Overview of Research on the Clinical Treatment of Allergic Rhinitis

Three kinds of treatment for allergic rhinitis(Western medicine,traditional Chinese medicine and their combination)were described respectively,and the different treatment methods of AR and their characteristics were analyzed.This study will help to further improve the diagnosis and treatment of the disease and promote the early recovery of patients.

Myricetin alleviates ovalbumin-induced allergic rhinitis in mice by regulating Th1/Th2 balance

Objective:To evaluate the effect of myricetin on ovalbumin(OVA)-induced allergic rhinitis in mice.Methods:Mice were sensitized and challenged using OVA(5%,500 mL)intraperitoneally and intranasally,respectively,on an alternative day for 14 days,followed by administration of myricetin(50,100,and 200 mg/kg)till day 21.Nasal symptoms,biochemical parameters,protein expressions,and histopathology were observed.Results:OVA-induced increased nasal symptoms including rubbing,sneezing,and discharge were significantly reduced by myricetin(100and 200 mg/kg)(P<0.05).Myricetin also protected against histamine challenge and attenuated elevated serum immunoglobulin E(IgE;total and OVA-specific),total IgG1,andβ-hexosaminidase levels,as well as leukotriene C4 and interleukins levels in nasal lavage fluid(P<0.05).Western blot analysis showed that myricetin significantly upregulated the protein expression of T-box expressed in T cells,while downregulating the protein expression of GATA binding protein 3,NF-κB,and IκB-α(P<0.05).Additionally,OVA-induced histopathological abberations in the nasal mucosa was markedly ameliorated by myricetin treatment(P<0.05).Conclusions:Myricetin exerts anti-allergic effects against OVAinduced allergic rhinitis via regulating Th1/Th2 balance.

Advances on the Treatment of Allergic Rhinitis by Traditional Chinese Medicine and Western Medicine

Background: Allergic rhinitis is a common and high incidence disease in clinic, which has a certain impact on the work, life and social activities of patients. Modern medicine still lacks effective treatment methods for such diseases. In recent years, clinical cases of children and adolescents have also increased year by year. Objective: In order to provide references for further study and practical treatment on allergic rhinitis, this paper summarized the advances on the treatment of allergic rhinitis by Traditional Chinese Method (TCM) and Western Medicine Method (WMM) in clinical practice and study. Method: Through detailed review and study of literatures, the theory and clinical experiences in TCM, WMM, and integrated treatment of the two were analyzed and summarized. Conclusions: TCM conducts personalized treatment for patients by syndrome differentiation. The main means are to regulate the body’s health Qi and Yang Qi. Drugs, acupuncture, psychology and other means of treatment are all used and the effects of treatment are very well. WMM mainly relieves the infiltration of local inflammatory cells, expands local capillaries, improves nasal permeability and alleviates the occurrence of allergic graduation by using kinds of drugs or surgery. Though both TCM and WMM are effective and have some common characteristics and each has its own characteristics, the combination of TCM and WMM has a good prospect and is more effective and can effectively reduce the adverse reactions of patients, because TCM is to change patients’ own constitution and the starting point of WMM is to eliminate the pathogen.

Prevalence of allergic rhinitis and associated risk factors in middle school students from Haikou,China

