HOUSE DUST MITE ALLERGEN (Derp1 AND Blot5) LEVELS IN ASTHMATICS' HOME IN HONGKONG

To measure Derp1 and Blot5 allergen levels in asthmatics’ homes in Hongkong. Methods Seventy houses were enrolled for a mite indoor environment study. Dust samples were obtained from two sites of each patients’ house: bed and floor. Derp1 and Blot5 levels were quantified by a two-site monoclonal antibody-based ELISA technique. Results The levels of Derp1 allergens found in bed (geometric mean (GM) 3.43 μg/g of dust; 95%CI, 1.89-4.96 μg/g) and on the floor (GM 1.12 μg/g of dust; 95%CI, 0.71-1.53 μg/g) indicated significant differences (P = 0.005). However, the levels of Blot5 allergens found in bed (GM 19.00 μg/g of dust; 95%CI, 0.89-38.90 μg/g) and on the floor (GM 6.14 μg/g of dust; 95%CI, 0.40-11.90 μg/g) showed no statistically significant difference. In addition, in regards to the exposure index for Derp1 and Blot5 allergens found in bed and on the floor, 17.6% in bed and 8.6% on the floor had levels of Blot5 ≥ 10 μg/g of dust, higher than those obtained for Derp1 (7.2% and 0% in bed and on the floor respectively, P < 0.05); higher percentages in bed and on the floor (25.0% and 35.7%) were observed for levels of Blot5 = 0 μg/g of dust as compared with Derp1 in bed and on the floor (4.3% and 14.5% respectively, P < 0.05). Conclusions Derp1 and Blot5 are the major allergens found in this regional study, Blot5 is a more potent allergen in Hongkong, probably reflecting the high level of exposure to Blomia tropicalis (Bt). Bt and Dermatophagoides pteronyssinus(Dp) allergens should be included for precise diagnosis and effective immuno-therapeutic treatment of mite allergy in Hong-kong.

Acaricidal activities of some essential oils and their monoterpenoidal constituents against house dust mite,Dermatophagoides pteronyssinus (Acari:Pyroglyphidae)

The acaricidal activities of fourteen essential oils and fourteen of their major monoterpenoids were tested against house dust mites Dermatophagoides pteronyssinus. Five concentrations were used over two different time intervals 24 and 48 h under laboratory conditions. In general, it was noticed that the acaricidal effect based on LC50 of either essential oils or monoterpenoids against the mite was time dependant. The LCso values were decreased by increasing of exposure time. Clove, matrecary, chenopodium, rosemary, eucalyptus and caraway oils were shown to have high activity. As for the monoterpenoids, cinnamaldehyde and chlorothymol were found to be the most effective followed by citronellol. This study suggests the use of the essential oils and their major constituents as ecofriendly biodegradable agents for the control of house dust mite, D. pteronyssinus.

House dust mite allergen Der f enhanced bronchial epithelial cell cytokine expression

The house dust mites (Dermatophagoides farinae, Derf) are the major source of aeroaller gens implicated in the expression of atopic disorders, including asthma, allergic rhinitis and atopic dermatitis. In particular, strong circumstantial evidence suggests that house dust mite antigens are important precipitating factors of asthma. Many house dust mite allergens are proteases that can elicit airway inflammation by stimulating the release of cytokines from bronchial epithelial cells. To investigate whether Der f allergen proteases induced cytokine production from the epithelial cell line BEAS-2B, BEAS-2B cells were cultured with 4 different concentrations of Derf (0.02, 0.2, 2, 20μg/ml) for 24-96 h, after which supernatants were assayed for interleukin (IL)-6 and IL-8 with ELISA. Reverse transcription-PCR was also performed. The cell sheets were intact throughout the observation in control group without any exposure to Der f antigen. In the experimental groups cells treated with Der f allergen showed changes in the anchorage status of the monolayer. There was a significant increase in the level of cytokine production compared with the untreated sample. The release of IL-6 and IL-8 increased in a concentration-dependent manner (P <0.05, respectively) with the addition of increasing dosage of Der f to the cell sheets. Levels of IL-6 and IL-8 began to rise at 24 h and 48 h after allergen exposure, and they increased significantly in the supematants at 72 h and 96 h. At the same time the concentration dependence of induction of IL-6 and IL-8 expression as well as an increase in the expression of IL-6 and IL-8 mRNA manifested evidently. HDM-induced airway inflammation may include Der f-mediated release of inflammatory mediators, and the proteolytic activity of an allergen may stimulate the release of proinflammatory cytokines from human bronchial epithelium. It is suggested that IL-6 and IL-8 production by bronchial epithelial cells may play a role in the pathogenesis of allergic asthma.

