Recent developments in immunotherapy approaches for allergic rhinitis

Allergic rhinitis(AR)poses a significant global health burden,with the potential to progress to asthma,thereby impacting patients’quality of life.Immunotherapy has demonstrated effectiveness in mitigating clinical symptoms by altering the underlying disease mechanisms of AR.This article provides a thorough review of the current state of immunotherapy for AR,encompassing various facets of immunotherapeutic strategies,elucidating their mechanisms and clinical implications.By presenting a nuanced understanding of the present landscape of immunotherapy for AR,this review aims to serve as a valuable reference for informing clinical treatment strategies.The subsequent analysis of diverse immunotherapeutic pathways offers a comprehensive understanding of their mechanisms and clinical implications.A meticulous examination is conducted on subcutaneous immunotherapy,sublingual immunotherapy,oral immunotherapy,intralymphatic immunotherapy,and innovative intravenous gold-induced autologous serum injection therapy.Each pathway is systematically elucidated,with its distinctive features and potential contributions to managing AR emphasized.In conclusion,synthesizing epidemiological insights,immunotherapeutic nuances,and pathway-specific analyses encapsulates a profound understanding of immunotherapy for AR.

Establishment and Evaluation of a Mouse Model of Allergic Rhinitis

[Objectives]To explore a new method for induction of allergic rhinitis in mice,and compare and evaluate it with common modeling methods.[Methods]36 mice were randomly divided into the control group,blank group and experimental group,and there were 12 mice in each group.The mice in the control group were conventionally induced.That is,the mice were first injected intraperitoneally with the mixture composed of OVA 50μg,[Al(OH)3]5 mg and 1ml of normal saline once every other day,and then since the 15 th d,20μL of 5%OVA solution was dropped into each nasal cavity once a day,which lasted for 7 d.The blank group was treated with the same amount of normal saline according to the control group,and received intraperitoneal injection and bilateral nasal drip respectively.In the experimental group,mice were first given intraperitoneal injection of the mixture composed of ovalbumin(OVA)75μg,aluminum hydroxide gel[Al(OH)3]8 mg and normal saline 1.5 mL for basic sensitization.On the 26 th d,20μL of 3%OVA solution was dropped into each nasal cavity once a day,which lasted for 10 d.The number of sneezes,the number of nose scratching,the amount of nasal discharge,and the activity of mice in each group were observed,and the behavior of allergic reaction was scored.Meanwhile,the number of eosinophils in the nasal discharge of mice and the IgE content in serum were measured.[Results]The score of nasal stimulation symptoms,the number of eosinophils and serum IgE level of mice in the control group and the experimental group were higher than those in the blank group(P<0.05),and there was no statistical significance between the two groups in the three indicators(P>0.05).[Conclusions]The modeling method was more suitable for the development of allergic rhinitis patients condition,and reduced the probability of death of mice due to modeling,and simplified the experimental operation.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Study on Cytokines IL-2,IL-6,IL-10 in Patients of Chronic Allergic Rhinitis Treated with Acupuncture

OBJECTIVES: To observe the plasmatic concentration of IL-6, IL-10 and IL-2 in the patient of chronic allergic rhinitis before and after acupuncture therapy. METHODS: Cytokine levels were determined before and after treatment in 30 healthy volunteers (Group A) and 90 patients of chronic allergic rhinitis (Group B) with an increased plasma IL-10 level. Group B was then divided into 3 subgroups: 30 patients treated with real acupuncture (Group B1); 30 patients treated with sham acupuncture (Group B2); 30 non-treated patients (Group B3). RESULTS: The allergic subjects of group B1, compared with controls, showed a significant reduction of IL-10 after a specific treatment with acupuncture (P

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.