Objective:To identify the prevalence and influencing factors of allergic rhinitis among middle school students in Haikou,and to provide reference for the prevention and treatment of allergic rhinitis among middle school students in Haikou.Methods:The stratified cluster sampling method was adopted to randomly select the middle school students(aged 12-18)from 8 ordinary or vocational middle schools in Xiuying District,Longhua District,Meilan District and Qiongshan District of Haikou as the survey subjects.The self-made questionnaire was used to conduct the survey from April to May in 2022.Results:A total of 2169 valid questionnaires were collected,the effective rate was 86.6%(2169/2479),814(37.5%)male students and 1355(62.5%)female students.The prevalence rate of allergic rhinitis reported by middle school students in Haikou was 39.8%(863/2169),including 599 cases of intermittent allergic rhinitis(69.4%)and 264 cases of persistent allergic rhinitis(30.6%).The January,February,November and December were the periods of high incidence of symptoms each year.The results of multivariate logistic regression analysis showed that:using antibiotics 5 times a year[OR=2.07,95%CI(1.24-3.45),P=0.005],using antibiotics 3-4 times a year[OR=1.77,95%CI(1.23-2.55),P=0.002],family history of allergic rhinitis[OR=3.84,95%CI(2.67-5.54),P<0.001],history of sinusitis[OR=7.77,95%CI(3.22-18.76),P<0.001],damp living environment[OR=2.87,95%CI(2.00-4.13),P<0.001],history of asthma[OR=8.69,95%CI(1.93-39.12),P=0.005],urban residents[OR=1.68,95%CI(1.35-2.09),P<0.001],frequent exposure to dust[OR=1.59,95%CI(1.20-2.12),P=0.001],male[OR=1.35,95%CI(1.10-1.66),P=0.005],furry pet[OR=1.39,95%CI(1.10-1.75),P=0.006],daily sleep time<8 hours[OR=1.30,95%CI(1.07-1.58),P=0.009]were risk factors for allergic rhinitis.Conclusion:The prevalence of allergic rhinitis among middle school students in Haikou was higher than reported in most areas of China.Male,urban residents,antibiotic use,sleeping less than 8 hours a day,feeding furry pets,living in humid environment,frequent exposure to dust,family history of allergic rhinitis,history of sinusitis and history of asthma were risk factors for allergic rhinitis.Family history of allergic rhinitis,sinusitis and asthma were the most significant factors.

Konjac-mulberry leaf compound powder alleviates OVA-induced allergic rhinitis in BALB/c mice

According to the proportion of 1:1, konjac flour and mulberry leaf powder are compounded into a kind of dietary fiber source(KMCP). It is found to be good for anti-inflammation. However, its precise anti-allergic rhinitis effect and mechanism remain unknown. In our work, the effect of KMCP on allergic rhinitis(AR)induced by ovalbumin(OVA)was investigated. We found that the number of nasal rubbing and sneezing, the eosinophil(EOS)count in the nasal mucosa, and the serum levels of histamine(HIS), OVA-specific immunoglobulin E(OVA-sIgE)and interleukin-4(IL-4)were decreased, and the histopathological changes of nasal mucosa were inhibited. Additionally, the experiments further proved that the KMCP treatment could exert substantial effects on short-chain fatty acids(SCFAs)metabolism in the cecum as well. Overall findings suggest that KMCP could suppress the inflammatory response in AR mice, and serve as a novel curative therapeutic for AR without side effects.

Efficacy and anti-inflammatory analysis of glucocorticoid,antihistamine and leukotriene receptor antagonist in the treatment of allergic rhinitis

BACKGROUND There are many adverse reactions in the treatment of allergic rhinitis(AR)mainly with conventional drugs.Leukotriene receptor antagonists,glucocorticoids and nasal antihistamines can all be used as first-line drugs for AR,but the clinical effects of the three drugs are not clear.AIM To examine the impact of glucocorticoids,antihistamines,and leukotriene receptor antagonists on individuals diagnosed with AR,specifically focusing on their influence on serum inflammatory indexes.METHODS The present retrospective study focused on the clinical data of 80 patients diagnosed and treated for AR at our hospital between May 2019 and May 2021.The participants were categorized into the control group and the observation group.The control group received leukotriene receptor antagonists,while the observation group was administered glucocorticoids and antihistamines.Conducted an observation and comparison of the symptoms,physical sign scores,adverse reactions,and effects on serum inflammatory indexes in two distinct groups of patients,both before and after treatment.RESULTS Subsequent to treatment,the nasal itching score,sneeze score,runny nose score,nasal congestion score,and physical signs score exhibited notable discrepancies(P<0.05),with the observation group demonstrating superior outcomes compared to the control group(P<0.05).The interleukin(IL)-6,IL-10,tumor necrosis factor-alpha,Soluble Intercellular Adhesion Molecule-1,Leukotriene D4 after treatment were significantly different and the observation group It is better than the control group,which is statistically significant(P<0.05).Following the intervention,the incidence of adverse reactions in the observation group,including symptoms such as nasal dryness,discomfort in the throat,bitter taste in the mouth,and minor erosion of the nasal mucosa,was found to be 7.5%.This rate was significantly lower compared to the control group,which reported an incidence of 27.5%.The difference between the two groups was statistically significant(P<0.05).CONCLUSION Glucocorticoids and antihistamines have obvious therapeutic effects,reduce serum inflammatory index levels,relieve symptoms and signs of patients,and promote patients'recovery,which can provide a reference for clinical treatment of AR.