Resistance of Commercial Bed Covers against Faecal Pellets of House Dust Mites:Behaviour of Seams and Zippers

This study evaluated the allergen impermeability against airborne allergens of dust mite droppings through all parts of commercial bed covers, including surface seams and zippers. Specimens were taken from places with and without seams and zipper. A novel penetration cell was developed to expose the specimens to an inoculum of purified mite droppings that was assessed for its allergen content Der p1 prior to the penetration tests. Using covers of different construction and material, the penetration level increased significantly in the presence of seams and zippers and could reach up to 6% depending on the seam’s/zipper’s characteristics and quality. Therefore, zippers and seams have to be considered as access points for the penetration of mite droppings. As for the penetration of airborne mite particles through the zipper, the penetration level was greatly attenuated by the presence of a cover strip. Depending on the respective quality and the construction type, the mite allergen Der p1 penetrated most likely through the zipper and seams of the specimens, already after a single laundry cycle. Hence, laundry may compromise the barrier performance and proves to be an important quality feature. In all samples, the textile surface showed sufficient allergen impermeability. Our conclusions provide recommendations to both manufacturers and users.

Acaricidal activity of Cymbopogon citratus and Azadirachta indica against house dust mites

Objective:To examine the acaricidal effects of the essential oil of Cymbopogon citratits leaf extract(lemongrass)and ethanolic Azadirachta indica leaf extract(neem)against house dust mites Dermatophagoides farinae(D.farinae)and Dermalophagoides pteronyssinus(D.pteronyssinus).Methods:Twenty-five adults mites were placed onto treated filter paper that is soaked with plant extract and been tested at different concentrations(50.00%,25.00%,12.50%,6.25%and 3.13%)and exposure times(24hrs,48hrs,72hrs and 96 hrs).All treatments were replicated 7 times,and the experiment repeated once.The topical and contact activities of the two herbs were investigated.Results:Mortalities from lemongrass extract were higher than neem for both topical and contact activities.At 50%concentration,both 24 hrs topical and contact exposures to lemongrass resulted in more than 91%mortalities for both species of inites.At the same concentration and exposure time,neem resulted in topical mortalities of 40.3%and 15.7%against D.pteronyssinus and D.farinae respectively;contact mortalities were 8.0%and 8.9%against the 2 mites,respectively.There was no difference in topical mortalities of D.pteronyssinus from exposure to concentrations oflemongrass and neem up to 12.50%;lemongrass was more effective than neem at the higher concentrations.Conclusions:Generally,topical mortalities of D.farinae due to lemongrass are higher than that due to neem.Contact mortalities of lemongrass are always higher that neem against both species of mites.

Development of time-resolved immunofluorometric assays for the detection of house dust mite-allergic IgE in human sera

Dermatophagoides farinae and D. pteronyssinus are the prevalent house dust mites (HDM) in tropical countries and are associated with allergic diseases. This investigation developed a time- resolved immunofluorometric assay (TR-IFMA) for the first time to detect specific IgE antibody in patients with skin prick test positive to HDM but no detectable IgE by other means. Levels of IgE to natural and recombinant HDM allergens were measured by TR-IFMA in 50 HDM-allergic patients and 19 healthy participants compared to sandwich enzyme-linked immunosorbent assay (ELISA). A recombinant allergen, rDerf2, showed a 14 kDa band corresponding to broad range proteins of natural HDM.TR-IFMA showed sensitivity lower than 0.35 kUA/l. TR-IFMA employing three HDM antigens showed good correlations with sandwich ELISA at R2 0.93-0.96. TR-IFMA detected HDM IgE in 62, 62, 25 percent of allergic patient serum sample compared to 28, 32, and 22 percent detected by ELISA result using three HDM allergen. TR-IFMA also detected 26.3, 31.6, and 5.3 percent positive samples from 19 healthy participants while ELISA showed 0, 5.3, and 0 percents IgE positive samples. The use of rDerf2 as an HDM allergen for the assay was verified with no statistically different from other HDM allergens. TR-IFMA showed lower detection limit than ELISA and yielded higher sensitivity for serum of people with allergic symptoms with no detectable HDM IgE. It is anticipated that TR-IFMA for HDM-specific IgE detection will play an important role in future diagnosis of HDM allergy in clinical laboratories and for different research purposes.