Mechanisms of traditional Chinese medicines in the treatment of allergic rhinitis using a network biology approach

Objective:To systematically explore the effect and mechanism of traditional Chinese herbs in the treatment of allergic rhinitis.Methods:Magnolia flower,xanthium fruit,astragalus root,paniculate cynanchum,scutellaria root,cicada molting,stephania root,small centipeda herb,and licorice root as traditional Chinese herbs are widely used to treat allergic rhinitis.With multiple database integration and entity grammar systems,a molecular interaction network of traditional Chinese herbs for treating allergic rhinitis was established.Bioinformatics approaches were adopted to integrate relevant data and biological information by multiple databases.Molecular interaction network of Chinese herbs for treating allergic rhinitis was constructed based on entity grammar systems model.The network was then used for elucidating the antiallergic rhinitis mechanism of the Chinese herbs on the molecular level.The subnetworks were also extracted to explicitly display the pathway and targets where effective components acted on.Results:Traditional Chinese herbs could influence various pathological aspects in allergic rhinitis including the production of pro-inflammatory substances,such as histamine and cytokine interleukin-4(IL-4),interleukin-13(IL-13),lowering immunoglobulin E(IgE)level or blocking antigen binding,altering the biological processes of IgE,modulating the balance of T helper(Th)or other cells by cell proliferation and differentiation,mediating cellecell signaling and second-messenger-mediated signaling,stabilizing the cell membrane,and affecting regulation of cellular defense response.Conclusion:The research theoretically confirms the mechanism of anti-allergic rhinitis by traditional Chinese herbs,provides important fundamental research information for treatment of allergic rhinitis,and may serve as a reference for new drug development and effective ingredients of compatibility.

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.

Mediation Effects of Placental Inflammatory Transcriptional Biomarkers on the Sex-Dependent Associations between Maternal Phthalate Exposure and Infant Allergic Rhinitis: A Population-Based Cohort Study

Objective Prenatal phthalate exposure has been associated with placental inflammatory factors and infant allergic rhinitis(AR).However,the results are inconclusive.We designed a population-based cohort study to examine the effects of placental inflammatory biomarkers on the sex-dependent associations between maternal phthalate exposure and infant AR.Methods A total of 2,348 pregnant women from Ma’anshan,Anhui Province,China,who were screened before antenatal visits and met the inclusion criteria,were included in the present study.We assessed AR in their offspring aged 36 months with a questionnaire.Quantitative PCR was performed to measure placental inflammatory factor m RNAs.The independent samples t-test and multivariable logistic regression were used to determine the associations between infant AR and maternal phthalates.Results Childhood AR may be related to education and family monthly income(P = 0.01).The phthalate metabolites,mono(2-ethylhexyl) phthalate(MEHP),mono(2-ethyl-5-hydroxyl) phthalate(MEHHP),in pregnant women were associated with a significantly increased risk for infant AR in males[P < 0.05;odds ratio(OR):1.285;95% confidence interval(CI):1.037-1.591,and OR:1.232,95% CI:1.008-1.507,respectively],but not females.Additionally,irritably-increased expression levels of HO-1 and IL-4 were associated with AR in male infants(OR:1.175;95% CI:1.038-1.329 and OR:1.181;95% CI:1.056-1.322,respectively).The association between maternal urinary MEHHP and placental HO-1 was marginally significant according to mediation analysis.Conclusion The associations of maternal MEHHP and MEOHP levels with fetal AR in males were significant.Placental HO-1 was a fractional mediator in the associations between MEHHP and AR.Thus,the placenta should be further investigated as a potential mediator of maternal exposure-induced disease risk in children.

Clinical Research into Ke Min Yin for Treatment of Persistent Allergic Rhinitis in Patients with Qi Deficiency and Blood Stasis

Persistent allergic rhinitis (PAR) is one of the common diseases at ear-nose-throat department. From August 1998 to May 2001, we randomly selected 60 cases of PAR with qi deficiency and blood stasis for a clinical observation. 30 patients in the treatment group were treated with Ke Min Yin (克敏饮), a herbal medicine, to supplement qi, expel wind, nourish blood and promote blood circulation; and the other 30 cases in the control group were treated with cetrine. Through systematic observation and statistical processing, the clinical research is summarized and reported in the following.