Study on the mechanism of Fuzi in the treatment of allergic rhinitis based on network pharmacology and experimental validation

Objective:To study the key target genes and signaling pathways in the treatment of Allergic Rhinitis(AR)with Radix Aconiti Lateralis Preparata(aka Fuzi).Methods:The TCMPS and PubChem databases were used to screen the active ingredients and target genes of Fuzi using oral bioavailability and drug similarity as screening conditions,and the GeneCards database was used to screen the target genes of AR.The online tool Venny2.1 was used to screen the target genes of Fuzi for the treatment of Allergic Rhinitis;the STRING database was used to obtain the protein-protein interaction(PPI)network of drug-disease targets,and the key target genes were identified by the MCC algorithm.The potential biological processes and signaling pathways were identified by GO enrichment and KEGG enrichment analysis.Finally,animal experiments were conducted to demonstrate the therapeutic effect ofFuzi on Allergic Rhinitis.Results:The TCMSP,PubChem and GeneCards databases were used to screen the 21 active compound components of Fuzi and 68 potential therapeutic target genes of Fuzi for Allergic Rhinitis.PPI network analysis identified the top ten key target genes,namely:PTGS2,TNF,IL6,AKT1,ALB,STAT3,CCL2,CXCL8,VEGFA and JUN,GO functional and KEGG pathway enrichment analysis showed that the significantly enriched functions and pathways of Fuzi on Allergic Rhinitis were closely related to Allergic Rhinitis.Finally,animal experiments were conducted to verify that Fuzi is effective in the treatment of Allergic rhinitis.Conclusion:Increased expression of IL-6 and TNF-αin nasal mucosal tissues of patients with Allergic Rhinitis was positively correlated with indicators related to the disease activity of AllergicRhinitis.Fuzi ameliorated the inflammatory changes in mice with Allergic Rhinitis by inhibiting the activation of Toll-like signaling pathway in the nasal mucosa and decreasing the expression activity of IL-6 and TNF-α.

Comparison of Allergic Rhinitis and Bronchial Asthma Impacts on Tympanometric Parameters in Children at Kano, Nigeria