Effect of a commercial air ionizer on dust mites Dermatophagoides pteronyssinus and Dermatophagoides farinae(Acari:Pyroglyphidae) in the laboratory

Objective:To investigate the short and long tenn efficacy of a commercial air ionizer in killing Dermatophagoides pteronyssinus(D.pteronyssinus)and Dermalophagoides farinae(D.farinae)mites.Methods:The effect of a commercial ionizer on D.pteronyssinus and D.farinae was evaluated in the laboratory,using a specially designed test.Mortality was assessed after 6,16and 24 hours for direct exposure and after 24,36,48,60 and 72 hours for exposure in simulated mattress.New batches of mites were used for each exposure time.Results:LT_(50)for direct exposure of ionizer was 10 hours for D.pteronyssinus and 18 hours for D.farinae.The LT_(50)for exposure in simulated mattress was 132 hours or 5.5 days for D.pteronyssinus and 72 hours or 3days for D.farinae.LT_(95)for direct exposure of ionizer was 36 hours for D.pteronyssinus and D.farinae.Meanwhile,the LT_(95)for exposure in simulated mattress was 956 hours or 39.8 days for D.pteronyssinus and 403 hours or 16.8 days for D.farinae.Conclusions:This study demonstrates the increasing mite mortalities with increasing exposure time of a commercial ionizer and suggests that negative ions produced by an ionizer kill dust mites and can be used to reduce natural mile populations on exposed surfaces such as floors,clothes,curtains,etc.However,there is reduced efficacy on mites inside stuffed materials as in mattresses and furniture.

Relationship between Foxp3-3279(rs376158) Polymorphism and Dust Mite Allergic Conjunctivitis

Purpose:To investigate the genotyping of Foxp3-3279(A /C,rs376158) genes in patients with dust mite-induced allergic conjunctivitis from Guangdong province and to explore the association between these genes and the susceptibility to dust mite allergic conjunctivitis.Methods:.In total,.80 patients with dust mite allergic conjunctivitis and 103 healthy Han Chinese were enrolled in the study and received genotyping of Foxp3-3279(A / C,rs376158)by PCR-SSP technique.Results: Genotype frequency of Foxp3-3279 AA,.CA,.and CC in patients with dust mite allergic conjunctivitis were 1.25%,25.00% and 73.75%,respectively. Gene frequency of C and A in patients with dust mite allergic conjunctivitis were 86.25%and 13.75% with no significant difference from healthy counterparts(both P>0.05).Conclusion:.Foxp3-3279 polymorphisms did not significantly differ between patients with dust mite allergic conjunctivitis and healthy controls, implying that this genetic locus is probably not an independent risk factor of the underlying pathogenesis of dust mite allergic conjunctivitis.

House Dust Mite Allergy Models—Reliability for Research of Airway Defensive Mechanisms

Extensive research of respiratory physiology and diseases of the airways and lungs provides better understanding of mechanisms of diseases and it is a source of new data with potential clinical application. The majority of the data in the field of airway defensive reflexes were obtained from guinea pig model, as the most convenient one. Neurophysiology and neuropharma-cology of the cough reflex—which is exclusively mediated by the vagus nerve, share close similarities between guinea pigs and humans. The models used to study pathological processes and their influence on airway-defensive reflexes use sensitization with ovalbumin—the protein from chicken egg, which does not mimic allergies within human respiratory system. House dust mites (HDM) (Dermatophagoides pteronyssius and Dermatophagoides farinae) represent frequent human aeroallergens, however the HDM models are used considerably less than ovalbumin models. The primary objective of this review is to focus on already validated models of HDM-induced airway diseases to see, whether some of them are suitable to study mechanisms of peripheral cough plasticity in a condition of HDM-induced pathological processes. The main purpose of future use and validation of HDM model is to produce higher ability to translate the results obtained in animal models to human cough research.

