAs in inflammatory upper and lower airway diseases, few miRNAs have been identified that directly link the upper and lower airways. In this article, therefore, we reviewed the relevant studies available in order to improve the understanding of the roles of miRNAs in the interaction and pathogenesis of UAD.     

Food allergy,a summary of eight cases in the UK criminal and civil courts: effective last resort for vulnerable consumers?

Food allergy has a forensic context. The authors describe eight cases in the UK courts involving fatalities, personal injury or criminal non‐compliance with food law from mainly ‘grey’ literature sources. The potentially severe consequences for people with food allergy of contraventions of labelling law have led to enforcement action up to criminal prosecution for what might otherwise be regarded as ‘trivial’ non‐compliance. The authors suggest there should be central collation of such cases. Non‐compliances should be followed up in a more rapid and robust manner. Evidence of fraud in the catering supply chain supports recent calls for zero tolerance of food fraud. Businesses must guard against gaps in allergen management, for which there are readily available sources of training and guidance, but also against fraudulent substitution in the supply chain, about which training and guidance should be developed. New allergen labelling legislation and case law appear to place responsibility on food businesses even for the forensically problematic area of allergen cross‐contamination. The courts can be an effective last resort for vulnerable consumers; however, there is evidence of knowledge and skill gaps in both the investigation and prosecution of potentially serious incidents of food allergen mismanagement and mislabelling. Thorough investigation of food allergy deaths is required with a tenacious and skilled approach, including early realisation that samples of the food and/or stomach contents from a post mortem examination should be retained and analysed. The supply chain must be rigorously examined to find out where adulteration or contamination with the fatal allergen occurred. © 2014 Society of Chemical Industry     

激光治疗过敏性鼻炎及其免疫功能的变化

目的:观察He-Ne激光鼻腔照射配合药物治疗过敏性鼻炎的效果。并进行免疫数据分析取得可信证据。方法:对用He-Ne激光鼻腔照射配合口服抗组胺药物加局部使用雷诺考特喷鼻剂67例(观察组)和药物对照组30例(对照组)的过敏性鼻炎患者进行治疗和疗效对比。此外单纯用激光照射对过敏性鼻炎观察治疗35例,并进行体液免疫动态追踪。结果:两组治疗前后总有效率相比,P<0.05,有显著差异。说明观察组疗效优于对照组。并在停药后第1、2、3、4周两组总有效率差异有显著性意义,停药后观察组总有效率明显较对照组高,且随停药时间延长,其总有效率间差距逐渐增大。从体液免疫动态观察看患者血清中IgE含量比正常人高(约4倍)[1]。结论:He-Ne激光鼻腔照射配合药物治疗成人过敏性鼻炎是安全有效、标本兼治、副作用少,并有着免疫增强和免疫抑制双向良性调节作用的一种有效疗法,值得临床推广。     

基于BALB/C小鼠模型评价牛乳αs1-酪蛋白的致敏特性

目的:评价过敏原的过敏症机理。方法:首先通过口腔灌胃的致敏方式建立αs1-酪蛋白致敏的BALB/C小鼠模型,通过测定小鼠特异性IgE抗体水平进行模型鉴定。评价αs1-酪蛋白对小鼠肥大细胞蛋白酶、组胺、细胞因子水平的影响,并进行临床和病理切片观察。结果:第42天用αs1-酪蛋白大剂量灌胃小鼠后,各组小鼠特异性IgE抗体水平显著升高,都产生不同程度的过敏症状,且中、高剂量组小鼠过敏反应强于低剂量组;以阴性小鼠为对照,致敏小鼠的肥大细胞蛋白酶、组胺、IL-4、IL-5、IL-10和IFN-γ细胞因子含量均显著升高,且随着致敏剂量的增加而增加;组织病理切片结果显示:αs1-酪蛋白中剂量和高剂量组小鼠产生了明显的炎症反应,局部肺泡隔塌陷或增厚,脾脏和胸腺中有淋巴结病灶产生,且小肠黏膜间质有炎细胞浸润。结论:基于BALB/C小鼠模型进一步揭示了αs1-酪蛋白的致敏机理。