Background: Allergic rhinitis (AR) is a multifocal IgE-mediated type I hypersensitivity reaction that affects sino-nasal mucosa and is characterized by excessive sneezing, watery rhinorrhea, nasal itching, nasal stuffiness and eyes itching. Bronchial asthma (BA) is one of the common childhood diseases that affects the respiratory system characterized by recurrent cough, wheezing, chest tightness and difficulty with breathing. The two conditions are different manifestations of allergic disease of the airway;the composition of the inflammatory substrate in the mucosa of allergic patients is similar to the late-phase allergic response seen elsewhere in the respiratory tract, such as in bronchial asthma. Aim: The aim was to compare the impacts of allergic rhinitis and bronchial asthma on tympanometric parameters in children. Patients & Methods: This is a hospital based comparative cross-sectional study. Two groups of participants aged 4 - 12 years, one group with documented clinical diagnosis of allergic rhinitis and the other group with documented clinical diagnosis of bronchial asthma were consecutively selected from ear, nose and throat (ENT) and pediatrics cardiopulmonary outpatient clinics of Aminu Kano Teaching Hospital Kano respectively. Equal number of children aged 4 - 12 years with no history of ENT diseases or bronchial asthma that were selected from elementary schools within the same community served as a control group. An interviewer-administered questionnaire was filled out for all the participants, complete ENT and chest examinations were carried out and subsequently all the selected participants had tympanometry done, findings were recorded and analyzed. Results: The mean age of participants with bronchial asthma was found to be 7.5 ± 2.6 years while participants with allergic rhinitis had the mean age of 6.8 ± 2.1 years. The mean middle ear pressure (MEP) of participants with bronchial asthma was found to be -15.22 dapa and -40.32 dapa in those with allergic rhinitis. Acoustic reflex was found to be absent in 15.4% of the participants with bronchial asthma and 29.6% of allergic rhinitis participants. Type B tympanogram was found in 2.8% of bronchial asthma participants and 7.3% in participants with allergic rhinitis. Type C tympanogram was found in 4.6% of participants with bronchial asthma and 15.5% of participants with allergic rhinitis. Type A tympanogram was found in 90% of participants with bronchial asthma and 75% of participants with allergic rhinitis. The difference between type A, B and C tympanograms of participants with bronchial asthma and those with allergic rhinitis was found to be statistically significant (Type A χ2 = 14.62, df = 4, p value = 0.01, Type B χ2 = 14.06, df = 4, p value = 0.01, Type C χ2 = 17.01, df = 6, p value = 0.01). Conclusion: Participants with allergic rhinitis were found to have more abnormalities of tympanometric parameters compared to participants with bronchial asthma which signifies allergic rhinitis conferred an increased risk of having middle ear diseases and otitis media with effusion compared to bronchial asthma.

Effect of acupuncture on acupoint "Yingxiang-Hegu" on Th1, Th2 cytokines and T-bet/GATA-3 of allergic rhinitis rats

Objective:To explore the effect of"Yingxiang-Hegu"on Th1,Th2-related cytokines and[2]transcription factors T-bet and GATA-3 in rats with allergic rhinitis.Methods:Rats were randomly divided into three groups:blank group,model group and acupoint group.The rat model of ovalbumin(OVA)AR was established,and the general condition of the rats was observed and scored.Acupuncture intervention was performed on the acupoint group on the second day after successful modeling,once per day for 20 min for 10 d.After intervention,the general behavior,behavioral score and histomorphological changes of nasal mucosa were observed.Eosinophils(EOS)were counted under microscope after nasal lavage smear staining,and the contents of total IgE,IFN-γ,IL-12,IL-4 and IL-5 in serum were detected by ELISA.Westernblot and IHC were used to detect the protein level and positive protein expression of specific transcription factors T-bet and GATA-3 in rat nasal mucosa.Results:After the establishment of the model,except for the blank group,the behavioral observation scores of rats in the model group and acupoint group were more than 5 points,indicating that the model was successful.After acupuncture intervention on acupoint"Yingxiang-Hegu",the behavioral score of rats in the acupoint group and western medicine group was significantly lower than that in the model group(P<0.05).Microscopic examination showed that the structure of nasal mucosa in the model group was obviously damaged,cilia were arranged discontinuously,uneven,local congestion and swelling,a large number of epithelial cells exfoliated and necrotic,goblet cell proliferation,obvious inflammatory cell infiltration.The pathological degree of nasal mucosa in the pair point group was significantly less than that in the model group.Compared with the model group,the levels of IFN-γ,IL-2 and IL-12 in serum were significantly increased,while IgE,IL-4,IL-5 and IL-6 were significantly decreased,GATA-3 protein and positive expression in nasal mucosa were significantly decreased and T-bet was significantly increased after acupuncture.Conclusion:Acupuncture at"Yingxiang-Hegu"can effectively improve the nasal sensitive symptoms and control nasal inflammation in AR rats.The mechanism may be that acupuncture at Yingxiang-Hegu can up-regulate the expression of T-bet,decrease the level of GATA-3,promote the production of Th1 cytokines and inhibit the synthesis and secretion of Th2 cells,thus restoring the immune balance of Th1 and Th2.