House dust mite allergens and nitrated products: Identification and risk assessment in indoor dust

Air pollutants can potentially lead to nitration of allergic proteins,thus promoting sensitization of these allergens.However,little is currently known about the nitration status of house dust mite(HDM)allergens.We identified the occurrence of nitrated products of two major HDM allergens Der f 1 and Der p 1 in dust samples collected from college dormitories in eastern China and assessed their associated health risk.The results showed that both non-nitrated and nitrated forms of the two allergens were detected in the dust in the range of non-detected(ND)-10.6,1.44-15.4,ND-22.4,ND-7.28μg/g for non-nitrated Der f 1,nitrated Der f 1,non-nitrated Der p 1 and nitrated Der p 1,respectively.The median rates of nitration were determined as 74.0%for Der f 1 and 20.4% for Der p 1 at consideration of one nitration site.Further analysis reveals that the levels of HDM allergens and their nitrated products were found to be generally higher during winter,in dormitories of lower altitude and with female occupants.Furthermore,the calculated risk indexes were at considerably high levels.Our findings suggest that nitrated HDM allergens have already accumulated in the environment at such significant levels and their associated health risk calls for our immediate attention.

Effect of house dust mite immunotherapy on interleukin-10-secreting regulatory T cells in asthmatic children

Background Subcutaneous specific immunotherapy has been demonstrated to be capable of inducing T-cell regulatory response.Interleukin-10 （IL-10） plays a crucial role in inducing allergen-specific tolerance.However the reports of the changes of IL-10 in house dust mite （HDM）-specific immunotherapy were varied.The aim of this study was to evaluate the function of IL-10-secreting regulatory T cells in asthma children successfully treated with HDM immunotherapy.Methods Peripheral blood mononuclear cells （PBMCs） were isolated from 27 patients following 1.5--2 years of HDM-specific immunotherapy （SIT, SIT group） and from 27 matched treated asthmatic children allergic to HDM （asthmagroup）.After 48 hours of in vitro stimulation with HDM extracts, IL-10-secreting regulatory T cells were measured by four colour flow cytometry.Sera were tested for allergen-specific IgG4 and IgE using the Immuno CAP 100 assay.Results PBMCs from children undergoing immunotherapy following HDM extracts stimuli produced significantly more IL-10 compared with the asthma group.The frequency of iTreg cells and aTreg cells increased in SIT group after HDM stimulation, while it was not affected in the asthma group.Among the iTreg cells and aTreg cells, the frequency of CD4＋CD25-Foxp3-IL-10＋ Treg cells increased the most which was 2 times higher than that in unstimulated cultures in SIT group.The levels of HDM-specific IgG4 of SIT group was significiently higher compared with asthma group, but there was no correlation of the levels of HDM-specific IgG4 and IL-10 secreting Treg cells.Conclusions HDM-specific immunotherapy can successfully upregulate the frequency of IL-10-secreting Treg cells.CD4＋CD25-Foxp3-IL-10＋ Treg cells may play a key role in inducing the immune tolerance in HDM-specific immunotherapy.

Caspase-1 activation by NLRP3 inflammasome dampens IL-33-dependent house dust mite-induced allergic lung inflammation

The cysteine protease caspase-1(Casp-1)contributes to innate immunity through the assembly of NLRP3,NLRC4,AIM2,and NLRP6 inflammasomes.Here we ask whether caspase-1 activation plays a regulatory role in house dust mite(HDM)-induced experimental allergic airway inflammation.We report enhanced airway inflammation in caspase-1-deficient mice exposed toHDMwith a marked eosinophil recruitment,increased expression of IL-4,IL-5,IL-13,aswell as full-length and bioactive IL-33.Furthermore,mice deficient for NLRP3 failed to control eosinophil influx in the airways and displayed augmented Th2 cytokine and chemokine levels,suggesting that the NLPR3 inflammasome complex controls HDM-induced inflammation.IL-33 neutralization by administration of soluble ST2 receptor inhibited the enhanced allergic inflammation,while administration of recombinant IL-33 during challenge phase enhanced allergic inflammation in caspase-1-deficient mice.Therefore,we show that caspase-1,NLRP3,and ASC,but not NLRC4,contribute to the upregulation of allergic lung inflammation.Moreover,we cannot exclude an effect of caspase-11,because caspase-1-deficient mice are deficient for both caspases.Mechanistically,absence of caspase-1 is associated with increased expression of IL-33,uric acid,and spleen tyrosine kinase(Syk)production.This study highlights acritical role of caspase-1 activation andNLPR3/ASCinflammasomecomplex in the down-modulation of IL-33 in vivo and in vitro,thereby regulating Th2 response in HDM-induced allergic lung inflammation.