Epidemiological Features of Allergic Rhinitis in Four Major Cities in Western China

Allergic rhinitis（AR）,with an increasing uptrend of the prevalence in many developed and developing countries,is a global health problem that affects people of all ages and ethnic groups.However,data on the prevalence of self-reported AR in western China are rare.This study investigated the epidemiological features of self-reported AR in western China.In the cross-sectional,population-based study,a validated questionnaire survey on self-reported AR was carried out in 4 major cities in western China by multistage,stratified and cluster sampling,from January to December 2008.The total prevalence rate was 34.3%,with 32.3%（Chongqing）,34.3%（Chengdu）,37.9%（Urumqi）,30.3%（Nanning）,respectively.The prevalence presented to increase with age before 30 years old while decrease with age after 30 years old,and the highest prevalence was in 19-30 years group in Chongqing,Chengdu and Nanning which significantly showed ＂persistent and moderate-severe＂ type（P0.0001）;In Urumqi,there wasn＇t a significant increasing or decreasing trend of prevalence rate with age but with an ＂intermittent and mild＂predominance（P0.0001）.There were no distinct sexual differences in prevalence rates in the 4 cities.The morbidity was positively related to monthly average temperature and sunshine（r=0.76645,P=0.0036;r=0.67303,P=0.0165）,but negatively associated with relative humidity（r=-0.64391,P=0.0238） in Urumqi.Interestingly,the monthly morbidity was negatively associate with average temperature,sunshine and precipitation in Nanning（r=-0.81997,P=0.0011;r=-0.60787,P=0.0360;r=-0.59443,P=0.0415）.Self-reported AR is becoming common in western China with a rapid development in recent years,affecting about three persons out of ten.The climatic factors may have an indirect impact on the prevalence rate through the effects on the local allergens.

Effect of RNA interference therapy on the mice eosinophils CCR3 gene and granule protein in the murine model of allergic rhinitis

Objective:To observe the clinical manifestations of allergic rhinitis mice and the expression changes of the eosinophils CCR3 and the granule protein rnRNA in the bone marrow,peripheral blood and nasal lavage fluid.Mctliods:Twenty-four BALB/c mice were randomly divided into the control group.PBS therapy group.siKNA therapy group and the CCR3 siRNA therapy group(n=6).Allergic rhinitis model were sensitized and stimulated by ovalbunfin,and CCR3 siKNA therapy group were administered with CCH3 transnasally before stimulated.The levels of the eosinophils CCR3.MBP.ECP and EPO in bone marrow,peripheral blood and nasal lavage fluid were detected by RT-PCR.Results:Compared to the control group and CCR3 siR.NA therapy group,the nasal mucosa of the PBS therapy group and siRNA therapy group developed epithalaxy.goblet cells hyperplasia,squamous epithelium metaplasia,epithelium necrosis,lamina propria and submucosa gland hyperplasia,vasodilatation,tissue edema,and the characterized eosinophil infiltration.RT-PCR indicated that the CCR3 rnRNA,MBP.ECP and EPC)expression in bone marrow,peripheral blood and nasal lavage fluid of the CCR3 siKNA therapy group was lower than the PBS therapy group and siR.NA therapy group(P<0.05).Conclusions:The RNA interference therapy to CCR3 by local administration pernasal can suppress the process of the development,migration and invasion of the allergic rhinitis eosinophil,thus can reduce the effect of eosinophils and then reduce the inflammation effect of the allergic rhinitis.It may be a new treatment for respiratory tract allergic inflammation.