Dust mite allergen-specific immunotherapy increases IL4 DNA methylation and induces Der p-specific T cell tolerance in children with allergic asthma

Allergen-specific immunotherapy(allergen-SIT)is a highly effective treatment for children with allergic asthma(AA),an immune-mediated chronic disease leading to bronchial muscle hypertrophy and airway obstruction in response to specific allergens.T helper cells and secreted cytokines play important roles in the pathogenesis of asthma,and epigenetic modulation controls genes important for T cell development and cytokine expression.This study evaluated T helper cell-secreted cytokines and DNA methylation patterns in children treated with Dermatophagoides pteronyssinus(Der p)allergen-SIT.Our results showed that after Der p challenge,peripheral blood mononuclear cells(PBMCs)from the SIT group,compared with the non-SIT AA group,produced lower levels of IL-4,IL-5 and IL-2.The SIT group,compared with the AA group,exhibited decreased sensitivity to the Der p allergen,concurrent with IL-4 down-modulation due to increased promoter DNA methylation,as estimated in PBMCs.Our results showed that SIT decreased IL-4 and IL-5,and inhibited T cell proliferation,by inhibiting IL-2 production after the specific allergen challenge.These results suggest that decreased IL-2 production and increased IL-4 cytokine promoter methylation is a potential mechanism of Der p-specific allergen desensitization immunotherapy.

Prevalence of sensitivity to cockroach allergens and IgE crossreactivity between cockroach and house dust mite allergens in Chinese patients with allergic rhinitis and asthma

Background Cockroaches are an important indoor allergen source causing allergic rhinitis and asthma. The aim of this study was to investigate the cockroach prevalence in mainland of China and the cross-reactivity of IgE between cockroach and house dust mite allergen in Chinese patients.Methods The cockroach sensitization pattern was based on a skin prick test （SPT） obtained from a national multicenter prevalence study, in which 6304 patients from 25 allergy centers across China participated. Factors, including different regions of China, age, gender and the correlations between the American and German cockroaches and house dust mite Der p were investigated. Eighteen out of 1236 clinical sera from south China were selected to perform the cross-inhibition assay between house dust mites and cockroaches.Results Totally 25.7% of patients were SPT positive to the American cockroach （Periplaneta Americana, Per a） and 18.7% SPT positive to the German cockroach （Blattella germanica, Bla g）. The prevalence of positive cockroach SPT was higher in southern than in northern China, higher in adults than in children, and higher in males than in females.Patients had relatively low levels of cockroach SPT reactions, mainly class 1 or 2. Of the SPT positive cockroach patients,88% were also SPT positive to house dust mite （Dermatophagoides pteronyssinus, Der p）. An IgE cross-inhibition study confirmed that Der P sensitization could cause false positive SPT reactions against cockroach.Conclusions A relatively high prevalence of cockroach sensitivity was found in mainland of China. However, a cross-inhibition study showed that only a small number of patients appear to have Bla g and/or Per a as primary sensitizing source. The importance of cockroaches as a risk factor for sensitization and triggers of allergic symptoms in mainland of China needs to be further investigated.

Do the microorganisms from laboratory culture spent growth medium affect house dust mite fitness and microbiome composition?

The interaction of house dust mites(HDM)and microorganisms is the key factor in the survival of these mites in human-made environments.Spent growth medium(SPGM)provides the rest of the dict,along with dead mite bodies and microorganisms.SPGM represents a source of microorganisms for the recolonization of mite food and the mite digestive tract.An experiment was performed to observe how adding SPGM to the HDM diet affects HDM population growth,the microbiome composition and the microbial respiration in microcosms.We analyzed American house dust mite(Dermatophagoides farinae)and European house dust mite(Dermatophagoides pleronyssinus)originating from control diets and diets treated with an extract of SPGM from 1-and 3-month-old mite cultures.The microbiome was described using 16S and 18S barcode sequencing.The composition of the bacterial and fiungal microbiomes differed between the HDM species,but the SPGM treatment influenced only the bacterial profile of D.farinae.In the D.farinae microbiome of specimens on SPGM-treated dicts compared to those of the control situation,the Lactobacillus profile decreased,while the Candinium,Staphylococ-cus,Acinetobacter,and Sphingomonas profiles increased.The addition of SPGM extract decreased the microbial respiration in the microcosms with and without mites in almost all cascs.Adding SPGM did not influence the population growth of D.farinae,but it had a variable effect on D.pteronyssimus.The results indicated that the HDM are marginally influenced by the microorganisms in their feces.

益生菌对尘螨过敏性变应性鼻炎儿童的症状、药物使用及生活质量的影响

目的探讨益生菌对尘螨过敏性变应性鼻炎(AR)患儿的症状、药物使用及生活质量的影响。方法招募115例尘螨过敏性AR患儿作为研究对象,根据治疗方案的不同分为常规组(58例)和益生菌组(57例)。常规组采用常规治疗,益生菌组在常规组基础上给予益生菌干预。比较两组不同时间点[治疗前(T0)、治疗6个月后(T1)、停药6个月后(T2)]主观感受视觉模拟评分法(VAS)评分、用药评分、标准化鼻结膜炎生活质量调查问卷(RQLQ)评分、鼻部症状评分。结果常规组T0时VAS评分、用药评分、RQLQ评分分别为(5.97±2.01)、(1.64±1.06)、(2.04±0.72)分,T1时分别为(2.79±1.07)、(0.71±0.44)、(1.69±0.93)分,T2时分别为(2.48±0.99)、(0.58±0.49)、(1.71±0.93)分;益生菌组T0时VAS评分、用药评分、RQLQ评分分别为(6.18±1.94)、(1.71±1.09)、(2.01±0.73)分,T1时分别为(2.05±0.78)、(0.49±0.45)、(1.37±0.67)分,T2时分别为(2.21±0.81)、(0.54±0.45)、(1.58±0.72)分。两组T1和T2时VAS评分、用药评分、RQLQ评分均较T0时降低,益生菌组T1时VAS评分、用药评分、RQLQ评分均低于常规组,差异有统计学意义(P<0.05);T0、T2时两组VAS评分、用药评分、RQLQ评分无明显差异(P>0.05)。常规组T0时鼻塞、鼻痒、喷嚏、流涕评分分别为(1.81±0.66)、(1.60±0.62)、(1.68±0.77)、(1.34±0.69)分,T1时分别为(0.95±0.53)、(0.87±0.49)、(0.90±0.56)、(0.96±0.46)分,T2时分别为(0.93±0.54)、(0.84±0.43)、(0.88±0.31)、(0.89±0.54)分;益生菌组T0时鼻塞、鼻痒、喷嚏、流涕评分分别为(1.78±0.57)、(1.63±0.61)、(1.70±0.70)、(1.41±0.69)分,T1时分别为(0.75±0.45)、(0.72±0.23)、(0.70±0.43)、(0.78±0.50)分,T2时分别为(0.91±0.43)、(0.83±0.51)、(0.86±0.53)、(0.85±0.50)分;两组T1和T2时鼻塞、鼻痒、喷嚏、流涕评分均较T0时降低,益生菌组T1时低于常规组,差异有统计学意义(P<0.05);T0、T2时两组鼻塞、鼻痒、喷嚏、流涕评分无明显差异(P>0.05)。结论尘螨过敏性AR患儿口服益生菌,可有利于减轻患儿症状,改善患儿生活质量,减少临床药物的使用,且具有时间依赖性。