Effects of lysedEnterococcus faecalis FK-23 on experimental allergic rhinitis in a murine model

In the current study, we sought to investigate whether lysed Enterococcus faecalis FK-23 （LFK）, a heat-killed probiotic preparation, attenuated eosinophil influx into the upper airway and had immunomodulatory activity in a murine allergic rhinitis model. Eighteen BALB/c mice were divided into three groups; the ovalbumin （OVA）-sen- sitized/challenged group, which received saline orally for 6 weeks （OVA group）, the OVA-sensitized/challenged group, which received LFK orally for 6 weeks （LFK-fed group）, and the non-sensitized group, which received saline for 6 weeks （saline control group）. Nasal rubbing and sneezing were monitored during the study. After the final challenge, interleukin （IL）-4, interferon （IFN）-y, and OVA-specific IgE levels in the sera and splenocyte culture supernatants were determined, eosinophilic infiltrate into the upper airway was quantified, and splenic CD4~CD25＋ regulatory T cells （Tregs） were examined by flow cytometry. We found that nasal rubbing was sig- nificantly reduced in LFK-fed mice compared to the OVA group on d 27 and 35, and sneezing was significantly inhibited by LFK administration for 35 d. LFK-fed mice had significantly less eosinophil influx into the nasal mucosa than the OVA group. There were no significant differences between the LFK-fed group and OVA group in the serum and splenocyte culture supernatant levels of IL-4, IFN-y, and OVA-specific IgE. Interestingly, the LFK-fed mice had a significantly greater percentage of splenic CD4＋CD25＋ Tregs than OVA group. Our results indicate that oral administration of LFK may alleviate nasal symptoms, reduce nasal eosinophilia, and increase the percentage of CD4＋CD25＋ Tregs in experimental allergic rhinitis.

Association between Promoter Polymorphisms of Interleukin-4 Gene and Allergic Rhinitis Risk: a Meta-analysis

Summary： The relationship of interleukin-4 （IL-4） C-33T and C-590T （C-589T） gene polymorphisms with allergic rhinitis was analyzed. Data about the case control studies of IL-4 gene promoter polymorphisms [C-33T and C-590T （C-589T）] and their association with allergic diseases and correlation between serum IL-4 levels and allergic rhinitis were retrieved. The Stata 12.0 statistical soitvcare was applied to analyze the correlation between IL-4 gene polymorphisms and allergic rhinitis. The meta-analysis result of TT/CC genotype of -590 （-589） polymorphism showed a significant association with allergic diseases [OR=1.93, 95% CI （1.61 2.31）, P=0.00]. Meta-analysis of the TT＋TC versus CC genotype of IL-4 C-33/T polymorphism revealed significant associations with allergic diseases [OR=3.23, 95% CI （1.13-9.25）, P=0.03]. Meanwhile, there was a significant correlation between serum IL-4 levels and allergic rhinitis [OR=2.52, 95% CI-（1.80-3.23）, P=0.00]. IL-4 gene -590 TT genotype may increase the risk of allergic rhinitis and the T allele mutation of -33 might be correlated with aller- gic rhinitis.

Single-allergen Sublingual Immunotherapy versus Multi-allergen Subcutaneous Immunotherapy for Children with Allergic Rhinitis

It has always been controversial whether a single allergen performs better than multiple allergens in polysensitized patients during the allergen-specific immunotherapy. This study aimed to examine the clinical efficacy of single-allergen sublingual immunotherapy(SLIT) versus multi-allergen subcutaneous immunotherapy(SCIT) and to discover the change of the biomarker IL-4 after 1-year immunotherapy in polysensitized children aged 6–13 years with allergic rhinitis(AR) induced by house dust mites(HDMs). The AR polysensitized children(n=78) were randomly divided into two groups: SLIT group and SCIT group. Patients in the SLIT group sublingually received a single HDM extract and those in the SCIT group were subcutaneously given multiple-allergen extracts(HDM in combination with other clinically relevant allergen extracts). Before and 1 year after the allergen-specific immunotherapy(ASIT), the total nasal symptom scores(TNSS), total medication scores(TMS) and IL-4 levels in peripheral blood mononuclear cells(PBMCs) were compared respectively between the two groups. The results showed that the TNSS were greatly improved, and the TMS and IL-4 levels were significantly decreased after 1-year ASIT in both groups(SLIT group: P<0.001; SCIT group: P<0.001). There were no significant differences in any outcome measures between the two groups(for TNSS: P>0.05; for TMS: P>0.05; for IL-4 levels: P>0.05). It was concluded that the clinical efficacy of single-allergen SLIT is comparable with that of multi-allergen SCIT in 6–13-year-old children with HDM-induced AR.

A cross-sectional study into the correlation of common household risk factors and allergic rhinitis in Taiwan's tropical environment

Objective:To discuss the effect of lesser-known potential risk factors,such as bedroom showers,on the prevalence of allergic rhinitis.Methods:A cross-sectional,population-based study was performed using both survey and fungal culturing in southern Taiwan.There were 998 participants enrolled in the survey,and 513 sets of fungal culture obtained.With score for allergic rhinitis(SFAR) more than 7,the patient was defined to have allergic rhinitis.Risks of allergic rhinitis were calculated as odds ratios for various predicted risk factors by logistic regression.Correlation between predicted risk factors and fungal level were examined with linear regression.Results:The adjusted odds ratio of frequently using bedroom shower to having allergic rhinitis was 1.572(95% confidence interval:1.090-2.265),and 0.962 for people with older age to have AR(95% confidence interval:0.949-0.976).As to the 24-hour fungal level,the standardized coefficient was 0.254 for frequent use of bedroom shower,and 0.106 for window open hours.Conclusions:Use of bedroom shower is a potential risk factor for allergic rhinitis development.

Sublingual immunotherapy for pediatric allergic rhinitis: The clinical evidence

Allergic rhinitis affect 10%-20% of pediatric population and it is caused by the Ig E-sensitization to environmental allergens, most importantly grass pollens and house dust mites. Allergic rhinitis can influence patient's daily activity severely and may precede the development of asthma, especially if it is not diagnosed and treated correctly. In addition to subcutaneous immunotherapy, sublingual immunotherapy(SLIT) represents the only treatment being potentially able to cure allergic respiratory diseases, by modulating the immune system activity. This review clearly summarizes and analyzes the available randomized, double-blinded, placebo-controlled trials, which aimed at evaluating the effectiveness and the safety of grass pollen and house dust mite SLIT for the specific treatment of pediatric allergic rhinitis. Our analysis demonstrates the good evidence supporting the efficacy of SLIT for allergic rhinitis to grass pollens in children, whereas trials regarding pediatric allergic rhinitis to house dust mites present lower quality, although several studies supported its usefulness.

Serum IL-10 Level in Allergic Rhinitis Patients and Its Effect on Serum Total IgE

To investigate the level of serum IL-10 in allergic rhinitis patients and the correlation between IL-10 and serum total IgE （TIgE）. 50 allergic rhinitis patients and 30 normal subjects were involved in the study. The levels of serum IL-10 and TIgE were measured by enzyme-linked immunosorbent assay （ELISA）, and the correlation between serum IL-10 and TIgE was analyzed. In the allergic rhinitis group, the levels of serum IL-10 and TIgE were 8.34±2.48 pg/mL and 142.6± 28.2 KUA/L. In the normal control group, they were 12.86±.88 pg/mL and 47.2±12.2 KUA. There were significant differences between the two groups （P〈0. 01）; and the level of serum TIgE in the patients was negatively correlated with that of IL-10 （r= -0.46, P=0. 02）. The level of serum IL-10 was significantly decreased in allergic rhinitis patients, which was beneficial to the synthesization of IgE. IL-10 plays an important role in the episode of allergic rhinitis.