益生菌联合特异性免疫疗法治疗小儿尘螨过敏性哮喘临床观察

目的探讨益生菌联合特异性免疫疗法治疗小儿尘螨过敏性哮喘的临床疗效。方法选取医院2022年4月至2023年4月收治的104例尘螨过敏性哮喘患儿,按随机数字表法分为对照组和观察组,各52例。两组患儿均予常规对症治疗及特异性免疫疗法(屋尘螨变应原制剂皮下注射),观察组患儿加服双歧杆菌乳杆菌三联活菌片。两组患儿均连续治疗6个月。结果观察组总有效率为96.15%,略高于对照组的92.31%(P>0.05)。治疗后,两组患儿的呼气流速峰值及第1秒用力呼气容积占预测值百分比均显著升高,呼出气一氧化氮水平均显著降低(P<0.05);白细胞介素6、白细胞介素17水平均显著降低,白细胞介素10水平均显著升高(P<0.05);γ干扰素水平均显著升高,白细胞介素4水平均显著降低(P<0.05);气道阻力、气道峰压、呼吸功均显著降低,肺动态顺应性均显著升高(P<0.05);整合素α_(4)β_(1)、整合素α_(v)β_(6)、血管细胞黏附分子-1、细胞间黏附分子-1水平均显著降低(P<0.05);大肠杆菌数量均显著减少,乳酸杆菌、双歧杆菌数量均显著增多(P<0.05);且观察组上述指标改善均更显著(P<0.05)。两组患儿不良反应发生率无显著差异(P>0.05)。结论益生菌联合特异性免疫疗法治疗小儿尘螨过敏性哮喘,可进一步提高患儿机体免疫功能,改善肺功能及呼吸功能,作用机制可能与辅助性T细胞(Th)17/调节性T细胞(Treg)、Th1/Th2、肠道菌群调节等有关。

舌下含服粉尘螨滴剂治疗变应性鼻炎的疗效分析

目的探讨舌下含服粉尘螨滴剂治疗变应性鼻炎的疗效。方法108例变应性鼻炎患者,随机分为研究组和对照组,每组54例。研究组患者舌下含服粉尘螨滴剂进行治疗,对照组患者注射粉尘螨滴剂进行治疗。2年后进行随访,比较两组患者治疗效果以及生活质量。结果研究组患者治疗总有效率96.3%高于对照组的85.2%(P<0.05)。研究组患者社会功能评分(81.5±5.4)分、躯体功能评分(83.3±4.8)分、角色功能评分(82.5±6.1)分、认知功能评分(80.7±5.9)分明显高于对照组的(68.4±5.3)、(62.8±4.7)、(63.8±5.3)、(62.7±4.7)分(P<0.05)。结论对变应性鼻炎患者进行舌下含服粉尘螨滴剂治疗,能够快速缓解临床症状,患者生活质量得到大幅度改善,应在临床中广泛推广使用。

尘螨-食物过敏综合征

尘螨-食物过敏综合征是由于进食与尘螨存在交叉抗原的食物(例如虾等)出现的速发型超敏反应,目前国内外均有报道尘螨与食物之间存在交叉反应,主要交叉抗原为原肌球蛋白。尘螨-食物过敏综合征患者的过敏症状轻重不一,原肌球蛋白致敏对尘螨过敏患者在进食虾等食物时应格外注意,以防发生难以预料的过敏事件。

一种新型尘螨过敏原激发液在诊断过敏性鼻炎中的应用

目的探讨利用北京协和医院户尘螨注射液用于鼻激发试验诊断尘螨过敏性鼻炎的有效性和安全性。方法利用国产户尘螨注射液和变应原溶媒配置鼻激发液,纳入尘螨过敏性鼻炎及对照组受试者进行鼻激发试验,应用Lebel评分评估激发试验。结果纳入尘螨过敏性鼻炎受试者84例,对照组23例。以临床诊断为“金标准”,尘螨鼻激发试验诊断过敏性鼻炎的敏感性为92.86%(95%CI:85.1~97.3),特异性为100.0%(95%CI:85.2~100.0),阳性预测值为100.0%(95%CI:94.2~100.0),阴性预测值为79.3%(95%CI:63.9~89.2)。ROC曲线下面积为0.964(95%CI:0.931~0.998)。鼻激发试验后,5例因鼻炎症状使用抗过敏药,2例使用赛洛唑啉鼻喷剂。随访72 h,所有患者均未报告咳嗽、喘息等。结论应用户尘螨注射液开展鼻激发试验具有较好的诊断性能,安全性良好。