p38 MAPK Regulates Th2 Cytokines Release in PBMCs in Allergic Rhinitis Rats

Th2 cytokines play a pivotal role in the pathogenesis of allergic rhinitis. To investigate the effect of p38 mitogen-activated protein kinase （MAPK） on the production of Th2 cytokines such as IL-4 and IL-5 in allergic rhinitis, a model of allergic rhinitis was established in SD rats. The expression level of p38 MAPK mRNA in PBMCs was detected by means of real time quantitative RT-PCR. The p38 MAPK activity in PBMCs was detected by Western blotting. PBMCs were cultured with various concentrations of p38 MAPK inhibitor SB 239063 or without the treatment, and then IL-4, IL-5 levels of the supernatant were determined by using sandwich ELISA. The results showed that mRNA expression and activity of p38 MAPK in PBMCs were significantly higher in allergic rhinitis rats than in control rats （P〈0.05）. The p38 MAPK inhibitor SB 239063 decreased the production of IL-4 and IL-5 in a dose-dependent manner. It is concluded that p38 MAPK plays an important role in the pathogenesis of allergic rhinitis which is associated with Th2 cytokines release.

Pediatric allergic conjunctivitis and allergic rhinitis

Objective： To assess the relationship between allergic conjunctivitis（AC） and allergic rhinitis（AR） in pediatric ophthalmology and E.N.T outpatient clinic. Methods：Eight hundred and ninety two patients were enrolled in survey during Mar. 2005-Jan. 2007, 407 allergic conjunctivitis cases were placed in the ophthalmology clinic group and 485 allergic rhinitis cases were from the E.N.T clinic. The comorbid disorders, histories, symptoms, signs of patients were recorded. Type 1 allergy was tested in 479 cases by a specific IgE antibody blood test. Eosinophils were detected in superficial conjunctival scrapings of the superior tarsal conjunctiva and mucosa surface scrapings of middle nasal meatus in 88 cases with both diseases. Results：302（74%）, 374（92%）, 116（29%） in 407 cases with allergic conjunctivitis had concomitant eczema, rhinitis and asthma, respectively; 334（69%）, 430（89%）, 145（30%） in 485 cases with allergic rhinitis had concomitant eczema, allergic conjunctivitis and asthma, respectively. The prevalence of allergic conjunctivitis concomitant allergic rhinitis and allergic rhinitis concomitant allergic conjunctivitis had no significant difference（x2=2,6, P 〉 0.05）. The prevalence of allergic conjunctivitis and allergic rhinitis concomitant eczema and asthma also had no significant difference （x2=3.08; x2=0.21, P 〉 0.05）. The degree of severity of two kinds of disease symptoms is not parallel, in the patients with seasonal allergic conjuctivitis（SAC） and perennial allergic conjunctivitis（PAC）, the clinical signs of AR were always severer（x2=258.2, P 〈 0.05） than those of AC. However, the results coincided with the cases with vernal keratoconjuctivitis（VKC）（x2=66.5, P 〈 0.05）; Eosinophils were revealed in 50（57%） conjunctival scrapings and nasal mucosa scrapings（x2=1.5, P〉 0.05）, 47（53%） cases had positive results in both scrapings. The main aeroallergens were house dust mites, house dust and fungi, and the main food-allergens were fish, crab and shrimp. Conclusion：The two disorders were shown to share more similarities than differences, as suggested that allergic conjunctivitis should be considered in future guidelines on preventing the development of rhinitis and asthma in children.

Non-allergic rhinitis in children: Epidemiological aspects, pathological features, diagnostic methodology and clinical management

Chronic rhinitis is a very common disease, as the prevalence in the general population resulted to be 40%. Allergic rhinitis has been considered to be the most frequent form of chronic rhinitis, as non-allergic rhinitis has been estimated to account for 25%. However, several evidences suggested that non-allergic rhinitis have been underrated, especially in children. In pediatrics, the diagnostic definition of non-allergic rhinitis has been often limited to the exclusion of an allergic sensitization. Actually, local allergic rhinitis has been often misdiagnosed as well as mixed rhinitis has not been recognized in most cases. Nasal cytology is a diagnostic procedure being suitable for routine clinical practice with children and could be a very useful tool to characterize and diagnose non-allergic rhinitis, providing important clues for epidemiological analysis and clinical management.